Family Support Services

Transcription

1 Family Support Services Mesa Developmental Services Allocation Handbook A Comprehensive Guide to Accessing, Understanding and Using Your Allocated Funds

2 FAMILY SUPPORT SERVICES ALLOCATION HANDBOOK A Comprehensive Guide to Accessing, Understanding, and Using Your Allocated Funds The following information has been compiled from the Family Support Services Program guide and procedures. This detailed information is available upon reuest from your Family Support Council or Mesa Developmental Services.

3 Table of Contents Introduction and Purpose: (Reference C.R.S &402) Pages 1-3 Legislative Intent FSS Program Goals Family Support Council Family Support Services Forms: Pages 3-5 Letter of Eligibility Letter of Ineligibility (Denial) Individual Plan Allocation Letter Allocation Review Form Quarterly Review Form Assistive Technology Loan Agreement Assistive Technology Training Agreement Statement of Expenses General Service Categories: (Reference C.R.S , DDS rule 9.4.1) Pages 6-10 Respite Care Professional Services Medical and Dental Transportation Other Individual Expenses Client Care Supplies Assistive Technology Home Modification Accessing Allocated Funds: (Reference C.R.S , DDS rule 9.3.4) Pages Respite Bills and Reimbursement Item/Merchandise Purchases Other Answers to Some Freuently Asked Questions Page 14 Revised 4/08

4 Introduction & Purpose Legislative Intent It is the intent of the General Assembly of Colorado that the service delivery system for individuals with developmental disabilities emphasize community living for persons with developmental disabilities and provide supports to individuals to enable them to enjoy typical lifestyles. One way to accomplish this is to recognize that families are the greatest resource available to individuals who have a developmental disability and that families must be supported in their role as primary care givers. (Title ,C.R.S.) The above legislative declaration provides a clear message for the desired results of the services and supports to persons with developmental disabilities and their families. It also identifies the family as a legitimate and essential resource when addressing the needs of a family member with a developmental disability. In response to the legislation, the Family Support Services Program (FSSP) has been developed as a partnership between families and publicly funded supports. The individual s and family s circumstances and needs are the primary consideration for determining the appropriate types of services or supports which can best assist a family with the least disruption to the family lifestyle. (Reference C.R.S &402) FSSP Program Goals To reduce, delay, or prevent out-of-home placement that is unwanted by the person or family, and support, if appropriate, returning the person to the home. To reduce the added stress on families as a result of supporting a family member with a developmental disability in the home. 1

5 To provide flexible and responsive services and supports which are easily accessible and chosen by the families who provide care for their family member with a developmental disability at home. To promote family choice and local decision-making. To encourage and support community participation for persons with developmental disabilities. To ensure that innovations in family services and supports are integrated in a timely manner statewide. Family Support Council A program, which is designed to support families, must also include families as an integral part of the decision-making process in order to insure that the program is responsive to family needs. Family Support Council is the place for families to voice their concerns and opinions. It is also an opportunity to participate in planning family activities. Meetings are held uarterly. Below are just a few of the functions of the Family Support Council. (For more details refer to DDS rule 9.1.4) Help plan family activities and educational opportunities. Make recommendations for the overall policy direction of FSSP. Be aware of local community resources available to assist families. Recommend budget parameters (FSS Allocation Committee). 2

6 Recommend training needed by members of the Council and families enrolled in the FSSP. Make recommendations regarding proposed family services or supports not specifically listed in statute (Title , C.R.S.). The Family Support Council is not responsible, nor encouraged, to become involved in decisions regarding individual families. This responsibility belongs to the Allocation Committee. The Council s involvement should be broader and address issues that impact families in general. Family Support Services Forms Family Support Services Plan/Individual Plan (FSSP/IP) This form will be completed with your Case Manager and Service Coordinator present. Services, needs, and goals for your child will be identified in this plan. Changes can be made to the FSSP/IP throughout the year as long as the changes are approved by your Case Manager or Service Coordinator. Letter of Eligibility This letter is sent to families when children are found eligible to receive services from MDS. This letter will tell families the name and phone number of their child s Case Manager. Letter of Ineligibility This letter is sent to families whose children are found not eligible for services from MDS. The reason(s) for denial will be stated in this letter. 3

7 Individual Plan The Individual Plan is to be completed once a year with your Case Manager and Service Coordinator. The IP is designed to identify family strengths, needs, and goals in order to provide the proper resources and services to our families. Allocation Letter Families found eligible for services will receive a notice stating how much money they have been allocated and the time frame the funds are to be used in. This period is typically six months. This letter will also include the name and contact number of your Service Coordinator. Quarterly Review Families receiving services will receive a uarterly review form every three months. This letter will inform you of how much money has been spent and how much is remaining. This form is sent out to help families keep track of their funds and to assist them in planning for future expenses. You will also be asked to let your Service Coordinator know if you do not intend to use all of your allocated funds. Remember, you can contact your Case Manager if you are out of funds and have further needs and other resources can be explored. Assistive Technology Loan Agreement Assistive technology and adaptive euipment purchased with FSS funds are to be registered with the FSS loan bank. Euipment is returned back to the bank when no longer needed, or when the child outgrows the item/euipment. This helps to keep funds working within the program and offers the opporutnity for families to borrow expensive 4

8 euipment that they may not be able to afford or that their child may outgrow. Statement of Expenses Families use this form in order to receive reimbursement for approved expenditures/purchases. A receipt for items/ euipment purchased must accompany this form. Forms being turned in for respite must have both the caregivers and parent s signature or they will be sent back to the family. Expense statements are due to your Service Coordinator by noon on Tuesdays in order to be cut on Wednesday. All checks are mailed. Statements received after noon on Tuesdays will be processed the following week. 5

9 General Service Categories (Reference C.R.S , DDS rule 9.4.1) The following is a brief description of each of the services covered by the FSSP allocated funds. Key points are in Italics for easy reference. If you have any uestions concerning the services you are receiving, please contact your Service Coordinator or Case Manager. Services you reuest will be listed in your IP. Respite Care Respite Care is temporary care of a person with a developmental disability in order to offer relief to the person s family or primary caregiver. Respite allows the family caregiver to deal with emergency situations or to engage in personal, social or routine activities that may otherwise be neglected, postponed or curtailed due to the demands of caring for a person who has special needs. Daycare services are not covered by allocated funds. There are other resources available for daycare expenses. Some respite funds/programs will not cover respite services provided by an individual under the age of 16. A Respite Provider List and Parent Packet are available with forms and tips for hiring a respite provider. Please contact your Case Manager, Service Coordinator or the MDS Respite Coordinator for these packets, or with any other uestions you may have concerning respite. Professional Services The key factor in determining what is considered a professional service is the need for the provider to be licensed or certified to perform a service that addresses the human condition. Such services include individual 6

10 counseling, therapies, vision and home health services provided to the family member with a developmental disability. Some professional services must be prescribed by a physician or specialized therapist. Medical and Dental These are expenses not covered by Medicaid, other medical or health insurance, or other programs. Examples: Prescribed medications, syringes, feeding tubes, suctioning euipment, catheters, lodging expenses incurred during out-of-town medical treatment, or long distance telephone calls to arrange or coordinate medical services. Also, those additional insurance expenses directly incurred by the family, which are related to the family member with a developmental disability, may be included. Remember that FSSP should only be used as a secondary coverage. Transportation Transportation (mileage) costs that are related to providing care and support to the family member with a developmental disability, and are above and beyond those typically incurred by other families, are eligible for reimbursement. For example, freuent medical appointments, therapy or program appointments where transportation expenses are not covered by other sources could be allowable expenses. Prior approval is reuired and dated receipts must accompany any Statements of Expenses turned in for reimbursement of fuel costs. Mileage tracking sheets are available at MDS. Client Care This category is to be used for reimbursement of the costs of diapers and wipes for children over the age of three years, 7

11 Other Individual Expenses This category is to be used for any services or items, which are provided for the person with a developmental disability which would not otherwise fall into the other reporting categories, and is not covered by any other resource or program. This may include services or items that are necessary as a result of the person s disability, including physical, medical, educational or behavioral needs. Examples of other expenses might include special diets, specialized clothing, and developmental materials. Assistive Technology There are no restrictions related to the type of euipment which may be appropriate and necessary for the family member with a developmental disability or the family, as long as the euipment pertains directly to supporting the person, and is identified in the Individual Plan. For example: Mobility Aids such as wheelchairs or braces, adaptive euipment such as special beds, switches, tools or jigs, communication devices, therapeutic toys, glasses, hearing aids, special kitchen or bathroom appliances/items, and vehicle modifications to enable access by the family member with a developmental disability. Home Modification These include a wide range of adaptations which are directly related to the person s disability and would not be considered part of a regular home maintenance or modification needed by all homeowners. These include physical adaptations to the home environment such as ramps, lifts, widened door frames, bathroom modifications, or repairs to the home structure or furnishing for damage caused by the family member with a developmental disability who has aggressive behaviors (not just normal wear and tear). All devices and 8

12 adaptations must be provided in accordance with applicable state or local building codes and/or applicable standards of manufacturing, design, and installation. 9

13 Accessing Allocated Funds (Reference C.R.S , DDS rule 9.3.4) The following section is a guide to help families understand how to access their allocated funds, the guidelines for respite and item/merchandise purchases, and how to submit bills for reimbursement. Basic Process for Accessing Allocated Funds Complete Individual Plan (IP) with MDS/FSS Staff to identify needs, goals, and funding. Amendments and additions to the IP can be added throughout the year by contacting your Case Manager. All expenditures must be approved by your Service Coordinator before purchase to receive a reimbursement. Save your receipts! MDS Family Support can only reimburse the family for respite expenditures. Respite/Care Providers must be paid directly by the family receiving the services. Purchase of euipment or other items you need can be arranged through the Service Coordinator. Therapy euipment or higher priced items recommended by a therapist must have a letter from the therapist prior to purchasing. All Statements of Expenses and bills for reimbursement must be submitted to MDS before noon on Tuesdays in order to receive payment on Wednesday after 2:00 PM. (Statements received after noon on Tuesdays will be processed the following week.) The check will be mailed to your home. 10

14 Respite Bills and Reimbursement Families using respite are responsible for paying the Care Provider. (MDS will not issue checks to Care Providers unless that Care Provider is licensed in the State of Colorado, or if alternate arrangements have been made with your Service Coordinator.) In order to be reimbursed for Respite, families must fill out a Statement of Expenses form. This form must include the following: Name of Vendor (person or agency receiving reimbursement. Generally, the parent s name goes here.) Name of child receiving services Parent/Guardian s home phone Dates and hours respite was provided Caregivers signature and phone number Parent/Guardian s signature If the Statement of Expenses form is not filled out properly, it could cause delays in receiving your reimbursement check. Forms not completed properly will be returned to the family. Respite Statements of Expenses must be sent in at least monthly for bookkeeping purposes. 11

15 Item/Merchandise Purchases FSS funds will cover the purchase of a wide variety of items/merchandise. Adaptive toys/euipment, assistive technology, magazine subscriptions, and educational tools are just some of the things covered by your FSS funds. Use the following format for item/merchandise purchases: Work with your Service Coordinator to choose the item. Get several bids or uotes for the item and submit them with your reuest. The Service Coordinator will make out a purchase order or check reuest and submit it to accounting for payment to business, firm or individual. Statements of Expense can be mailed to your home or picked up in person at MDS front desk. To be reimbursed for an item purchased directly by the family, item must have prior approval and the dated receipt for that item must be given to your Service Coordinator. No reimbursements are possible without a dated receipt. Payment reuests must also be submitted before noon on Tuesday in order to receive a check on Wednesday after 2:00 PM. Receipts must accompany submitted check reuests and Statements of Expenses. Trips At times, families may find themselves facing trip expenses for out-of-town doctor or therapy appointments, conferences and/or trainings, and approved trips directly involving the family member with the developmental disability, such as Special Olympics. FSS can help with some of these expenses, however, FSS funds cannot be used to cover family vacations or leisure trips. The following guidelines will 12

16 help you in planning for a trip. Trips must have prior approval by your Service Coordinator. FSS funds will help cover lodging and gas (mileage), but they will not cover food purchases. Save receipts to turn in to your Service Coordinator for reimbursement. Be sure to note if you will pick up the check or if you want it mailed to you. Family Support and CSG cannot pay for all of your needs, but we can help you coordinate and/or find resources to help you with most situations and challenges. Call us! (970) We are here to help you! Family Support cannot pay for all of your needs, but we can help you coordinate and/or find resources to help you with most situations and challenges. Call us! (970) We are here to help you! 13

17 Answers to Some Freuently Asked Questions 1) Q - Can families choose anything they want in order to provide support to their family member with a disability in the family home? A - Although the FSS Program does provide for a great deal of flexibility in how the needs of the family are met, it is not an anything goes program. There are guidelines that determine whether a service or support is allowable. The availability of resources may also influence decisions which are made at the local level. 2) Q - Can families change their minds about how they want to use funds authorized for them? A Families should be allowed the opportunity to adjust their Individual Plan as the needs of the family change over time. Any changes to your IP must be discussed with, and approved by, your Case Manager and Service Coordinator. 3) Q - Can Respite Care be used for child care while a parent is working or at school? A No. Regular child care expenses incurred for work or education by the family would not be any different than what any other family would have to deal with, and would normally be considered outside of the allowable parameters of the program. However, under extenuating circumstances, the local review process for exceptions would be available. 4) Q Can funds transfer with a family if they move to another Community Centered Board (CCB) service area? A Yes. A family s remaining funds will transfer to the nearest CCB in their new location. 14

18 Mesa Developmental Services Family Support Services Program 950 Grand Avenue Grand Junction, CO (970) FAX (970) www. mesadev.org