1

JULY 2012

PERSONNEL Kristy Cook started as the Bureau of Rehabilitation Services Director of Policy and Planning on April 16, 2012. She began her career with Vocational Rehabilitation Serves (VRS) in 2006 as a VR Counselor in Columbus, IN followed by transferring to Indianapolis in 2008. Kristy continued to serve as Area Supervisor for two Indianapolis offices and held her most recent position as Region Manager for Central Indiana since 2009. She is currently appointed by Mayor Greg Ballard to serve on the EmployIndy Board of Directors and the Executive Committee for the Mayor’s Advisory Council on Disability. Kristy holds a Bachelors of Science degree in Psychology from Eastern Kentucky University and a Masters in Education/School Counseling from the University of Cincinnati. She has experience working with substance abuse counseling, mental health counseling, and school counseling.

Greg Hunter has joined the Bureau of Developmental Disability Services (BDDS) Data Unit as a Support Systems Analyst, on April 30 2012. Greg has an extensive background in information technology systems and supports with One America, Electronic Data Systems, and MDwise Hoosier Alliance.

Laura Genrich-Perkins joined Deaf and Hard of Hearing Services (DHHS) as a Program Coordinator on June 11, 2012. She received her BA degree from Gallaudet University and has worked in the Deaf and Hard of Hearing community for many years. Laura has a large array of knowledge and experience that should benefit DHHS and the Deaf/Hard of Hearing community.

Leslie O’Sullivan started as the Client Service Project Coordinator, on June 11, 2012 for the Bureau of Developmental Disabilities Services (BDDS). She started her career as a BDDS Service Coordinator in 2009 and later became the District Manager for the Terre Haute office in 2011. Leslie received her Bachelor’s of Arts in Sociology from Franklin College and holds Master’s in Education/School Counseling from Purdue University.

Personnel

Web Additions

Statewide Initiatives

BDDS

Supervised Group Living

BDDS Waiver Data

Employment First

Housemate Survey & Process

BRS Federal Indicator Progress

New VRS Regions and

Managers

VRS Success Story

Deaf/Blind Annual Training

BVIS Update

BQIS

NCI Project

90-Day Checklist

Provider Re-Approvals

Complaint Investigations

Mortality Data

CERT Update

Incident Reporting

DDB

First Steps

2

WEB ADDITIONS Webinar: Autism and Developmental Disabilities waivers combine The Division of Disability and Rehabilitative Service (DDRS) with the Autism Society of Indiana and Indiana Resource Center for Autism hosted a webinar on May 30, 2012, to discuss the combining of the Autism and Developmental Disability Medicaid Waivers. The webinar has been posted to the DDRS website on the Bureau of Developmental Disabilities Services (BDDS) webpage. Questions posed during the webinar have also been posted with answers from DDRS, the Autism Society of Indiana and the Indiana Resource Center for Autism. Quarterly Provider Meeting PowerPoint DDRS has posted the PowerPoint presentation from the June 27, 2012 Quarterly Provider meeting. A link to the presentation can be found on the DDRS Announcement webpage.

State Line Item Manual The Bureau of Developmental Disabilities Services (BDDS) has updated its Service Definitions Manual for State Line services and made it available on the DDRS website under DDRS Manuals. The changes and revised rates of reimbursement will be effective July 1, 2012. The revised rates of reimbursement reflect Medicaid waiver services rates.

Waiver Amendments The amendment for the Community Integration and Habilitation Waiver (formerly the DD Waiver) has been posted the to the DDRS Draft Policy webpage. The expected effective date is September 1, 2012, pending CMS approval. The Family Supports Waiver, located on the BDDS webpage has been approved by CMS with an effective date of September 1, 2012.

Statistics DDRS has updated the Statistics webpage to include the total number of individuals placed on a waiver weekly, monthly and yearly. This information will be updated at the beginning of every week.

STATE WIDE INITIATIVES Wait List Letters DDRS has been working to make some positive changes in its service delivery to consumers. In preparation for these changes, DDRS is making an effort to ensure that the Medicaid Waiver Wait List is as up to date as possible. Over 19,000 letters and Waiver Wait List Status Forms were sent to consumers whose names were listed on the Wait List in March 2012, asking them to:

1. Review and update their contact information (if necessary) on the Waiver Wait List Status Form 2. Indicate their desire to remain on the Waiver Wait List on the Waiver Wait List Status Form 3. Contact their local BDDS office if interested in placement into group homes

DDRS has had a very positive response, and as of July 12, 2012, staff has updated 16,042 consumers’ information. As a result thus far, there have been 1,899 consumers’ names removed from the Waiver Wait List because:

they indicated they desired to be removed

3

they were already on the Waiver for which they were on the Wait List, or

they were no longer living at the address DDRS had on file, and there was no other address in our system

If you did not receive an initial Wait List Letter and believe you should have, please contact your local BDDS office to determine if you are in our data system. A FAQ about the Wait List letter is available on the Announcements page.

BUREAU OF DEVELOPMENTAL DISABILITIES SERVICES

Supervised Group Living Vacancy All SGL vacancy reports should be on the form that was revised December 2011. All reports should be sent to Ron Smith (Ronald.Smith@fssa.in.gov ) and Jeanette Siener (Jeanette.Siener@fssa.in.gov).

DDRS/BDDS Waiver Data

BDDS

Waiting List

Individuals Targeted (February 2011 to July

2, 2012)

Total Served

Developmental Disabilities Waiver 19,086 463 7,230

Support Services Waiver 11,868 1,497 4,994

Autism Waiver 5,615 213 550

Second Quarter 2012

April 1-June 30

Placements 152

Vacancies as of April 31, 2012 149

Total Capacity (Vacancy Rate) 3.9%

4

Employment First Initiative Updates The SELN work-plan is in the action phase, with several groups meeting on the various focus areas. All case managers have been trained on Employment First, as a result from Bloomington and Kokomo work groups. Also, all of the demonstration sites are currently setting their goals for next year. The graph below outlines the 2011 numbers and percent of BDDS Waiver Consumers in Integrated Work Hours and Wage Data for the past 24 months.

Housemate Survey & Matching Process A housemate matching process was recently established to assist individuals looking for roommates. Questionnaires were sent to individuals that may be currently seeking housemates or may wish to add a housemate in the future. The information collected will be put into a database. In the future, individuals or teams will be able to request a review of the information submitted by potential housemates. Personal identification will not be released in the review process. With consent of both parties, the individuals’ names will be released and case managers will facilitate introductions with the individuals and their teams.

5

BUREAU OF REHABILITATION SERVICES Federal Indicator Progress BRS is nine months into Federal Fiscal Year 2012 and already showing significant progress towards meeting the Federal Indicators. At the close of FFY 2011, BRS was below standard in three indicators. At this time, BRS is below on only one indicator, but anticipates hitting the target by 9/30/2012. BRS Management would like to thank all staff for their continued daily efforts in fulfilling the BRS mission and assisting individuals with disabilities in obtaining/maintaining employment.

Federal Performance

Indicator

Federal Target Indiana Result FFY11

(10/1/10-9/30/11)

Indiana Result FFY12

(10/1/11-6/29/12)

1.1 Total Rehabilitation

Equal to/Greater Than

Previous Year

Previous Year’s total:

FFY11: 4,404

4,404 3,558

1.2 Rehabilitation Rate 55.80% 53.43% 59.16%

1.3 Competitive

Employment Outcome

72.60% 97.55% 97.27%

1.4 Percentage of People

(Competitively Placed)

With Significant Disability

62.40% 73.77% 75.30%

1.5 Ratio of Avg. Hourly

Wage (Competitive

Rehabilitants) to Avg.

Hourly Wage (All

Employed Hoosiers)

0.52 ratio 0.61/ $11.34 .60/$11.50

1.6 Own Income Largest

Source of Support at

Closure Compared to

Start of Services

53.0 48.42 50.56

2.1 Service Rate for

Minorities

.80 .77 .81

6

New VRS Region Alignment and Managers

VRS recently realigned its regions to make them more similar and compact. The new map has been posted to the VRS webpage. The chart below outlines the new alignment and includes the Region Managers, both old and new.

Old New

Region 1

Kim Dequis 1, 2, 3, 4, 5 1 (Gary W), 2 (Gary E), 3 (Valparaiso), 4 (South Bend), 5 (Elkhart)

Region 2

Rheonna Snedigar* 7, 8, 9, 10, 11

7 (Ft. Wayne N), 8 (Ft. Wayne S), 10 (Marion), 11 (Muncie), 23

(Richmond)

Region 3

Jan Reed*

12, 13, 14, 15,

16

6 (Lafayette), 9 (Kokomo), 12 (Anderson), 13 (Indpls NE), 14 (Indpls

Central)

Region 4

John Kaufman

6, 17, 18, 19,

20

17 (Terre Haute), 18 (Vincennes), 19 (Huntingburg), 20 (Evansville),

25 (Clarksville)

Region 5

Jeff Hughes*

21, 22, 23, 24,

25

15 (Indpls W), 16 (Indpls S), 21 (Bloomington), 22 (Columbus), 24

(Seymour)

*new managers

Rheonna Snedigar started with VRS in 2004 as a Counselor and became the Area Supervisor of the Richmond office in 2009. Rheonna has a M.Ed. in Counseling and Educational Psychology with a focus in Rehabilitation Counseling from the University of Missouri – Columbia. Prior to working for VR, Rheonna worked in the mental health field.

Jan Reed started with VRS as a counselor in 1998 and served on the Rehabilitation Services Commission. She assumed the position of Supervisor for Indianapolis, Central in 2009. Jan holds a Master’s in Rehabilitation Administration from Southern Illinois University and a National Certification as a Certified Rehabilitation Counselor. She has previous experience working at DMHA as a Provider and Community Liaison.

Jeff Hughes started as the VRS Region Manager for Region 5 on Monday, June 11, 2012. His most recent experience with VRS was as the Coordinator of Training and Professional Development and is a former VRC.

VRS Success Story The following e-mail was sent to VRS Counselor Satomi Wakabayashi, from a consumer out of the Muncie Office. “Hi, my name is Robin, and on Jan. 9, 2009 I woke up and found out that I had optic neuritis which left me legally blind. I went to Vocational Rehab to meet with Satomi to try to come up with a plan for me. VRS helped me in so many ways I can't thank them enough. They first paid for me to go to bioptic driving school, which

7

enables me to drive with special glasses, which they paid for and now I can drive with no restrictions!! They paid for my eye wear and my appointment with a low vision specialist. They also paid for my special telescope glasses to enable me to return back to work as a dental hygienist, which I had done for 18 years prior to my incident with optic neuritis. Without VRS' help I could not have returned back to work, and to a career that I truly love!! VRS is amazing! They truly care about their clients and do all they can to help. Without their help and support I don't know where I would be today. Thanks so much Voc Rehab!!”

Deaf/Blind Annual Training The Deaf/Blind Annual Training was held at Pokagon State Park in Angola, Ind. While the drive was long for some, it was well worth the time as the facility was totally accessible and the staff’s eagerness to work with us was amazing. Eighty-eight participants attended this year’s training, including Vocational Rehabilitation Counselors for the Deaf, Counselors for the Visually Impaired, Supervisors, Independent Living Centers, Indiana School for the Deaf, Interpreters/CART, SSP, Deaf/Blind individuals, vendors, and several service dogs. Each day was packed with various workshops, and the evenings were filled with activities to promote networking opportunities and Deaf/Blind interaction. Plans are currently underway for next year’s training.

BVIS Update BVIS administers a program that serves people who are over 55 years of age and cannot read newsprint with best visual correction. There are currently eight programs in the state. Services offered include outreach services, visual screening, surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions, hospitalizations related to these services, provision of eyeglasses and other visual aids (electronic and non-electronic), adaptive equipment, mobility cane training, Braille instruction, guide services, reader services, transportation, information and referral, peer counseling, and advocacy.

BVIS recently completed a Request For Funding (RFF) that includes $400,000 for an Adaptive Aid Grant and is working on a second RFF to disperse 2013 Grant funds.

Business Enterprise Program (BEP) is in negotiations with The Emmitt J. Bean Center to provide Vending and Cafeteria services that will also allow BEP to place others with disabilities.

BUREAU OF QUALITY IMPROVEMENT SERVICES Announcing the National Core Indicators Project In August 2012, DDRS will join approximately 30 other states participating in the National Core Indicator (NCI) Project. The purpose of the NCI Project is for states to obtain data on a standard set of outcome measures to assess their own performance and compare themselves to other participating states across the country. The core indicators assess outcomes of services provided to individuals and address key areas of concern including human rights, service planning, community inclusion, employment, choice and decision making, relationships, satisfaction, health, and safety. States obtain information on the core indicators through interviews with individuals (and/or their guardians as necessary).

BQIS Surveyors will be conducting the face-to-face interviews with a random sample of individuals (and/or individuals’ guardians) receiving DDRS Home and Community Based Services (HCBS) waiver services.

8

Individuals (and/or individuals’ guardians) will be asked to provide their verbal consent to participate in the NCI Project at the time they are contacted to schedule the interview. Interviews will be scheduled at the individual’s (or individuals’ guardians) convenience and are planned to take approximately one hour to complete. All feedback obtained during the interviews are completely confidential and States participating in the NCI Project are not permitted to use NCI data for individual-specific remediation purposes. DDRS will be using aggregated, NCI Project data to support its overall quality assurance system. More information about the NCI Project can be found on its website.

90-Day Checklist As of June 16, 2012 case managers began using an updated version of the 90-Day Checklist when conducting their quarterly reviews with individuals’ support teams. DDRS has made considerable efforts to make the 90-Day Checklist and the case management’s review process more meaningful. Links to the updated 90-Day Checklist and the accompanying interpretive guidelines have been added to the BDDS webpage.

Provider Re-Approvals On July 1, 2012 DDRS implemented a provider re-approval process that grants current providers re-approval terms of either 6, 12, or 36 months. Residential habilitation service providers that have the oldest original approval date will be reviewed first. The goal is to re-approve all 125 residential providers prior to the end of the year. The following documents have been posted on the BDDS Provider Relations webpage to explain the provider re-approval process:

Provider re-approval process description

Sample Provider Re-approval Profile (PRP), which captures all of the information used to determine length of a provider’s re-approval term,

Frequently Asked Questions and responses, and a

Glossary of the technical terms used in this process

Please refer any questions to the BQIS.Help@fssa.in.gov

Visiting Individuals for BQIS Complaint Investigations When BQIS receives allegations concerning an individual’s (or individuals’) health and welfare potentially being at risk, BQIS Surveyors will visit the individual in their home or day program. Surveyors do not schedule these visits in advance, and may enter an individual’s home or day program at any time when the individual is receiving Medicaid Home and Community Based Waiver Services (HCBS). The objective of these visits is to substantiate or not substantiate allegations as they were described concerning the individual’s health, safety, and/or environment.

Individuals/Guardians receiving HCBS waiver services need to be aware and understand that to receive its Federal funding, the State of Indiana has made several assurances to the Federal Centers for Medicare & Medicaid Services. The primary assurance the state has made is to assure the health and welfare of all individuals receiving waiver services. If BQIS surveyors, BDDS service coordinators, case managers, or other agents representing the State encounter a pattern of being unable to enter an individual’s home, the individual’s waiver status may be in jeopardy. The State cannot assure an individual’s health and welfare if its representatives are unable to enter an individual’s home and assess the individual in their environment.

9

For your reference, DDRS has posted its policy regarding individual/guardian responsibilities while receiving waiver funded services on the DDRS Policies webpage. Mortality Review Communication BQIS’s Mortality Review Committee (MRC) reviews deaths of all individuals who received DDRS-funded services and provides systemic and provider-specific recommendations to mitigate future deaths from occurring due to the same or similar circumstances. BQIS will post supporting data and systemic recommendations resulting from these reviews on a quarterly basis. While the mortality data presented on the BQIS webpage may pertain to comorbid conditions that are not directly attributable to the cause of death, providers’ further examination is warranted as the risks involved with these conditions may have contributed to the cause of death. The expectation is for providers to increase its staff’s awareness of the issues discussed and to identify and make necessary systems changes to prevent future deaths and other negative outcomes for individuals. Compliance Evaluation Review Tool (CERT) Communication A summary of results and recommendations from reviews conducted through March, 2012 can be found on the BQIS webpage. The purpose of this information is for providers to assure alignment of their practices, procedures and files with the outlined regulations. Providers taking this approach will reduce organizational risk and facilitate a positive review process for those involved. On October 1, 2011 BQIS started using an updated version of the CERT that takes into account the new DDRS policies issued over the past several months. The data posted here is the first update based on reviews conducted using this new version of the CERT. The updated CERT is available on the BQIS webpage.

Incident Reporting Communication Similar to the Mortality Review and CERT Communications, BQIS is initiating a new quarterly communication, specific to incidents reported for allegations of abuse, neglect, and exploitation. This communication contains statewide, aggregated incident data collected through March 31, 2012 related to individuals receiving DDRS Home and Community Based Service waivers. Analysis of incident data is presented on the incident types reported most frequently, aggregated provider response time for reporting and closing incidents, and providers’ follow-up actions when investigating incidents of abuse, neglect, or exploitation allegations. This first Incident Reporting Communication is available on the BQIS’s Incident Reporting webpage.

DISABILITY DETERMINATION BUREAU Sylvia Funk was promoted to the Operations Director position for the Disability Determination Bureau (DDB), effective May 28. Sylvia will succeed Thomas Gernand in this position after his retirement in June 2012. Since coming to DDB as an Adjudicator Trainee in November 1991, Sylvia has held several increasingly responsible positions within DDB, starting as Trainer in 1995; followed by Working Leader in a production unit, Unit Supervisor; and most recently the Regional Supervisor for a newly created production region in the bureau. She is a graduate of Indiana University.

10

FIRST STEPS

First Steps has indentified the following priorities for the next fiscal year:

Continued improvement with billing of private insurance

o Improve use of diagnosis/ICD9 recoveries

o Increase monitoring of insurance recoveries

RFPS and Contract Development

o Quality Review Activities

o System Points of Entry (SPOE)

o Contract extension for Central Reimbursement Office (CRO)

Integrated Case Management System (ICMS)

o Continue development and planning

Initiation of agency program audits in late Spring 2012

For additional information on these priorities please email firststepsweb@fssa.in.gov.