The New Jersey Department of Human Services Division of Developmental Disabilities QUARTERLY DIVISION UPDATE FOR INDIVIDUALS, FAMILIES AND PROVIDERS Jonathan S. Seifried, MA Acting Assistant Commissioner April 26, 2018
Overview Executive Management Team and Unit Contacts Fee-for-Service (FFS) Implementation Ombudsman for People with ID/DD NJ ABLE Plan Update Transportation for SDEs Fiscal Intermediary (FI) Update The Stephen Komninos Law 2
Executive Management as of March 2018 3 Jonathan Seifried Carol L. Jones Eric Kaufmann Charles Naus Jennifer Joyce Kelli Rice Michelle Whitmore Diane Flynn 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
DDD Unit Contacts 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 Wendy.Yosco@dhs.state.nj.us Housing Eric Kaufmann 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 4 CCP Fee-For-Service Michelle Whitmore Michelle.Whitmore@dhs.state.nj.us
FFS Implementation: Contract Renewals Agencies not fully converted to FFS by June 30, 2018 will have contracts renewed for those individuals without approved service plans Notices related to renewal to be issued soon Respite and Emergency homes will remain in contract at least through December 31, 2018 5
FFS Implementation: Community Care Program With the folding of DDD s Community Care Waiver (CCW) into the State s Comprehensive Medicaid Waiver in November 2017, the program name has changed Community Care Waiver is now Community Care Program (CCP). We are working to update our website and communication materials to reflect the name change CCP Manual will be released in early May 6
FFS Implementation: Community Care Program 8500+ Community Care Program (CCP) Transition Letters and Support Coordination Agency Selection Forms sent to individuals identified for transition from CCP to CCP-FFS 6400+ CCP individuals assigned to Support Coordination Agency 7 3900+ CCP individuals with approved Individualized Service Plan (ISP)
FFS Implementation: Supports Program Current Supports Program (SP) enrollment: 6700+ Full enrollment of all eligible individuals into SP still on track to be completed June 2018 Review of SP-enrolled individuals who are not accessing services other than Support Coordination To ensure needs are being appropriately addressed To ensure individuals are aware of available services Identify individuals who may need to be dis-enrolled from SP SP Manual will be released in early May 8
FFS Implementation: Support Coordination Increased capacity Medicaid/DDD approved Support Coordination Agencies: 120 Individuals currently assigned to SCA: 12,219 DDD currently developing training curriculum on SC Basics Training will be incorporated into SC orientation process Curriculum Workgroup includes DDD and SCA representatives Once initial curriculum is identified feedback from Family Advisory Council will be obtained 9
Ombudsman for People with ID/DD Office of the Ombudsman for Individuals with Intellectual or Developmental Disabilities (ID/DD) and Their Families 10 Paul Aronsohn appointed by Governor Murphy April 2018 In, but not of, NJ Department of Treasury Information, support, oversight for New Jersey children and adults with ID/DD DCF Division of Children s System of Care DHS Division of Developmental Disabilities
Ombudsman for People with ID/DD Duties to include: 11 Serving as a source of information for individuals and their families, to help them better understand state and federal laws and regulations; Coordinating with the State Council on DD, to provide information and support on navigating and understanding the process for obtaining services from the state Division of Children's System of Care and DDD, including information on transitioning between the two programs; Providing information and communication strategies to individuals and their families for resolving disagreements with various state agencies, as well as education on the dispute resolution;
Ombudsman for People with ID/DD Duties to include: 12 Working with service recipients, families and the departments to facilitate the provision of services and supports; Identifying common concerns for individuals and their families, and making recommendations to the Division of Children's System of Care, DDD, DCF and DHS; and To assist the Division of Children's System of Care and DDD in creating public information programs designed to inform individuals with intellectual or developmental disabilities, their families, and the public about the role of the ombudsman
NJ ABLE Plan Achieving a Better Life Experience (ABLE) Act federal legislation signed into law in 2014 establishing tax-free savings account for eligible individuals with disabilities Signed into law in NJ in 2016 NJ ABLE Plan and website set to launch April/May 2018 13
NJ ABLE Plan Enables eligible individuals with disabilities to establish ABLE savings accounts that will not affect their eligibility for public benefits such as SSI and Medicaid Earned income on an ABLE account is not taxed Withdrawals used for qualified disability-related expenses for/on behalf of the beneficiary Funding that will supplement, but not supplant, benefits provided through private insurance, Medicaid, SSI, the beneficiary's employment and other sources. 14
Transportation for SDEs New mandatory code for transportation provided by a self-directed employee effective March 2018 Reasonable & Customary hourly wage 15-minute unit increments 15 Employer/employee enrollment, employee hourly wage, employee timesheet submission and payment all handled the same as with other SDE-provided services Support Coordination Agencies notified in March New and renewed plans must use the new code for SDEprovided transportation
Fiscal Intermediary Update DDD contract with Easterseals NJ (ESNJ) extended through June 30, 2019 DHS/DDD continuing to review options to address EIN issue Information will be distributed as it becomes available until then, business as usual PPP/DDD SDE Option dual enrollees continue with ESNJ 16 Dual enrollees able and willing to identify someone other than the individual to act as Employer of Record can transition to PPL
Fiscal Intermediary Update PCG Public Partnerships, LLC (PPL) 17 Customer Service phone line Available Monday Friday, 8am 5pm: 844.842.5891 Website: www.publicpartnerships.com Online Employer/Employee Enrollment: www.pplenroll.com
Fiscal Intermediary Update PPL walk-in office hours Princeton Office 619 Alexander Road, Princeton, NJ 08540 MON, TUE, WED: 12pm 4pm; THU, FRI: 9am 12pm Newark Office 24 Commerce Street, 7 th Floor, Newark, NJ 07102 TUE: 9am 12pm; THU: 12pm 4pm If individuals prefer to schedule an office appointment, call 609.945.6420 Special Saturday hours held 2/24/18 at The Arc Mercer 18
Fiscal Intermediary Update Escalating issues to Public Partnerships: For all stakeholders: NJDDD-CS@pcgus.com 844.842.5891 For qualified providers: NJDDD-QP@pcgus.com For Support Coordinators: NJDDD-SC@pcgus.com After allowing at least one business day, all stakeholders may escalate unresolved issues to: NJDDD-ADMIN@pcgus.com Escalating issues to DDD: For all stakeholders: DDD.FeeForService@dhs.state.nj.us For Support Coordinators: SC Agency s Quality Assurance Specialist ( DDD Mentor ) 19
New Jersey Department of Human Services LEGISLATIVE UPDATE OFFICE OF PROGRAM INTEGRITY AND ACCOUNTABILITY AND DIVISION OF DEVELOPMENTAL DISABILITIES APRIL, 2018 *CURRENT AS OF 04/26/18
AGENDA 22 Introduction Updated Statutory Requirements The Stephen Komninos Law Public Law 2017, Chapter 238 Criminal History Record Information Public Law 2017, Chapter 328 Child Abuse Record Information Public Law 2017, Chapter 213 Discussion Law Provisions Next Steps
The Stephen Komninos Law - Overview 23 Signed into law October 6, 2017 Effective May 1, 2018 Law establishes new processes and requirements for provider agencies, the Division of Developmental Disabilities (DDD) and units within the Office of Program Integrity and Accountability (OPIA)
The Stephen Komninos Law - Overview DHS working to operationalize provisions 24 Stakeholder input critical to implementation Regulatory and policy changes needed Requires provider training, information exchange and support
The Stephen Komninos Law - Overview DHS Communications Plan includes: Information will be posted on DHS web page, including: Power Point presentation and link to corresponding webinar webinar available on You Tube Statute Commissioner s letter to guardians/families and to providers Fact Sheet Charts identifying incidents reportable to guardians for community and facilities Posters 25 Worked with College of Direct Supports on a training module for direct care staff will be part of the mandatory training bundle Office of Licensing (OOL) Bulletin Presentations at trade organizations, quarterly provider meetings Internal staff training
The Stephen Komninos Law - Overview 26 The Stephen Komninos Law requires significant changes to key practice areas
Two Unannounced Site Visits Annually Two, unannounced site visits to all community-based, residential programs to evaluate risk of abuse, neglect and exploitation DHS Field Safety and Services Unit within OPIA Specific to group homes and supervised apartments DHS developing a safety assessment tool Agency response to visits/identified findings Agency liaisons to address immediate safety concerns Data and trend analyses to remediate risk Interface with agencies, OOL, DDD Provider Performance Monitoring Unit (PPMU) 27
Guardian Notification of Injuries Residential/day program provider responsibility to notify guardian/family member - incidents/ allegations involving: All minor, moderate and major injuries reportable according to DHS regulations Guardian/family member must be notified as soon as possible; no later than two hours Extraordinary circumstances, no later than eight hours with a detailed explanation for delay provided to DHS and guardian/family member within 14 days 28
Guardian Notification of Injuries Requires providers to establish a process to identify family members requesting injury notification or opting out 29 Delayed notification requires agency to submit written, detailed explanation for delay to guardian/requesting family member and DHS Critical Incident Management Unit (CIMU)) within 14 days of incident
Guardian Notification Notification must be in-person or by telephone 30 Any follow-up communication may be electronic Permits guardian/family member to opt out via written notification/ consider preferences Individual served can indicate he/she does not want family member to be notified Guidance provided on leaving message with information
DHS action includes: Guardian Notification Updated page within Unusual Incident Reporting and Management System (UIRMS) Guardian/family member notification will be documented, tracked in UIRMS Updated Unusual Incident Report (UIR) form Regulations/Division Circular to outline number of attempts, other considerations Updated DHS Administrative Order/ policies Agencies require an internal system for ensuring documentation/tracking of guardian/family notification DDD PPMU will follow-up with agencies using monthly/quarterly exception report 31
Injury Verification DHS expanded the Critical Incident Management Unit (CIMU) within OPIA 32 Injury verification within 48 hours of all incidents/ allegations in community-based, residential programs and DHS developmental centers involving: Abuse, neglect and/or exploitation All major and/or moderate injuries Emphasis on timely and accurate reporting
Guardian Participation in Office of Investigations Interview 33 A guardian may participate in an Office of Investigations (OI) interview of the individual the guardian represents All OI staff trained Created an informational insert to include with OI initial notification letter to guardian- explaining process Will work with guardian to facilitate he/she sitting in on OI interview May need staff to also participate Facility/agency will be notified
Guardian Participation in Office of Investigations Interview Guardian or family member may provide information to facilitate an investigation 34 A guardian will continue to receive a letter summarizing the findings of an OI investigation- will include remedial action taken The actual records/reports of an investigation shall also be provided to the guardian or other person responsible for the welfare of the individual if the information is needed in connection with the provision of care, treatment, assessment, evaluation or supervision and the provision of information is in the best interest of the individual as determined by DDD
Drug Testing Direct Care Staff Drug testing requirements: 35 Direct care staff applying for employment at a program, facility, or living arrangement licensed or funded by the Department At least once per year, one or more direct care staff subject to random drug testing-total number of random tests at discretion of person responsible for overall operation Drug testing permitted as-needed with reasonable suspicionand through established process/written approval of person responsible for overall operation
Drug Testing Direct Care Staff Employee must be removed if he/she fails to comply Employee testing positive: May be referred for treatment services, or Terminated from employment DHS working to identify most effective and prudent approach Amendments to regulations OOL/PPMU oversight 36
Reporting Abuse, Neglect and Exploitation Strengthens requirements for reporting abuse, neglect and/or exploitation to: Person employed or volunteering in a program, facility, community care residence, or living arrangement licensed or funded by DHS Person conducting site visit Program providing community-based services with indirect state funding Maintains existing immediate reporting requirements for abuse, neglect and/or exploitation Identifies specific information needed when reporting 37
Reporting Abuse, Neglect and Exploitation Expands Tara s Law penalties for failing to report: 38 For employees/volunteers in all settings - failing to report is a disorderly person offense DDD case manager/case manager supervisor - failure to report is a fourth degree crime DDD case manager/case manager supervisor - failure to report and incident results in death, is a third degree crime Person convicted of the above subject to $350 per day penalty for each day allegation not reported
Reporting Abuse, Neglect and Exploitation DHS amending UIRMS to capture failure to report Training is critical College of Direct Supports module Existing staff - 60 days from date of availability New staff at time of hire Test for competency 39 Updating Report Abuse poster Consequences for failure to report
Exchange of Parent/Guardian Contact Information 40 Requires developmental centers to schedule meetings with parents/guardians twice per year to provide an opportunity to share experiences Requires community-based, residential programs and day program providers to: Request contact information from each parent/guardian If parent/guardian agrees, provider will exchange contact information with other parents/guardians within the program for opportunities to share experiences Programs/agencies with multiple sites identify the scope of who is included, consider individual preferences, keep information updated and accessible
Criminal History Record Checks Updated legislation for conducting federal and state criminal history record information (CHRI) checks for: Agency employees and agency heads Community Care Residence (CCR) providers Individuals living in the household of a CCR provider Alternates for CCR providers Signed into law on/about January 12, 2018 Effective immediately 41
Criminal History Record Checks Shifts responsibility for conducting fitness for employment determinations from the agency to DHS 42 DHS responsible to: Make fitness determination within 14 days of receipt of federal and state CHRI Provide written notification to employee and agency head of qualification/disqualification
Criminal History Record Checks 43 If disqualified via state conviction, DHS required to provide the employee the convictions which constitute the disqualification Employee may petition for a hearing on the accuracy of the CHRI with the appropriate state or federal agency or court
Criminal History Record Checks 44 Agencies shall not employ an individual or qualify a CCR provider, alternate or CCR family member if determined by DHS to be disqualified Employment must be terminated if employee refuses to cooperate with CHRI check Provisional employment within agency is permitted for up to six months with sworn attestation when CHRI results are pending Duties must be performed under supervision until CHRI check is cleared
Criminal History Record Checks 45 Shifts responsibility for determining rehabilitation from agency to DHS Establishes timeframes for employee and DHS to determine rehabilitation: Employee has 14 days from date of written notice of disqualification to provide evidence of affirmatively demonstrated rehabilitation DHS has no longer than 60 days from receipt of evidence to determine qualification and provide written notification to individual/agency head May be submitted electronically with authorization
Criminal History Record Checks 46 Office of Licensing - Plans of Correction Plans of correction required for all licensing deficiencies Requires OOL to complete an unannounced, follow-up inspection of site if life/safety deficiencies are identified
Child Abuse Record Information Checks Signed into law August 7, 2017 Effective February 1, 2018 Requires checks of the Department of Children and Families (DCF) child abuse registry for any person seeking employment in: Any facility or program licensed, contracted, regulated or funded by DHS Providing community-based services with indirect funding Known as CARI check 47 Law also applies to staff employed by DCF provider agencies, DHS developmental centers
Child Abuse Record Information Checks 48 Working with DCF on a process DHS to amend regulations to prohibit employment if employee is identified on the registry as substantiated for child abuse/neglect
Next Steps Follow-up action: Regulatory changes Staff understanding of and cooperation with DHS staff Agency contact information/point person for verification visits Identify guardian/family member, obtain updated contact information and maintain information on file Agency protocols for: 49 Verification and unannounced visits Drug testing Family contact information sharing Timely reporting
Office of Licensing Update 50 Draft Revision of Regulations Obtained provider input External factors Resolving outstanding issues with DDD Next steps: Regulatory process
Office of Licensing Update 51 Announcements Danielle s Law Informational Bulletin Background Checks Plans of Correction Unannounced Inspections Feedback from Providers Personnel Changes
Questions 52 OPIA created an email address for providers to email questions regarding the Stephen Komninos Law DHS-SKLAW.OPIA@dhs.state.nj.us Lauri Woodward, Director Office of Program Integrity and Accountability (609) 292-1617