Tuesday, September 29, 2015

Extended Services under FS and CIH Waivers

The Centers for Medicare & Medicaid Services (CMS) have approved the Family Supports waiver (FSW) renewal and Community Integration & Habilitation waiver (CIH) amendment. 

Effective July 1, 2015, supported employment follow-along (SEFA) was replaced with extended services (ES). Extended services are ongoing employment support services which enable a participant to maintain integrated, competitive employment in a community setting that pays at or above minimum wage. 

Here is a comparison of SEFA and ES allowable and non-allowable core components: http://www.in.gov/fssa/files/SEFA_and_extended_services_comparison_.pdf

Friday, September 25, 2015

Online #Survey for CIH #Waiver Transformation

The Division of Disability of Rehabilitative Services (DDRS) would like to take this opportunity to thank the many family members, participants and providers who attended the town hall meetings the last couple of weeks. Your feedback is extremely important as we plan for the future of the waiver program. 

To continue the conversation about CIH Transform and gather additional thoughts and feedback, we have posted a couple of additional documents on the CIH Transform webpage.

  Questions asked at the town hall meetings are now available as an online survey. Both the provider and family/participant surveys will be open until Friday, October 9, 2015. The survey may be accessed here or on the CIH Transform webpage.

  State policy schedule – this schedule outlines the process the state will use when discussing general topics and policies. This timeline should assist you when making comments to the state on policies or knowing what topics the state is discussing. The policy schedule is available on the CIH Transform webpage

Over the next several weeks, DDRS will continue to post new documents to the CIH Transform webpage. We encourage you to provide input, feedback and ideas about the CIH Transform project by emailing your questions or comments to CIHW@fssa.in.gov . 

Thursday, September 24, 2015

We're HIRING in Central IN and the Fort Wayne area

Family Voices Indiana
Seeking Family Leaders
to serve as
Health Information Specialists
Central Indiana (Indy and surrounding counties) and
Fort Wayne area
Inline image 1 

If you are a parent of a child with a disability, Family Voices of Indiana wants and needs YOU!

 Indiana’s Family to Family Health Information Center will:
Address the health care financing information needs of Indiana’s families raising children with special health care needs and disabilities ages 0-21

Connect families to existing resources, direct support and advocacy

Support and expand the Family Leadership Network statewide

Now accepting applications from Family Leaders to support this project as contractors working up to 40 hours a month from your community 

Applications Due by Oct 9

•Must be the parent/caregiver of a child with special health care needs
•Knowledge of services and systems in Indiana. We provide additional training and support
Provide information, assistance and support regarding healthcare financing and resources to families raising CYSHCN
Provide care coordination follow-up for families monthly for up to a year
Contribute to the FV Indiana electronic information network to ensure access to timely and accurate healthcare financing information and resources for families
Report data related to the work of the FV Indiana Family to Family Health Information Center
If you are interested in receiving more information and/or an application packet, please contact:
Jennifer Akers, Project Director

Wednesday, September 23, 2015

Register Now for October Town Hall Meetings on #Disability Issues

You are invited to a Town Hall Meeting to provide input on the Five-Year Strategic Plan for the Indiana Governor's Council for People with Disabilities (Council); facilitated by the Indiana University Public Policy Institute (Institute). You will be assigned to tables for the discussions based on your ranking of seven issues (Leadership, Health Care, Education, Employment, Transportation, Community Supports for Children and Adults, and Legal Justice/Rights) on the registration form.

Review the Council's Policy statements on the seven issues here.

Town Hall feedback will be utilized in the development of the final plan which will guide the work of the Council, including its training and dissemination activities, the events it sponsors, and the projects it funds. Participating is voluntary and will not affect your current or future relations with the Council. If you have any questions or concerns, please contact Laura Littlepage of the Institute at llittlep@iupui.edu or 317-261-3061.

There will be six Town Hall sessions held at three locations - two at each location.Your input matters.

If you are able to attend one of these sessions, register here.

We look forward to seeing you there.
Wednesday, October 7, 2015
2:00 - 4:30 p.m.
6:00 - 8:30 p.m.
Deaconess Hospital, Health Science Building
Johnson Hall
600 Edgar Street
Evansville, Indiana 47710

Fort Wayne
Wednesday, October 21, 2015
2:00 - 4:30 p.m.
6:00 - 8:30 p.m.
Holiday Inn at IPFW and the Coliseum, Ball Room
4111 Paul Shaffer Drive
Fort Wayne, Indiana 47925

Wednesday, October 28, 2015
2:00 - 4:30 p.m.
6:00 - 8:30 p.m.
Delaware Township Community Center
9094 E. 131st Street
Fishers, Indiana 46038

Thursday, September 17, 2015

How the New Rule on #Habilitative Services Affects Children with Special Needs

The federal government issued a new rule in February regarding the Essential Health Benefits (EHBs) that must be included in all individual and small-group health plans sold in or outside of ACA Exchanges.  This rule may lead to improved “habilitative” services for children with disabilities.  Habilitative services are “Health care services that help you keep, learn, or improve skills and functioning for daily living.” (See  https://www.healthcare.gov/glossary/habilitative-habilitation-services/.)  For children with special needs, this could include services such as speech, physical, and occupational therapies. 

What changed?
Under the previous regulations, insurers could define habilitative services themselves if the state benchmark plan did not include those services and the state did not establish its own definition.  Under the new rule, effective for plans beginning in 2016, there will be a federal definition of habilitative services,[i] which will apply if the state benchmark plan does not cover habilitative services and the state does not define them.[ii]  No longer will insurance issuers have the flexibility to establish their own definitions. 

In addition, the February 2015 rule prohibits health plans from placing coverage limits on habilitative services that are less favorable than any limits imposed on rehabilitative services.[iii]   Moreover, beginning in 2017, states must have separate limits on habilitative and rehabilitative services.[iv]  They cannot combine those services into one benefit.

What Does this Mean?
A Commonwealth Fund analysis[v] of 2014 policies showed that benchmark plans in 28 states and the District of Columbia (DC) included habilitative services. Five of these states and DC also established a specific definition of habilitative services.  In cases where the benchmark plan didn’t include habilitation services, 11 states created a definition and 11 states allowed insurers to do so.  (As noted above, insurers will no longer be able to create their own definitions after 2016, however.) This means that habilitative services will be different for children with special needs depending upon the state in which they reside.  Parents can find their state’s benchmark plan on the Centers for Medicaid and Medicare Services (CMS) website (see Resources.)   

What’s Happening in the States?
  According to a post in the “State Refor(u)m” blog,[vi] states are approaching definitions of habilitation in different ways.  Some are adopting the federal definition of habilitative services.  Others are taking different approaches. For example:
Ø  Arkansas requires parity with rehabilitation and coverage of specific habilitation services.
Ø  California also requires parity and is considering legislation that would adopt the federal definition of habilitative services for plans beginning after January 1, 2016.
Ø  The Hawaii legislature considered a bill to include speech/swallowing therapy, ABA (applied behavioral analysis), medical equipment, orthotics, and prosthetics as habilitative services but the bill didn’t pass.

Although there will be differences in states regarding which therapies are available to children with disabilities, it is good news that there is now a federal definition of habilitative services.  Previously, many insurance companies would only provide rehabilitative services to regain lost skills (such as learning to speak again after a stroke, or walking again after a car accident).  They would deny therapies for children as “developmental” or “educational.”  Now more children with special needs will have access to the therapies they need.

This tip sheet is based on an ACA blog authored by Lauren Agoratus, M.A.  Lauren is the parent of a child with multiple disabilities who serves as the Coordinator for Family Voices-NJ and as the southern coordinator in her the New Jersey Family-to-Family Health Information Center, both housed at the Statewide Parent Advocacy Network (SPAN) at www.spanadvocacy.org. More of Lauren’s tips about the ACA can be found on the website of the Family Voices National Center for Family/Professional Partnerships: http://www.fv-ncfpp.org/.

Friday, September 11, 2015

Accessing health care financing programs for children with special health care needs

Children with special health care needs are those with medical or developmental needs who require more services than that required by typical children. Such an extraordinary level of services can quickly drain the budget of any family without adequate supports. Fortunately, any professional working with these families can help them find a path to paying for the services they need. What follows is a “cheat sheet” about how to direct a family to help with information about, and applications for, four key health care financing programs.

Indiana Medicaid
            Indiana has many different forms of Medicaid that offers good insurance coverage for children. The types most typically available to children include Hoosier Healthwise Package A or C, and Medicaid Disability. Eligibility for these programs depend on income. The first step to applying for Medicaid is to apply online at https://www.ifcem.com/CitizenPortal/application.do# or to visit the regional Division of Family Resources (DFR) office (local offices information available by clicking on the family’s county at http://www.in.gov/fssa/dfr/2999.htm). Families can find help for applying by contacting their nearest Covering Kids & Families office (http://www.ckfindiana.org/contact-coalitions.php) or an Indiana navigator near them (http://www.in.gov/healthcarereform/2468.htm)

Children’s Special Health Care Services (CSHCS)
            Children’s Special Health Care Services (CSHCS) is a program of the Indiana State Department of Health to provide coverage for health care expenses related to a child’s special health care needs. Eligibility depends on the child’s diagnosis and income. It requires children to have applied for Medicaid, but its income limit is higher than Medicaid at 250% of the federal poverty line ($60,625 or less for a family of four). Information about the CSHCS program, including how to apply, is at http://www.in.gov/isdh/24680.htm . A convenient place to apply in Indianapolis is at the CSHCS in Riley Hospital for Children (contact at 317-944-4603), and families should be able to apply at their local DFR offices (http://www.in.gov/fssa/dfr/2999.htm).

The ACA and children’s coverage
            Families can apply for health insurance for themselves and/or their children from the federal insurance marketplace at https://www.healthcare.gov/apply-and-enroll/ or by calling 1-800-318-2596 (TTY: 1-855-889-4325). If a child qualifies for a state Medicaid program, the marketplace application will identify that and, if not, identify marketplace plans that would be available to them. Families who need help understanding marketplace plan options can call this number as well, visit www.healthcare.gov, or receive one-on-one help from an Indiana navigator (http://www.in.gov/healthcarereform/2468.htm).

Medicaid waivers
Children with qualifying developmental disabilities, including autism, may be eligible for an Indiana Medicaid waiver. Waivers offer Medicaid health coverage and other services without counting parental income and resources. Families can apply for a waiver for their CSHCN at any age. Because they typically have a waiting list, families should apply as soon as possible.

·         Children with an intellectual/developmental disability are most likely to qualify for a Family Supports waiver through the Bureau of Developmental Disabilities (BDDS), with 8 local offices throughout Indiana (http://www.in.gov/fssa/files/BDDS.pdf ). 

·         Children with significant medical needs or a traumatic brain injury are most likely to qualify for an Aged & Disabled waiver through their Area Agency on Aging (AAA). Families can apply for this waiver by contacting their local AAA, with locations and contacts available at http://www.in.gov/fssa/da/3478.htm .

·         Children who may qualify for both waivers can apply for both; however, they can only receive services from one waiver at a time.

For general information

            For help understanding any of these children’s health insurance programs, contact Covering Kids & Families (http://www.ckfindiana.org/ ; (574) 968-1645) or Family Voices Indiana (http://fvindiana.org/ ; 317-944-8982).

Thursday, September 10, 2015

Survey about the #ACA and People with #Disabilities

from Easter Seals:

Easter Seals is exploring the real life experience of people with disabilities in accessing specific health services that are mandated under the ACA. We are focusing this effort on:

Rehabilitative services
Habilitative services
Behavioral health services/mental health and autism services, and
Information about and access to prescription drugs

Our project seeks to verify how people are accessing required services and if there are barriers to access. We will explore whether policy changes at the federal and state level are necessary to improve access.
The survey should take less than 10 minutes to fill out and we will close the survey on September 15, 2015.

SURVEY LINK: https://www.surveymonkey.com/r/HealthExchangeQuestionnaire

If there are questions, please contact Mary Andrus, Assistant Vice President for Government Relations at 202-347-3066 ormandrus@easterseals.com.