Team 2: Intake and DD Eligibility Meeting Minutes (5-1-14)

Meeting Location:  CISA - 101 Madison Avenue, Lincoln, IL

Members Present

Members Absent

• Sean Walsh, DDD/BCS
• Shirley Perez, Family Support Network
• Katherine Hamann, The Arc/Guardian

Meeting Notes

Agenda Item 1: Welcome and Introductions

Agenda Item 2: Review of Feedback

• Mary Lou requested members input on what they had heard or been asked about regarding the Life Choice process. Several members discussed DHS-DD presentations, community discussions and provider reactions to the changes projected for the project. Confusion regarding ISC responsibilities and the service plan writing was discussed by a few providers with Team members. DHS-DD presented at the recent ARC convention and over all response there was positive. Families continue to ask how this will affect my family member.
• Discussion focused on how to respond in an effective manner to encourage acceptance of whatever process evolves out of the work groups.
• It was agreed by the group that we need to reinforce this process and pending change is not necessarily due to specific practices that were wrong but an effort to change based on changing expectations from families and to keep up with federal regulations. The team also agreed that we need to assure we are presenting the process and project in a clear manner due to the confusion and misconceptions.

Agenda Item 3: Review of each step of the PAS process

• What is the value of each step of the PAS process and how does it make the system work better or add value to the individual and services?
• We discussed the Obra 1, DD PAS 2, 3, 4 and 5 and their relevance to the process and service below are the recommendations developed from this discussion.

Recommendations

1. Changes in services for adults who are in waiver and there is program movement between waiver or in ICF-DD setting remove the requirement for another PAS since disability and eligibility have already been determined.
2. If 24 hour skilled nursing is the service required then a psychological within the last 5 years should not be required to determine need for 24 hour skilled nursing. (When a 24 hour skilled nursing placement is needed, the nursing facility does NOT require the psychological).
3. Psychological Evaluation should not recommend needed services or future needs of the individual specific to a waiver program. Recommendations should be general recommendations in regard to current needs. Form should be updated to reflect this.
4. Medical History within the last 90 days and physical within 30 days is not needed to determine eligibility for waiver services. May be relevant for 24 hour skilled nursing but not to determine DD eligibility. It could be required if further review of supporting documentation is necessary, but not for every eligibility determination.
5. DD PAS 4 is not needed to determine initial eligibility for DD services. 
6. DHS DD requirements for eligibility based on proof of MR before age of 18 is more restrictive than the federal guidelines of proof before the age of 22 years. This should be changed. 
7. The Life Choice project work group #3 (PUNS and Waiver Determination) request they review 1000.45 in the PAS manual as part of their process.
8. Regular meetings (quarterly) between DHS-DD and ISC agency staff as a group to assist with the exchange of information, issues and training to assure continuity across all agencies and improve performance.

Next meeting

May 19th, 2014, from 10:00 to 2:00

Location to be determined request Bloomington/Joliet area for moderator