part 17

[Virtual Presenter] We have important news to share: Our program offers essential services to individuals with intellectual/developmental disabilities. Our administrative agency ensures that the individual's identity will not be revealed without written consent or a court order, in accordance with the H&W and T-B-I Waivers DDRS HCBS Waivers. Providers must also follow these standards when offering waiver services or other necessary services. When a complaint is investigated, the ombudsman reports their findings to the complainant. If a complaint is not investigated, the ombudsman informs the complainant of the decision and reasons for not investigating. This allows individuals to have a voice and advocate for their rights. We have a toll-free hotline available for receiving complaints about individuals with intellectual/developmental disabilities on waivers. All complaints received must be passed on to the statewide waiver ombudsman. The ombudsman will notify the individual that the complaint process is separate from a Medicaid fair hearing, but both options are available for addressing concerns. We conduct provider compliance reviews for non-licensed waiver service providers and licensed providers who offer services outside the scope of their license. These reviews include a check of provider policies and adherence to state and federal requirements. If a provider fails to cooperate or complete required actions, they may face sanctions from the B-D-S Quality Assurance Director. This ensures that providers are accountable and individuals receive high-quality services. Additionally, we prepare an annual report detailing the program's operations, trends, and recommendations for improvement. This report is shared with the governor, legislative council, and D-D-R-S director to keep stakeholders informed. We are committed to the success of our program and serving individuals with intellectual/developmental disabilities..

[Audio] This presentation aims to showcase the services available for individuals with intellectual and developmental disabilities through a program overseen by the Family and Social Services Administration (F-S-S-A-). Slide 2 will cover the programs outlined in the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers, including care coordination and provider reviews. F-S-S-A conducts various audits, including self-audits, desk audits, and on-site audits, to ensure program integrity. These audits are based on data analysis, identification of outliers and problematic billing patterns, and referrals from other divisions and state agencies. The Program Integrity Unit works closely with all waiver divisions and maintains open communication for policy clarification and other concerns. Although the Fraud and Abuse Detection System (F-A-D-S-) contractor may be involved, F-S-S-A maintains overall oversight throughout the process. The Audit Division of F-S-S-A reviews waiver audit schedules and findings to avoid repetition and ensure consistent methodology. In addition to provider reviews, certified care managers approved by the Division of Aging provide care management services for individuals on Medicaid waivers. Until 2025, the 15 local Area Agencies on Aging (AAAs) serve as the single point of entry for Medicaid waivers. Once eligibility is determined and approved, the A-A-A will provide the necessary documentation for the H&W or T-B-I waiver. We appreciate your attention and look forward to sharing more about the services we offer for individuals with intellectual and developmental disabilities through this program..

[Audio] This meeting is about discussing the services offered under Section 12 of the H&W and T-B-I Waivers DDRS HCBS Waivers. Our service coordinators and care coordinators are highly qualified to provide the best care for our clients. Service coordinators must have at least one year of experience with the program population, be a registered nurse or licensed practical nurse, and hold a bachelor's or associate degree. They also have to have experience in delivering healthcare, social services, or case management. Our care coordinators must receive training on recommended topics from the F-S-S-A if any issues with their services arise. Care management cannot be conducted by anyone who also provides in-home or community-based services under F-S-S-A waivers, or anyone with common ownership or control of such services under the Medicaid waiver program. It is important to note that reimbursement for care management services is only possible when the client becomes eligible for waiver services. Care managers must meet the F-S-S-A guiding principles, which include being responsive, efficient, and effective in service delivery, as well as promoting effective communication, respect, dignity, and personal empowerment for all individuals. They must also adhere to person-centered planning, informed choice, and fiscal stewardship, while providing quality customer service and complying with F-S-S-A standards. Failure to cooperate with the review procedure or complete corrective actions may result in sanctions or even termination as a waiver provider. This is a serious matter and we are dedicated to ensuring the best care for our clients. For any concerns, we have a toll-free telephone line available at all times. It is important to us to address and resolve any issues in a timely manner..

[Audio] This presentation will discuss the DDRS HCBS Waivers, specifically Section 12, which covers the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. It is our top priority to protect the privacy of all individuals receiving waivers. We ensure that their identity is kept confidential and only shared with their written consent or a court order. Any complaints are thoroughly investigated by our ombudsman, who then reports their findings to the complainant in a timely and professional manner. In addition to our strict privacy policies, we also have ongoing Medicaid H-C-B-S Waiver Care Management Standards that all care managers must adhere to. These standards include maintaining high levels of professionalism and ethical conduct, following all documents issued by the F-S-S-A-, and complying with federal, state, and local laws and regulations. Care managers are also required to complete annual training. Before being eligible for Medicaid reimbursement, care managers must complete a comprehensive orientation program that covers topics such as general care management, narrative, skilled needs, activities of daily living, and incident reporting. They are also required to complete an additional 18 hours of training annually, which can cover topics such as care coordination, documentation, medical terminology, and specific diagnoses or treatments that affect our diverse client base. It is important to note that certain training topics, such as care management orientation and required annual retraining, do not count towards the required 18 hours. Additionally, all training documentation is regularly reviewed in compliance surveys and at the request of the FSSA. Our commitment to privacy, professionalism, and ethical standards is evident in every aspect of our program. We strive to provide the best possible care to our waiver individuals and are constantly seeking ways to improve and enhance our services. Thank you for your attention..

[Audio] The H&W and T-B-I Waivers DDRS HCBS Waivers include a program, outlined in Section 12, that offers services to individuals with intellectual/developmental disabilities. Any information about these individuals will be kept confidential, unless written consent or a court order is obtained. An ombudsman is responsible for reporting findings to the person who filed a complaint and will also inform them if the complaint is not being investigated. Additionally, a yearly report is created that describes the program, identifies any trends, and makes recommendations for changes. Complaints regarding waiver individuals can be made through a toll-free telephone line at any time. Compliance reviews are conducted for both non-licensed and licensed providers to ensure they are following state and federal requirements. If a provider does not cooperate with the review process or fails to complete corrective actions, they may be referred to the B-D-S Quality Assurance Director for a formal complaint. This could result in sanctions, including termination as a waiver provider. All actions taken with providers are documented in OMPP's certification platform. Before taking any action, alternative service options will be offered to affected participants through their care manager..

[Audio] We are discussing how to support individuals with intellectual/developmental disabilities through the program outlined in the H&W and T-B-I Waivers. As an administrator, I ensure that the individual's identity is not disclosed without written consent or a court order. As an ombudsman, I report findings and notify if not investigating a complaint. An annual report is prepared describing the program's operations, identifying trends, and recommending changes. A toll-free telephone line is available to receive complaints regarding waiver individuals. Provider compliance reviews are conducted for all non-licensed waiver service providers and licensed providers that offer services outside the scope of their license. Compliance reviews include a review of provider policies and adherence to state and federal requirements. Any provider who fails to cooperate with the review procedure or complete the corrective action process is referred to the B-D-S Quality Assurance Director or designee as a formal complaint, which may result in sanctions up to and including termination as a waiver provider. Documentation of all corrective actions taken with providers is maintained in OMPP’s provider certification platform. Prior to taking action to suspend or terminate a provider, alternative service options will be provided to any affected participants through their care manager..

[Audio] We offer various services for individuals with intellectual/developmental disabilities through our programs outlined in the H&W and T-B-I Waivers DDRS HCBS Waivers. We prioritize the privacy and confidentiality of the individuals we serve by ensuring that their identity will not be disclosed without written consent or a court order. Any provider who fails to cooperate with the review procedure or complete the corrective action process is considered a formal complaint, which may result in sanctions up to and including termination as a waiver provider. We have a toll-free telephone line to receive complaints regarding waiver individuals and investigate and prepare an annual report describing the operations of the program, identifying trends, and recommending changes. Our program offers a variety of services, including Adult Day Services – Level 3 (Category 2), Attendant Care (Agency), Attendant Care (NonAgency), Attendant Care (ConsumerDirected), Participant-Directed Home Care – Skilled, Participant-Directed Home Care – Unskilled, Home and Community Assistance (Agency), Home and Community Assistance (Non-Agency), Structured Family Caregiving (Level 1), Structured Family Caregiving (Level 2), Structured Family Caregiving (Level 3), Adult Family Care (Level 1), Adult Family Care (Level 2), Adult Family Care (Level 3), Personal Emergency Response System – Install, Personal Emergency Response System – Maintenance, Home Modification Assessment, Home Modifications – Install, Home Modifications – Maintenance, Home-Delivered Meals, and Library Reference Number: PRPR10014. We are committed to complying with all state and federal requirements and have policies and procedures in place to protect the identity of the individual. We value your feedback and are committed to providing the best services possible for individuals with intellectual/developmental disabilities. Thank you for your time and attention..

[Audio] We offer services for individuals with intellectual/developmental disabilities. Our agency values the privacy of our clients and we are committed to ensuring their well-being. We prepare a report on our program's operations, identify trends, and recommend changes every year. We offer a toll-free telephone line for complaints about waiver individuals. We conduct compliance reviews for all non-licensed waiver service providers and licensed providers that provide services outside their scope of license. Providers that fail to cooperate with the review procedure or complete the corrective action process are referred to the B-D-S Quality Assurance Director or designee as a formal complaint, which may result in sanctions up to and including termination as a waiver provider. We document all corrective actions taken with providers in our provider certification platform. We always offer alternative service options to any affected participants through their care manager before taking action to suspend or terminate a provider. We are confident that our services can positively impact the lives of individuals with intellectual/developmental disabilities..

[Audio] We are committed to delivering exceptional services to our clients. Our program includes an ombudsman who reports any findings to the complainant and notifies them if the complaint is not investigated. This ensures that our clients have a voice and that their concerns are heard and addressed promptly. We take all complaints seriously and will take appropriate corrective action to ensure that our clients receive the best possible care. Our provider compliance reviews are conducted for all non-licensed waiver service providers and licensed providers that offer services outside the scope of their license. These reviews ensure that our providers meet the highest standards of quality and are providing services that are safe, effective, and beneficial to our clients. Any provider who refuses to cooperate with the review procedure or complete the corrective action process will be referred to the B-D-S Quality Assurance Director or designee as a formal complaint, which may result in sanctions up to and including termination as a waiver provider. We believe that our program is a crucial step towards providing high-quality services to individuals with intellectual/developmental disabilities. We are committed to continuously improving our services and to ensuring that our clients receive the best possible care. Thank you for your attention, and if you have any questions, please don't hesitate to ask..

[Audio] Intensive Adult Day Services (Level 3) includes additional services such as hands-on assistance or monitoring with all A-D-Ls and personal care, one or more direct health interventions required, rehabilitation and restorative services, including physical therapy, speech/language therapy, and occupational therapy (coordinated or available), and therapeutic intervention to address dynamic psychosocial needs, such as depression or family issues affecting care. The minimum staff ratio for Intensive Adult Day Services (Level 3) is one staff for each four individuals, with an RN consultant available..

[Audio] As an author and voiceover script writer, I am here to provide you with an overview of the services that we can provide for individuals with intellectual/developmental disabilities through the program outlined in Section 12 of the waivers. We offer a range of services for individuals with intellectual/developmental disabilities. These services include provider compliance reviews, which are conducted for all non-licensed waiver service providers and licensed providers that offer services outside the scope of their license. Compliance reviews include a review of provider policies and adherence to state and federal requirements. Any provider who fails to cooperate with the review procedure or complete the corrective action process is referred to the B-D-S Quality Assurance Director or designee as a formal complaint, which may result in sanctions up to and including termination as a waiver provider. It is important to note that documentation of all corrective actions taken with providers is maintained in OMPP’s provider certification platform. Prior to taking action to suspend or terminate a provider, alternative service options will be provided to any affected participants through their care manager. We have strict qualifications for our providers. These qualifications include being licensed or certified, complying with the Adult Day Services Provision and Certification Standards, and adhering to other standards, such as financial information, liability insurance, maintenance of personnel records, and operations manual. We also offer accreditation from the Indiana Association of Adult Day Service as part of the adult-day provider credentialing through the F-S-S-A-. All providers, both new and existing, are given the option of receiving accreditation from the Indiana Association of Adult Day Service. We understand the importance of protecting individuals with intellectual/developmental disabilities, and we take this responsibility seriously. We have policies and procedures in place to protect individuals from unusual occurrences and to report on any incidents. We also have a notice of termination of services policy, a transfer of individual’s record upon change of provider policy, and a provider organizational chart policy. We are committed to providing high-quality care and services for individuals with intellectual/developmental disabilities. We have a quality assurance and quality improvement system in place, and we regularly review and update our policies and procedures to ensure that we are meeting the needs of our clients. Thank you for considering our services. If you have any further questions, please do not hesitate to contact us..

[Audio] Our program offers a variety of services for individuals with intellectual and developmental disabilities. Our services are carefully designed to provide the highest quality of care while respecting the privacy of our participants. We ensure that the identity of each individual is kept confidential, unless written consent or a court order is obtained. This is to respect the privacy of our participants and maintain their autonomy. Additionally, our program has an ombudsman responsible for reporting any findings to the complainant, ensuring transparency, and giving our participants a voice in the program. We prepare an annual report that describes the operations of our program, identifies trends, and recommends changes for improvement. This ensures that our program is always evolving to meet the needs of our participants. To address any concerns, we have a toll-free telephone line open to receive complaints regarding waiver individuals. We conduct compliance reviews for all non-licensed waiver service providers and licensed providers offering services outside the scope of their license. If a provider fails to cooperate with the review process or complete the corrective action, they will be referred to the B-D-S Quality Assurance Director for further action. All actions taken with providers are carefully documented and maintained in our provider certification platform. Before taking any action to suspend or terminate a provider, we always provide alternative service options to any affected participants through their care manager. Overall, our program is dedicated to providing excellent services for individuals with intellectual and developmental disabilities. We are committed to ensuring their privacy, protecting their rights, and continually improving our services to meet their unique needs..

[Audio] We will discuss the services that can be provided to individuals with intellectual and developmental disabilities through the program outlined in Section 12 of the H&W and T-B-I Waivers DDRS HCBS Waivers. The administrative agency ensures the confidentiality of the individual's identity, unless written consent or a court order is obtained. The ombudsman reports any findings to the complainant and notifies them if the complaint is not being investigated. An annual report is prepared to describe the operations of the program, identify any trends, and make recommendations for any necessary changes. We have a toll-free telephone line that is continuously open to receive complaints regarding waiver individuals. Provider compliance is ensured through regular reviews of all non-licensed waiver service providers and licensed providers offering services outside the scope of their license. These reviews include a thorough examination of provider policies and adherence to state and federal requirements. Any provider who fails to cooperate with the review procedure or complete the corrective action process is referred to the B-D-S Quality Assurance Director or designee as a formal complaint. This may result in sanctions, including termination as a waiver provider. All documentation of corrective actions taken with providers is maintained in OMPP's provider certification platform. Before taking any action to suspend or terminate a provider, alternative service options will be provided to any affected participants through their care manager. Finally, we will focus on the specific services offered under Section 12 of the H&W and T-B-I Waivers DDRS HCBS Waivers. These include home and community assistance related to instrumental activities of daily living (IADLs) and medication oversight, to the extent permitted by state law. It is important for all A-F-C services to follow a written service plan that addresses the specific needs of the participant, as determined by their P-C-A--. These services must also meet the level of service needs for each individual. It is required for the provider to live in the A-F-C home unless another provider has been contracted prior. These service standards ensure that each individual receives the necessary care and support to improve their quality of life. Thank you..

[Audio] The final slide of our presentation focuses on the necessary documentation that providers must adhere to when offering services to individuals with intellectual and developmental disabilities through the program outlined in Section 12 of the H&W and T-B-I Waivers DDRS HCBS Waivers. The administrative agency responsible ensures that the individual's identity remains confidential unless written consent or a court order is given. The ombudsman will report their findings to the complainant and inform them if a complaint is not being investigated. Additionally, an annual report is prepared to describe the program's operations, identify any trends, and make recommendations for changes. It is crucial for providers to follow the documentation standards set by the program. This includes daily documentation to support services provided by the A-F-C in addressing the needs identified in the P-C-A--. This may involve the participant's status, such as their health, mental health, medication, diet, sleep patterns, and social activity. Monthly updates are also required, covering any changes in the participant's status, participation in consumer-focused activities, and medication management records, if applicable. All documentation must be thorough and accurate. Moreover, compliance reviews are carried out for all non-licensed waiver service providers and licensed providers that offer services outside the scope of their license. These reviews ensure that providers comply with state and federal requirements. Any provider who does not cooperate with the review process or complete the corrective action process may face sanctions, including termination as a waiver provider. Documentation of all corrective actions taken with providers is recorded in OMPP's provider certification platform. Before taking any action to suspend or terminate a provider, alternative service options will be provided to any affected participants through their care manager. We appreciate your attendance at this presentation on DDRS HCBS Waivers Section 12: Health and Wellness and Traumatic Brain Injury Waivers. We hope that this information has been valuable and informative. Thank you..