About Special Kids and Family Voices presented an overview of Medicaid Disability. This webinar covered the changes that have recently occurred to this program. How is eligibility determined now? How do the changes effect those already receiving benefits? Where do you turn if you have questions?
Presenters: Christine Held, ASK Trainer
Jennifer Akers, Family Voices Project Coordinator
Feel free to contact Family Voices Indiana if you have any questions or need assistance: 317 944 8982 info@fvindiana.org
Slides:
Webinar:
Broadcast live streaming video on Ustream
Family Voices, a national grassroots network of families and friends, advocates for disability services that are family-centered, community-based, comprehensive, coordinated and culturally competent for all children and youth with disabilities. Family Voices Indiana seeks to share advocacy opportunities and updated information on issues that impact Indiana families of children with disabilities or special needs. www.fvindiana.org
Thursday, July 31, 2014
Wednesday, July 30, 2014
Action alert: Support Funding for CHIP ( Children's Health Insurance Program )
Sens. Ron Wyden, Orrin Hatch and Reps. Fred Upton and Henry Waxman teamed up to send a letter to all 50 governors on whether and how CHIP should be reauthorized and what changes they recommend. "Because CHIP is a federal/state partnership, it is critical for Members of Congress to receive analysis and insights on CHIP from our state partners," the lawmakers wrote Tuesday."
The letter: http://1.usa.gov/1n0IcNb.
Additional information from Families USA: http://familiesusa.org/blog/2014/04/congress-should-make-funding-children%E2%80%99s-health-insurance-program-chip-top-priority
It strikes us that this would be a perfect chance for families from all 50 states to give their input! If your child receives CHIP, or you recognize its importance for other children, please share your thoughts with your legislators. Conveniently, the letter lists all the emails such input should be directed to. Relatedly, it has been the experience of Family Voices Indiana that we can easily reuse letter families write with this kind of input as Letters to the Editor, thus amplifying our voices.
Tuesday, July 22, 2014
Family Leadership Development Funding
We're excited to announce that Family Voices Indiana will continue to serve another year as the family health information center for the state. We dedicate part of our HRSA funding to support family leadership. This funding will continue to be available though May 31, 2015.
From its inception, Family Voices has been committed to leadership training. Recognized as expert stakeholders by government and private leaders, families of children with special health care needs and/or disabilities should be key players in improving state policies that impact them. We encourage families to work with state agencies, to sit on state and local government advisory commissions, and to participate in the legislative process.
Unlike most other groups, this unique community of families also requires child-care stipends, and travel money. Therefore, to support this participation, the family to family health information center at Family Voices Indiana has created the Family Leadership Development Fund. The Family Leadership Development Fund will assist families to participate in activities (public forums and meetings, task forces and work groups, etc.) that are intended to solicit public/consumer input and perspective concerning disability-related public policy, programs and services.
Parents who request to participate in formal meetings, committees, task force, etc. may receive a stipend, if approved. The following stipulations generally apply:
• must be the parent of a child with disabilities and/or special health care needs
• must have no other paid affiliation or role with the organization hosting the formal meeting, committee, task force, etc.
• must not be participating with the financial support of another program
• events or activities of 4 hours or less/day (including travel) may be reimbursed $50
• events or activities of more than 4 hours/day (including travel) may be reimbursed $100
• families may access this for stipends totaling $250/yr
• priority will be given to families who agree to write a summary of the mtg for Family Voices
• An email or signed letter of verification from the head of the agency or organization sponsoring the activity to Family Voices Indiana
To apply for this funding, please request an application from Family Voices Indiana by calling 317 944 8982 or emailing Jennifer@fvindiana.org
Wednesday, July 9, 2014
CMS Clarification about #Medicaid Covered Services for #ASD
Family Voices shares the following bulletin from the Center for Medicaid. It is important to note that ALL children with Medicaid are covered by EPSDT benefits, not just those with ASD. If you have questions, feel free to contact us.
DATE: July 7, 2014
FROM: Cindy Mann, Director
Center for Medicaid and CHIP Services
SUBJECT: Clarification of Medicaid Coverage of Services to Children with Autism
In response to increased interest and activity with respect to services available to children with
autism spectrum disorder (ASD), CMS is providing information on approaches available under
the federal Medicaid program for providing services to eligible individuals with ASD.
EPSDT Benefit Requirements
Section 1905(r) of the Act defines the EPSDT benefit to include a comprehensive array of
preventive, diagnostic, and treatment services for low-income infants, children and adolescents
under age 21. States are required to arrange for and cover for individuals eligible for the EPSDT
benefit any Medicaid coverable service listed in section 1905(a) of the Act that is determined to
be medically necessary to correct or ameliorate any physical or behavioral conditions. The
EPSDT benefit is more robust than the Medicaid benefit package required for adults and is
designed to assure that children receive early detection and preventive care, in addition to
medically necessary treatment services, so that health problems are averted or diagnosed and
treated as early as possible. All children, including children with ASD, must receive EPSDT
screenings designed to identify health and developmental issues, including ASD, as early as
possible. Good clinical practice requires ruling out any additional medical issues and not
assuming that a behavioral manifestation is always attributable to the ASD. EPSDT also
requires medically necessary diagnostic and treatment services. When a screening examination
indicates the need for further evaluation of a child’s health, the child should be appropriately
referred for diagnosis and treatment without delay. Ultimately, the goal of EPSDT is to assure
that children get the health care they need, when they need it – the right care to the right child at
the right time in the right setting.
The role of states is to make sure all covered services are available as well as to assure that
families of enrolled children, including children with ASD, are aware of and have access to a
broad range of services to meet the individual child’s needs; that is, all services that can be
covered under section 1905(a), including licensed practitioners’ services; speech, occupational,
and physical therapies; physician services; private duty nursing; personal care services; home
health, medical equipment and supplies; rehabilitative services; and vision, hearing, and dental
services.
If a service, supply or equipment that has been determined to be medically necessary for a child
is not listed as covered (for adults) in a state’s Medicaid State Plan, the state will nonetheless
need to arrange for and cover it for the child as long as the service or supply is included within
the categories of mandatory and optional services listed in section 1905(a) of the Social Security
Act. This longstanding coverage design is intended to ensure a comprehensive, high-quality
health care benefit for eligible individuals under age 21, including for those with ASD, based on
individual determinations of medical necessity.
Read the entire bulletin here: http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-07-14.pdf
Monday, July 7, 2014
Public Comment: Transition/Renewal Plan for CIH #Waiver
Family Voices shares the following announcement from DDRS:
From: Nicole Norvell, Director, Division of Disability and Rehabilitative Services
Re: Community Integration & Habilitation Waiver Renewal and Transition Plan; Opportunity for public
comment
Date: July 7, 2014
The Family and Social Services Administration’s (FSSA) Division of Disability and Rehabilitative Services
(DDRS) and the Office of Medicaid Policy and Planning (OMPP) have developed a high level transition
plan on how Indiana plans to meet the new Home and Community Based Services (HCBS) rules.
The transition plan will include how DDRS will review state standards, rules and policies; how DDRS will
assess community based settings and a timeline for doing so; a timeframe for the completion of a
comprehensive transition plan; a process for bringing all HCBS settings into compliance and a plan for
ensuring the health and safety of individuals.
To support the transition plan process, the Centers for Medicare and Medicaid Services (CMS) has
reviewed a draft of Indiana’s plan and provided valuable feedback. Now, stakeholders are being asked
to provide public input and comment in order to allow Indiana to develop a comprehensive assessment
plan.
The high level transition plan and the Community Integration and Habilitation (CIH) Waiver application
will be submitted to the CMS no later than August 15, 2014. DDRS has posted the transition plan, for
review and comment, on the Draft Policies for Public Comment webpage.
Comments and suggestions will be received for a period of 30 days, ending on August 7, 2014, and may
be emailed to DDRSpolicies@fssa.in.gov or submitted in writing to:
The Division of Disability and Rehabilitative Services
402 W. Washington St., Rm. W451
Indianapolis, IN 46204-2243
Action Alert: Caregiver Support Funds/Respite Available
Family Voices shares the following announcement from BDDS:
From: Julie Reynolds, Director, BDDS
Re: Caregiver Support Services Application Process
Date: July 7, 2014
The Division of Disability and Rehabilitative Services (DDRS) Bureau of Developmental Disabilities Services (BDDS) would like to announce that Caregiver Support Services funds will be available for the fiscal year 2015 beginning July 1, 2014. The Caregiver Support Services is 100 percent state funded and is available on a first-come, first-served basis. Applications received during fiscal year 2014 for Caregiver Support Services do not carry over to fiscal year 2015. An application must be completed for each fiscal year’s Caregiver Support Services funds.
Applications may be made online, by mail or in-person. To apply online, please access the following DDRS webpage at https://ddrsprovider.fssa.in.
To apply by mail or in-person please call or visit your local BDDS District Officeand request an application. A frequently asked question document is also available on the BDDS webpage.
As long as the Caregiver Support Services funds are available, services may be approved and available when 1) an individual meets the state definition of intellectual and developmental disabilities eligibility and 2) the primary caregiver selects a provider. Caregiver Support Services will not be available to the primary caregiver if the individual is receiving or begins to receive other services from the BDDS or programs such as (but not limited to) Vocational Rehabilitation Services, First Steps, CHOICE, Division of Aging waiver, etc.
The initial budgets will be approved in the amount of $500 for each eligible individual regardless of the number of eligible individuals residing in the residence. Upon exhaustion of funding, subsequent budgets may be requested by the Caregiver Support Services provider and will be reviewed on a case by case basis. Any new budget is dependent upon available funds.
Tuesday, July 1, 2014
Important Information about the 1634 (June 1) #Medicaid Transition
To: Parents of Children with Autism Receiving Applied Behavior Analysis (ABA)Therapy Services
From: Your Indiana Family Advocacy Organizations - About Special Kids (ASK), The Autism Society of Indiana (ASI), The Arc of Indiana, Covering Kids and Families (CKF), Family Voices Indiana, The Indiana Chapter of the American Academy of Pediatrics (INAAP), and The Indiana Resource Center for Autism (IRCA)
Re: ABA Therapy Coverage, Medicaid and the “1634 Transition” (Also called “The June 1st Changes”)
Because of a transition at the state level, some parents have heard conflicting information regarding the type of Medicaid their child must have after June 1, 2014, if the child also has Supplemental Security Income (SSI).
We want to provide parents with accurate information and provide a way to contact The Office of Medicaid Policy and Planning (OMPP) and the Family and Social Services Administration (FSSA) to clarify any of their questions. Much of this confusion is based upon the “1634 Transition” that Indiana began on June 1, 2014.
What is the 1634 Transition? Simply put, in the past, the State of Indiana used different eligibility criteria for disability determination than the Social Security Administration, which is a federal entity. In July 2012, the state started accepting Social Security Administration (SSA) determinations of disability. As of June 1st, the “1634 Transition” means that the State of Indiana must now cover all SSI recipients automatically without meeting other criteria other than receiving SSI, and must abide by the eligibility determination by the Social Security Administration, whether approval or denial of disability eligibility.
For more information please visit: www.in.gov/fssa/files/1634_Stakeholder_Presentation_FINAL.pdf or
For example, several families report that their child has been moved from MDWise under Hoosier Health Wise (HHW) a managed Medicaid program, which covers ABA, to what is being called “MASI”, which does not cover ABA. MASI is a different category; it is SSI-related Medicaid coverage.
If this happens, you have the option to switch to MASI, or remain on Hoosier Health Wise (HHW) if still eligible. If the child is under MDWise, to keep ABA service coverage, contact your local DFR and tell them you would like for your child to remain on MD Wise with HHW. If your contact at your local DFR tells you that you must accept MASI, we recommend that you give them the information below from Matthew Cesnik, the Eligibility Director for OMPP.
Individuals that receive SSI will be enrolled into the new category, MASI. However, individuals may opt into another category for which they may qualify, such as a children’s Medicaid category under Hoosier Healthwise. An individual cannot opt into CHIP (Children’s Health Insurance Program) if eligible for a Medicaid category.
Protections were put into place in the State’s eligibility system for children receiving ABA services so the children would remain on the Hoosier Healthwise Medicaid category for the month of June in order to allow time for the family to contact DFR. If the families believe that coverage was switched in June, DFR should contact OMPP Eligibility Director.
We hope that having this reference to give to DFR will make the process of switching your child back to a Medicaid category that covers ABA a little easier for you, if you choose to switch from MASI. Please share this information with your ABA provider and ask them to check on your status with Medicaid more frequently as they file claims for their services to be sure that your child remains in a Medicaid category that covers ABA.
Parents may contact any of the advocacy organizations listed below for assistance with these types of coverage issues. We will contact OMPP Eligibility on your behalf so that they can assist you and work with DFR leadership on your particular situation.
Thank you.
Family Voices Indiana
PH: 317-944-8982
www.fvindiana.org
About Special Kids (ASK)
PH: 317-257-8683
Toll Free: 1-800-964-4746
www.aboutspecialkids.org
The Autism Society of Indiana (ASI)
Toll Free: 1-800-609-8449
www.autismsocietyofindiana.org
The Arc of Indiana
PH: 317-977-2375
Toll Free: 1-800-382-9100
www.arcind.org
Covering Kids and Families (CKF)
PH: 1-574-968-1645
www.ckfindiana.org
The Indiana Resource Center for Autism (IRCA)
PH: 812-855-6508
Toll Free: 1-800-825-4733
The Indiana Chapter of The American Academy of Pediatrics
PH: 317-586-0732
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