ARWorks: Healthcare Options If You’ve Lost Your Coverage

The 2 graphics below are of a letter that is going out to ARWorks beneficiaries who had their coverage closed last week. It contains options for them going forward.

Also, DHS posted many of their notices and letters that have gone out here: https://ardhs.sharepointsite.net/ARWorks/Notice_Samples/Forms/AllItems.aspx

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ARChoices: Update From Legal Aid

This is an update from Kevin De Liban from Legal Aid of Arkansas. He wants to help us understand the latest on ARChoices.


Just a quick update on yesterday’s meeting in the legislature. The Public Health committee gave the RUGs algorithm an unfavorable review, meaning that the committee thinks that DHS should not adopt the RUGs algorithm. At least 4 people on the ARChoices program were present and testified before the legislators, as well as parent caregivers, advocates, case managers, and care agencies. These voices–especially the people on the ARChoices program–let the legislators know the details about how the RUGs algorithm has hurt many beneficiaries. Here is a newspaper article about the meeting.

That is not the end of the process. The RUGs algorithm now goes to the Rules and Regulations Subcommittee on Tuesday, September 18, at 1 p.m. in Room A of the MAC Building. The agenda includes a list of the legislators on the committee as well as other details.

Public comment will be accepted at this meeting. If the Rules subcommittee votes against the RUGs algorithm, it should be the end of it. But, there are some technicalities involved, and I have no way of knowing what the likely outcome is. Whatever happens, it’s inspiring to see how all sorts of people in different situations have been working in their own ways for justice on this issue.


How to contact Kevin with concerns or questions:

Kevin De Liban, Attorney
Economic Justice Practice Group Leader
Legal Aid of Arkansas–West Memphis

310 Mid-Continent Plaza, Suite 420
West Memphis, AR 72301
Phone: (870) 732-6370 x. 2206
Fax: (870) 732-6373

How to Best Communicate with Legislators

read the artic

If you can’t see the graphic above, you can read the article.

Compare Medicaid in each State

Each and every state may have Medicaid, but it is not all run the same. According to ASHA, “State regulations and standards differ greatly in other areas of Medicaid, including:

  • provider requirements for Medicaid participation, credentialing, and supervision;
  • documentation requirements for plan of care approval, criteria for services, authorization, and reimbursement justification;
  • Medicaid audit process and penalties for errors;
  • use of the Children’s Health Insurance Program (CHIP).”

Make sure you’re aware of these differences. For example, TEFRA is an optional waiver that not all states carry, and if they do, they don’t utilize it the same. For example in Arkansas, if a child meets the health requirements, it is accessible for families, no matter their income, on a sliding pay scale. However, the way we understand its application may be specific to Arkansas. If you move, you may not have TEFRA at all.

So how can you know what’s available to you? Use the resources below to find out more about Medicaid and how it’s different across the US!

What if your state has limited resources? There may be more out there than you know. Look around at state and local resources. There are national programs, state benefits, foundations, organizations, and grants that may help you in a bind. For example, check out this list of foundations that assist for children’s special needs.

If Medicaid matters to you, please constantly tell your elected officials. The trend is to cut Medicaid and provide those funds elsewhere. Get the facts to boost your confidence, but don’t stop communicating! Tell your legislators why Medicaid saves you! Here are some ways we could see Medicaid change in coming years.

Each link leads to a different resource we’ve found to try to help you with info or tangible resources. MSL will add to this list as we find more!

2018 Election Info

It’s election season! In fact, early voting for primaries has begun. That means it’s time for you to do some homework and make decisions about which issues are most important to you. Sometimes your values on different issues may clash, which is why it’s important to rank one of them as most important to you.

Medicaid is a hot topic. We’ve seen a lot of change, and depending on the officials we elect, we may see even more. That’s why it’s important to be informed about election deadlines, requirements, and the candidates.


Your first question might be:

Who’s running?

Click here to find out.


Next you’re probably asking:

What are the deadlines?

Elections for the office of Arkansas House of Representatives will take place soon!

  • candidate filing deadline – March 1, 2018.
  • primary election – May 22, 2018.
  • primary runoff election – June 19, 2018.
  • general election – November 6, 2018.

All 100 House seats are up for election in 2018. Arkansas state representatives serve two-year terms, with all seats up for election every two years.

Elections for the office of Arkansas State Senate are also happening soon.

  • candidate filing deadline – March 1, 2018,
  • primary election – May 22, 2018.
  • primary runoff election – June 19, 2018.
  • general election – November 6, 2018.

A total of 18 seats out of the chamber’s 35 seats are up for election in 2018.Arkansas state senators serve one two-year term and two four-year terms each decade.

Arkansas will also hold elections for Governor, Lieutenant Governor, Attorney General, Secretary of State, Auditor, and Treasurer on November 6, 2018. The candidate filing deadline was March 1, 2018.

The 2018 U.S. House of Representatives will hold elections

  • candidate filing deadline – March 1, 2018,
  • primary election – May 22, 2018.
  • general election – November 6, 2018.

Arkansans elect representatives to the U.S. House, one from each of the state’s four congressional districts.


How can I be informed about the candidates?

As candidates are campaigning, make sure you take every opportunity to inform yourself. Know what questions to ask!


Have I met the requirements to vote?

Voter Registration

To register to vote in Arkansas you should provide one of the following:

  • The Last Four Digits of your Social Security Number
  • Your Arkansas Driver’s License Number

If you do not have any of these IDs, you can provide a copy of one of the following with your registration application:

  • Current and Valid Photo ID
  • Government Issued Document that shows your current name and address
  • Utility Bill
  • Government Check
  • Bank Statement
  • Paycheck that Shows your current name and address

You can alternatively provide one of these documents when you vote to complete your registration.

Voting In-Person

In Arkansas, you need to show a valid ID to vote. You can use any ID from this list:

  • Paycheck that shows your Current Name and Address
  • Current and Valid Photo ID
  • Utility Bill
  • Bank Statement
  • Government Check
  • Government Issued Document that shows your Current Name and Address
  • Veteran Health ID Issued by US Department of Veterans Affairs

Where should I vote?

Find out.


Source 1

Source 2

Source 3

What if you don’t agree with your Assessment results?

Even though many people may not need to appeal, several of you have asked before about how to appeal your Independent Assessment if you aren’t satisfied with your tier placement. We asked DHS for the appeal policy.

Watch for more resources on how to appeal, tips, and what your rights are!

DHS says that below is the information that you will receive with your Independent Assessment results packet.  Each person will receive this notice after his/her IA has been scored.  These results packets began going out Friday.  Some individuals began receiving PASSE services prior to the receipt of their results packets. 

 If you do not agree with your assessment results:

You, your representative, and your provider have the right to request a hearing.

Requirements for the request:
  1. the request must be received at the DHS Office of Appeals and Hearings’ address below no later than (date calculated from notice mailing date [35 days + mailing date])
  2. Please put your request for a hearing and for any services in writing. With your request, please include a

copy of this letter and mail it to:
Arkansas Department of Human Services
Office of Appeals & Hearings
P.O. Box 1437, Slot N401
Little Rock, AR 72203
Division of Medical Services

If you ask for a hearing, these are your rights, per DHS:

  • You may go to the hearing
  • You may be represented by a lawyer or any other person you choose
  • Before the hearing, you have the right to see your record and any other evidence to be used at the hearing
  • You have the right to present your own evidence
  • You have the right to bring your own witnesses
  • You have the right to question any witness against you
  • You have the right to request, if applicable, certain current services continue “as is” pending an appeal decision if your request is received at the Office of Appeals and Hearings’ address listed above by (date calculated from notice mailing date [15 days + mailing date])

You may be able to get free legal aid.

If you need legal help, DHS sends these recommendations:

 DHS also recommended the following link might be helpful to review:  http://humanservices.arkansas.gov/images/uploads/occ/DHSPolicy1098.pdf to understand the process.

Watch for more resources on how to appeal, tips, and what your rights are!

MSL has attended presentations by other community resources such as Disabily Rights Arkansas who have explained in more detail what to put in your letter and tips you might need. One very important thing to do is MAKE SURE TO KEEP EVERYTHING MAILED TO YOU AS WELL AS ALL ASSESSMENTS OR THINGS THAT COULD BE USED AT THE HEARING. We will be collaborating with these other organizations to release more resources as soon as we can!

 

Public Comment: New 0-5yo Screener

A new developmental screener will now be REQUIRED to determine if a child is eligible to go to rehabilitation centers like Easter Seals, Access, the Allen School, Peds Plus, etc.

Public comment ends tonight on this rule change – August 12, 2017! Take this chance to comment on rules that affect you! Read the manuals for things that might affect you, and then send your comments and questions to Shelby.Maldonado@dhs.arkansas.gov. Make sure to tell her which documents below you’re commenting on. If you need any help, just watch a video tutorial below.

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Here are the important Screener Rule changes that you might want to read:

DDS Standards for Certification, Investigation and Monitoring – Redline DDS-Stnds-Redline.doc DDS STANDARDS for Certification, Investigation, an Monitoring for Center-Based Community Services  1. Summary DDTCS-CHMS 2. Info
CHMS-2-17 Provider Manual Update CHMS-2-17up.doc CHMS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info
DDTCS-2-17 Provider Manual Update DDTCS-2-17up.doc DDTCS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info

 


 

EXAMPLE OF COMMENTS SENT:
My public comment on the new screen:
DDS-Stnds-Redline.doc – Section 502.R, 504.A
CHMS-2-17up.doc – Section 203.100 C2, 217, 218.300, 241.000 B6, 242.000 A,
DDTCS-2-17up.doc – 202.000 B

I am concerned about the lack of details, such as what type of screen this will be. How can a short screen determine whether my child’s functionality would benefit from day habilitation? Also, I ask for the credentials of the people performing the screen to be qualified clinicians.

I’m concerned that parents and physicians need training to ensure that disruption in services does not occur.

My public comment on the Opt in/Opt Out:
CHMS-2-17up.doc – Section 206,
DDTCS-2-17up.doc – 203.000, 204.000, 214.131A, 214.132, 215.100D,

I am concerned that in Opting out, a parent must relinquish the child’s IDEA rights for as long as the child attends that center and/or as long as that center chooses to be opted out. Ok top of that, I’m concerned that services could be disrupted, especially if a parent chooses not to relinquish those rights and must find another place of service. Also, this may remove the freedom of choice for the parent if there is not another place of service nearby. Last, I’m concerned that disruption of services might occur as a child is transitioned into the school system.

I’m concerned that parents, therapists, educators, and advocates need training to ensure that disruption in services does not occur.


Use this form below, and it will go to the correct DHS representative.

Public Comment: BH Rule Changes

Public comment ends tonight – August 12, 2017! Take this chance to comment on rules that affect you! Read the manuals for things that might affect you, and then send your comments and questions to Shelby.Maldonado@dhs.arkansas.gov. Make sure to tell her which documents below you’re commenting on. If you need any help, just watch a video tutorial by clicking the red button below.

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Here are the important BH Rule changes that you might want to read:

INPPSYCH-1-17 Provider Manual Update INPPSYCH-1-17up.doc Manual Update for Inpatient Psychiatric Services for Under Age 21

 

OBHS-1-17 Provider Manual Update OBHS-1-17up.doc Manual Update for Outpatient Behavioral Health Services

 

Residential Community Integration Program Certification ResCommReintCert.doc Residential Community Integration Program Certification

See all the BH manuals that show rule changes.

Independent Assessment Resource

As you may know, Independent Assessments will be required for any Medicaid recipient in Tier 2 or 3 for Behavioral Health or Developmental Disability Services of DHS, as well as other Medicaid populations in Arkansas.

Public comment for these rules ends tonight, August 12, 2017! Read the manuals for things that might affect you, and then send your comments and questions to Shelby.Maldonado@dhs.arkansas.gov. Make sure to tell her which documents below you’re commenting on. If you need any help, just watch a video tutorial by clicking the red button below.

img_0478-1

AR Independent Assessment Manual AR_IA_July_17.doc New manual for Independent Assessment 1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact

See all of the manuals for Independent Assessments.


 Optum (the company that DHS has contracted to do these assessments) has released the following resource to help you understand the Independent Assessment process.

Click on the image below to learn more:

Screen Shot 2017-08-11 at 10.34.16 AM

 

Public Comment Help – PASSE Model Phase I

DHS has released a manual/rule change for public comment until August 11, 2017. After that, you will not be able to get your comments on the record. In addition, they are hosting a public hearing on August 8.


You should read the manual for yourself to make sure you cover everything that concerns you. However, even if you read it, you might still wonder what to say. The comments below are an example of what one person plans to send in.

Use the form below. By choosing “Submit,” you will send an email directly to the appropriate DHS representative. Enter your information, and type your comments into the text box. You may copy/paste the comments listed at bottom into the comment section of the form, but don’t do so unless you have read it first and agree with it all. The following comments are just examples of one person’s opinions. Public comments are most effective when you make them more personal to you!


EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE | EXAMPLE

This is my public comment regarding PASSE-New-17up.doc:

Section 211.000 – It says that the PASSEs should begin October 1, 2017. I believe that this model is not ready to begin taking on clients for several reasons. Rules like this one still have to be sent through the legislature for their approval. The Insurance Department isn’t supposed to approve the PASSEs until mid-September, which will only leave them a couple of weeks before they start managing people’s care. We don’t know what the rules will be, and we don’t know who the PASSEs will be. If the PASSEs aren’t ready and don’t do a good job, they could make mistakes. This will hurt people. I want DHS to push the date back and allow us to keep things the way they are until the PASSEs have had adequate time to review all of the finalized rules and to hire and train people who understand the rules.

Section 214.000 – It says that people can choose another PASSE during the first 90 days and once every year. How will we know what the differences between each PASSE is? I want to pick the best PASSE, but I don’t understand all of the rules or what they all offer. (At this point, I have reason to wonder if the PASSEs themselves understand the rules, as they have not been finalized.) It also says “on the beneficiary’s annual anniversary of attribution to a PASSE.” Is this a single day to respond, or is it a week? You need to define how long that amount of time would be.

Section 214.000 D – It says a client can move because of “poor quality of care,” but how do we prove that? That is a relative term. Who determines what kind of care is poor? I believe that the patient should determine whether care is poor and what that means in their situation.

Section 215.000 – What if the abeyance is due to DHS/Medicaid’s fault in paperwork (and the client can prove that)? Will the coordinator help the recipient to know that their Medicaid eligibility is in dispute and help them to figure that out?

Section 222.000 G – “The right to be provided written notice of a change in the beneficiaries care coordination” should be at least 14 days, not 7 days. If you are relying on snail mail, half of the time can be used simply in sending the notification, leaving the receiver very little time to respond or make other arrangements. Why isn’t this policy the same as 223.000 B, allowing 30 days from the time it goes into effect?

Section 231.000 – The travel times and distances listed need to be cut in half, especially for DD and BH providers who are seen on a more frequent basis. For example, it is not in the best interest of a child or adult to have to travel an hour to and then an hour to return from a location to see a therapist multiple times per week.

Section 241 G, 242 A, & 243.000 – DHS needs to give the PASSEs enough money to have a qualified individual available to help me whenever I need them, as many times as I may need them. Many providers seem to be concerned that the amount announced at the AR Waiver Conference (in July 2017) of $177 is not enough. I want them to get what they need so they can give me what I need. After December 31, 2018, they should have a different funding source and should not use any money from recipients’ care for administrative funding needs.

Section 242.000 – It says in the document that care coordinators will be employees of the PASSE (241 B). However, it does not say where the care coordinators should be located. Because Arkansas is so rural, care coordinators located in the communities they serve would be most knowledgeable for their clients.

Section 254.000 – Will DHS be required to submit the data received from PASSEs, such as data that shows savings or lack thereof, for public viewing? We want to see that data as well.

Section 261.000 – This says that grievances must be resolved within 30 days of the filing date. What will happen in the meantime? If a person needs treatment, do they have to wait all that time to receive it?

Section 264.000 – This description needs more definition. Who may serve on a Consumer Advisory Council? I believe that beneficiaries or direct consumers should serve, but caregivers who speak in place of beneficiaries who can’t speak for themselves should also be able to serve.