Highlights of note include:
DD Waiver Approved
The Amendment of the DD Waiver was approved by CMS on March 7, 2011. Highlights of the DD Waiver Amendment include:
Restructuring the various ratios found under Community and Facility Based Habilitation and Prevocational Services into small, medium and large group sizes.
Modification of service descriptions to mirror the recently approved Support Services Waiver where indicated Restoration of previous limits under RHS so that parents; step-parents and legal guardians may deliver no more than a combined total of 40 hours per week in RHS services. Modification of Performance Measures to mirror those found in the recently approved Support Services Waiver Renewal.
Removal of the 12-month time limit on prevocational services. Monitoring of these
services will be provided by a case manager or service coordinator.
Full details of these and other modifications may be found within the “Purpose of Amendment” section of the federally approved DD Waiver Amendment Application. A link to the recently approved amendment is found at: http://www.in.gov/fssa/ddrs/2639.htm
Objective Based Allocations were released on March 15th for individuals with June anniversary dates. This marks the sixth month into the transition to OBA. Please remember that teams should review the ALGO level at the annual meeting and submit a BRQ (Budget Review Questionnaire) if they feel an individual has been assessed at the wrong ALGO level. The BRQ is the questionnaire that assists the PAR Specialist review the individual’s file. The team may request a copy of submitted BMR and BRQs from the case manager. Please note that an individual may appeal any NOA, in which they have disagreement, in the same manner as before. Each NOA contains instructions on how to appeal and an individual’s right to appeal. Appeals are sent directly to the Office of Hearings and Appeals. A BMR may be submitted by the case manager on behalf of the team to provide additional supports as needed until the appeal is heard by an Administrative Law Judge.
Adult Foster Care Clarifications
Are ICAPs completed for clients receiving AFC?
Yes, if they are new because we don’t know if they are going RHS or AFC prior to the initial CCB being created.
If IPMG has received OBA for AFC clients, should this have happened?
It’s not technically an OBA it should be the AFC allocation amount. Ex. If AFC6
was on their last CCB it will give them an Algo level etc, but it will give them the
level 1, 2, or 3 daily rate times the number of days in the plan year.
If the team does not agree with the AFC level can they appeal?
Yes, like they would appeal any NOA decision but a PAR or BRQ is not applicable
for an individual receiving AFC.
Should the team not send in a BMR?
If it is because they disagree with the assessed AFC level.
If it is because they do not like allocation.
No, they need to re-examine if AFC is the appropriate service for them.
If they are awaiting an appeal.