Category: Resources

UPDATED: Here are your rights with the PASSE system.

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We have been asked to update this post for clarity. These are your rights, but we don’t want anyone to lose services. So please see the updates below.

The PASSE system has been going for 31 days now. We have 29 more days of the “transition plan” where our plans are supposedly covered as they were before the PASSE took over. Some people were put into the PASSE system, and they want out. They’re being told that they can’t get out, but there are things people can do.

You have rights!

(1) There is a lawsuit you can join.

If you feel you’ve been wronged by the PASSE system, contact Thomas Nichols at Disability Rights (tnichols@disabilityrightsar.org). He will want to know specifically how you’ve been wronged:

  • have you ever had to pay out of pocket for a service?
  • have you lost providers and have no other choices in your area?
  • has the PASSE denied to pay for a medicine or forced a new co-pay?
  • has the PASSE denied a service you were getting?
  • have you tried and tried to contact your care coordinator with no response?
  • is your PASSE unreachable? have they returned your calls?

(2) You can opt out of the PASSE. (BUT)

If you call to opt out of the PASSE, you will lose access to the services that only the PASSE program provides.
– You will lose your Waiver slot if you are a person with the DDS Waiver or Wait list. This should be a careful decision because a lot of people have waited a long time for these services.
– If you get BH services, you will not be able to get those higher level services you might need.

Yes, there are ways you can opt out of the PASSE. BUT you need to be careful and protect yourself. Dropping out may solve a problem for you now, but it may cause you a problem later. Make sure you ask all of the right questions (see below). You might still be able to get what they call “State Plan Services,” but you won’t be able to get the “Community & Employment Supports Waiver” or the “Arkansas Community Independence Waiver.” Depending on how you qualify for Medicaid, you might not get any services at all.

DD

If you’re with the Developmental Disability side, that means you are giving up your waiver slot. You might be giving up some services you might need. Also, the way you qualify for the DD Waiver is different than other Medicaid, so you may not qualify for any services. Some people have waited a super long time for services, and we just don’t want you to do anything that hurts more in the long run.

Programs like ARKids and TEFRA are only for “kids.” For example, if you are on TEFRA right now, you could choose to drop your waiver waiting list slot and go back to TEFRA. Please remember that TEFRA only lasts until you’re 19. The service options are limited for adults, so make sure you will have coverage if you drop your waiver slot.

If your plan is to drop out and come back to the Waiver, just know that you do have to start all over again.

BH

If you’re with the Behavioral Health (mental health) side, you can go back to Tier 1 services, but there may be some services you can’t get now. So if you are a child who was with ARKids, but then because of a BH assessment were put into a PASSE, you could go back to ARKids. The way you do this is by not getting your next reassessment. You have to be assessed to be in a PASSE, so if you turn down your next Independent Assessment when Optum calls, they won’t put you in a PASSE.

Questions to ask:

  1. What services will I lose if I opt out of the PASSE?
  2. Which Medicaid program will I qualify for if I opt out of the PASSE?
  3. Can I still go to {name the provider} if I drop out of the PASSE?

If you want to drop out of the PASSE, you need to call the PASSE Ombudsman. They can send you the right direction. 1-844-843-7351

*Remember, if you are on the BH side, you might have to wait until you can refuse your next Independent Assessment.

(3) You can turn down an Independent Assessment.

Everyone in the PASSE is supposed to have gotten an Independent Assessment. If you refuse a re-assessment, you will be dropped from the PASSE program. If you are on the DD Waiver, that means you will lose your spot.

Before you get put into a PASSE, you have to get an Independent Assessment. This company named Optum calls and sets up an appointment. You can turn this down. They may tell you that you have to do it, or you could lose services. You do not have to do it. This is your choice.

Not getting an Independent Assessment for DD or BH does mean that you can’t be in the PASSE system. So look at #2, and make sure you are making the best choice for you.

(4) You can call your legislators.

Call your legislators. They voted this in, and they need to hear if something is affecting you negatively. They represent us, and we need to let them know what’s going on.

Here’s how! Visit:http://www.arkleg.state.ar.us/assembly/2019/2019R/Pages/LegislatorSearchResults.aspx?member=&committee=All&chamber=

Click their name, and it will take you to their contact info.

Arkansas Session 2019

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The AR Legislative session has been going on a few weeks. They will be making important decisions that affect us. Here are some resources to help you stay up-to-date no matter where you live.

See the bills that have been filed:

The boxes are check for 2019. Just click Submit to see the latest list.

http://www.arkleg.state.ar.us/SearchCenter/Pages/historicalbil.aspx

See today’s calendar to decide which committees you want to watch.

Public Health, Welfare, & Labor are committees for both Senate and House that discuss bills that affect Medicaid. Each meeting has an agenda, so you can see if the bill you care about is on the list for today.

http://www.arkleg.state.ar.us/assembly/2019/2019R/Pages/Home.aspx

Watch what’s going on right now:

(Business hours)

http://sg001-harmony.sliq.net/00316/Harmony/en/View/UpcomingEvents/20190208/-1

Watch previous sessions and committees:

Bills travel to different committees, to the House, and Senate before they hit the Governor’s desk. You might want to go back to see how your legislators voted or if they discussed your concerns in the meetings.

http://sg001-harmony.sliq.net/00316/Harmony/en/View/RecentEnded/20190208/-1

1 PASSE Quits: 5 Things You Need to Do

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Big news this week in case you missed it. There were 4 PASSEs, and now there are 3. ForeverCare says they can’t move forward, right before the PASSEs would all receive the payment to manage everyone’s care on March 1. What does this all mean? Now what?

The news has covered this some in the past few days. Forevercare says the program isn’t ready, but DHS says they are. Watch this video or read this news story to see what ForeverCare had to say:

screen shot 2019-01-19 at 9.33.55 am

If you don’t know what the PASSE is, check this out (MSL Resource).

Or watch this previous town hall recording from DHS.

In light of ForeverCare’s announcement, this is what you can do:

(1) If you are concerned about this whole thing, you need to contact DHS through the PASSE Ombudsman.

They’re supposed to take our complaints, concerns, and help us solve problems:

Call –  1-844-843-7351 (during business hours)

Email – PASSEOmbudsmanOffice@dhs.arkansas.gov

More info – https://humanservices.arkansas.gov/about-dhs/dms/passe-ombudsman If you’re a provider, and you’re confused or concerned about all of this and how it will work before March 1, you need to contact DHS through

Tanya Giles | tanya.giles@dhs.arkansas.gov | 501-320-6189

(2) A lot of people want to contact their legislators and let them know what’s going on. After all, the state legislators voted this through when they voted for Act 775.

Keep them up to date on how this system is affecting you.

Contact our state legislators.

Contact any elected legislator in the US.

See how your local Representatives or Senators voted on Act 775.

(3) If you thought this was confusing, get ready for more. Keep a note pad by the phone. Keep everything that is mailed to you, and keep a phone log.

If you are a ForeverCare family, they are going to be your PASSE until March. Even after you’re reassigned, your new PASSE isn’t supposed to officially take over until March 1. But your new PASSE will be contacting you to give you more information, find out more about you and everything you need. So make sure you don’t forget ForeverCare’s contacts.

FOREVERCARE
  • Gateway Healthplan
  • Their HANDBOOK (rules, your rights, and information)
  • 1-855-544-8744
(4) You’re going to get reassigned in early February, and you’re going to get 90 days to switch PASSEs if you want.

That means you’ll have until May to decide if you like your PASSE, and if you don’t, you’ll have to research which one you want to go to.

Here is the other PASSE information. You need to check out their handbooks and networks. Ask other families what they like and don’t like about their PASSEs.

Some of them are having family and provider meeting this month. Call them to find out when theirs is!

  • Arkansas Total Carehttp://www.arkansastotalcare.com | 1-866-282-6280

    CEO, John Ryan – jryan@centene.com

    Care Coordination Contact: Amber Baker | (501) 478-2597

    Amber.Baker@ArkansasTotalCare.com

    HANDBOOK

    NETWORK LIST – none shown on website

  • Empower Healthcare Solutionshttp://www.getempowerhealth.com | 1-866-261-1286

    CEO, Nicole May – nicole.may@beaconhealthoptions.com

    Care Coordination Contact: Jamie Ables | Office (501) 707-0961

    Jamie.Ables@beaconhealthoptions.com

    HANDBOOK

    NETWORK LIST

  • Summit Community Carehttp://www.summitcommunitycare.com | 1-844-405-4295

    CEO, Jason Miller – jason.miller@summitcommunitycare.com

    Care Coordination Contact: Tiffany Parkhurst | (501) 773-6273

    Tiffany.parkhurst@summitcommunitycare.com

    HANDBOOK

    NETWORK LIST

(5) After ForeverCare’s announcement, everyone became more concerned and had serious questions. Make sure you ask your questions! Ask DHS, ask your legislators, and ask in our group.

This is what DHS had to say to our questions as of Jan 18:

page 1page2page3

ARWorks: Healthcare Options If You’ve Lost Your Coverage

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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

Screen Shot 2018-09-15 at 1.26.18 PMScreen Shot 2018-09-15 at 1.26.32 PM

ARChoices: Update From Legal Aid

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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

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read the artic

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

Compare Medicaid in each State

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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

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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?

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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!