The New Jersey Department of Human Services Division of Developmental Disabilities

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The New Jersey Department of Human Services Division of Developmental Disabilities QUARTERLY DIVISION UPDATE FOR INDIVIDUALS, FAMILIES AND PROVIDERS Jonathan S. Seifried Acting Assistant Commissioner December 2017

Overview Executive Management Team and Unit Contacts Program Development Update Community Care Program (Formerly Community Care Waiver) Fee-for-Service (FFS) Transition Fiscal Intermediary (FI) Transition Stephen Komninos Law Provider Performance and Monitoring 2

Executive Management as of 12/2017 3 Jonathan Seifried Carol L. Jones Eric Kaufmann Charles Naus Jennifer Joyce Kelli Rice Michelle Whitmore Diane Flynn Doris Windle Acting Assistant Commissioner Chief of Staff Assistant CFO, DHS Chief Information Officer Director, Supports Program and Employment Services Director, Community Care Waiver Unit Special Assistant Division Communications Developmental Center Operations

DDD Unit Contacts 4 Unit Contact Name Contact Email 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 Housing Development Eric Kaufmann Wendy.Yosco@dhs.state.nj.us Eric.Kaufmann@dhs.state.nj.us Housing Subsidies 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

Program Development Notice of Intent to License Effective December 1, 2017 5 Allows for the processing of new site NPI numbers with Medicaid ahead of licensure Once Medicaid processes and forwards to DDD, the site will be released once licensure occurs

Community Care Waiver Program 6 Effective November 1, 2017, the Community Care Waiver was folded into the State s Comprehensive Medicaid Waiver. The CCW is now referred to as the Community Care Program (CCP) As a result, the following services are now available in the CCP for participants who have transitioned into fee for service: Community Inclusion, Goods and Services, Interpreter Services, Natural Supports Training, and Supports Brokerage. Administrative change only no action needed

FFS Implementation: CCW Conversion 4,700+ SC Agency Selection Forms sent to CCW individuals 1,400+ CCW individuals assigned to SC Agency Benchmarks 5,000 SCA Selection forms to be sent by December 31, 2017 Additional 3,000 by March 1, 2018 Additional 2,000 by May 1, 2018 7

FFS Implementation: Supports Program Current Supports Program (SP) enrollment: 5,130 Projected timeline to complete SP enrollment: December 2017: 5,500 March 2018: 7,000 June 2018: Full enrollment 8

FFS Implementation: Support Coordination Increased capacity Medicaid/DDD approved Support Coordination Agencies: 100 Expansion of SCA monitoring and mentoring Increased number of monitors reviewing ISPs 9

Fiscal Intermediary Transition 10 PPL and DDD project management teams continue to meet weekly PPL COO, CFO, and EVP of Strategic Operations directly involved with management of NJ program PPL onboarding new Account Manager for NJ PPL on-site weekly at DDD Administrative office to troubleshoot emergent issues

Fiscal Intermediary Transition Revised enrollment process for new Employers of Record and Self-Directed Employees Supplemental payments distributed to underpaid SDEs Steady increase from July to November in successfully reimbursed SDE timesheets and provider invoices 11

Fiscal Intermediary Transition Steady decrease from July November of issues reported by transitioned SDE Option participants Limited number of complex cases continue to require intensive DDD/PPL troubleshooting DDD anticipates transitioning next small cohort from Easterseals NJ (ESNJ) to PPL after the New Year 12

Fiscal Intermediary Transition Decrease in pended timesheets and invoices PPL has added four FT employees dedicated to researching pended timesheets/invoices Decreased wait time for PPL customer service callers Increased PPL customer service call backs 13

Fiscal Intermediary Transition Transportation DDD and PPL are working to finalize and operationalize transportation reimbursement process for SDEs Outstanding SDE reimbursements for transportation expected to be issued by or before January 2018 14

Stephen Komninos Law Signed into law by Gov. Christie October 2017 Provides protections for individuals with intellectual/developmental disabilities (I/DD) Upgrades offenses committed against individuals with I/DD Improves transparency and accountability in investigations of abuse, neglect and exploitation of individuals with I/DD DHS and DDD have until May 1, 2018 to operationalize provisions of the law 15

Overview of Komninos Law Provisions Two unannounced visits per year to every licensed community-based residential setting to evaluate risk factors for abuse, neglect and exploitation An individual s guardian must be notified by residential program within two hours of any major, moderate or minor physical injury to the individual (can be within eight hours in extraordinary circumstances) 16

Overview of Komninos Law Provisions Within 48 hours of an incident report involving moderate or major physical injury or abuse, neglect or exploitation, a DHS employee must visit the location of the reported incident and verify the level of severity of the injury Mandatory drug testing prior to employment and random drug testing after employment 17

Overview of Komninos Law Provisions 18 Every Developmental Center must have bi-annual scheduled meetings with parents and guardians or residents, to provide them an opportunity to share experiences about individuals Monetary penalties collected under Danielle s Law must be dedicated to providing training to caregivers Expands penalties to disorderly persons, fourth or third degree crimes for failure to report (depending on staff involved and severity of incident)

Overview of Komninos Law Provisions Residential service providers must request contact information from parents/guardians of every resident and advise them that, if they agree, their contact information will be shared with parent/guardians of other residents, enabling them to share their experiences When requested, guardians can be present for investigative interviews, and can terminate interviews in certain circumstances 19

Overview of Komninos Law Provisions Requires notification to guardian of summary findings, remedial actions, and Central Registry inclusion Other covered areas such as timeframes, etc. 20

Provider Performance & Monitoring Unit (PPMU) 21 DDD Mission Statement The Division of Developmental Disabilities (DDD) assures the opportunity for individuals with developmental disabilities to receive quality services and supports, participate meaningfully in their communities and exercise their right to make choices.

Provider Performance and Monitoring Unit (PPMU) DDD Core Principles Ensure health and safety while respecting the rights of individuals Promote and expand community-based supports and services to avoid institutional, segregated and out-of-state services 22 Promote individual choice, natural relationships and equity in the provision of supports and services Ensure access to needed services from other New Jersey State and local agencies Support provider agencies in achieving core principles Ensure that services are high in quality and culturally competent Ensure financial accountability and compliance with all laws and ethical codes Ensure clear, consistent communication and responsiveness to stakeholders Promote collaboration and partnerships with individuals, families, providers and all other stakeholders

Shift in Provider Auditing/Monitoring 23 Component of DDD System Reform Division s role would shift from individual case management, referrals, etc. to quality assurance/improvement, monitoring, and technical assistance Prior to System Reform Conducted audits once every five years Focused on compliance with standards manuals such as the Adult Day Program and Supported Employment Manuals Relied on Case Managers & Licensing for residential providers Not necessarily aligned with other auditing/licensing entities redundancy/inconsistency

Separation of Case Management and Provider Monitoring for Improved Service and Quality 24 Support Coordination Provider Monitoring Focused on individuals Focused on providers Individual-level objectives, issues, and responsibilities; goal and outcome management Provider- and systems-level objectives, issues, and responsibilities; quality monitoring and management

Working Together 25 Provider SC/CM Family/ guardian Individual Provider Performance & Monitoring

Provider Performance & Monitoring Unit (PPMU) 26

PPMU Benefits 27 Clear consistent communication and responsiveness to stakeholders Partner in solutions On site technical assistance Neutrality Centralized point of contact into Division by provider/service

Expectations of PPMU Minimum of bi-annual visitation to day and residential sites Team approach to problem solving Best practice recommendations Technical assistance 28

Enrollment Current PPMU Projects Enhanced onboarding for new providers Day Services Finalizing day certification tools, scheduling 2018 dates Behavioral Services Development behavior-related resource materials and monitoring tools Residential Services Development of Komninos Law monitoring tool Stakeholder input 29

Quality Assurance Current PPMU Projects Alignment of practices to Supports Program and Community Care Program standards COMING SOON Clinical Services Recruitment Community Based Services 30