Overview of Intellectual Disability and Day Support Waivers Provider Training
This content delves into the training modules provided by the Division of Developmental Services in 2013, covering topics such as becoming an ID Waiver Provider, supporting individuals in the ID and DS Waivers, residential services, crisis stabilization, and more. It also highlights key agencies involved in waiver services and the history of the ID Waiver program.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Overview of the Intellectual Disability and Day Support Waivers Provider Training Module 1 Division of Developmental Services Department of Behavioral Health and Developmental Services 2013
ID Waiver Provider Modules 1. Overview of the ID and DS Waivers 2. Becoming an ID Waiver Provider 3. Supporting People in the ID and DS Waivers 4. Introduction to Planning 5. Residential Services 6 PA, Respite and Companion - DBHDS-licensed 7. Employment and other Day Services (Agency Directed) 8. Crisis Stabilization and Supervision 9. Assistive Technology, Environmental Modifications and Transition Services 10. Skilled Nursing 11. Personal Emergency Response System 12. Consumer Directed Services and Services Facilitation 13. Therapeutic Consultation 14. Preauthorization and Reimbursement 15.Monitoring and Oversight 2
About the ID & DS Home & Community Based Waivers States apply to CMS/Medicaid match For individuals with intellectual disability Pays for long-term in-home and community services Waives certain Federal Medicaid requirements Two of 6 Home & Community Based Waivers Virginia offers 3
Waiver Highlights Began ID Waiver in 1991 Expanded services in 1994 Added Consumer-Directed Services in 2001 Added Day Support Waiver in 2005 Added MFP in 2008 Added PC Practices and the SIS in 2009 4 Just the Facts ID Waiver
Key Agencies Community Services Boards (CSBs) or Behavioral Health Authority (BHAs) Waiver Service Providers Department of Behavioral Health and Developmental Services (DBHDS) Department of Medical Assistance Services (DMAS) 5
The Big Picture CMS (Federal) Virginia General Assembly (State) DMAS DBHDS CSBs/BHAs (Local) CSB Support Coordinator Waiver Services Providers 6
Key Agencies Community Services Boards (CSBs) or Behavioral Health Authority (BHAs) Single point of entry Support Coordination 7
Key Agencies Waiver Service Providers Community-based Selected by the individual Person-centered supports 8
Key Agencies Department of Behavioral Health & Developmental Services (DBHDS) Daily Operations Pre-Authorization Licensing Technical Assistance Human Rights Training 9
Key Agencies Department of Medical Assistance Services (DMAS) Single state agency for Medicaid Payment to providers Service audits and fraud Quality reviews Appeals 10
Other Key Agencies DSS Public Schools DARS 11
ID and DS Waiver Eligibility Diagnostic Functional Financial 12
Diagnostic Eligibility 6 years or older: psychological evaluation stating diagnosis of intellectual disability Under age 6: psychological or standardized developmental evaluation stating diagnosis of intellectual disability or at developmental risk 13 Psychological Evaluation Guidance
Diagnostic Eligibility For children under age 6: At Risk or ID Developmental risk: presence before, during or after birth of conditions related to the occurrence of a developmental disability and for which no specific developmental disability is identifiable through available diagnostic and evaluative criteria. ID as demonstrated by evidence of cognitive and adaptive delay OR presence of a syndrome typically associated with ID 14
Functional Eligibility CSB Support Coordinator (SC) confirms functional eligibility by completing: Level Of Functioning (LOF) Survey Within 45 days of date of request for services 15
Functional Eligibility LOF Survey Must meet ICF-ID level of care in 2 or more categories Completed within 6 months prior to start date Completed annually Applies to children under 6, too 16
Financial Eligibility DSS-determined Different financial limits for Medicaid Waivers Based upon the individual s income only Possible patient-pay obligation 17
About the Waivers Waiver Slots Each person requires a slot Each CSB has an allocation of slots 18 Just the Facts ID Waiver
About the Waivers Slots Awarded ID Waiver Day Support Waiver Based on urgency Annual allocations Based on date of need Limited to 300 slots 19 Day Support Waiver Facts
About the Waivers If no slot, name placed on a Statewide Waiting List (WL) CSB submits to DBHDS Urgent and Non-urgent DBHDS maintains Statewide WL All Urgent in state served first 20
About the Waivers ID Waiver Services 21
ID Waiver Services Residential -Congregate -In-Home Day Support Therapeutic Consultation Personal Assistance Respite Companion Pre- Vocational Assistive Technology Transition Services Supported Employment Environmental Modification Service Facilitation Skilled Nursing Crisis Stabilization Self Directed P ersonal E mergency R esponse S ystem Respite Companion Personal Assistance 22 ID Waiver Overview
About the Waivers DS Waiver Services 23
DS Waiver Services Residential -Congregate -In-Home Day Support Therapeutic Consultation Personal Assistance Respite Companion Pre- Vocational Assistive Technology Transition Services Supported Employment Environmental Modification Service Facilitation Skilled Nursing Crisis Stabilization P ersonal E mergency R esponse S ystem Consumer Directed Respite Companion Personal Assistance 24
About the Waivers Individual selects . . . Agency-Directed Services or Self-Directed Services or A Combination of Both 25
About the Waivers Allowable support activities Criteria and limitations Individual Support Plans 26
About the Waivers Team Approach Individual Substitute Decision Maker Support Coordinator Waiver service providers Other providers, as needed Others, as requested by the individual 27 Just the Facts ID Waiver
Available Resources: Department of Behavioral Health and Developmental Services Division of Developmental Services Offices of Licensing and Human Rights http://www.dbhds.virginia.gov 29
