PASSE – Phase II Updates

CBDBCDE3-D211-4188-B125-634849764A84

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!

Your Rights When You Appeal

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.

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!

 

PASSE Q&A Follow-up

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.





Live Q&A with DHS about PASSEs

MSL took your questions to DHS, and they answered live on Facebook. This video has several good demonstrations and answers that you might need to see. The PASSEs will start taking clients in February 2018.

Watch the video:

Independent Assessment: How to Be Prepared

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:


IMPORTANT INFORMATION

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.


THINGS THAT CAN HELP

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:

  • Read the full assessment itself in PDF form
  • View a presentation to explain the DDS changes
  • View a presentation on IAs for providers
  • Read the training that has been sent to PCPs

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.

Click on each image to access the resource.

The Full Independent Assessment people will get:Screen Shot 2017-11-14 at 11.34.00 AM


Presentation for Individuals, Families, and Staff:

Screen Shot 2017-11-14 at 11.45.56 AM


Presentation for Providers:

Screen Shot 2017-11-14 at 11.56.46 AM


Training that was sent to all PCPs:

Screen Shot 2017-11-14 at 12.00.05 PM


Previous related MSL posts:

Independent Assessment Manuals

 

 

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.

Screen Shot 2017-08-12 at 11.17.25 AM

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.

img_0478-1

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