The PASSE System – How to Take Action

Updated: 4/10/18 12:10pm

The PASSE system was voted in by our legislature last year, and now the time has come for us to see the changes.

If you need a reminder, the PASSE stands for Provider-led Shared Savings Entity, and they will be managing the care for tiers 2 & 3 of behavioral health and developmental disability services.

DHS has begun to assign people to the 4 licensed PASSEs after each person’s Independent Assessment is complete.

MSL is actively working to get you more information on the PASSEs themselves. The information we have so far is listed below. If you have a question, you can call the DHS PASSE expert in your area. See the list.

These changes may be happening to you or a loved one, but you can do these 7 things to help yourself in this new process:

1. Make sure your provider knows about the PASSE and everything it involves.

Update: DHS said this week that they are in the process of setting reimbursement rates for providers – the actuary process. Because of that, some providers will not know what you mean when you mention the PASSE to them. Their business office may know and may be waiting on these rates before making any decisions. However, you can still take this information to your provider and/or to the business office.

The top 2 packets are ones that DHS has distributed to providers. Don’t assume yours has received it. Every provider you use needs to be sure they understand this. The 3rd is a collection of contact information of all PASSEs specifically for providers to help them join. Take care of yourself, and take these to every provider you see.

  • A Family letter to take to your providers that explains this for you
  • Resource that was sent to PCPs
  • Resource that explains PASSEs in depth
  • Resource that explains how to join
  • Give them the contact information below

Some have been concerned whether ACH is covered. This is the response:

“State supported hospitals UAMS and ACH will be enrolled with every PASSE. Many doctors are enrolled through their networks but may not know that yet. You can call every PASSE and interview them so you are making an informed choice.”

2. Get to know the PASSEs.

*MSL has requested websites for all – check back for updates.

Arkansas Total Care
Empower
Summit (Arkansas Provider Coalition)
ForevercARe

3. Join a PASSE Advisory Committee.

Every PASSE must have a committee of individuals and caregivers affected by the PASSE to give them feedback on what’s truly happening, especially if that doesn’t match what’s supposed to be happening. Use the contact info above to send your request to join a council.

4. Remember, you have choices.

Once you have been assigned a PASSE, you have 90 days to change to another. Call your PASSE, and make sure they include your providers. If they don’t, use the info above to find a PASSE that better suits you. We will continue to provide more info as we can!

5. If you feel lost, take some time to catch up.

What is a PASSE? Will you be affected? MSL has been following the PASSE from the very beginning. Take some time to catch up and read all about them.

6. Keep MSL informed.

If you learn anything, especially from a specific PASSE, share it with us! If you have any problems, MSL works to solve those for you. Please let us know by:

7. Think about how you’re feeling now, remember that at the next vote.

Our legislature voted this into effect. We called, we emailed, and we visited – all to let them know what we need. If you feel that this good for you, remember that, and perhaps send a note to let them know. You might want to vote for your representatives again. If you feel they didn’t listen to you or didn’t represent you well by voting for this, you should send them a letter to let them know. However, you also have the power to change who is in office. Make sure you place an informed vote. See how your local Representatives or Senators voted on Act 775.

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.





Tax Reform Bill: How to Contact AR Senators


Watch the video above to get all of the contact information to get contact information and tips.

Other helpful links:

https://www.npr.org/templates/event/embeddedVideo.php?storyId=567758536&mediaId=567762951

Are you thankful for Medicaid?

Author: Lainey Morrow, Medicaid Saves Lives’ Founder

It’s customary this time of year to count our blessings, and there’s one in particular that millions of Americans shouldn’t forget: Medicaid. 

If you’re a recipient (or know a recipient), think for a second what your life would be like without Medicaid.

My little girl qualifies for TEFRA because of her diagnosis, and she’s thriving because Medicaid gives her treatments like therapy and medicines that we simply can’t afford. Medicaid not only helps her day-to-day, but it’s also giving her a future where she may someday be able to live on her own and provide for herself. Because of Medicaid, she can climb stairs, say that she wants a drink, draw a line, feed herself with a spoon, and sit quietly with other students around a table. When I think of life without Medicaid, I see many who would be crushed under personal debt and suffering without hope.

If you’re thankful for Medicaid, please tell those who make our state and national policies, especially if you need to continue receiving it.

This is the perfect time of year to let our lawmakers know that we’re thankful for Medicaid. Why? Because it’s improving and even saving lives! I ask you to take a moment, and write your elected officials a note. Even better, include a photo. Tell them why Medicaid is important to you. If writing several is overwhelming, just start with one. 

You can also post on social media about why Medicaid is important to you using the hashtag #thankful4Medicaid to help others see why Medicaid is so important.

We need to tell everyone the great things that Medicaid does and who it helps. People need to hear this positive message. By sending notes, calling, and posting on social media, we are clearly communicating that we still need Medicaid, and we’re directly asking the people in charge to continue funding Medicaid for us.

Let’s flood our government with letters and calls this holiday season!

Arkansas Only

Contact any elected official in the US!

What Tier Would I Be Placed In?

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:

Developmental Disability Service Tiers

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


Behavioral Health Services Tiers

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

Understanding the House Tax Bill

Taxes affect our daily lives, and the House is working on a bill to “reform the tax code.” If taxes are drastically altered, it won’t just affect our personal taxes; Medicaid funding could be affected as well. For example, Senator Cotton called for the repeal of the Obamacare individual mandate through tax reform. That’s why it’s so important to stay on top of what’s happening.

A House committee released the bill, the “Tax Cuts and Jobs Act,” this afternoon, and it’s a very long read. 

This is just a first version. They will revise the bill and try to pass it through the House by Thanksgiving to send to the Senate in order for it to take affect by January 1, 2018. 

Take the time to try to understand it and respond if necessary. Here are a few articles to help you understand what’s going on:

Make sure you understand this for yourself, and contact your U.S. Senators with your questions, concerns, and comments!

    Waiver Waiting List – Important News for “the 500”


    In February 2017, DHS notified 500 people that they would be receiving the funding to come off of the waiver waiting list this year. They sent paperwork for each recipient to fill out. In July, they sent another letter.

    As of today, barely 250 people have responded, and the rest are in danger of losing their chance to come off the waiting list.

    Our state DHS had to request the additional 500 slots from a federal agency, and that agency, Centers for Medicare and Medicaid, finally granted it on August 22, 2017. In the meantime, DHS sent another letter this summer in order to reach the rest of the people who have not yet responded. They also began working on plans of care for those who have responded. Once a person responds, it will take 60-90 days to set up the Independent Assessment, the staff required for the plan of care, supplies, and possible residencies. 

    If you have already been communicating about your plan of care, you will most likely see some progress in September to October. It is important to note that the federal approval was holding up progress. If you had chosen the company who you’d like to work with, please know that they were only notified as soon as the federal approval came through. You should be hearing from them soon.

     Those of you in the 500 who were notified in February should receive DHS’ final letter in the coming days. If you have not yet responded to DHS about your spot in the top 500, they will also attempt to reach you by phone. If they can’t reach you by phone, they will remove you from the list of 500 and move on to the next people waiting. 

    If you have questions about this, you can’t simply call any office. You must call these specific people:

    – For the status of applications:
    Merinesa Morris
    (501) 683-0571

    – For all other questions:
    Regina Davenport
    (501) 683-0575

    If you are a person on the waiting list, a caregiver, or a provider of someone on the list, please share this to ensure that this information gets to the correct people.

    Here is a copy of the letter that will be going out:


    Medicaid Saves Lila

    IMG_6439

    This is my sweet girl, Lila. She’s active and intelligent. She loves to swing, eat blackberries, and paint. Don’t you dare turn your back on her because she’s mischievous too! She loves her friends, family, and kitty-cats. She is absolutely the most wonderful thing I’ve ever done with my life, and she just so happens to have Down Syndrome.

    IMG_0135

    She might smile a lot, but her life hasn’t been easy. Born almost a month early due to multiple complications, Lila spent some time in the NICU. She’s overcome multiple illnesses and surgeries, including open heart surgery soon after her first birthday and many others since. In fact, we have received 2 new diagnoses this year alone, and she’ll have at least one surgery.

    IMG_0134

    My husband and I are proud Arkansans. We’re educated, hard-working, tax-paying citizens. At the time of Lila’s birth, we lived in another state. Despite the fact that we both had good jobs and primary insurance coverage, we struggled to provide for her needs. When we moved back to Arkansas, Lila was significantly delayed in many areas.

    IMG_6519 Our friends told us about TEFRA, a type of Medicaid funding that provides for disabled children and that requires the family to pay a premium. Our primary insurance pays first for all that it will cover, and Medicaid makes sure that Lila doesn’t go without the rest. We gladly pay a monthly fee for this essential assistance!

    Lila now receives medical treatments that she needs from specialists and Occupational, Physical, and Speech therapy. She attends a school where she is loved and accepted, and they practice important skills in the classroom to prepare her for mainstream Kindergarten. Lila is constantly learning the necessary skills to be independent: speaking new words, learning to feed herself, to dress herself, and to climb stairs. One of my favorite moments was the first time I ever heard her say, “Ma Ma.” Can you imagine waiting 4 years to hear that?

    IMG_2776We never expected to need Medicaid. Even though we’d paid taxes for years for Medicaid, we didn’t know that a person’s life can change drastically in a moment – a car accident, a stroke, a job loss, a cancer diagnosis, a chromosomal difference – to cause them to need Medicaid. We thought that if we worked hard enough, we could take care of ourselves and Lila. But no matter how hard we work or what we give up, we just can’t afford to provide for all of Lila’s needs. Now, because of Medicaid, Lila is thriving, and we’re not being crushed under the weight of Lila’s ever-growing medical debt. We have hope that she will continue to develop and someday be a valued, contributing member of society. We are incredibly thankful for Medicaid.

    We tell everyone we can how essential Medicaid is! Lila has visited the Capitol and state lawmakers multiple times to represent herself and friends like her. Since she can’t speak much yet, my husband and I tell them how much Medicaid is literally saving lives. I can’t wait for the day that Lila will tell them herself. She brings a beauty and light to this dark world, and we will never stop fighting for her!

    IMG_7902

    Revised Senate health care bill: Where are we now?

    A revision of the BCRA Senate Health Care   bill has been released, but what’s different? We have the one-stop-shop for understanding the bill for yourself.

    Some reports say that they want to vote as early as Tuesday. Get to reading and then get to calling!

    Every call matters. Here’s the number for Senators across the nation: 866-426-2631

    Find your states US Representative & contact his/her office

    Find your state’s US Senator & contact his/her office

    Read the new revised bill to make sure you discover everything for yourself.
    Check out these resources to guide you:
    IMG_0121

     

     

    What was the original bill?

    Full text of the original bill. Click on the image below, and  use the resources above to help you.
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    ASAN Advocacy Training Resource

    With the looming Medicaid cuts, people want to learn how to get involved and fast! This training resource is from the Autistic Self Advocacy Network. You may be advocating for a different condition, but the information they’ve gathered here is very valuable for everyone.

    Their page gives a whole list of information and strategies to effectively take action when advocating for yourself or a loved one.

    Their page will give you:

    • A Self-Advocate’s Guide to Getting Through to your Elected Officials
    • Fact Sheet: How to Call Your Elected Officials
    • Fact Sheet: In-Person Meetings with Elected Officials
    • Fact Sheet: Sending Elected Officials Emails, Letters, and Faxes

    Get to work!