Advisory Committee on Services to Persons with Developmental Disabilities
Thursday, July 15, 2021
10:00 a.m. - via TEAMS
1. CALL TO ORDER: Wanda Felty, Chairperson;
ROLL CALL: Robin Arter, Think Ability; the following Committee members were present: Wanda Felty, Lara Morrison, Janie Fugitt, Lorraine Sylvester, John Corpolongo, Eddie Miller, Diann Arnett, Traylor Rains, Robin Arter,
Entered after rollcall: Lisa Turner and Michelle Disario and Tori Collier.
APPROVAL OF MINUTES: The committee motioned to approve minutes with modification to add a second letter “t” to Janie Fugitt’s last name.
Committee come to a consensus the next meeting will be offered both an in person option and a virtual TEAMS option September 15, 2021 10:00 am to 12:00 pm.
Committee discussed the Direct Support rate needs to increase to a competitive living wage.
DDS UPDATE – Beth Scrutchins DDS director:
Rate Study-We are doing a service modernization study to take a deep dive into how services and supports are provided in some other states, gathering feedback from our providers to see what it should look like. We want to create the best outcome for the people we want to support. We are not looking at decreasing any services, but we are looking to see if there is a way we can modernize and transform our system. This is something we are doing in tandem with the rate study, because we know we need to evaluate our rates. We are doing everything we can to meet the needs.
American Rescue Plan-We are proposing at looking at how we can increase the use of remote support. It can increase independence and it can be a piece of the workforce puzzle. One of the things we would like to do and we are submitting to CMS is to be able to have a smart house so people can go see the different technologies available to try out , take a look and tour to really be able to see how some of this technology might work and meet someone’s needs. We are continuing to educate people about remote supports and how it can increase independence. Some have used it and it has been great, it is not for everyone, but we think it is a piece of the solution. We are looking at ways to expand self-direction for people and make sure they are aware it is an option that our staff are knowledgeable to work with families around self-direction and that is an option for individuals as well.
We are working on some onetime needs by increasing the dental limit, eyeglasses and the transportation cap, so some of these things will meet some onetime needs. We are moving to having a safe wide data system. This will allow everyone to have real time information on the family side, the advocate, the case manager and the provider side. Everyone will have access to the real time information. We are in the process of rolling this out. We are starting with intake and the wait list. We will be rolling it out within the next 1 to 2 years. This will allow us to provide information and reports and data in ways we have not been able to. It is a challenge for us right now and this will strengthen our ability to communicate about not only service provision, outcomes and trends. We are excited about moving forward with it.
Some of these things we will not be able to move forward on unless we have approval with CMS with this specific pot of money. This type of money requires quarterly reporting and requires approval from CMS. Some of these things we might not be able to move forward with if not approved by CMS. None of the plans have been approved yet.
We are also trying to explore of having some sort of both respite homes and crisis homes so that some families can access a respite home for planned respite hopefully to overt getting into any type of crisis situation maybe a small 4 to 6 bed type home where people could access services for respite. We are also looking at having same kind of help where there is a crisis situation and the person may not need inpatient treatment, but there is a crisis situation in the home and the family needs help. We are exploring different options. We feel this could fill a gap we have.
One of the pieces is to offer technology grants to our providers to be sure there are no barriers to be able to implement this. We are also looking at proposing vocational grants for our providers so they know the type of services they can provide in our communities and encourage innovation and exploring different vocational options. How can we help providers with competitive integrated employment for people they support? More options and more opportunities. Maybe with a little funding they can use some of that money to transform some of their services.
DDS waiting list update- Liberty is coming to manage intake for DDS. The first part of this is assessing every single person on our waiting list, not just with a survey getting group information as we have before, but actually giving individual information an assessment with each person and also navigating to any available resources depending on what their needs. We have not been able to resource our intake to do that. Once you were on the list, we have not been able to connect to families with everyone on the wait list like this before. We have a webpage on www.ourokdhs.org we can send that out with the notes. There is a waiting list tab on there where we are going to update information and frequently asked questions. There is a place on the website where you can submit questions directly to us, this way we can answer them individually or on that page as well.
We look to roll out with the assessment first part of September. We are going to contact everybody, we asked Liberty to gear up and frontload the assessment so they will be training more folks to do the assessment. We know assessing the entire wait list will take about 9 months, but we want to offer as many assessments in the first couple of months so we can tie these assessments to projected cost so we can give a real number to the legislature about what we think it cost to work the waiting list. Our goal is to work the entire waiting list.
Approval of Rules:
The rules below were approved by Committee.
317:40-5-5 is amended to: (1) update terminology; (2) align fire and weather drills with 340:5-22.1; (3) combine with 317:0-5-6, which aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-6 is being revoked to (1) combine with 317:40-5-5, which aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-40 is amended to: (1) remove pets and domestic animal guidance from sanitation to its own section for broader application of relevant rules. Adding components to ensure service recipient health and safety considerations are considered. Much of the same language was carried over to the new location but additions include health of the pet, appropriate supervision, and actions following an injury to the service recipient. (2) Added an exception to allow members to share a bedroom with adult members under specific conditions and only when approved by division director or designee. (3) Added an exception to allow members and non-members to share a bedroom under specific conditions and only when approved by division director or designee. (4) added language to clarify the types of bedding that is acceptable for members. Box springs are no longer specifically required when the bed is designed not to need one. (5) Added language clarifying the types of bedding not allowed for members. (6) added an exception for the division director or designee to allow use of non-traditional bedding for temporary respite. (7) Added provision for the individual to have access to a phone including periods of time when the member is home alone. (8) Reduce requirements for evaluation of a home when the member lives with an unrelated HTS. DHS will continue to complete a home profile, but certain documentation is no longer required such as the medical evaluation, financial assessment, etc. The provider contributes to evaluation of the home through collaboration with DHS staff.
317:40-5-50 is amended to (1) combine with 40-5-50, 40-5-51, 5-52, 5-54, and 5-56, which aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-51 is being revoked (1) combine with 40-5-50, 40-5-51, 5-52, 5-54, and 5-56. The revision aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-52 is being revoked (1) combine with 40-5-50, 40-5-51, 5-52, 5-54, and 5-56. The revision aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-54 is being revoked (1) combine with 40-5-50, 40-5-51, 5-52, 5-54, and 5-56. The revision aligns with the Governor’s order to reduce unnecessary sections of rules.
317:40-5-55 is amended to (1) update terminology; (2) clarify limits on the provision of respite; (3) clarify limits on transportation for vacation and other non-covered trips; (4) change initial contact for substitute supervision from Case Manager to Foster Care Specialist; (5 ) clarify requirement for use of the Personal Possession Inventory; (6) change citation for reporting of abuse requirements to include 340:2-3-33; (7) increase members minimum contribution to $300; and (8) update language for reporting suspected abuse.
317:40-5-56 is being revoked to (1) Combine with 40-5-50, 40-5-51, 5-52, 5-54, and 5-56. The revision aligns with the governor’s order to reduce unnecessary sections of rules.
317:40-9-1 is amended to (1) update terminology; (2) add Job Coaching as a Self-Directed service in the IHSW-A, IHSW-C, and the Community Waiver when the member lives in a non-residential setting (3) incorporate use of Appendix D-26 to address cost limits on employment services;
The Committee approved to not vote for policy 340:100-1-2, 340:100-3-27, 340:100-5-22.7, 340:100-17-25, 317:40-5-59 table these policies and vote at next meeting September 15, 2021.
340:100-1-2 is amended to (1) update terminology; (2) add a definition for enabling technology; (3) update the definition for prescription medication to account for prescribing by nurse practitioners and physician’s assistants; and (4) update the definition of family homes to include adoption.
340:100-5-22.7 is amended to (1) remove requirement for use of Claim Form, 10AD012E; (2) add requirement for provider to submit a written budget when requested; (3) add language to clarify criteria for when a service recipient may reimburse DDS.
340:100-17-25 is amended to: (1) update terminology (2) update the definition of group placement to match the job coaching policy and the rate change that was effective October 1, 2020.
317:40-5-59 is amended to (1) update terminology; (2) added provision clarifying policy requirements for using back up services.
340:100-3-27 was pulled from review by DDS to allow additional revisions to be made.
340:100-3-27 is amended to (1) update terminology; and (2) add rules regarding virtual monitoring by a case manager as requested with changes to the HCBS waivers effective 07/01/21.
PUBLIC COMMENT – No comment
Possible Action Item-