DHS recently released a new presentation with updates to their work on the PASSEs Phase II. This includes milestones and network adequacy standards, and where they are with Independent Assessments.
They did listen to our concern that people have been enrolled before the networks were adequately formed, and they will hold open enrollment in October of 2018.
Catch up on all previous PASSE posts!
We appeared live on Facebook with Managing Attorney Thomas Nichols from Disability Rights Arkansas to answer your questions and discuss your rights when appealing a Medicaid decision. Watch because this video is full of helpful information from beginning to end!
Thomas refers to a presentation with more information on appeals that you might want to view.
When filing an appeal, you have resources in the state to help you. Even if you can’t afford it, you can find quality lawyers or law advice. Make sure to contact:
Also, we reference Rights that we listed in a previous post. Make sure to read it.
DHS recently hosted a FB live about the PASSE to answer our questions, but some of your questions were not answered at that time. The images below show DHS’s follow-up answers to some of the questions.
For those of you who would like to go back and watch the Facebook live video from January 19, click here.
Every single person who is a Tier 2 or Tier 3 and receives Medicaid services for a Developmental disability or a Behavioral health issue will undergo an Independent Assessment. This means you need to understand what it is and what will happen. MSL has gathered some resources to help you be prepared:
First of all, you’re probably asking, which Tier am I in? Click the link to find out!
If you are Tier 2 or 3, you will receive a notification letter about your assessment. It may come from a company you don’t recognize, but make sure to look for a letter and read carefully for the words Independent Assessment. Once you receive a letter, you will soon receive a phone call to schedule a meeting.
You are allowed to take people with you in these assessments, such as a parent or provider. The assessment itself can take from one hour to three hours. It is critical carefully consider and answer the questions because they determine your Tier placement.
Once your assessment is finished, you will have to wait to receive results. Once they are compiled, both you and your primary provider will receive a copy.
DHS has released the following resources to assist you or a loved one in preparation for these Independent Assessments. MSL has gathered it all in one place for you:
The two power point presentations may be of help what is taking place within the DD service system. Additional information may also be found at the following website https://www.medicaid.state.ar.us/general/programs/passe.aspx.
The Full Independent Assessment people will get:
Presentation for Individuals, Families, and Staff:
Presentation for Providers:
Training that was sent to all PCPs:
Previous related MSL posts:
Independent Assessment Manuals
Certain people who receive Medicaid through Developmental Disability Services and/or Behavioral Health Services will be contacted about an Independent Assessment – only Tiers 2 and 3. Read the following situations to decide where you might fit:
Tier 1:
Individual receives DD services under the Medicaid State Plan (DDTCS, CHMS, therapy, etc.), but does not meet ICF/IID level of care eligibility
Tier 2:
Individual meets ICF/IID level of care eligibility, but does not currently require 24 hours/day of paid support and services to maintain his or her current placement
Tier 3:
Individual meets ICF/IID level of care eligibility and does require 24 hours/day of paid support and services to maintain his or her current placement
Tier 1: Counseling
Time-limited services provided by a qualified licensed practitioner in an outpatient setting to assess and treat mental health and/or substance abuse conditions
Tier 2: Rehabilitative
Home and community-based services with care coordination including a full array of professional and para- professional services for individuals with higher needs. Services provided by certified behavioral health agency staff members.
Tier 3: Residential
Services provided in residential setting for individuals with the highest need
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 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 |
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 