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As part of INARF’s continuing commitment to ensuring members are informed, we have compiled updates on key issues and activities in which the INARF Board of Directors, Governmental Affairs Committee, and Staff have been engaged in on your behalf. During the Legislative Session, INARF will update members on the top issues twice as often, releasing an Advocacy Update approximately every two weeks. Things move fast during the Session, and your INARF team will keep you informed every step of the way. Have a question or want to share your perspective on the issues below? Please contact either Christiaan Campbell or Keith Digman for assistance. Have an issue or concern that is impacting your business that is not listed in this update? Please let us know by clicking here. Healthy Indiana Plan 2.0: With no approval for the expansion of Pence’s centerpiece healthcare plan, the governor used the opportunity afforded at his “State of the State” address to stand firm, stating that he will not accept terms that, “relegate low-income Hoosiers to substandard healthcare or jeopardize the fiscal health of our state." According to a local media source, a CMS official stated that there is no specific reason for the length of time it is taking to reach a decision on the waiver, but that negotiations are a part of the normal process for 1115 waiver proposals. Waiver Re-Write and Rate Reform Activities: There is no new information on the status of the Family Supports and Community Integration & Habilitation Waiver submissions for CMS approval. Both were submitted at the end of December, 2014, and are under review by CMS. Of note is a joint statement from several national associations, clarifying that services that are not in compliance with the CMS Final Rule may continue to be funded by HCBS Waiver dollars during the five year transition period. This statement re-iterated recent guidance from CMS on this issue and was intended to combat varying interpretations about the when the timelines for full compliance. The RHS Daily Implementation Work Group held its first meeting last week. The group is working with the Division to resolve several implementation issues previously identified by the INARF Board of Directors. In addition, the work group identified additional issues through their discussion, primarily around managing settings with a mix of reimbursement approaches. The work group will be meeting next week to continue the discussion. Facility and Community-Based Employment Services: The VR Rate Reform Work Group was expanded to include two additional representatives from community mental health centers and four additional members from the Bureau of Rehabilitation Services (BRS). VR is adding a Briljent representative for future meetings as well. All were assigned to one of three task forces, focused upon service definitions, documentation, or training. All groups met last week, and developed work plans with the goal of being fully prepared to begin training on May 1, and launch the Hybrid model, State-Wide, on July 1. A series of Questions and Answers regarding the new Provider Application were released last week, and will be updated as more questions are submitted to BRS. The application must be completed and submitted by February 7 in order for an organization to be considered for a Provider Service contract beginning on July 1, 2015. INARF was concerned about the separation of services in the document, allowing each to be selected independently. INARF received assurances that that continuity throughout all phases of employment was expected and that providers would not be permitted to select / provide single services. Supervised Group Living Work Group: The Extensive Support Needs Work Group met in early January. The group reviewed and provided feedback on BDDS policies and procedures to provide guidance to service coordinators and other field staff. The group also discussed approaches to training topics for service coordinators to develop a deeper understanding of the program and its unique features. Gap Analysis Project: Sen. Grooms has filed a SB504 to implement a pilot based on the Gap Analysis recommendations. It has been assigned to the Committee on Family & Children Services Quality Improvement Initiative: The Membership Support and Development Committee will be meeting in late January to develop work groups and development plans for INARF’s “System of Excellence” program. Key areas of focus will be the expansion and refinement of Indiana Core Indicators, a deliberate and systematic process for provider assistance, the development of an “Industry Intelligence Center,” and identification of professional development activities around quality and best practices. Other Developments: Last week, a federal district court further whittled away at the Department of Labor’s (DOL) Final Home Care Rule, which was to take effect on January 1st. specifically, the DOL’s revised definition of “care activities” and “companionship services” were brought into question, and ultimately vacated. This decision follows on the heels of another case in late December, where a third-party employer provision was similarly voided. While the decisions state that the DOL overstepped their authority, and that these provisions should be addressed by congress, it is anticipated that the case will be appealed. These developments are good news for providers of home care and shared living services, which would have been required to pay minimum wage and overtime to workers currently reimbursed under other mechanisms. Quarterly Summaries: Advocare, the software portal currently in use by Indiana Case Managers and service providers, posted a change on its system last week. Providers were informed that that an option to submit monthly summaries had been removed from the system and those quarterly summaries would now be the required documentation from providers to case managers. This change is a welcome one for providers of services to individuals with disabilities, and was strongly encouraged by INARF. North Willow: On January 15th, DDRS announced that plans are underway to transition North Willow from a large private ICF/IDD to a nursing facility. As a result of this transition, many of the individuals currently residing at North Willow will be moving into the community – either through the waiver or group home program. All transition related activities are being coordinated through BDDS’ Central Office. INARF is working with local member agencies to produce videos of the variety of available community settings for the individuals who will be transitioning, as well as on gathering member data on program vacancies and capacity to serve new individuals. All member agencies interested providing residential services to individuals transitioning from North Willow may fill out this form, describing current vacancies. Completed forms may be forwarded, via email, to Kim Opsahl, who will coordinate with BDDS.