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Audio (MP3) Listen in New Window Presentation (PDF) Open in new window BDDS Updates - Overview • BDDS Organization • Local Office Changes • Targeting – FSW • CIH Renewal and Transition Plan • FSW Renewal • Extended Services • Pre-Vocational Services • Money Follows the Person Grant (MFP) • RHS Daily Rate • OBRA Review • Questions BDDS Organization Julie Reynolds, BDDS Director Kristina Heili, Director of Policy Agency Liaison (DOC, DCS, DOE, DMHA, DA) Policy Team Holly Wimsatt, Director of Client Services Field Service Director - Districts 1, 2, 3, 6 Field Service Director - Districts 4, 5, 7, 8 Wendy Miers, Director of Operations Operational Performance and Project Management Data Systems & Claims OBRA/State Line Waiver Unit Locket Phillips, Director of SGL/Institutional Care SGL, ESN, CRFMNR, SOF Local Office Changes • Concrete Timelines to complete enrollments • 45 Days from Intake or Acceptance Date to Level of Care • 15 Additional Days to On-Boarding or Waiting List • Upgrade of Staff Positions to enhance hiring and retention • Fully Staffing District Offices is BDDS #1 Hiring Priority FSW Targeting • Beginning August 15, 2014 BDDS began Targeting 300 Individuals per month • Targeting will continue at this level on the 15th of every month • As of August 15th there are 3,396 Individuals on the Waiting list • The Average length of time on the Waiting list is currently 2 ½ Years CIH Waiver Renewal and Transition Plan • Transition Plan Public Comment Closed August 7th • Transition Plan Submitted to CMS on August 15th • Indiana now has 120 Days to “implement” Transition Plan • This applies to all FSSA Divisions with Medicaid Waivers (Aging, DMHA) CIH Transition Plan • Home and Community Based Services Survey • Utilizing IIDC • Utilizing the Employment and Day Services Model • Residential Settings are the Key at this time • Person Centered Planning and Processes FSW Renewal • Due December 31, 2014 • BDDS has established clear internal timelines for completion • Changes to Service Definitions • PAC • SEFA Extended Services • New Service Definition Under Both Waivers • Supported Employment Follow Along will Continue to be a Function of Vocational Rehabilitation • Clear Path from VR Services to BDDS Extended Services • Transition is the Key • Public Comment Pre-Vocational Services In 2011 CMS Issued Guidance on Pre-Vocational Services that explained that pre-vocational services are not an end point, but a time limited (although no specific limit is given) service for the purpose of helping someone obtain competitive employment “Prevocational services should be designed to create a path to integrated community based employment for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities” “Waiver funding is not available for the provision of vocational services delivered in facility based or sheltered work settings, where individuals are supervised for the primary purpose of producing goods or performing services. The distinction between vocational and pre-vocational services is that pre-vocational services, regardless of setting, are delivered for the purpose of furthering habilitation goals such as attendance, task completion, problem solving, interpersonal relations and safety, as outlined in the individual’s person-centered services and supports plan. Prevocational services should be designed to create a path to integrated community based employment for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities." “Although this is guidance with respect to the 1915 (c) Waiver program, we note that states have obligations pursuant to the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and the Supreme Court’s Olmstead decision interpreting the integration regulations of those statutes. Consistent with the Olmstead decision and with person centered planning principles, an individual’s plan of care regarding employment services should be constructed in a manner that reflects individual choice and goals relating to employment and ensures provision of services in the most integrated setting appropriate.” Money Follows the Person Grant (MFP) • Initiative Through the Division of Aging • Official Announcement to be made by OMPP • BDDS Goal – Utilize MFP funding for those transitioning from Institutional Settings • Individuals will have to meet BDDS and MFP Requirements OMPP Announcement • The Money Follows the Person (MFP) program is funded through a federal grant to help states move individuals from institutional settings to home and community-based settings. The Centers for Medicare and Medicaid Services (CMS) has approved the addition of individuals with intellectual and/or developmental disabilities who reside in a qualified institution and who meet the eligibility and level of care requirements for the Community Integration and Habilitation (CIH) waiver to the MFP Grant. • Effective October 1, 2014, providers who are currently enrolled as a CIH waiver provider will also qualify and be enrolled to serve participants of the new MFP-CIH program. RHS Daily Rate Work Group • DDRS and INARF Work Group is Examining Options for a Daily Rate for a Subset of Individuals Receiving RHS • Next Meeting is September 3rd • Details Still Being Developed • Recommended Changes Would Lead to Public Comment and Potential CIH Waiver Amendment OBRA System Review • Provide a comprehensive plan to research and analyze the current OBRA system • Conduct focus groups and provide analysis of results • Conduct onsite reviews of current service delivery locations in collaboration with OBRA providers • Develop and present a final report which will identify short and long term strategies and recommendations for improvement in the OBRA system • Provide ongoing technical assistance Resources • September 16, 2011 CMS Information Bulletin • http://downloads.cms.gov/cmsgov/archived-downloads/CMCSBulletins/downloads/CIB-9-16-11.pdf
Local Office Changes • Concrete Timelines to complete enrollments • 45 Days from Intake or Acceptance Date to Level of Care • 15 Additional Days to On-Boarding or Waiting List • Upgrade of Staff Positions to enhance hiring and retention • Fully Staffing District Offices is BDDS #1 Hiring Priority FSW Targeting • Beginning August 15, 2014 BDDS began Targeting 300 Individuals per month • Targeting will continue at this level on the 15th of every month • As of August 15th there are 3,396 Individuals on the Waiting list • The Average length of time on the Waiting list is currently 2 ½ Years CIH Waiver Renewal and Transition Plan • Transition Plan Public Comment Closed August 7th • Transition Plan Submitted to CMS on August 15th • Indiana now has 120 Days to “implement” Transition Plan • This applies to all FSSA Divisions with Medicaid Waivers (Aging, DMHA) CIH Transition Plan • Home and Community Based Services Survey • Utilizing IIDC • Utilizing the Employment and Day Services Model • Residential Settings are the Key at this time • Person Centered Planning and Processes FSW Renewal • Due December 31, 2014 • BDDS has established clear internal timelines for completion • Changes to Service Definitions • PAC • SEFA Extended Services • New Service Definition Under Both Waivers • Supported Employment Follow Along will Continue to be a Function of Vocational Rehabilitation • Clear Path from VR Services to BDDS Extended Services • Transition is the Key • Public Comment Pre-Vocational Services In 2011 CMS Issued Guidance on Pre-Vocational Services that explained that pre-vocational services are not an end point, but a time limited (although no specific limit is given) service for the purpose of helping someone obtain competitive employment “Prevocational services should be designed to create a path to integrated community based employment for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities” “Waiver funding is not available for the provision of vocational services delivered in facility based or sheltered work settings, where individuals are supervised for the primary purpose of producing goods or performing services. The distinction between vocational and pre-vocational services is that pre-vocational services, regardless of setting, are delivered for the purpose of furthering habilitation goals such as attendance, task completion, problem solving, interpersonal relations and safety, as outlined in the individual’s person-centered services and supports plan. Prevocational services should be designed to create a path to integrated community based employment for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities." “Although this is guidance with respect to the 1915 (c) Waiver program, we note that states have obligations pursuant to the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and the Supreme Court’s Olmstead decision interpreting the integration regulations of those statutes. Consistent with the Olmstead decision and with person centered planning principles, an individual’s plan of care regarding employment services should be constructed in a manner that reflects individual choice and goals relating to employment and ensures provision of services in the most integrated setting appropriate.” Money Follows the Person Grant (MFP) • Initiative Through the Division of Aging • Official Announcement to be made by OMPP • BDDS Goal – Utilize MFP funding for those transitioning from Institutional Settings • Individuals will have to meet BDDS and MFP Requirements OMPP Announcement • The Money Follows the Person (MFP) program is funded through a federal grant to help states move individuals from institutional settings to home and community-based settings. The Centers for Medicare and Medicaid Services (CMS) has approved the addition of individuals with intellectual and/or developmental disabilities who reside in a qualified institution and who meet the eligibility and level of care requirements for the Community Integration and Habilitation (CIH) waiver to the MFP Grant. • Effective October 1, 2014, providers who are currently enrolled as a CIH waiver provider will also qualify and be enrolled to serve participants of the new MFP-CIH program. RHS Daily Rate Work Group • DDRS and INARF Work Group is Examining Options for a Daily Rate for a Subset of Individuals Receiving RHS • Next Meeting is September 3rd • Details Still Being Developed • Recommended Changes Would Lead to Public Comment and Potential CIH Waiver Amendment OBRA System Review • Provide a comprehensive plan to research and analyze the current OBRA system • Conduct focus groups and provide analysis of results • Conduct onsite reviews of current service delivery locations in collaboration with OBRA providers • Develop and present a final report which will identify short and long term strategies and recommendations for improvement in the OBRA system • Provide ongoing technical assistance Resources • September 16, 2011 CMS Information Bulletin • http://downloads.cms.gov/cmsgov/archived-downloads/CMCSBulletins/downloads/CIB-9-16-11.pdf