- Heather Houser, Prairieland
- John Gordon, CISA
- Kimberly Johnson-Evans, Parent
- Katherine Hamann, The Arc/Guardian
- Julie Hobson, CSO, Inc.
- Shelly Lawler, SICCS
- Vickie Kean, Don Moss & Associates
- Ginny Jarrell, DDSME
- Alice Devany, DDSME
- Dr. Geunyeong Pyo, DHS/DD
- Joe Turner, DHS/DD
- Sean Walsh, DD/BCS
- Mary Lou Bourne, (Facilitator) NASDDDS
Agenda Item 1: Welcome/Introductions
Some of the groups are finishing up their meetings. There is overlap in some discussions that are taking place in Life Choices workgroups as well as in other workgroups under different initiatives but the recommendations are coming together.
CMS in Washington is pushing the new HCBW community definition for residential as well as nonresidential settings and are reviewing the 1115 waivers for new innovations.
Mary Lou agreed to send out the CMS Q/A regarding the new regulations on community settings. Although there may be some trepidation with the changes, Mary Lou felt that generally speaking, new innovations make their own space and don't usually make something else go away.
Agenda Item 2: Agreements, PUNS Initial Data, Intake Forms, Universal Assessment Tool
The issue regarding the cost of psychological evaluations will be turned over to the Business Process Team. They will likely require some data from the ISCs that will help when determining possible policy changes. Information such as how many psychologicals are for new people, how many are for people that transfer from a different waiver, how many are for individuals who are diagnosed as severe/profound, how many psychologicals have been done so far this year and how many in total for last year may be needed?
A review of the various intake forms revealed that although there is not a universal document, many of the ISCs are collecting much of the same information. Typically, the information gathered includes, what type of assistance they want/need, demographics, diagnosis, guardianship information, service history and other ROCs information. Generally speaking intakes are done by a specific staff person with backup staff available.
Most initial intake information is taken over the phone and then a follow up appointment for an in-person meeting is scheduled by the Service Coordinator. Families/individuals are generally provided a list of information that will be needed to determine eligibility and asked to have as much of that documentation as possible available at that first meeting. During that face-to-face meeting a PAS, PUNS or both is completed and any additional information is gathered to determine eligibility for the DD program.
Once all the information is in place the ISC makes a determination of eligibility (DDPAS-10) and forwards the packet (ROCs Screen and DDPAS-5 and DDPAS-6) to the DHS/DDD Region Facilitator or Bureau of Transitional Services to confirm DD eligibility. DHS/DD can overturn the ISC's determination of eligibility or crisis status. If approved the information is sent to the Rates Division and DHS sends the family a letter stating their loved one has been determined to eligible for DD services.
Some data that may be of interest is the ratio of total referrals received at an agency compared to the number determined eligible. Where are referrals made when determined ineligible? It was generally felt that there is need for a formal process to review for eligibility prior to putting an entire packet together.
The Universal Assessment Tool (UAT) request for bid/proposal is still open therefore nothing to review at this time. It was believed that having a universal assessment tool might be an opportunity to partner with aging and/or veterans agencies.
Agenda Item 3: Updates From Other Life Choices Teams
- Team 1 - Role Enhancement: They recommend individual Service Coordination (ISC) instead of using three names/acronyms (ISC/PAS/ISSA). They see the role of ISCs to be eligibility determination, PUNS, Case management, service coordination and service facilitation. They recommend:
- review/update the ISC manual so that procedures are clarified
- review performance indicators for ISC staff
- regular meetings with the DD Division occur
- specific data reporting/tracking system be available to all agencies
- additional training be provided with input from ISC staff regarding topics
- a clear explanation of the collaborative responsibility of expanding community services (division, providers, ISCs)
- Team 3 - Just started but thanks go to Kathryn and Kimberly for helping out with family representation.
- Team 4 - Person-Centered Profile/Provider Selection has finished meeting. They have a set of recommendations. They distinguish between a Profile and a Plan which is drafted by the provider. The Profile Preferences will be used to ask providers if they can meet the person's needs. CMS requires that personal preferences be honored.
- Team 5 - Quality team will be reviewing what the service coordinators role is when they are doing an individual review, looking at a less descriptive type of format, not just checking boxes but to follow responses into the direction it needs to go. The questions will be linked to the CMS Quality Indicators Framework. PAS are the review arm of the DD Division to make sure the plan is being done as written by reviewing the services an individual is receiving.
Agenda Item 4: REVIEW INTAKE FORMS/COMPARISON
Discussion: Design an intake form that will help service coordinators ensure the person is getting the services in the plan, are services being delivered as written? IASCA recommended some revisions to the visiting notes three or four years ago but no action was taken by the DD Division. Cathy Wampach, Michelle Tibbs and Mary Spriggs were involved in this process and may have some information. Can the ISC Approval form be universal?
Agenda Item 5: ISC STAFF PERFORMANCE INDICATORS
Some possible indicators could be the number of referrals made before a provider is found, number of days from first meeting (intake) until decision is made regarding eligibility for DD Services.
Agenda Item 6: RECOMMENDATIONS
- DD Division develop a simple one page fact sheet, easy to read (8th grade level) for families that helps them understand the criteria and procedures for eligibility determination and a separate sheet explaining intake. This should include a definition page and acronym explanation
- Required information for intake be standard/consistent (same form)
- Create statewide data base to capture this information
- Separate the DD eligibility process from the full intake process
- DD Division should provide mandatory training consistently across the state on the eligibility process to all ISC staff.
- DD Division should provide additional training with input from ISC staff on topics
Agenda Item 7: NEXT MEETING TO BE DETERMINED