Shawnee County CDDO
Affiliate Meeting
Feb. 8, 2010
Present: LaBreer Allen, Catholic Charities; Quinta Avance, KNI; Ramona Macek, CDDO; Mitzie Tyree, TARC; Olga Hennessey, TARC; Dolores Cummings, TARC; Mary Ann Keating, TARC; Tonya Sterling. Firm Foundation of Topeka; Jennifer Brancaccio, TARC; Doug Gerdel, Life Patterns; Timili Gartner, CDDO
I. CDDO Updates:
v January Affiliate Report Overview
· 1,046 individuals receiving services (770 adults, 276 children) in Shawnee County.
· There was 1 individual determined eligible and 2 determined ineligible.
· There were 5 crisis requests reviewed by the funding committee; 1 was approved and 4 were denied.
· Individuals changing service providers included: 6 day services (includes multiple providers), 2 - residential services, 0 - case management (possibly 2 will be reflected on next month’s report) and 3 - payroll agents.
· There are 49 individuals (30 Medicaid eligible; 19 Non-Medicaid) who have not chosen a case management provider.
· There were 226 POC’s reviewed for the month. Of the POCs reviewed for in home supports 44% was over allocation and 56% at allocation.
Ø Quinta Avance, KNI, takes referrals for individuals for community services for Building Bridges II. She stated that KNI provides behavioral consulting and dental services for individuals receiving services from most of the affiliated providers. Part of the Building Bridges team duty will be making sure that the home county provider’s have the means to provide supports and services to the individual’s moving out of KNI. The home county is determined by where the guardian resides. At this time there are 149 individuals residing at KNI. Quinta stated that each year guardians are asked if they are interested in pursuing community services instead of the institution. Sometimes the response is yes but there are concerns about how much support the person will receive with a community service provider. Ramona stated that funding for services will be Money Follows the Person for 365 days. There were several questions of what happens after 365 days when there is a waiting list for HCBS waiver services.
Ø Concerns include: How far back will it push those already on the waiting list. Guardians have fears about community service programs some of which are legitimate while others are not. Mary Ann, TARC, stated that the CDDO and KNI want the individual’s transition from KNI to community services successful. There also must be trust that the individuals’ needs will be met.
Ø Ramona reported KNI statistical information so that providers would have an idea of what we are looking at for the residents.
Age: 30-39 33%
40-49 34%
Gender: Male 66%
Female 34%
Disability: Profound 88%
Severe 10%
Unable to Walk 67%
Non-Verbal 82%
Seizures 65%
Specialized Behavior Supports 33%
Feeding tube 33%
Resided 10 years or more 93%
Ø It was stated the services that KNI currently provides to individuals in the community will continue such as AT, Behavioral Outreach Program and dental.
Ø Ramona attended the SRS/CDDO/CSP meeting on Jan. 21st. Areas discussed include:
Ø The Governors budget allotment and 10% reduction/shortfall. The information is available on the KMAP website. Ramona mentioned that EDS has an 800 number for providers to call if needed.
Ø Please note that oral health was eliminated as of Jan. 1, 2010 and temporary respite was eliminated Feb. 1, 2010. Due to the 10% medicaid reduction, providers will receive a 10% reduction of payment for billings submitted to EDS. According to SRS, this information was shared with all enrolled medicaid providers and mentioned in the KMAP provider bulletin. SRS will make the changes on the MMIS January 28th.
Ø Legislative update – SB372 Guardianship and HB2440 Victims Notification
Ø Ramona stated that Billie has forwarded email about Kate’s Law. Excerpt from email: If enacted, Kate's Law would require that health insurance in Kansas cover the diagnosis and medically necessary treatment for autism spectrum disorders. This legislation will have far-reaching positive effects on families affected by autism, our public schools, state-funded programs and the fiscal health of Kansas.
Please join fellow autism advocates from across Kansas during the week of January 25 - 29 and email, call, FAX or visit your Kansas legislators. Ask them to please support Senate Bill 12 (House Bill 2367). Please refer to the bill numbers rather than "Kate's Law" as some legislators may not be familiar with the bill.
Ø Ramona reported that 365 individuals had been refinanced from the State General funds to HCBS services and that refinancing is no longer an option.
Ø The CDDO Reviews are back-logged as the state has restructured job responsibilities. The CDDO reviews are to be posted on the SRS website 30 days after conducted. As of Feb. 21st, the 25 SRS quality improvement personnel will be supervised by Brian Bolen and Amy Swanson, central office/CSS staff, instead of the regional offices.
Ø KU Beach Center has interviewed 120 families but would like to have 250 families with children between the ages of 5 and 18 interviewed. KU Beach Center would like CDDOs to give additional information to case managers and as they encourage family participation in the Support Intensity Scale (SIS). Ramona requested KU send the information electronically so CDDOs may forward it to case managers.
Ø Frank Stahl, SRS, is to be sending the non-licensing KAR 30-63-10 draft to the work group members for review. Changes to Article 63 and the licensing requirements have been finalized which was effective Jan. 15, 2010.
Ø The Statewide Quality Oversight committee data that is provided by CDDO’s on a quarterly basis is located on the SRS website.
Ø There was discussion about targeted case management vs. service coordination. SRS is revising the on-line module testing for case managers. It will involve more information about the MR/DD Waiver definitions, Plans of Care and Needs Assessments.
Ø Case management - There were 158,000 additional TCM units requested for 2008 at a cost of $1.7 million and 122,000 additional units requested for 2009 at a cost of $1.3 million.
Ø Ramona forwarded information about the Employment First Initiative conference scheduled for April 15th & 16th.
Ø The 2005-2010 Strategic plan outcomes are now available on the SRS website. A workgroup will work on the goals and objectives for the next five year plan.
Ø The outcomes of the SRS TCM cost study has not been shared with CDDOs.
Ø There was discussion regarding day service exceptions and if there is a need for a new waiver, Enhanced Residential services. This would allow a person who meets predetermined criteria, such as medically fragile or elderly to be allowed to stay home rather than be required to be out for the mandatory 25 hours per week as outlined in the day service definition. Currently a provider must submit a written day service exception request to the CDDO Funding Committee for review which is then forwarded to the SRS Program Manager for approval.
Ø Ramona participates on the state sponsored Challenging Behavior workgroup which is working on a system-wide response to address challenging behaviors. See attachment. This work group includes CDDO’s, CSP’s and SRS. Ramona stated that the group is meeting in two weeks if anyone has suggestions for the group to let her know.
Ø Other concerns noted due to the reduction of funding include: individuals moving back into larger group settings, staff turnover and there has been an increase of staff calling the police for behavioral issues.
Ø SRS/CDDO contract renegotiations – Contract language revisions have not been agreed upon between the parties. Areas discussed during the meeting, include Addendum #1, exceptions to exceed allocation and appendix E Crisis funding.
Ø Ramona stated that crisis requests have doubled the past 6 months as the waiting list continues to grow.
Ø It was stated that perhaps it would be good to encourage the parents and/or guardians of KNI residents to attend the Shawnee County Transition Council Resource Fair in March.
Ø Mary Ann stated that we all need to continue to contact our legislators to restore cuts and not to allow any more cuts due to be voted on June. 30th. She stated that www.invisiblekansans.org would be a good place to start to write letters to your legislator. Also if there are any parents or individuals waiting for services that would be interested in giving testimony to legislators to let Ramona know.
Ø At this time there is discussion of CDDO’s exchanging State Aide and the State General Funds for the 10% HCBS waiver reduction. There are 6 CDDO’s, which includes the SNCDDO, opposed to doing this as it would have an negative impact on those receiving services through state general funds.
Ø Mitzie Tyree, Self-Determination, thanked the CDDO for keeping everyone updated.
Ø See attachment for FY2011 SRS Budget (Governor’s Budget Recommendations)
II. Upcoming training opportunities:
Ø March 18th – POC refresher (for case managers that have been through POC training previously).
Ø March 25th – CDDO Quarterly Training – flyer to be emailed
Ø March 29th – Transition Council Resource Fair – 9 a.m.-Noon Topeka Public Library – flyer to be emailed
Next meeting is scheduled March 8, 2009