The New Jersey Department of Human Services DDD of Developmental Disabilities QUARTERLY DDD UPDATE FOR INDIVIDUALS, FAMILIES AND PROVIDERS Jonathan S. Seifried, MA Assistant Commissioner October 2, 2018
Overview Executive Management Team and Unit Contacts Fee-for-Service (FFS) Implementation Register Ready Advocacy of Individuals Served Komninos' Law Law Update DSP Wage Increase Provider Recruitment 2
Executive Management as of October 2018 3 Jonathan.Seifried@dhs.state.nj.us Carol.Jones@dhs.state.nj.us Eric.Kaufmann@dhs.state.nj.us Charles.Naus@dhs.state.nj.us Jennifer.Joyce@dhs.state.nj.us Kelli.Rice@dhs.state.nj.us Mariana.Pietrunti@dhs.state.nj.us Michelle.Whitmore@dhs.state.nj.us Diane.Flynn@dhs.state.nj.us Robert.Artis@dhs.state.nj.us Assistant Commissioner Chief of Staff Assistant CFO, DHS Chief Information Officer Director, Supports Program & Employment Services Director, Waiver Unit Director, Support Coordination & Case Management Special Assistant DDD Communications Family Outreach
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 Kelli Rice Kelli.Rice@dhs.state.nj.us 4 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 CCP Fee-For-Service Michelle Whitmore Michelle.Whitmore@dhs.state.nj.us
FFS Implementation: Community Care Program 10,995 Community Care Program (CCP) Transition Letters and Support Coordination Agency Selection Forms sent to individuals identified for transition from CCP to CCP-FFS 10,150 CCP individuals assigned to Support Coordination Agency 8520 CCP individuals with approved Individualized Service Plan (ISP)approved plans 5
FFS Implementation: Supports Program Current Supports Program (SP) enrollment: 8,704 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 6 Identify individuals who may need to be dis-enrolled from SP
FFS Implementation: Support Coordination Support Coordination (SC) capacity Medicaid/DDD approved SC Agencies: 156 SC Maximum Capacity: 26,022 Individuals currently assigned to an SC Agency: 18,443 Remaining Capacity: 7,579 7
Register Ready 8 NJ Register Ready is a voluntary special needs registry in case of disaster or emergency; allows the opportunity for people with disabilities and their families to provide their name and information so it can be shared with emergency response agencies Registering on NJ Register Ready ensures that emergency responders are prepared to serve people with disabilities in the event of a disaster or other emergency
Advocacy In an effort to increase collaboration, the Division is meeting with advocacy organizations to develop statewide opportunities to hear directly from the individuals we serve Engaging with the following Advocate organizations New Jersey Self-Advocacy Project The Boggs Center People First New American Movement 9
Identified need: Advocacy Assess what is currently happening in the state in advocacy 10 Plan steps that can be taken to strengthen and enhance current efforts Develop recommendations for action Provide valuable input as DDD continues its systems change and allow self-advocates to have a voice in those changes
Advocacy First step is a steering meeting with the four advocacy groups to: Define mission Ensure meetings are put together in a way that works for advocates Identify topic areas Choose locations/dates 11 The meetings that are ultimately held will be open to all advocates, whether they belong to an organization or not
Komninos' Law Update Field Safety and Services Unit Two-hour guardian notification Incident verification Drug testing CARI (Child Abuse Record Information) checks 12
Komninos' Law Update Field Safety and Services Unit (FSSU) Launched August 8th, 2018 Sites visited 770 Individuals visited 1,972 Incident Reports generated 22 Send after-hours contact information to: Dhs-sklaw.Opia@dhs.state.nj.us 13
Komninos' Law Update Two-hour guardian notification Any major injury Any moderate injury Minor injury as a result of Abuse Neglect Restraint Suicide attempt Send explanation letters within 14 days to CIMU 14 DHS.CIMADMIN@dhs.state.nj.us
Incident Verification Komninos' Law Update 2,539 incidents verified since implementation 2,286 completed within the first 24 hours (90%) Timely reporting is important Current contact information is key 15
Drug Testing Komninos' Law Update 191 agencies actively drug testing 6,673 completed drug tests since implementation 95% of all tests are negative Random testing to begin in January 2019 Webinar Training opportunities in November 2018 16
CARI Checks Komninos' Law Update 17 Began July 16, 2018 Approximately 2,700 applications uploaded 1,571 applications have been forwarded to DCF for processing 940 applications have been returned 5 records were found, resulted in removal Less than 150 agencies have uploaded applications
DSP Wage Increase On June 30, 2018 legislation was passed to provide funding for a wage increase for Direct Support Professionals (DSPs) The legislation requires funding to be provided by increasing Fee-For-Service (FFS) reimbursement rates for specific services provided through the Supports Program and Community Care Program See page B-212 of below link for detail: www.nj.gov/treasury/omb/publications/19approp/94.pdf 18
DSP Wage Increase The legislation includes $20M to be portioned out to the Department of Children and Families, Department of Labor, and DDD The DDD allocation of this amount, plus the federal matching funds available, will provide an estimated $32M in additional funding to providers 19
DSP Wage Increase FFS rate increase is in effect as of October 1, 2018 FFS Individual Budgets will be increased accordingly Service providers are required to pass along the increase to DSPs 20
DSP Wage Increase FFS and Self-Directed Employees (SDEs) If in FFS, the individual/family can engage Support Coordinator in negotiating an increased wage for SDEs Automatic rate increases did not occur as the amount paid is negotiated Increase in salary is not mandatory for SDEs as the wage is negotiated 21
DSP Wage Increase For the period of July 1, 2018 to September 30, 2018, funding will be disbursed to service providers via a one-time payment that they must pass on to staff, much like last fiscal year Amount of increase will be based on each provider s proportion of FFS payments for that period 22 October 1, 2018 forward the increase will be provided through the rates
DSP Wage Increase Once changes are made, Support Coordinators will have to move any un-approved plans through the process of approval again Approved plans will be adjusted to reflect new rates with no action needed by the Support Coordinator 23 Questions or issues related to the DSP Wage Increase should be directed to: DDD.FeeForService@dhs.state.nj.us
DSP Wage Increase 24 Impacted services Career Planning www.nj.gov/humanservices/ddd/documents/rate-increase-grid.pdf Community Based Supports Community Inclusion Services Day Habilitation Individual Supports Pre-Vocational Training Respite Supported Employment
DSP Wage Increase 25 Service Service Description / Tier Procedure Code Old Rate New Rate Career Planning Career Planning H2014HI 13.25 13.63 Community Inclusion Services Tier A H2015HIU1 2.36 2.43 Tier B H2015HIU2 2.99 3.07 Tier C H2015HIU3 3.73 3.84 Tier D H2015HIU4 5.6 5.76 Tier E H2015HIU5 7.46 7.68 Community-Based Supports CBS H2021HI 7.01 7.21 CBS (Acuity) H2021HI22 11.89 12.23 Day Habilitation Tier A T2021HIUS 2.36 2.43 Tier A/Acuity Differentiated T2021HIU1 3.43 3.53 Tier B T2021HIUR 2.99 3.07 Tier B /Acuity Differentiated T2021HIU2 4.35 4.47 Tier C T2021HIUQ 3.73 3.84 Tier C/Acuity Differentiated T2021HIU3 5.43 5.59 Tier D T2021HIUP 5.6 5.76 Tier D/Acuity Differentiated T2021HIU4 8.15 8.38 Tier E T2021HIUN 7.46 7.68 Tier E/Acuity Differentiated T2021HIU5 10.87 11.18
DSP Wage Increase 26 Service Service Description / Tier Procedure Code Old Rate New Rate Individual Supports Individual Supports H2016HI 7.01 7.21 Individual Supports Acuity H2016HI22 11.89 12.23 Tier A H2016HI52 70.52 72.54 Tier A/Acuity Differentiated H2016HIU1 149.84 154.14 Tier B H2016HIUS 141.04 145.09 Tier B /Acuity Differentiated H2016HIU2 299.68 308.28 Tier C H2016HIUR 235.07 241.82 Tier C/Acuity Differentiated H2016HIU3 499.46 513.8 Tier D H2016HIUQ 329.1 338.55 Tier D/Acuity Differentiated H2016HIU4 699.25 719.32 Tier E H2016HIUP 423.13 435.27 Tier E/Acuity Differentiated H2016HIU5 899.04 924.84 Prevocational Training Individual T2015HI22 12.73 13.09 Tier A - Group T2015HIUS 2.68 2.76 Tier B - Group T2015HIUR 3.4 3.49 Tier C - Group T2015HIUQ 4.24 4.36 Tier D - Group T2015HIUP 6.37 6.55 Tier E - Group T2015HIUN 8.49 8.73
DSP Wage Increase 27 Service Service Description / Tier Procedure Code Old Rate New Rate Respite Day & Overnight Camp T2036HI 229.2 235.78 Day Camp Only - up to 6 hours per day T2036HI22 114.72 118.01 In-Home - Per Diem CCR Only S9125HI 141.04 145.09 Respite T1005HI 4.78 4.91 Respite Daily - Out of Home Overnight Tier A T1005HI52 57.36 59.01 Respite Daily - Out of Home Overnight Tier A / Acuity Differentiated T1005HIU1 114.72 118.01 Respite Daily - Out of Home Overnight Tier B T1005HIUS 114.72 118.01 Respite Daily - Out of Home Overnight Tier B / Acuity Differentiated T1005HIU2 229.44 236.03 Respite Daily - Out of Home Overnight Tier C T1005HIUR 191.2 196.69 Respite Daily - Out of Home Overnight Tier C / Acuity Differentiated T1005HIU3 382.4 393.38
DSP Wage Increase 28 Service Service Description / Tier Procedure Code Old Rate New Rate Respite Continued Respite Daily - Out of Home Overnight Tier D T1005HIUQ 267.68 275.36 Respite Daily - Out of Home Overnight Tier D / Acuity Differentiated T1005HIU4 535.35 550.72 Respite Daily - Out of Home Overnight Tier E T1005HIUP 344.16 354.04 Respite Daily - Out of Home Overnight Tier E / Acuity Differentiated T1005HIU5 688.32 708.08 Supported Employment (Group) Tier A - Group T2019HIUS 2.79 2.87 Tier B - Group T2019HIUR 3.53 3.63 Tier C - Group T2019HIUQ 4.42 4.54 Tier D - Group T2019HIUP 6.62 6.81 Tier E - Group T2019HIUN 8.83 9.08 Supported Employment (Individual) SE Individual T2019HI 13.25 13.63
Budget Comparison 29 Tier Supports Program Original New Ceiling Difference Ceiling A $19,000 $19,546 $546 Aa $25,000 $25,719 $719 B $28,000 $28,805 $805 Ba $36,000 $37,035 $1,035 C $32,000 $32,920 $920 Ca $42,000 $43,207 $1,207 D $48,000 $49,380 $1,380 Da $62,000 $63,782 $1,782 E $58,000 $59,667 $1,667 Ea $78,000 $80,242 $2,242 Tier Community Care Program Original New Ceiling Difference Ceiling A $44,740 $46,026 $ 1,286 Aa $79,692 $81,982 $ 2,290 B $79,480 $81,764 $ 2,284 Ba $145,383 $149,562 $ 4,179 C $117,801 $121,186 $ 3,385 Ca $224,303 $230,750 $ 6,447 D $168,122 $172,954 $ 4,832 Da $317,226 $326,344 $ 9,118 E $212,442 $218,549 $ 6,107 Ea $406,150 $417,823 $ 11,673
DSP Wage Increase 30 The difference noted on the previous slide will be placed in a 4 th budget category called DSP Service that can only be used for the impacted services This ensures the funding is only used for services that impact DSP wages, as intended by the legislation
Provider Recruitment 31 Webinar to be held October 3, 2018 to solicit new and current providers to develop additional capacity for individuals with intense behaviors, medical needs requiring on-site nursing, or a combination thereof Services requested include those received in an individual/family s home (e.g. employment/day services, respite, behavioral supports) or in a provider managed setting (e.g. group home or supervised apartment)
Webinar will outline Provider Recruitment Information of DDD population in NJ Service needs Need for both in home supports, as well as out of home NJ s Medicaid Wavier Services Budgets 32
Provider Recruitment Notice of webinar distributed to: DCF DMHAS DDD Communications Trade Organizations in NJ and PA Agencies that had approached NJ previously Agencies suggested by national experts 33
Provider Recruitment Incentives 34 Division is currently developing a Request for Letter of Interest (RLI) that will identify incentives for providers to develop residential settings for individuals with intense behaviors and/or medical needs requiring on-site nursing Preference will be given to providers new to DDD who have a track record of serving the targeted populations in other states or in New Jersey for other entities
Provider Recruitment Incentives Current elements of RLI Maximum of 16 new residences across entire RLI Maximum of four programs awarded to any single agency Maximum of $60,000 per four-person residence Funding released when all residents move in and residence is fully occupied Restricted to housing not currently open or in development Agency must accept DDD referrals no substitutions 35 Majority of sites will serve those with behavioral health needs
Helpful Links Register Ready www13.state.nj.us/specialneeds/signin?returnurl=/special Needs/ DSP Wage Increase Language from FY19 Appropriations Act (Page B-212) www.nj.gov/treasury/omb/publications/19approp/94.pdf DSP Wage Increase Original versus New Rates www.nj.gov/humanservices/ddd/documents/rate-increasegrid.pdf 36