HCBS Advisory Committee August 2023 Summary

The HCBS Advisory Committee's August 2023 meeting covered updates on upcoming policy and procedure changes, feedback on remote supports and respectful language, and addressing questions from attendees. Key topics included ICF-IID Level of Care Determination Policy, Language Access Policy, Case Transfer Procedures, and the Participant Directed Services Policy. Feedback highlighted the need for clearer guidelines on remote monitoring data privacy and revising policies for safety concerns during remote support. Despite some concerns, the overall response emphasized maintaining in-person meetings with a virtual option for accessibility.

• HCBS Advisory Committee
• Policy updates
• Remote supports
• Feedback
• Language

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1. HCBS Advisory Committee August 2023 Crystal Thomas, Manager of SOPPI Martina Kramer, Acting Legislative & Policy Analyst June 26, 2022

2. AGENDA I. Introduction II. Upcoming Policy and Procedure Updates III. Feedback on Remote Supports and Respectful Language IV. Questions and Answers V. Summary and Next Steps

3. Upcoming Policy & Procedure Updates For August ICF-IID Level of Care Determination Policy has been published. Language Access Policy and Procedure have been published and went into effect on August 1st. Each administration is working on developing Case Transfer Procedures and Policy Authority Procedures. IMEU Policy The Participant Directed Services Policy is being reviewed internally and the Procedure is in development.

4. Remote Supports Summary of Public Feedback Pre-COVID policy-and-procedure-development activity was in-person, thus permitting the involvement and active participation of providers. This was extremely valuable from a provider perspective as it allowed provider experience to be reflected in policy/procedures being developed; it presented an opportunity to know DDS employees and their respective roles and responsibilities; it offered an opportunity for urgent problem resolution to occur; and it generally created opportunities to understand the agency culture. These positive attributes are not highlighted in the current proposal. Response: Our meetings are in person with a virtual option for people who can not be there in person.

5. Remote Supports Summary of Public Feedback A 30-minute response time in contexts where it is determined that an individual is in need of in-person support is unacceptably short particularly in cases where remote supports are being used to ensure safety inside or outside the home. The policy and procedure should be revised to clarify that in circumstances where there is any safety component to remote supports, this time window may be shortened considerably. Response:

6. Remote Supports Summary of Public Feedback The screening tool assumes that hesitancy to accept remote supports is indication that an individual needs further education on technology. In some circumstances, an individual may simply have made an informed decision that AT would not be an appropriate way to meet their needs. Not all concerns about AT can be alleviated through education and awareness. Response:

7. Remote Supports Summary of Public Feedback (cont d) Concerns remain regarding privacy with respect to remote monitoring data, including the need for clear guidelines on data retention and access privileges. We recommend that these issues be addressed carefully with an eye toward minimizing the risk of a person experiencing harm as a result of remote supports. Response:

8. Remote Supports Summary of Public Feedback (cont d) In light of the significant privacy concerns presented, consent from an individual and his or her representative should be obtained wherever possible, and that a representative should not be permitted to consent to remote monitoring over a person s objection.. Response:

9. Remote Supports Summary of Public Feedback (cont d) Concerns remain regarding addressing practical barriers, such as access to internet and appropriate devices. Response:

10. Respectful Language Policy Summary of Public Feedback We agree with DDS s proposed policy on respectful language. In particular, we commend DDS for recognizing and respecting that people served by DDS may have differences in opinion regarding respectful terminology. Response: Thank you.

11. Questions and Answers Crystal Thomas, Manager SOPPI Crystal.Thomas2@dc.gov Martina Kraemer, acting LPA Martina.Kraemer@dc.gov

12. Summary and Next Steps Next HCBS Advisory Committee Meeting: October 30, 2023