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Tag: comment
How to Make a Public Comment Before Sept. 12, 2018
DHS notified the public of some proposed rule changes on several issues. You have the opportunity to take action and make a public comment until September 12, 2018 on those documents. How would one choose to make a public comment about the many issues that are changing? Watch the video for more details!
This is how you can place your own public comment for the record:
1. First, follow this link (copy and paste it into your internet address window): https://medicaid.mmis.arkansas.gov/General/Comment/Comment.aspx
2. You will see some documents on a long page that are available for public comment by September 12, 2018. The documents you want look just like the ones in the graphic below. The ones in the long section on bottom are old, and the date has passed.
3. You will want to view the documents. Click on the blue link with that name (on the Medicaid website), and it will download the file for you.
4. Open the file from your document downloads, if it doesn’t open automatically for you.
5. At first glance, it may be difficult to understand, but try to read through it as best as you can. You might understand more than you think.
6. After you read through it, you might want to send in some comments about how this will affect you. For example in the PASSE manual, you might want to comment on what the PASSE is required to cover.
7. You can choose to mail your comments, but the faster way is by email. You can send your comments in an email to becky.murphy@dhs.arkansas.gov, but be sure to reference which manual you’re commenting on in the subject line.
8. Make sure to do this before September 12, 2018!
9. You can also choose to go to a public comment and say your comments there:
AR Choices: How to Make a Public Comment
You have the opportunity to take action and make a public comment until July 31. How would one choose to make a public comment about the Arkansas Choices issue? What would one say?
This is how you can place your own public comment for the record:
- First, follow this link (copy and paste it into your internet address window): https://medicaid.mmis.arkansas.gov/General/Comment/Comment.aspx
- You will see some documents on a long page that are available for public comment by July 31, 2018. The 3 documents you want look just like the ones in the graphic below. The ones in the long section on bottom are old, and the date has passed.
- You will want to view the document named “ARCHOICES-1-18route.doc”. Click on the blue link with that name (on the Medicaid website), and it will download the file for you.
- Open the file from your document downloads, if it doesn’t open automatically for you.
- At first glance, it may be difficult to understand, but try to read through it as best as you can. You might understand more than you think. (See below for more assistance.)
- After you read through it, you might want to send in some comments about how this will affect you. For example, you might want to comment on the use of the algorithm itself, or you might want to comment on how they would score you and how that method may cut your hours.
- You can choose to mail your comments, but the faster way is by email. You can send your comments in an email to becky.murphy@dhs.arkansas.gov, but be sure to reference which manual you’re commenting on in the subject line like “Public Comment Submission, ARCHOICES-1-18route.doc.”
- Make sure to do this before July 31, 2018!
If you were to make a comment, what would you say? Well, Disability Rights Arkansas has released their official comments that they have submitted. This is a great example that can help you with what you might want to say. Read through this very thorough comment that was written by a qualified and informed attorney, and it might help you make sense of ARCHOICES-1-18route.doc. You might also want to read the previous post about the update and comments from Legal Aid of Arkansas.
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AR Choices: Update & Public Comment
Here is a detailed update from Kevin de Liban from Legal Aid about AR Choices.
Also, please note that Public Comment ends on this issue on July 31, 2018. There is one more public hearing on July 26th in Little Rock. Kevin’s update can help you with ideas of what to say as you examine the manuals available for public comment. Don’t miss this chance to speak up for what you need!
As you know, a court invalidated the RUGs algorithm a little over two months ago. DHS is now trying to re-implement the RUGs algorithm to take effect on October 1. Rule-making is the name for the process by which DHS is trying to make this change. DHS has proposed that the algorithm work the same way it did before being invalidated.
Until October 1, it appears that DHS intends to keep everyone on the program at the same level of attendant care they have now and that DHS will not allow any new applicant to the program to receive attendant care services. Legal Aid of Arkansas is actively working to change this through a new lawsuit filed on June 29.
Here is some other relevant information:
(A) The public comment period for rule-making on the algorithm runs until 7/31. Here are the manuals available for public comment. The public has a right to participate in the rule-making process. If they choose to do so, people may offer comments by email to becky.murphy@dhs.arkansas.gov or by mail to the DHS Division of Medical Services, Office of Policy Coordination and Promulgation, P.O. Box 1437, Slot S295, Little Rock, Arkansas 72203-1437. Please include the title of the document you are commenting on when you email. Here is the notice of rule-making that DHS has published for more information.
(B) DHS is hosting public meetings about the rule-making. The remaining meetings is on 7/26 in Little Rock (Ark. Enterprises for the Developmentally Disabled ;105 East Roosevelt Rd.). People can offer verbal comments at the meeting. The meetings start at 5 p.m.
(C) Legal Aid has had nearly 200 cases relating to the RUGs algorithm in the last two and a half years. Here is some of what we’ve learned about how the algorithm works.
(1) The algorithm doesn’t provide enough care to meet the needs of people on ARChoices.
The most care someone can get under RUGs is 5.5 hours per day unless they need IV medication, suctioning, tracheostomy care, a ventilator, or a feeding tube (then, they can get 6.5 hours per day). This is not nearly enough to meet the care needs of many people on the program. Because of the cuts to care, many people ended up lying in their own waste, skipping meals, getting bed sores, and staying shut in. Even when people have family members make up for the cuts, they have had to go through more anxiety, have family work outside the home in ways that threaten their care, or consider moving to a nursing home.
(2) The RUGs algorithm cuts the hours of people who have not gotten any better.
People who used 8 hours per day (the max for people under 65) or 7 hours per day (the max for people 65 or over) before the algorithm were cut even though their medical conditions and abilities did not improve.
(3) The RUGs algorithm has not been validated or verified in Arkansas.
The only testing that has occurred on RUGs took place in Ontario, Canada and Michigan, which have different situations than Arkansas. Also, though DHS says that it used statistics to come up with the hours that different people get, DHS admits they lost the data. This means that there is no way of knowing how or why DHS figured that 5.5 hours per day was enough for someone with quadriplegia or cerebral palsy (or any of the other amounts DHS gives for people with different conditions and abilities).
(4) There is no documented evidence of problems with the system of nurse discretion that DHS used for 17 years before the algorithm.
Before 2016, DHS used nurses to decide the number of attendant care hours. Legal Aid never received a single complaint from clients about the nurses’ decisions. Since DHS started using the algorithm in 2016, we have worked on nearly 200 cases. Now, DHS says that nurses were biased and that the algorithm is more objective or fair. But, before 2016, DHS did not tell a single nurse that they were giving out too many or too few hours, did not do any kind of study to show whether nurses were giving out too many or too few hours, and did not tell nurses to change the way they were giving out hours.
(5) Our clients generally do not think the complicated RUGs algorithm is fair.
The algorithm is 21 pages of computer code. Most average people can’t understand it. Also, the way the algorithm works totally excludes a doctor’s opinion about the amount of care someone needs. People on the program cannot understand the criteria by which their hours are set, cannot fight reductions, and cannot plan for the future.
If you need help or more information, here is Kevin’s information:
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
One Therapy Rule – Part 1
MSL has done some research on a change coming our way. You may have heard of it – the “One Therapy Rule,” formally known as the EIDT Program. Watch this video and stay tuned for your opportunity to take action.
Input Needed: INDEPENDENT ASSESSMENTS
Next week, our Founder Lainey Morrow will be meeting with DDS Director Melissa Stone, BHS Director Paula Stone, and Optum (the company doing the Independent Assessments).
They are going to answer our questions about Independent Assessments and explain the whole process. What questions would you like for Lainey to ask them?
Also, they plan to provide training on the IA process, so you can know what to expect. They’ve asked for feedback on which method each one of you would prefer. This doesn’t mean they promise to provide it in that way, but they want your input.
Use the form below to send your questions and input. If you don’t see an option that fits you, add your own.
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.
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.
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 |
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.
| 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:
Medicaid Saves Lives 