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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: Coverage under HIP 2.0 began on February 1, after a much awaited approval was issued by CMS a few days earlier. The program will ultimately insure 350,000 low income Hoosiers. Traditional Medicaid for individuals 19 to 64 will be eliminated in favor of the new plan. Interestingly, Indiana’s congressional delegation is expected to vote in favor of repealing the Affordable Care Act this week, which would eliminate funding for HIP 2.0, according to a news source. 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. A Work Group has convened to make recommendations for the implementation of the RHS Daily Rate. The Work Group is working on clarifying a variety of issues related to implementation including loss of housemates, managing settings where not all individuals receive the RHS Daily Rate, and preserving the flexibility to shift resources from the Residential allocation into the DAYS or BMAN reserve. The Rate Reform Work Group will be re-convened within the next few weeks to revisit Day Services Rate Reform. Facility and Community-Based Employment Services: The VR Rate Reform Work Group met this week to continue preparation for the launch of the “Hybrid Model” on July 1. An Executive Briefing has been recommended in advance of state-wide training, to give a high-level overview of the changes and to address budgeting questions. Other Work Groups were approved by the Membership Support and Development Committee to focus on recommendations for successful transition to compliance with the CMS Final Rule and to “Move the Dial” toward community-based services. Supervised Group Living: An advance copy of a revision of revised Interpretive Guidelines for the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) State Operations Manual was released in late January. These Guidelines, commonly referenced as "Appendix J," are developed to clarify the intent Medicaid's Conditions of Participation. The new version will take effect on February 15, 2015. Steve Corya will give an overview of these changes at the February 19 INARF Quarterly Professional Interest Section Meeting. Over the next few weeks, INARF will reconvene the SGL Work Group to meet with the new Director of Facility Services. Gap Analysis Project: SB 504 is set for a hearing on Monday, February 9th during the Senate Family & Children Services. If passed, SB 504 would authorize a pilot program based on the recommendations from the Gap Analysis Project. Wellness Coordination: Providers continue to have concerns about Wellness Coordination, including accountability for certain documentation requirements. Near the end of January, Advocare released an update to the Wellness Coordination Guide, along with an expanded Question and Answer Section. Although the Guide addresses some provider concerns, there are several cross-referenced entries that do not give definitive answers. In a conversation with Advocare representatives this week, INARF staff were informed that many training and guidance documents are in a state of almost continual revision. Information is released directly on the Advocare system, and not in the form of a DDRS update or publically accessible announcement. Advocare will now forward a copy of any new materials to INARF, and is creating an INARF login for direct access in the near future. Advocare is sponsoring two webinars over the next several weeks to answer questions and review documentation. INARF will continue to work toward submitting recommendations to BDDS through the efforts of a MSDC Work Group, and directly with Advocare to address member concerns as they arise. Quality Improvement Initiative: The Membership Support and Development Committee has approved the formation of Work Groups to develop Indiana Core Indicators and establish a “System of Excellence” for INARF members. The Indicators and program design are anticipated to be complete in July of 2015. Training and resources will be in place by the end of the year. DOL Final Home Care Rule: The Department of Labor’s (DOL) Final Home Care Rule remains in contention, awaiting the results of an appeal. The Court vacated the Home Care Rule’s prohibition against third-party employers availing themselves of the companionship exemption and the revised definition of what constitutes “companionship services” for Fair Labor Standards Act purposes. ANCOR has been following the case, and has released a summary of the current status and a Frequently Asked Questions document. North Willow Status: All submitted openings have been forwarded to BDDS, and will be considered by consumers and families after they determine their choice of service. Transitions to new providers must be complete by April 30, 2015.