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)

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Summary of June 18, 2009, Meeting Outcomes re: Colorado Adult SLS plan

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 Sharon at DDD and Amy Haight at HCPF. Copies should be sent to all Arc chapters as well as Liz.  DDD and HCPF will review these reports and respond back to us within 10 days.

·        will continue to submit FAQs that cover broad issues.

·        will submit questions specific to case management issues to Sharon at DDD and Amy Haight at HCPF.

·        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.

 

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