MEETING JUNE 18, 2009 OF DDD, Arc, HCPF AND THE LEGAL CENTER
Hello
everyone,
First,
thanks to Sharon, John, Barb and Christine for meeting with us yesterday.
While the decibel level was high at various times as we talked over one another,
we learned a lot and I believe the meeting was very productive. I’ve attached
a summary that—I think—reflects our discussion. It made sense to me to send
this simultaneously to everyone on the list. PLEASE read it and let everyone
know if I’ve mischaracterized something.
Second,
I “invented” some dates for when we could expect responses to additional information
requests. I’ve noted those in red.
Sharon,
John, Barb and Christine, please let me know if these dates are acceptable.
If not, let us know when we can expect the materials.
Third,
there are four other issues that I know of that I will send later today in the
form of “FAQs” as they cover broad areas of interest to many.
Finally,
the underlining in the summary is intended to highlight subject areas not for
emphasis.
Thanks
so much for your time and attention to this issue. Please
let everyone know as soon as possible of inaccuracies or omissions in the summary.
Mil
gracias.
Marijo
Rymer
Executive Director
The Arc of Colorado
1580 Logan--Suite 730
Denver, CO 80203
303-864-9334 ext 11
303-229-9499 (cell)
=================================================
Summary
of June 18, 2009, Meeting Outcomes re:
Participants:
Sharon
Jacksi, John Miles, and Christine Thomas: DHS/DDD; Barb Prehmus, HCPF
Carol
Meredith, Tim Cairns, Linda Skafflen, Brenda King, Stephanie Garcia, Aileen
McGinley, Marijo Rymer: Chapters of The Arc; Liz Fusilier, The Legal Center
1.
DDD
will:
·
draft a
letter to be sent directly from the Division to all families/self advocates
currently receiving SLS services with a broad overview of the new waiver requirements,
rationale for changes, and how improvements may occur as the plan is implemented. DDD will send a draft of that letter
to Arc leaders and Liz Fuselier by June 23, 2009.
We will review the draft and make “family friendly” suggestions and send
it back to Sharon Jacksi by June 30, 2009. Marijo
will be responsible for summarizing input and submitting it to DDD.
·
send to each Arc chapter
and The Legal Center by June 23, 2009
a copy of the basic contract between DHS/DDD—HCPF—and CCBs—purpose is
to enable advocates to help families understand what they can expect from CCBs.
·
send to each Arc chapter
and The Legal Center by June 23, 2009 an
outline of what is included in case management training regarding SLS implementation
·
send to
each Arc chapter and The Legal Center by June
23, 2009 information showing how utilization projections were determined:
i.e. how many people at each Support Level currently receive services
totaling less than the new Authorization Limit and how many receive services
that cost more than the Authorization Limit. The information will include the
range of dollar amounts for each support level. This data will be very helpful
in explaining the overall SLS picture to families.
2.
Arc
Execs will:
·
submit to Sharon, Christine,
and John a draft
outline/table of contents for a “family guide
to SLS” by June 25, 2009. DDD will
propose initial text and send it back to us by July 2, 2009.
At that point, Marijo will contact Christine and arrange a meeting or
conference call among the interested Arc Execs and Liz to do further work on
the guide and establish deadlines for completion.
·
will submit anecdotal reports on specific
issues/questions to
·
will continue to submit
FAQs
that cover broad
issues.
·
will submit questions specific
to case management issues to
·
become more
familiar with the state Medicaid plan
to improve guidance and direction for families.
·
will inform
DDD and HCPF of issues that may indicate a pattern of system or network inadequacy. Some of this information may not be
evident in data from PARs or ISP reviews; e.g. a pattern of providers
choosing to terminate certain services because of rate inadequacies, unavailability
of new providers, lack of state plan providers etc.
3.
Common
understandings (in no particular order)
·
The service
definition for respite
allows
for such services
to be provided in community settings. The language in the definition, “may
be provided in the participant’s home or the care providers’ home” is not intended
to exclude other settings. Clarification
on this subject will be sent to the DD community via the next response to FAQs
by June 25, 2009.
·
Mentorship
includes one-to-one interactions
that fall under “methods such as instructing, providing experiences, modeling,
and advising” and includes but is not limited to, “interviewing providers, participation
on boards etc.”
·
We all
acknowledge that there is a
problem with rates for some services that are determined by six Support Levels
while there are only four Authorization Limits
thus potentially creating a situation where a person in levels 4 or 6 may “run
out” of service units more quickly than their counterparts at levels 3 and 5.
DDD is working on this issue and will provide a solution by June
25, 2009.
·
Authorization
Limits for various Support Levels may change
based on utilization data. At
least 6 months of information will be needed before any changes can be proposed.
·
The difference
between the General Fund appropriation
for SLS services of $54,167,273 and the Division’s
projected expenditures
for 09-10 of $51,152,636 is designed to cover the cost
of phasing out some service plans
over the next year. Assuming
that next year’s appropriation is the same as this year’s that money will be
used to increase Authorization Limits
·
Individual
service plans for persons with developmental disabilities who qualify for Medicaid
should reflect appropriate “order
of access”—i.e. services covered by the state plan should be reflected first;
the Medicaid waiver will be used to provide services that are not covered under
the state plan. Case managers should help families to
access providers for benefits covered in the state plan in addition to those
for waiver benefits.
·
Families
can dispute
Support Levels
via the dispute process outlined by DDD and can appeal
reductions in service.
·
Finally,
we all understand that while the new plan takes effect July 1, 2009, that it
is “a work in progress” and subject
to change as utilization data is known and as problems and flaws are identified.