Shawnee County CDDO/ Affiliate Meeting

Shawnee County CDDO Affiliate Meeting Minutes April 9th, 2007

I. CDDO Updates:  Affiliate Report (handout) – Reviewed the Affiliate report. There are 924 individuals receiving services in Shawnee County as of March 31st. (handout)  FY 2007 SRS Exceptions to Allocation report – Reviewed report. (handout)  Statewide Funding Committee Updates – . There were 150 additional waiting list spots made available. 50 out of 100 people have declined services on the statewide waiting list as of March. Individuals at the top of the statewide WL have a request date of July 9th 2004. . 110 people statewide received funding for van lifts, home mods, etc. which cost around $575,000. . The waiver amendments were approved. . Enhancement of Services – Currently individuals can’t enhance services even if their name comes up off the WL and/or if their tier changes. A committee is being established to work on a Needs Assessment tool that would be used statewide. Hopefully this year at contract negotiations some language will be added to the contract regarding enhancement of services. . Statewide Funding Committee probably won’t meet again until Sept 2007.  The Contract Oversight Committee had its first meeting in March and will meet regularly prior to contract negotiations. A big topic of discussion has been children with DD in the foster care system. The committee will be meeting with advocacy groups tomorrow to get their input. This includes Families Together, SACK, DRC and the DD Council. There has been discussion about the difference between all the CDDO’s regarding foster care and individuals transitioning onto the MR/DD waiver. It was brought up that if a child is not placed in their home county you won’t receive DD funds. Several CDDO areas don’t approve all 31 days of children’s residential services because the additional DD service is determined by the child’s need for additional supports. A provider asked how this would affect those children already living out of their home county. Ramona is not for sure how it’s going to look. There was also discussion about funds going directly to the foster care system. The biggest push is to have a statewide Needs Assessment tool to justify why the enhanced rate is needed over the regular foster care reimbursement rate.  Statewide EF waiting list process – Currently there are 12 people on the Statewide Waiting List for Extraordinary Funding. Shawnee County CDDO does not have anyone on the statewide EF waiting list at this time. All EF requests/documents must be submitted to the CDDO Funding Committee to review and determine EF eligibility. When EF eligibility has been determined individuals are assigned a level of need. The level of need is rated on a scale of 1 through 6. Levels 1-4 take priority for removal from the statewide WL. The CDDO completes and submits the SRS notification form for individuals to be added to the EF waiting list when determined eligible.  EF Workgroup – SRS has developed a draft policy for extraordinary funding. The draft policy was reviewed at the last workgroup meeting and several key items are being revised. The EF workgroup has scheduled the next conference call on April 27th to finalize the draft policy. The following revisions to the EF tool/process were recommended: more description detail for the levels of need on the justification sheet; if someone is determined eligible for EF in one CDDO area and changes service providers or CDDO areas that the need for EF be reevaluated after 90 days of moving/changing providers. SRS shared that the number of people no longer needing EF is 18 individuals statewide, several due to deaths. One person in Shawnee County was determined ineligible for EF and one person chose not to re- apply for EF. The EF tool is available on the SRS HCP’s website. Timeliness in submitting paperwork was also discussed. If a provider does not submit required paperwork within an individual’s birth month, the individuals POC would be changed to reflect the regular tier. The provider may then submit the paperwork at a later date to request the individual be added to the statewide EF waiting list as outlined in the EF protocol. Any changes to the current process will not be implemented prior to July 2007 (the next contract year).  SRS/CDDO Contract – Reminder to send Ramona comments/suggestions regarding the contract language. You can call her at (785) 232-5083 ext 408 or email her at [email protected] (Foster care and Crisis funding are the hot topic areas.)

II. HCP/CSS News:  SRS/DD Stakeholder Conference call 04/02/07 – Ramona highlighted some of the items discussed.  Realignment of SRS – Sherrie Radcliff (QEC) will still complete KLO’s and Kathy Bryan (Performance Improvement) will conduct the licensing review of service providers in this area. Kathy has been receiving training from Sherrie and the transition of licensing responsibility to SRS Regional Staff is July 1st 2007.  The BASIS Enhancement field changes will be effective July 1st. HCP is still testing the changes and will be contacting several CDDO’s to test the changes and hopefully get all the bugs worked out first before it’s rolled out to all CDDO areas.  Statewide Foster Care Workgroup – The work group is identifying roles and responsibilities of foster care placing agencies and CDDO personnel. Shawnee County CDDO established a Children’s Residential Collaborative Network to identify roles and responsibilities on a local level as well. The statewide work group is looking at developing a Needs Assessment to determine a child’s level of support need due to their disability. The next meeting for the statewide group hasn’t been scheduled.  Centers for Medicare & Medicaid Services has approved the Waiver Definitions submitted in August 2006. Supported Employment and Personal Assistive Services are new services so there will be a delay in accessing these services until there are written policies with EDS regarding billing. SRS will offer training in several areas of the state prior to the new services beginning.  Starting July 1st respite and night support may not be billed as a bundled (daily) rate. It needs to be billed hourly. The changes do affect several Self- Determination participants in Shawnee County. Self-Determination will be mailing letters to families and are scheduled to meet with HCP on March 8th. The Self Determination program is not accepting new referrals for AFS and CFS at this time. They are accepting referrals for day and residential. SRS has until FY 2009 to determine what other changes are needed for individuals accessing AFS and CFS bundled rates.  Statewide Quality Oversight Committee – CDDO’s have begun collecting data on agreed upon performance outcomes for individual’s satisfaction with the services provided during the day, at home and by their case manager. Only the individuals response is recorded and not the response of their staff, guardian etc. CDDO’s will submit data to SRS on a quarterly basis as requested.  Services have been offered to 100 people statewide and out of those 100 people 50 have declined services for a variety of reasons. It is encouraged that when TCM’s meet with individuals/families they update the waiting list information as needed. It is anticipated that another 282 people statewide will offered services in FY2008.  HCP has moved from the 10th floor to the 9th floor of the Docking Building. They still have the same email addresses and phone numbers.  TCM updates – HCP and CMS oversight – The current TCM definition is similar to what is a billable activity although billing will change from a monthly encounter to 15 minute units. There also will be a cap on the number of units that may be billed for each individual. The cap hasn’t been determined. The rate for TCM reimbursement has not been determined but hopefully tomorrow HCP will notify the CDDO’s. The target date to implement changes from the current process is July 1st 2007. TCM providers will become the enrolled Medicaid provider and will need to get a provider number from EDS. Documentation requirements will include a start and stop time for each billable activity. It was asked if HCP was going to offer training. The response was probably not by July 1st, hopefully in the near future. The TCM DD Handbook is outdated and will also need revised to reflect any changes. There was discussion about no duplication of case management services. It is still not known how this will look for individuals that have a Mental Health CM, ACIL Waiver CM, RADACK, Foster Care, etc.  Any information received from HCP about TCM changes will be forwarded on to affiliates. Brian may not have all current affiliates email addresses so you might get it twice because the CDDO will forward it on again.  The Contract Negotiations have been schedule in May and June.  Autism Waiver – Mary Ann participates in the meetings and an autism waiver draft has been written.  http://www.srskansas.org/hcp/cssindex.htm - New items added on the SRS web site: Quality Assurance Manual & System Transformation.

III. Other Announcements:  Licensing – Several providers expressed their concerns regarding Sherrie Radcliff requiring a Risk Assessment be completed anytime there is a Behavioral Support Plan. It also was discussed that a risk assessment is being required for individuals taking Psychotropic medications for mental health reasons and have a mental health diagnosis. One provider said they have all this information in the person’s PCSP and questioned why it is needed on another form. The provider also stated they may not have a Risk Assessment attached to the PCSP because once they completed a risk assessment the supports are put in place. Another provider said a lot of the time, a team will go through the Functional Assessment verbally in a meeting and from the meeting notes they put together a Behavior Support Plan. Ramona will try to get additional clarification from Sherrie and will email licensed providers.

IV. Info/updates/resources/trainings:  April 10th – Resource Fair at Washburn University 4:00pm – 6:30pm (flyer)  May 24th – CDDO Quarterly Trainings: 8:30am-9:00am CDDO Overview, 9:00am- 10:00am Article 63/Licensing, 10:00am-12:00pm BASIS and 1:00-4:00 Beginning POC. RSVP to Jennifer Schreiner at [email protected]  May 30th Supporting Relationships training from 8:30am-12:30pm. RSVP to Jennifer Schreiner at [email protected]  June 13th – PCSP Training from 9:00am-4:00pm. RSVP to Jennifer Schreiner at [email protected]

Next meeting is scheduled May 14th, 2007