The New Jersey Department of Human Services Division of Developmental Disabilities

Transcription

1 The New Jersey Department of Human Services Division of Developmental Disabilities QUARTERLY DIVISION UPDATE FOR INDIVIDUALS, FAMILIES AND PROVIDERS Elizabeth M. Shea Assistant Commissioner Jonathan Seifried Acting Assistant Commissioner September 27, 2017

2 Overview Leadership and Location Changes Community Care Waiver Update Habilitative Therapies Update Fee-for-Service (FFS) Implementation Fiscal Intermediary (FI) Transition Council on Quality and Leadership (CQL) DDD Unit Contacts 2

3 Leadership and Location Changes Jonathan Seifried new Acting Assistant Commissioner over DDD, as of 9/29/2017 Per Governor s Executive Order, Division of Mental Health and Addiction Services (DMHAS) moving under Department of Health 3 DDD s Administrative Office in Hamilton will re-locate to the Department of Human Services Central Office building in Trenton (222 South Warren Street) in order to allow DMHAS to occupy the Hamilton space

4 Leadership and Location Changes Once DDD Administration has settled in Trenton, we will begin to assess alternative locations for DDD meetings, including the Quarterly Division Update Meetings for Individuals, Families and Providers Quarterly Update Meeting time slots 4

5 Community Care Waiver Update Federal Centers for Medicare and Medicaid Services (CMS) approved folding DDD s Community Care Waiver (CCW) into the State s Comprehensive Medicaid Waiver, effective November 1, Will help streamline fee for service program operations New services that DDD sought approval to add to the CCW will become immediately available to CCW participants who have transitioned into fee for service CMS requires notification to CCW participants DDD letters and FAQs mailed to all CCW participants Administrative change only no action needed

6 Habilitative Therapies Update Per memo of agreement between the Division of Medical Assistance and Health Services, the Medicaid Fraud Division, and the Division of Developmental Disabilities: 6 Individuals are no longer required to provide a denial from their Medicaid managed care organization (MCO) before accessing DDD-funded physical therapy, occupational therapy, and speech, language and hearing therapy that is habilitative in nature

7 Executive Management as of 9/29/17 7 Jonathan Seifried Carol L. Jones Husam Abdallah Eric Kaufmann Charles Naus Jennifer Joyce Kelli Rice Darlene Yannetta Diane Flynn Acting Assistant Commissioner Chief of Staff Assistant Division Director, Developmental Centers Assistant CFO, DHS Chief Information Officer Director, Supports Program and Employment Services Director, Community Care Waiver Unit Director, Provider and Constituent Relations Division Communications

8 DDD Unit Contacts 8 Unit Contact Name Contact Intake James Schiralli James.Schiralli@dhs.state.nj.us Support Coordination Cheryl Betz Cheryl.Betz@dhs.state.nj.us Supports Program Jennifer Joyce Jennifer.Joyce@dhs.state.nj.us Provider Performance & Monitoring Wendy Yosco Wendy.Yosco@dhs.state.nj.us Housing Courtney Davey Courtney.Davey@dhs.state.nj.us Case Management Mariana Pietrunti Mariana.Pietrunti@dhs.state.nj.us Contracting Jose Gonzalez Jose.Gonzalez@dhs.state.nj.us Quality Improvement Heather Ciociola Heather.Ciociola@dhs.state.nj.us

9 FFS Implementation: CCW Conversion 1,000+ SC Agency Selection Forms sent to CCW individuals Nearly 700 CCW individuals assigned to SC Agency Approximately 6,000 CCW individuals have been identified for CCW Conversion Pilot, Cohort 1 and Cohort 2 combined 9

10 FFS Implementation: Important Reminders for Providers If not done already, providers must submit Combined Application to provide Individual Supports Individual Supports 10 Only available in Community Care Waiver (CCW) program Available to individuals living in a DDD-funded residential setting (e.g., group home, supervised apartment) or living in their own/family home Community Based Supports Only available in Supports Program Available to individuals living in their own/family home

11 FFS Implementation: Important Reminders for Providers New development goes directly into fee-for-service 11 Once an individual is in FFS (billing to Molina), he/she should no longer be reported on attendance Be sure to complete Combined Application for any services you wish/expect to provide After a residential site is licensed, new Combined Application must be submitted for the newly licensed location

12 FFS Implementation: Supports Program Current Supports Program (SP) enrollment: 4,000+ Approximately 60 of these are enrolled in Supports Program + Private Duty Nursing (SP+PDN) Projected timeline to complete SP enrollment: December 2017: 5,500 March 2018: 7,000 June 2018: 12 Full enrollment

13 FFS Implementation: Support Coordination Increased capacity Medicaid/DDD approved Support Coordination Agencies: 99 Individuals currently assigned to SCA: 8,664 Expansion of SCA monitoring and mentoring Adding four Quality Assurance Specialists (QAS) Assistant Directors over Mentoring and Monitoring 13 Quarterly Progress Reports for SCAs not yet released to approve ISPs

14 FI Transition 14 4,300 individuals transitioned from Easterseals on July 1 Weekly meetings with DHS Commissioner, DDD, DDS and PPL staff to identify and resolve issues Chuck Naus, DDD s Chief Information Officer completed a 2-day on-site visit with PPL finance and technology teams Enrollment Specialists PPL has committed to increasing the # and adding trainings Qualified Provider Account Managers and a QP-specific help desk

15 FI Transition: Known Issues DDD is aware of and working closely with PPL to resolve issues on a case-by-case basis and systemically 15 Non-payment, wrong payment for some Self-Directed Employees (SDE) Non-payment, wrong payment for some qualified providers Enrollment issues for new SDE services Transportation billing process PPL customer service response/message consistency

16 FI Transition: Qualified Providers All QP-delivered services transferred to Public Partnerships July 1, For QP services delivered July 1 forward, use Public Partnerships Qualified Provider Invoice QP payment issues should be escalated following the process on slide #18 QPs that have not yet submitted invoices for services delivered after 7/1 should do so immediately

17 FI Transition: PPP/DDD Dual Enrollees Employer Identification Number (EIN) issue for PPP/DDD SDE Option dual enrollees 17 Public Partnerships is not currently able to support dual enrollment under a single EIN but has submitted a proposal to NJ DHS currently under review to design the systems and processes required to support dual enrollment under a single EIN At this time, unless notified otherwise, individuals who are dually enrolled in both PPP and the DDD SDE Option (with Easterseals as the FI) should continue submitting DDD SDE timesheets to Easterseals

18 FI Transition: Escalation of Issues Escalating issues to Public Partnerships: For all stakeholders: (or ) For qualified providers: For Support Coordinators: After allowing at least one business day, all stakeholders may escalate unresolved issues to: Escalating issues to DDD: For all stakeholders: For Support Coordinators: SC Agency s DDD Mentor 18

19 Council on Quality and Leadership (CQL) CQL Personal Outcome Measures (POM) 19 My Human Security Non-negotiable human and civil rights My Community Access to be in, a part of, and with community My Relationships Social support, intimacy, familiarity, and belonging My Choices Decisions about one s life and community My Goals Dreams and aspirations for the future

20 Council on Quality and Leadership (CQL) Training for POM Certified Interviewers Training of QI and Provider Performance and Monitoring staff to begin early October, other units to follow Training for POM Certified Trainers 20 Training of QI and Boggs Center staff to begin early October Training of DDD staff more broadly and incorporation into training for Support Coordinators, SC Supervisors, Providers, individuals and families to follow

21 Council on Quality and Leadership (CQL) Review of current processes and practices, including planning and monitoring documents, to begin in November Currently in discussion with CQL about use of Basic Assurances System for use by Provider Performance & Monitoring in Quality Assurance and Technical Assistance efforts 21

22 Council on Quality and Leadership (CQL) CQL Basic Assurances System Rights Protection and Promotion Dignity and Respect Natural Support Networks Protection from Abuse, Neglect, Mistreatment and Exploitation Best Possible Health Safe Environments Staff Resources and Supports Positive Services and Supports Continuity and Personal Security 22

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