Friday, January 6, 2012

DDRS quarterly bulletin: waivers, services, First Steps and more.....

Family Voices encourages its members to stay up-to-date on information that may affect their family. We've embedded the latest quarterly bulletin from DDRS to help you learn more about disability services in Indiana. We appreciate DDRS's efforts to share this information more readily with the public and we hope you will take advantage of this opportunity.

Here are some highlights from the bulletin:

DDRS Waiver Manual 2011 DDRS has added a Waiver Manual to the website to use as a guide for the DDRS’ Waiver program.

Provider Questions and Answers Provider questions and answers from the October Quarterly Meetings are now posted on the BDDS web page under Quarterly Provider Meetings. This page will be updated after each Quarterly Meeting once all questions are complied and answered.

Waiver Journey DDRS recently added the Waiver Journey to the website, which outlines how to apply for a waiver and the steps one goes through to receive services.

BDDS and VR (Voc Rehab) Referrals: BDDS and VR have streamlined the referral process. For those individuals of working age BDDS now scans referrals directly to VR when individuals apply for services. In addition, VR contacts BDDS upon individuals applying for VR services so BDDS can confirm/complete eligibility prior to beginning supported employment services. There has been a steady increase in referrals to VR from BDDS. Referrals to and from VR are now being tracked in DART.

SEFA (supported employment follow along) work group was developed by VR with input from BDDS field staff. Proposed new SEFA forms were developed by VR to include additional information to better monitor the transition and follow-along process.

IPMG is making final modifications to the case management training developed by the Bloomington group. Once completed, IPMG will begin training case managers at their district meetings as well as have the training available with a voice over for new case managers as they come on board or for existing case managers to use at any time.

Children’s Group Home MOU A Memorandum of Understanding (MOU) is currently in development with the Department of Child Services (DCS). The MOU will address children’s group home placements for wards of DCS who have an ID/DD and meet ICF/MR Level of Care. Further details will be available soon when the MOU is finalized.

DD Waiver Second Amendment: The DD Waiver Second Amendment has been approved by CMS with an effective date of October 1, 2011. Highlights of the Amendment include:

 The legislated requirement of accreditation has been added to the provider qualifications of all providers of day services
 Community Based Habilitation (Group), Facility Based Habilitation (Group), Prevocational, and Supported Employment Follow-Along service definitions have been modified replacing ratios with applicable group sizes
 Allowable Activities of service definitions have been relabeled as Reimbursable Activities
 The term Intellectual Disability has replaced prior references to mental retardation wherever possible
 Reimbursement is no longer granted under any waiver funded service for participation in Individualized Support Teams
 A new Emergency Placement reserved capacity priority criteria category has replaced categories previously titled:
o Eligible individual in other setting whose health and welfare is threatened
o Eligible individual with loss or incapacitation of the primary caregiver
o Eligible individual with an aging primary caregiver

NOTE THAT INTERPRETIVE POLICY CLARICATIONS RELATED TO THIS NEW CATEGORY ARE FORTHCOMING
The 40-hour-per-week limit applicable to the delivery of Residential Habilitation and Support (RHS) service hours to an adult waiver participant by any combination of parents, step-parents and/or legal guardians of an adult waiver participant has been further modified. The 40-hour-per-week limit is now applicable to the delivery of RHS service hours to an adult waiver participant by any combination of relatives* as defined within the federally approved waiver application. The implementation date of this revision will be March 1, 2012.

*Using Indiana Administrative Code 405 IAC 1-12-11 Allowable costs; services provided by parties related to provider as the foundation, DDRS has established the following definition pertaining to a relative. Related/relative implies any of the following natural, adoptive and/or step relationships, whether by blood or by marriage, inclusive of half and/or in-law status:
1. Aunt (natural, step, adopted)
2. Brother (natural, step, half, adopted, in-law)
3. Child (natural, step, adopted)
4. First cousin (natural, step, adopted)
5. Grandchild (natural, step, adopted)
6. Grandparent (natural, step, adopted)
7. Parent (natural, step, adopted, in-law)
8. Sister (natural, step, half, adopted, in-law)
9. Spouse (husband or wife)
10. Uncle (natural, step, adopted)

Autism Waiver Amendment: The Autism Waiver Amendment submitted to CMS at the end of 2011 mirrors the currently approved DD Waiver Second Amendment.

Supervised Group Living: Level of Care (LOC) Reminder - Level of care (LOC) is re-determined when significant changes occur. For example, changes to medical/ behavior/ supervision needs and findings of W197, W198, W407, etc. from ISDH will cause DDRS to perform a level of care review.

BDDS District Office Restructuring: On November 15, 2011 each District Office underwent a restructuring of its staff to further improve the efficiency and effectiveness of monitoring services of Hoosiers with Intellectual and Developmental Disabilities. A breakdown of the changes at each District Office can be found on the DDRS Announcements web page.

DDRS/BDDS Waiver Data As of December 21, 2011, the unduplicated count of individuals on the waiting list for all three BDDS’ Waivers is 19,613, eighty-five percent (85%) of whom are currently receiving other services through programs or agencies including First Steps, Medicaid, Department of Education, Department of Child Services, etc. The table below indicates the current numbers related to waitlist, targeted individuals, and those currently being served on each waiver.

Over the calendar year 2011, First Steps, with the support of stakeholders, made great strides to meet programmatic and financial obligations. Staff and contractors worked diligently to implement program changes, while delivering quality services to young children. First Steps also implemented changes to insurance billing, allowing First Steps to bill carriers a monthly fee for early intervention services. For covered plans, it is expected that this type of billing will result in additional revenue and ease the billing process.

DDRS Quarterly Update January 2012

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