cms proposal highlights

8/2/2019 CMS Proposal Highlights

1/15

I N F O R M A T I O N P R O V I D E D B Y

Proposal to change SupportServices Waiver to Family Support

Waiver


2/15

How you can comment on this proposal

You can send concerns to CMS (agency that approvesproposal): Associate Regional Administrator

Verlon Johnson

312-353-1133 [email protected]

The public comment period for the state will last 30business days from the date of posting (3/18/12)

Please send all comments [email protected]


3/15

Sec 144 and proposal to change waiver system

It is important to note that the Sec 144 proposalincludes the provision that individuals will no longeruse the Support Services/Family Support Waiver as astepping stone to the DD/Autism waiver. Unless

individuals meet yet to be defined priority criteria,they maynever receive the DD/Autism waiver.

Except where noted, information was obtaineddirectly from the states proposal to CMS

You can learn more about the entire Sec 144 reportin our powerpoint:http://www.fvindiana.org/Trainings/DDwaiver/index.html


4/15

Purpose of the Amendment

Reflecting a name change from the Support ServicesWaiver to the Family Supports Waiver

Addition of the Participant Assistance and Care (PAC)service

Increasing the waiver funding cap from $13,500 to$16,250 Bringing portions of the Family Supports Waiver in line

with recent changes directed by CMS under the recentlyapproved Autism Waiver Amendment

Reflecting legislated changes Removal of references specific to contracted Case

Managers/Management


5/15

How DDRS reports input was sought

DDRS meets with small groups of parents and providersand attends Powerful Parent meetings on a regular basis.

Since July 1, 2007, the DDRS has contracted with the Arcof Indiana (Arc) to serve as an extension of the Division.

Prior to the renewal, the DDRS and OMPP sought publicinput on how to improve the ways participants and theirfamilies are served as well as ways to heighten person-centered principles in the architecture of Indianas

waiver service delivery system.


6/15

How DDRS reports input was sought

The IIDC hosted Community Conversations in threecities: Indianapolis (Central Indiana), New Albany(Southern Indiana), and Fort Wayne (Northern Indiana).In all, 197 participants participated in the Conversations

In a one month time frame, a total of 432 individualsresponded to a statewide online survey.

In total, 656 individuals participated in the variouspublic input opportunities to address: Whats Working;

Whats Not Working; Concerns and Suggestions aboutCurrent and New Waiver Services; and Concerns andSuggestions about Processes and Procedures


7/15

You STILL have a chance to provide input

SHARE YOUR VOICE. Tell your story.

Contact CMS: Associate Regional Administrator, VerlonJohnson 312-353-1133 [email protected]

Tell the stakeholder group, including The Arc, what yourconcerns are

Attend Powerful Parents meetings and other meetingsaround the state

Talk to your state legislators. Find them here:http://www.in.gov/legislative/contact/index.html

Stay-up-to-date on other possible changes


8/15

Changes to the cap under new waiver

Participants will be allowed a total cost limit of $16,250per year for any combination of services selected underthe Family Supports Waiver, formerly known as theSupport Services (SS) Waiver. The State reasonablyexpects that targeted individuals have available services

and supports from sources other than the waiver (forexample, family caregivers, educational settings, or otherpublic programs and supports) which, in combination

with the waiver services, will be sufficient to ensure theirhealth, safety and welfare.

At the time of this amendment, the State does not projectadditional increases or adjustments in the $16,250individual cost limit will be needed.


9/15

Eligibility determination process

Use of the Developmental Disabilities Profile (DDP) is to be discontinued as ofAugust 1, 2012. Instead, the LOC Screening Tool (first used for waiver Level ofCare determinations in September 2011), continues to be used, while othercriteria used in the determination of Level of Care remain unchanged

The ID, DD or other related condition must have an onset prior to age 22 and

be expected to continue. The ID, DD or related condition must also result insubstantial functional limitations in at least three (3) of the following areas ofmajor life activities:

Self-care.

Understanding and use of language.

Learning.

Mobility.

Self-direction.

Capacity for independent living.

Economic self-sufficiency


10/15

How will new people be added to the FSW?

Entrance to the Family Supports Waiver, formerlyknown as the Support Services Waiver, is governedon a first come, first served basis by the applicant'ssigned and dated application for waiver services.

The State may reserve a portion of the participantcapacity of the waiver for specified purposes (e.g.,provide for the community transition ofinstitutionalized persons or furnish waiver services

to individuals experiencing a crisis) subject to CMSreview and approval.


11/15

Will people ever move to another waiver?

When there is a change in the participant's condition orcircumstances post-entrance to the waiver that requires theprovision of services in an amount which exceeds the cost limit, inorder to ensure the participant's health and welfare, the State willtake the following actions:

Evaluate the participant for enrollment into another waiveroperated by the Division of Disability and Rehabilitative Services

when the participant meets the specific reserved capacity criteria forentrance to the waiver

Evaluate the participant to determine if they appear to meet the

eligibility criteria for participation under another waiver programoperated by another Division, such as a waiver requiring NursingFacility Level of Care and operated by the State's Division of Agingand complete a referral to the Division of Aging when theparticipant appears to meet criteria or upon participant request


12/15

NEW SERVICE: Participant Assistance and Care

PAC services support and enable the participant in activities of daily living, self-care, and mobility with the hands-on assistance, prompting, reminders,supervision and monitoring needed to ensure the health, safety and welfare ofthe participant.

Assistance with personal care, meals, shopping, errands, scheduling

appointments, chores and leisure activities (excluding the provision oftransportation)

Assistance with mobility including but not limited to transfers, ambulation,use of assistive devices

Assistance with correspondence and bill paying

Escorting the participant to community activities and appointments

Supervision and monitoring of the participant

Reinforcement of behavioral support

Reinforcement of principle of health and safety

Completion of task list


13/15

Case management

Case Management: This service is currently beingprovided outside the waiver to all SSW enrollees.Indiana proposes to again allow choice of providers.

Note: This service will be a required purchase out ofthe waiver budget. Approx $1200-$1500/yr


14/15

What can I buy with $16,250/yr?

The most frequently utilized services are:

Pre Voc (8:1) $4.72/hr

Respite $23.24/hr

Individual Community Hab $22.09/hr Facility Based Services (4:1) $8.48/hr

Behavioral Support $72.80/hr

Note: we are unsure of rate for PersonalAssistance/PAC, but it will likely be in the $20-25/hrrange


15/15

Next Steps

Most importantly, you should SHARE YOUR VOICE.If this proposal is approved, changes may occur assoon at July 1, 2012

Learn about Understanding the Funding Maze and

Filling the Funding Gaps via our online webisodesand webquests, found on our website:

http://www.fvindiana.org/training

Contact us if you need help: 317 944 8982

[email protected]

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