DDRS Provider & Case Manager Monthly Webinar May 5, 2021
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DDRS Provider & Case Manager
Monthly Webinar
May 5, 2021
Welcome and Today’s Agenda • DDRS Goals • COVID-19 Data Update • Bowen Center Update • NCI Data Update • BMR/BRQ • Waiver Redesign • Reminders
DDRS Goals for COVID-19 Efforts
Help prevent the spread of COVID-
19 and keep people alive
Operationalize flexibilities
Provider network maintained
Empower person-centered decision-
making for self-advocates, families,
case managers, and providers
Image by: McChrystal Group & NASDDDS
COVID-19 Data:
Total Number of BDDS COVID Positive
Cases
CIH FSW
1420 1001
SGL
838
Total Cases: 3259
Total COVID-Related Deaths: 56
COVID-19 Data: Age Among Unique COVID Positive Cases
COVID Positive
Cases by County
3259 Total Cases
Data as of 5/4/2021
Total COVID-related deaths- 56COVID-19 Data:
Total Number of Staff COVID Positive
Cases
CIH
1373
SGL
615
Total Cases: 1988
Total COVID-Related Deaths: 5COVID-19 Data:
Positive Staff Cases by
County
1988 Total Cases
Data as of 5/4/2021
Total COVID-related deaths- 5Bowen Center Update
Indiana COVID-19 Reserve Workforce Needs Request
Form is being retired.
If you have a need for health workforce reserve
personnel, please contact:
Bowen Center for Health Workforce Research & Policy
bowenctr@iu.edu
317-278-0316NCI Data Update
On behalf of BQIS, the Indiana Institute on Disability and
Community (IIDC) at Indiana University is facilitating the
National Core Indicator surveys.
Individual Surveys
• IIDC contacts the individual and requests their participation
in this survey.
• The individual has the choice to participate.
• The survey date/time is arranged during the initial contact.
• The survey is conducted via an online platform.
More information available on the BQIS webpage:
https://www.in.gov/fssa/ddrs/quality-improvement/BMR
BMR Denials by Responsible Party & Reason
March 1, 2020 to May 1, 2021
(135 Total Denials)
100
80 18
60
40 54 63
20
0
Provider Case Manager
Arrears Incorrect foundation CCBBMR
• Of the 117 BMR denials for being in arrears, 44
were resubmitted and approved.
• Of the 18 BMR denials with denial/appeal letters
for being on the incorrect foundation CCB, four
(4) were resubmitted and approved.
• The resubmissions were usually for slightly
different date ranges and different amount of
requested hours.
• BMRs submitted on the incorrect foundation CCB
must be resubmitted by the date given in the
denial response.BMR
BMR Reminders
• A BMR is a temporary request for funds that is in addition to the approved allocation and notice
of action (NOA).
• A BMR addresses a short-term need and issued for a situation that is expected to resolve
itself. It addresses the temporary needs of an individual receiving services when the individual
has a change in condition or status that will require the additional services or supports for the
individual to remain in the community.
• Timely request and submission of a BMR is the responsibility of the provider and case manager.
– The case manager should be documenting all relevant details regarding the BMR request
in case notes (i.e., when the request was made, if/when the case manager requested
additional information from the provider, when the additional information was received,
etc.).BMR
Important Things to Note
• Waiver funding belongs to the individual. If there is insistence
regarding the BMR being submitted—despite individual and/or team
disagreement—the case manager shall submit the BMR noting the
disagreement in the request for further BDDS review. Authority to
approve or deny requests for additional funding, via a BMR, lies
solely with the Division of Disability and Rehabilitative Services
(DDRS).
• It is the individual’s choice—not the provider’s choice—to move to
either the RHS Hourly or RHS Daily rate and when a request is
made, this must be documented in a JIRA ticket . Please reference
the recent guidance regarding requests for changes to residential services
and related BMR requests.BMR
Important Things to Note (cont’d)
• For BMRs that are submitted consecutively for a loss of housemate,
appropriate and updated documentation for every subsequent
BMR—including a progress update in regards to resolving the need
for future BMRs—must be provided.
• Reminder that there is a temporary allowance to submit BMRs 60
days following the status date change. Please be sure to review
Appendix K for details.Waiver Redesign Goals and Guiding Principles Increase Person-Centered Planning Improve Coordination of Care Increase Community Engagement Enhance Member Experience Maintain Qualified Providers Comply with HCBS Rule Promote Efficiency
Waiver Redesign
Our Current Modified Approach
Synthesis of Stakeholder Feedback and Current
Capacity to Inform Areas of Priority
Improve team
Enhance Case
dynamics through Focus on key
Management and
shared outcomes supports to build
System
and independence
Navigation
communication
All people have the right to live, love, work,
learn, play and pursue their dreams.Waiver Redesign
Key System-wide Efforts (New & Existing)
• Systems Quality & Satisfaction
• Partners in Transformation and Culture Quality
Continuation (existing initiatives in DDRS)
Improve team • Simplify Service Names and Clarify Service Definitions
dynamics (waiver amendments)
through shared • Systems Consolidation (Release 2 Fall 2021)
outcomes &
communication • Capacity Building through Training, Information and
Resources
• Alignment and update of policy and guidance
• Resources and Information for Individuals & Families
Supporting the Vision of Individuals and Families
through Partnership & CollaborationWaiver Redesign
Key System-wide Efforts (New & Existing)
• Institutionalization Modernization
• Assessing the needs of individuals, determining their
desires
• Money Follows the Person & PASSR TA
Focus on key • Re-engagement efforts and improving PASSR process with
supports to build greater emphasis on person-centered approaches
independence
• Enhance understanding and language
• Remote Supports
• Behavior Supports
• Specialized Medical Equipment & Supplies
Supporting the Vision of Individuals and Families
through Partnership & CollaborationWaiver Redesign
What we have heard from individuals & families
“I need I would be “I need
someone to lost without someone
help me find my case to have
resources” manager my back”
I rely on my
case
manager to
Enhance Case know what I
Management and “I need my case don’t.
manager to
System understand “Case “I wish my case
Navigation how services managers manager
impact my need more would think
budget” training” outside the
box”
“Case managers “My case
should focus on “I need my case manager
what could be manager to should be the
rather than what communicate glue that holds
is” with me better” it all together”Waiver Redesign
What we have heard from CMCOs & Case Managers
“Case
“We need managers
more “We are should be
training” different change agents”
than other
providers”
Enhance Case
Management and
“I need the state
System
“We want to to tell my case
Navigation managers what is
be a partner”
expected of
them”
“That isn’t what
“CMCO’s my CMCO has
should be held directed us to
accountable” do”Waiver Redesign
Key System-wide Efforts (New & Existing)
• Deliver Case Management via a 1915(b)(4)
• Enhance Case Management Service Definition
Enhance Case • Develop Comprehensive Quality Guide for Case
Management and
System Management
Navigation • Build Case Manager Capacity through Training,
Information and Resources
Supporting the Vision of Individuals and Families
through Partnership & CollaborationWaiver Redesign What is a 1915(b)(4)? • Selective Contracting Waiver (Pursuing only for Case Management) • Operates in coordination with the 1915(c) • Provides mechanism and service delivery not otherwise available in 1915(c) • Involves issuing a Request for Services (RFS) for procurement with selected entities • Separate review and approval by CMS
Waiver Redesign Opportunities in 1915(b4) Implementation Quality Improvement ✓ Consistent Messaging ✓ Training Coordination and Planning ✓ Non-financial incentives ✓ Increase capacity of state staff to provide quality technical assistance ✓ Strengthened Relationship and Partnership
Waiver Redesign
Opportunities in 1915(b4) Implementation
Greater Outcomes for Individuals & Families
✓ Connected to an array of supports
✓ Greater self-determination
✓ Meaningful engagement in family & community
✓ Enhanced quality of life
✓ More opportunities to develop skills in
o Employment
o Activities of daily living
o Healthy relationshipsWaiver Redesign
Our Aim
To provide integrated supports and services within
the context of person, family and communityWaiver Redesign
Our Why
Case management is a
foundational service which all
other supports and services are
coordinated.Waiver Redesign Our Need Case managers and companies who are: ✓Navigators ✓Advocates ✓Partners
Waiver Redesign
Timeline
2020 2021
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar
RFS Development & RFS Announcement & Ongoing Collaboration
Responses Due Selection Process, Announcement & Contracting BDDS/CMCO
Communication
January 1, 2022
Implementation
• Release of RFS – May 4th
• Waiver amendments submitted to CMS – August 1st
• RFS awards published – October 1st
• Contracts signed – December 30th
• Start date – January 1, 2022
*Planned mailed communications throughout this timeline from
BDDS directly to individuals and familiesWaiver Redesign
RFS Next Steps & Special Considerations
• Release of RFS – May 4th
– Response Training Sessions for Vendors
• RFS Responses Due – July 6th
– Extended Time to Complete & Submit Proposals
• RFS Awards Published – October 1stWaiver Redesign
Opportunities for Stakeholder
Partnership & Feedback
• Development of individual & family satisfaction survey
• Topics to be included in Case Management Quality
Guide
• Waiver Amendments (Tribal Notice & Public
Comment)
• Waiver Redesign Reimagined: Plan Moving Forward
Release and Summary of Stakeholder FeedbackFederal Public Health Emergency
ON APRIL 21, 2021, THE FEDERAL PUBLIC HEALTH
EMERGENCY WAS EXTENDED FOR 90 DAYS
Appendix K is approved for 6 months AFTER the public
health emergency endsEmergency Back Up Plan
Providers and Case Managers should still be working
on emergency back up plans that address staffing shortages
Case Managers
•Talking with individuals and families that brainstorm possibilities for
supports which may include
•What does the person do well that can be leveraged or expanded upon
•Utilization of Appendix K Flexibilities
•Utilization of other waiver supports such as remote supports
•Relationships that may be able to provide some supports
•Technology that can be leveraged for support
•Community activities and resources for support
•Communicating the plan to the IST
•Facilitating the plan with the IST
•Ensuring the individual and family’s rights and consentEmergency Back Up Plan
Providers and Case Managers should still be working
on emergency back up plans that address staffing shortages
Providers
• Specific to staffing shortages
• Should be having advance communication with individuals
& families on staffing challenges that include determining
how individual may be supported if/when staffing is not
available (remote supports, family members, etc)
• Communicating with BDDS before staffing challenges become a
crisis
• Communicating the plan to the IST
• Ensuring the individual and family’s rights and consentMask Mandate
MASK ADVISORY 4/6/21:
As an advisory, it will now be left up to businesses and local governments to enforce
mask wearing if they so choose. Wearing masks remains a safety measure
recommended by the Center for Disease Control to reduce the spread of COVID-19
ALL DECISIONS SHOULD BE PERSON-CENTERED AND
DRIVEN BY THE INDIVIDUAL AND FAMILY
When determining return to “normal” activities such as day programs, community
outings and/or home visitations providers, case managers, individuals and families
should consider
•Local county restrictions
•Local county infection rates
•CDC Guidelines and Recommendations
•Vaccinations (who has received it, who has not)
•At risk conditions of the individualsPlease watch DDRS Announcements for information on next month’s webinar
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