Texana CenterProvider Meeting AgendaFebruary 18, 2010 Introductions Information for HCS Participants & Families

Purpose of Transition Impact, Goals and Timeline for Texana CenterChanges Effective June 1, 2010Resources for Additional Information

Review of FAQs DRAFT Brochure for Families

Next Meeting – May 20, 2010 – 2 p.m. – 4 p.m.• 13100 Southwest Freeway, Suite 130 Sugar Land, Texas 77478

Information for HCS Participants & Families and Involved Stakeholders

Texana CenterFebruary 18, 2010

Transition of HCS Case Managementto MRA Service Coordination

Information Overview

Purpose of TransitionImpact, Goals and Timeline for Texana CenterChanges Effective June 1, 2010Resources for Additional Information

Purpose of Transition to MRASB 1, Section 48 (81st Session):

Provides $207 million General Revenue for home and community-based programs for people with intellectual and developmental disabilities and for reshaping the system of services.

7,832 people on waiting lists to receive waiver related community services by August 2011.

Additionally, HCS services to be provided to people leaving large & medium ICFs, children aging out of foster care, and children & adults at risk of institutionalization.

Funding for increased community services contingent, in part, on transfer of case management from the HCS Provider to the MRA.

Purpose of Transition to MRA SCTexas Legislature’s goals to increase:

Oversight of community-based services qualityPerson-directed planning of services & supports to

increase efficiencies and satisfactionAccountability of HCS program – approximately:

16,800 HCS Participants (current), over 20,000 with expansion 500 HCS Providers

Texas Legislature considered that these goals could be best met with Case Management being provided by a local authority separate from the entity, or agency, providing services.

Purpose of Transition to MRA SCTexas Legislature chose the MRA as the Local Authority

entity most experienced and best equipped to assume HCS Service Coordination. Texana Center, as the MRA,• Is mandated by law to function as the local authority

for developmental disability services.• Has experience providing Service Coordination as the

local authority. • Has expertise in Person Directed Planning processes

through its history with QAIS and state contract.• Has structure to separate Authority and Provider

functions to avoid conflicts of interest within provider network.

Impact for Texana CenterCurrentlyAs an HCS provider, we provide HCS Case Management

to the individuals enrolled in the Texana Center HCS program

Effective 6/1/2010Texana Center Authority Services will provide HCS-

MRA Service Coordination to approximately 840 individuals, served by all HCS Programs in the Texana Center local service area

Impact for Texana CenterCurrently Provider relations limited to Provider Fairs, Provider Meetings and

enrollments. 201 Certified HCS Providers for the Texana area:

32% (65) serve persons in Texana counties 33% (66) serve persons in same Waiver Contract Area: Brazoria Galveston,

and Harris counties 8% (16) serve persons statewide, but not in our Waiver Contract Area 27% (54) serve zero persons

Effective 6/1/2010 Provider relations expands to estimated 65 HCS Provider Agencies

serving persons in Texana counties.

Trends Growth in Provider Base: 24% (49) during FY’09 and FY’10

Texana Center Goals for June 1, 2010

Understand the new roles for HCS Providers and HCS-MRA SC, and set up systems for these functions

Hire, train and equip staff to provide qualified and consistent Service Coordination for HCS participants

Communicate with all HCS Provider agencies about changes,

new roles and Texana Center processes

Inform and support HCS participants & families to minimize disruption to services

Texana Transition TimelineAs the MRA, Texana must locally plan to transition successfully on June

1, 2010. Our planning began in November and will continue through May.

November 2009Conduct initial HCS Case Management transition meetings

between Providers and Texana MRADecember 2009Access information for all HCS consumers through DADSLocate office space for HCS-MRA SCs January 2010Begin HR processes to hire for the HCS-MRA SC unitInitial planning for the March-May Interim Period

Texana Transition TimelineFebruary 2010Continue HR processes to hire for the HCS-MRA SC unitPlan for HCS-MRA SC unit equipment: Computers,

Phones, Vehicles, Furniture & SuppliesImplement Texana Center webpage for HCS-MRA SC

TransitionConduct Second HCS-MRA SC transition meeting

between Providers and Texana MRAEducate Advisory Boards, PNAC, Texana Board of

Trustees

Texana Transition TimelineMarch 2010Complete HR processes to hire for the HCS-MRA SC unitReceive documents from HCS ProvidersApril 2010Create HCS-MRA SC record for each HCS ParticipantNotify Providers, HCS Participants and their families of

caseload assignmentsHold informational meetings with HCS Participants and

their familiesTrain staff

Texana Transition TimelineMay 2010Train staffNotify each HCS participant of the name and

phone number of the assigned HCS-MRA Service Coordinator

Continue to hold informational meetings with HCS Participants and their families

Conduct Third HCS-MRA SC Transition meeting between Providers and Texana MRA, to include HCS-MRA SC introductions

Fundamental Changes Effective June 1, 2010HCS Provider Agencies will no longer provide Case

Management. The MRA will provide Service Coordination to all HCS participants. The HCS Provider will continue to provide all other HCS services.

 HCS Interdisciplinary Team will be replaced by the Service Planning Team, to include the HCS participant, LAR and Service Coordinator. “a planning team consisting of an applicant or individual [HCS

Participant], LAR, service coordinator, and other persons chosen by the applicant or individual or LAR on behalf of the applicant or individual (for example, a program provider representative, family member, friend, or teacher).”

 

Fundamental Changes Effective June 1, 2010There will be three elements for Service Planning:

Person-Directed Plan by the MRA Service Coordinator is the ongoing planning process for services & supports

The Individual Plan of Care (IPC) by the HCS Provider is the budget document for each participant

The Implementation Plan by the HCS Provider is the plan defines the detail for service delivery: how often, how long, training objectives and activities, and measures for progress.

Fundamental Changes Effective June 1, 2010Both the HCS-MRA Service Coordinator and the HCS

Provider will have monitoring responsibilities, and be responsible for communicating monitoring results with each other.The HCS-MRA Service Coordinator will monitor

Did the HCS and non-HCS services identified in the PDP occur?Did the person make progress towards desired outcomes?Is the person/family satisfied with progress?Are the expectations for health and safety being met?

The HCS Provider will monitorWere the services delivered in compliance with HCS Principles?Is progress occurring per the Implementation Plan?

Changes: Service Coordination Accessibility

SC monitoring frequency will vary based on the needs and preferences of the person

Minimum frequency of face-to-face contact is quarterly

SC monitoring includes communication with families and providers

Discovery process for PDP development or renewal addresses frequency

Changes: Additional MRA Responsibilities

The HCS-MRA Service Coordinator will be involved when: Emergency HCS services are neededLevel of Need assessments are completed(agree/disagree)Suspension of HCS services occurTermination of HCS services are recommendedTransfers between HCS Providers are requestedConsumer Directed Services option are requestedPermanency Planning for persons under age 22 is required  

Changes: Rights and ComplaintsHCS-MRA SC must inform/assist HCS participant/LAR

regarding: Exercising legal rights as citizen & person with disability

Process for filing complaints with MRA about SC provision

Process for filing complaints about HCS services to • MRA• DADS• DFPS to report allegation of abuse, neglect or exploitation

Resources for Additional InformationRefer to the DADS website for transition

www.dads.state.tx.us/hcscmtransition/Refer to Texana Center website for transition

www.texanacenter.comParticipate in Information Meetings to be

conducted in April and MayContact Texana Center Authority Services at 281-

342-0090, or by e-mailTamra.lang@texanacenter.comSheri.talbot@texanacenter.com

Transition FAQs-Service PlanningQuestion 1: What is a Person-Directed Plan (PDP) and who

participates in its development?Question 2: What is an Individual Plan of Care (IPC) and who

participates in its development?Question 3: What is an Implementation Plan (IP) and who

participates in its development?Question 4: How does the person-directed planning process

support the service planning process in the HCS Program?Question 5: Does the development of the PDP and IPC need to take

place at two separate meetings or can they be done at the same meeting?

Question 6: How will the MRA SC communicate their agreement or disagreement with the IPC and MR/RC?

Transition FAQs-Service Planning Question 7: What avenues are available to program

providers for adding services to the IPC in an emergency? Question 8: Can the MRA SC can authorize an increase in

services on the IPC when it is submitted? How will DADS processes for reviewing changes in IPCs and requests for increases in LON work following this transition? (Added 12/7/09)

Question 9: Who is responsible for justifying the services on the IPC and where should the justifications be documented? How will DADS review HCS Program service component justification information following this transition? (Added 2/2/10)

Transition FAQs-Service PlanningQuestion 10.How will HCS Program transfers be

handled after this transition? (Added 2/2/10)Question 11.How does the MRA SC assist the

individual in choosing an HCS Program provider? (Added 2/2/10)

Question 12.Who will be responsible for maintaining an individual’s LOC/LON, including completing the MR/RC and ICAP? (Added 2/2/10)

Transition FAQs-MonitoringQuestion 1. What is the MRA SC’s role in monitoring HCS

Program providers? (Added 12/7/09)Question 2. If the HCS provider is not in the setting

monthly to conduct a face-to-face case management visit, whose responsibility is it to ensure individuals' health and safety and to conduct quality assurance related to the provision of foster/companion care? (Added 12/7/09)

Question 3. Please explain the responsibilities for monitoring in the HCS Program for the MRA SC and the HCS provider. (Added 12/7/09)

Transition FAQs-MonitoringQuestion 4: How will MRAs who are also HCS

Program providers be monitored and how will the division of responsibilities be applied in these situations? (Added 2/2/10)

Question 5: Following the transition, will the MRA SC or the HCS Program provider be responsible for routinely reviewing the individual’s plans such as quarterly reviews? (Added 2/2/10)

FAQs-COORDINATION BETWEEN AN HCS PROVIDER AND MRA SC

Question 1. How does DADS plan to accommodate circumstances beyond a provider’s control when performing certification reviews? For example, will providers be cited for missing paperwork if the reason for the missing paperwork is that the MRA SC did not provide it in a timely fashion?

Question 2. How will DADS assist the MRA SCs and program providers in maintaining productive working relationships and help to resolve complaints should they arise?

Question 3. How will documentation be shared between the HCS provider and MRA SC regarding the provision and monitoring of an individuals’ program services? Will the MRA SC share PDP progress reviews with the HCS provider?(Added 12/7/09)

FAQs-COORDINATION BETWEEN AN HCS PROVIDER AND MRA SC

Question 4. The rules require specific time frames for the program provider to notify the MRA SC of certain occurrences. For example, the program provider must:

notify the MRA SC of a suspension within one business day after services are suspended;

notify the MRA SC as soon as possible but no later than 24 hours after the program provider reports or is notified of an allegation of abuse, neglect , or exploitation involving an individual; and

if an emergency situation occurs, attempt to notify the MRA SC as soon as the emergency situation allows.

Will the MRA SC be "on call" to receive this notification? What type of response or support is the MRA SC going to provide in such instances? What forms of notification are acceptable? Can we use e-mail? (Added 12/7/09)

FAQs- MISCELLANEOUSQuestion 1. Who is responsible for responding to an

emergency? (Added 12/7/09)Question 2. Will MRA SC staff be able to see information

entered into CARE by providers? (Added 12/7/09)Question 3. What topics will be covered in the program

handbook currently in development? (Added 12/7/09)Question 4. Currently individuals and LARs have a choice

of HCS providers and if they don’t like their case manager they can transfer to another provider. Is that same process available for MRA service coordination? (Added 12/7/09)

Question 5. Is there a maximum caseload for an MRA SC? (Added 12/7/09)

FAQs- MISCELLANEOUSQuestion 6. How will funding change in the HCS Program

when case management is no longer provided by the HCS provider? (Added 12/7/09)

Question 7. How will HCS providers cover the costs associated with the provision of program coordination responsibilities following this transition? (Added 12/7/09)

Question 8: Following this transition will the HCS Program provider continue to be required to manage the individual’s personal funds upon the written request of the individual or LAR? Can the HCS Program provider charge the individual or LAR a fee for handling the individual’s funds? (Added 2/2/10)

FAQs- MISCELLANEOUSQuestion 9. Is Targeted Case Management

funded by contact or by month? (Added 2/2/10)

Question 10.What process is in place to ensure an HCS Program provider may enter billing for services if the MRA SC is late reviewing the IPC in CARE for agreement or disagreement? (Added 2/2/10)

QUESTIONS ABOUT THE HCS CASE MANAGEMENT TRANSITION FOR INDIVIDUALS, LEGALLY AUTHORIZED REPRESENTATIVES (LARS) AND ACTIVELY INVOLVED FAMILY MEMBERS

Question 1. Can an individual or LAR choose their MRA? How will the MRA assign MRA SCs to individuals? Can an individual change their MRA SC if they want to?

Question 2. How will an individual, LAR, or actively involved family member access the MRA SC to   request assistance? If the MRA SC assigned to an individual is away from work for an extended period how will the individual receive needed service coordination?

Question 3. What are the minimum education and experience requirements for an MRA SC? For an MRA SC Supervisor?

QUESTIONS ABOUT THE HCS CASE MANAGEMENT TRANSITION FOR INDIVIDUALS, LEGALLY AUTHORIZED REPRESENTATIVES (LARS) AND ACTIVELY INVOLVED FAMILY MEMBERS

Question 4.   What size caseload will each MRA SC be required to carry? How many MRA SCs can an MRA have in a single unit?

Question 5. Will there be a complaint process with appeals if an individual or LAR is dissatisfied with the service coordination they receive from the MRA or HCS Program service provision by the HCS Program provider?