The Michigan Department of Health and Human Services &

The Michigan Association of CMH Boards Present:

2016 ANNUAL HOME AND COMMUNITY

BASED WAIVER CONFERENCE

November 15 & 16, 2016

Kellogg Hotel & Conference Center

East Lansing, Michigan

Layout of the Kellogg Center Rooms we are using: BIG TEN A/B (On the North End of Kellogg) BIG TEN C (On the North End of Kellogg) Centennial Rooms (On the North End of Kellogg) Room 103 (On the South End of Kellogg) Room 105 (On the South End of Kellogg) Room 106 (On the South End of Kellogg) Heritage Room (South End of Kellogg)

CONFERENCE AGENDA

Tuesday, November 15, 2016

8:00am – 4:15pm Conference Registration (South Lobby)

8:00am – 8:45am Group Networking Breakfast (full breakfast buffet will be served until 8:45am) (Big Ten A/B)

9:00am – 9:15am Conference Welcome and Introduction (Big Ten A/B)

9:15am – 10:15am

Plenary Session: “Laughter is the Best Medicine” (Big Ten A/B)

Qualifies for 1 CEU hour - Iris Zink, Adult Rheumatology Nurse Practitioner, Owner of Lansing Rheumatology

This will be a fun presentation on the benefits of laughter for health and learning environments. Topics to be discussed include studies of laughter and why laughter helps. Participants will be able to: 1. Acknowledge three physical benefits of laughter; 2. Recognize strategies for laughter for healing; 3. Describe five stages of grief; 4. Describe three things that make people laugh; and 5. Laugh at least once during this presentation.

10:15am – 10:30am Coffee Break (Big Ten A/B and South Lobby)

Concurrent Workshops:

10:30am – 12:00pm 1. Racial and Poverty Disparities for Autistic Children Qualifies for 1.5 CEU hours - Mira Krishnan, PhD, ABPP, Principal Consultant at Mira Krishnan LLC

Building on work done via a Michigan Department of Health and Human Services Innovation Grant, this talk outlines the effects of racial outcome disparities and poverty disparities on autistic children. Changing US demographics as they relate to early childhood interventions will be examined. Disparities during pregnancy and perinatally will be examined, such as elevated risk for low birth weight, as well as early childhood disparities for young children from ethnic minority communities, with an emphasis on issues facing the African American / Black and Hispanic / Latino communities. The extension and amplification of disparities during school age, such as social isolation risk and differences in management by medical professionals will be examined. Childhood poverty will be defined, and effects of childhood poverty that may compound challenges autistic children face will be investigated. Finally, best practices to address these issues and build staff cultural competence, identified during grant implementation, will be shared. Participants will be able to: 1. Identify two racial/ethnic groups that are more represented among young children than among adults in the US / Michigan; 2. List two pregnancy/natality/early life health disparities that affect minority autistic children; 3. List two disparities that affect minority autistic children during school age and beyond; 4. Define the federal poverty limit and describe the percentage of children in Michigan who live in poverty; 5. Describe two disparities based on poverty that may affect autistic children; and 6. Identify two best practices for improving staff awareness of disparities and effectiveness with poor and minority families.

10:30am – 12:00pm 2. HSW Waiver Overview Qualifies for 1.5 CEU hours

- Charlyss Ray, BSOT, QIDP, Specialist for Services and Supports for Persons with Developmental Disabilities, Michigan Department of Health and Human Services

- Lori Caputo, Departmental Technician, Michigan Department of Health and Human Services This session will provide the attendee with basic information about the Habilitation Supports Waiver: eligibility, enrollment, documentation, RLA codes and BH-TEDS will be clarified and discussed. Supports and services under the HSW program will be described with policy highlights and examples of what may or may not be covered. There will be plenty of time for questions from the audience at the end of the power point presentation. Participants will be able to: 1. State four key components for the Initial HSW Application; 2. List three supporting documents that may accompany an initial HSW application; 3. Describe the difference between the parameters of a goal and objectives; and 4. Give three reasons an application or a recertification may pend.

10:30am – 12:00pm 3. CLS Roundtable Overview Qualifies for 1.5 CEU hours - Belinda Hawks, Bachelor of Science, Psychology, QIDP, Master of Public Administration, Federal

Compliance Manager, Michigan Department of Health and Human Services - Mary Phillips, MSW, Director of IDD services, Livingston CMH - Janice Short, LBSW, MA, LLP, Director of IDD, The Guidance Center

This is a round table discussion that will offer an opportunity for CMHP and PIHP providers to participate in answering a set of five questions related to Community Living Supports. Participants will be able to: 1. Learn and share information across CMHP and PIHP systems; 2. Discuss challenges and opportunities; and 3. Understand CLS Medicaid provider language.

10:30am – 12:00pm 4. Shifting the Focus to Community Based Employment and Moving from Fee for Service to Outcomes Based Payments; Employment Services in Oakland County for Persons with Disabilities

Qualifies for 1.5 CEU hours - Anya Eliassen, MBA, Chief Financial Officer, Oakland County Community Mental Health Authority - Francisco Gamboa, MA Counseling, LLPC, Community Liaison, Oakland County Community Mental

Health Authority Centers for Medicaid and Medicare Services (CMS) spends approximately $500 million per year for segregated day programs, while spending slightly above $100 million per year to support competitive employment. Through an Employment First policy, CMS would over time essentially reverse these figures, with the vast majority of funds going to support competitive employment. At a local level, how do we put more emphasis on community based employment and move from fee for service to outcomes-based payments? Learn how this is happening in Oakland County. Participants will be able to: 1. Describe the federal and state rules impacting the evolution of employment services from facility based to community based employment; 2. Understand alternative funding models that pay for employment outcomes not volume of service; and 3. Comprehend alternative payment methodology while reporting in 15 minute units.

10:30am – 12:00pm 5. Choice Voucher System in the Children’s Waiver Program Qualifies for 1.5 CEU hours - Audrey Craft, MS, LLP Specialist, Federal Compliance, Michigan Department of Health and Human

Services - Terri Nekoogar, MA/LPC, Program Supervisor, Specialized Children and Family Services, Macomb

County CMH Services - Ellen Sugrue Hyman, Behavioral Health and Developmental Disabilities Administration, Michigan

Department of Health and Human Services - Virginia O'Donnell, BA/SW, Case Manager, Specialized Children and Family Service, Child Waiver,

Macomb County CMH Services - Jane Giannattasio, Parent

The Choice Voucher System allows families in the Children’s Waiver Program to choose and directly hire providers to implement the supports and services for their children. Families have control over resources allocated to the child’s individual plan of service and supports, and greater flexibility in tailoring supports to meet individual needs. This presentation will describe the differences between self-determination for adults and the Choice Voucher System for Children. It will also identify and describe the steps to implementing the Choice Voucher System, and advantage and responsibilities of families. Participants will be able to: 1. Identify two differences between self-determination for adults and the Choice Voucher System for children; 2. List five steps to implementing the Choice Voucher System; and 3. List three advantages for families using the Choice Voucher System.

10:30am – 12:00pm 6. Children’s Waiver Program Decision Guide Qualifies for 1.5 CEU hours - Kathy Neville, BA, JD, MDiv; Insurance Advocate, Penultimate, Ltd.

The Children’s Waiver Program Decision Guide session provides training in the core skills needed to determine the appropriate, medically necessary range of hours for Community Living Supports (CLS) as defined in the Medicaid Provider Manual. These skills include assessment of the each child’s needs, significant family resources to meet those needs, and evaluation of appropriate hours using the Decision Guide Table. As a result of this session, participants will also be able to meet standards reviewed during Children’s Waiver Program Site Reviews including writing a Category of Care narrative for each child and will be able to provide documentation that Category of Care training has been completed. Participants will be able to: 1. Identify three key factors in assessing the child’s needs, family circumstances, and available resources that are used to determine whether or not Community Living Supports (CLS) are medically necessary; 2. Determine which one of the six Category of Care definitions in the Medicaid Provider Manual (four categories for challenging behavior and two categories for medically/physically complex needs) most accurately reflects the current needs of the child; 3. Understand and use the Decision Guide Table in the Medicaid Provider Manual to identify the appropriate range of CLS hours for each of six areas of “Additional Family Resources”; 4. Describe two fact patterns of school participation that affect CLS authorization maximums; and 5. Identify three elements required for the written Category of Care narrative summary that will satisfy Individual Plan of Service requirements during a Site Review.

12:00pm – 12:45pm Group Lunch (Big Ten A/B)

Concurrent Workshops: 1:00pm – 2:30pm

7. Children’s Waiver Program Overview Qualifies for 1.5 CEU hours

- Audrey Craft, MS, LLP Specialist, Federal Compliance, Michigan Department of Health and Human Services

- Kelli Dodson, BS, Analyst, Federal Compliance, Michigan Department of Health and Human Services This session is intended for case managers, administrators and parents who are new to the Children’s Waiver Program or desire an elementary overview of the program. The session will be a brief look at the prescreen, application and approval process, budget and funding allocations, and waiver and state plan Medicaid coverage. There will be a focus on required documentation and timelines, implementation instructions and a question and answer period. Participants will be able to: 1. List five eligibility requirements for the Children’s Waiver Program; 2. Identify four Children’s Waiver Services; and 3. Describe four steps in the waiver prescreen through approval process.

1:00pm – 2:30pm 8. Sensory Processing Treatment for Individuals with Challenging Behavior – Part One of a Two Part Session

Qualifies for 1.5 CEU hours - Martha J. Farrand, MS, OTR, Occupational Therapist

Participants will learn about three main sensory systems and how activities that activate these systems can be used to decrease problematic behavior by calming and organizing the nervous system. Participants will be able to: 1. List 3 types of sensory processing deficits; 2. List at least 3 symptoms for each deficit; 3. Describe how sensory systems can be used to either calm or alert the nervous system; and 4. Understand when clients need to be referred for assessment.

1:00pm – 2:30pm 9. The Medicaid Autism Benefit, Applied Behavior Analysis (ABA), ASD Care Coordination & Crisis/Safety Planning for Older Children, Adolescents, and Emerging Adults with Autism

Qualifies for 1.5 CEU hours - Nicole Dwyer, LPC, Autism Spectrum Disorder Specialist, Detroit Wayne Mental Health Authority

The Medicaid Autism Benefit expansion was implemented January 1st of this year. This expansion now allows individuals to access evidence-based Applied Behavior Analysis (ABA) services through age 20. This transformed the benefit from an Early Intervention Service under the (i)SPA into an EPSDT Service. This presentation will provide an overview and understanding of how ABA services can positively impact individuals ages 6 and up. It will also provide care coordination, resources, and information for providers delivering services to the 0-20 autism population, including crisis and safety planning, to ensure quality care is delivered for each family in services while service capacity increases. Participants will be able to: 1. Identify the eligibility requirements for the Medicaid Autism Benefit; 2. Identify what ABA is, what it looks like, and how ABA can help older children, adolescents, and adults with Autism; 3. Identify key care coordination and crisis/safety planning needs for families with individuals with Autism; and 4. Identify ABA & ASD related resources available to families and providers.

1:00pm – 2:30pm 10. Let’s Talk About Sex Again!: Running a Group for People with Developmental Disabilities About Relationships and Sexuality

Qualifies for 1.5 CEU hours - Erin M. Parcell, MA, LPC, Master’s in Counseling, Licensed Professional Counselor, Supervisor

Senior Developmental Disabilities Clinician, CEI-CMH Transitions Grand Ledge - Rebecca Jones-Henry, MA, LLPC, Master’s in Counseling, Developmental Disabilities Clinician, CEI-

CMH Life Consultation - Shian Yu, MA, LLPC, Mental Health Therapist, CEI-CMH

Erin M. Parcell, MA, LPC, Rebecca Jones-Henry, MA, LLPC and Shian Yu, MA, LLPC have been involved in the past three years in developing a group to meet the identified need of education for people with developmental disabilities in the area of healthy relationships and sexual health. The group was piloted in the Summer of 2013 and has since been run four times with positive results. The group is using a curriculum “Sexuality Across the Lifespan” developed by Florida Developmental Disabilities Council, Inc. (2005, Rev 2011) that is free to use and has been utilized in groups all over the United States. The curriculum has been recommended by the START team as the most effective tool to use with youth/adults with Autism Spectrum Disorder. Erin, Rebecca, and Shian bring a person-centered and fun perspective to a topic that is often anxiety provoking and difficult to approach. Come join us to learn how to bring this necessary group to your school or program! Participants will be able to: 1. Identify the needs of people with developmental disabilities to have education in healthy relationships and sexual health; 2. Identify a curriculum to work with in order to lead a group addressing healthy relationships and sexual health; 3. Describe the process from referral to graduation; 4. List at least three ways to address concerns that arise from care givers/guardians in response to people wanting to participate in the group; 5. Describe attributes that would make a person a good/poor candidate for the group; and 6. Describe the role of trauma in the group and how to address that as a group facilitator.

1:00pm – 2:30pm 11. Supported Decision Making – Practical Alternatives to Guardianship Qualifies for 1.5 CEU hours - Paul Newman, BS, MSW, Chief Operations Officer, Community Living Services - Kathy Lentz, BA, MM, Senior Executive Officer, Kalamazoo Community Mental Health & Substance

Abuse Services Many adults with Intellectual/Developmental Disabilities request or require assistance from others to help make decisions regarding supports and services received. Different options for assistance in decision making will be explored, with emphasis on those that maintain the highest level of freedom and authority for the individual. Guardianship, the option that strips individuals of their legal rights, is an option more people are familiar with, although it is the most restrictive. Michigan has some of the highest use of guardianships for individuals with Intellectual/Developmental Disabilities among all states (NCI, 2015). This session will provide tools for using alternatives to guardianship that provide support to individuals without removing legal rights. Participants will be able to: 1. Understand the current/historical use of guardianships within the state of Michigan; 2. Understand the implications of guardianship for Self Determination, empowerment and self-advocacy; 3. Learn the different options under Michigan law for supporting individuals to be as independent as possible in decision-making; and 4. Provide examples for documentation decision making support.

1:00pm – 2:30pm 12. National Core Indicators Qualifies for 1.5 CEU hours - Barbara LeRoy, PhD, Wayne State University, MI-Developmental Disabilities Institute - Amy Peckinpaugh, LBSW, Departmental Analyst, Michigan Department. of Health and Human

Services National Core Indicators (NCI) is a voluntary effort by public I/DD agencies to measure and track their own performance. The core indicators are standard measures used across states to assess the outcomes of services provided to individuals and families. Indicators address key areas of concern including employment, rights, service planning, community inclusion, choice, and health and safety. Participants will be able to: 1. Use NCI data for strategic planning and quality improvement; 2. List 4 core indicators which are key areas of concern for Michigan; and 3. Understand the employment status and the experience of persons with I/DD served by the behavioral health system.

2:30pm – 2:45pm Refreshment Break (South and North Lobby Area)

Concurrent Workshops:

2:45pm – 4:15pm 13. HSW - Focus on Quality and Compliance Qualifies for 1.5 CEU hours - Belinda Hawks, Bachelor of Science, Psychology, QIDP, Master of Public Administration, Federal

Compliance Manager, Michigan Department of Health and Human Services - Yingxu Zhang, BA, MPP, Analyst, Federal Compliance Section, Michigan Department of Health and

Human Services Topics discussed will include Quality Improvement Strategy and performance measures, update on HSW procedural changes, Federal oversight of the HSW and potential changes as well as how to improve the content of the initial HSW applications and some common reasons for pending packets. Participants will be able to: 1. Identify performance measures where there are opportunities for improvement based on data for FY 14 and FY15; 2. Identify how the site review process is linked to compliance related evidence for annual federal report; and 3. Identify how to utilize the data systems – BH-TEDS and Waiver Support Application (WSA) in the HSW operations.

2:45pm – 4:15pm 14. Sensory Processing Treatment for Individuals with Challenging Behavior – Part Two of Two Part Session

Qualifies for 1.5 CEU hours - Martha J. Farrand, OTR, Occupational Therapist

Participants will learn about three main sensory systems and how activities that activate these systems can be used to decrease problematic behavior by calming and organizing the nervous system. Participants will be able to: 1. List 3 types of sensory processing deficits; 2. List at least 3 symptoms for each deficit; 3. Describe how sensory systems can be used to either calm or alert the nervous system; and 4. Understand when clients need to be referred for assessment.

2:45pm – 4:15pm 15. ASD Parent Panel Qualifies for 1.5 CEU hours - Lisa Grost, MHSA, Autism Section Manager, Michigan Department of Health and Human Services –

Facilitator - Parent Panel of Families receiving Applied Behavior Analysis (ABA)

Finding out your child has autism is life-changing for most parents. Applied Behavior Analysis is an evidenced based service being provided to thousands of families with youth who have autism in Michigan. This family panel will share with you the successes and challenges of autism and Applied Behavior Analysis (ABA). ABA is covered by Medicaid and Michigan regulated insurance coverages. Participants will be able to: 1. Hear parents’ perspective in raising children with ASD; 2. Describe challenges experienced in different service systems; and 3. Suggested solution to help families.

2:45pm – 4:15pm 16. Understanding the Medicaid Administrative Fair Hearing Process the New 2017 Managed Care Regulations Changes

Qualifies for 1.5 CEU hours - Lisa Gigliotti, JD, Administrative Law Judge, Michigan Administrative Hearing System

An overview of Medicaid Fair Hearings will be given, including the current federal regulation and impending 2017 federal regulations impact on Home & Community-Based waiver recipients (including ICDE enrollees) and Community Mental Health enrollees. The types of notice of action that must be provided to a Medicaid beneficiary, when and which notice must be used will be explained. Practical tips and online resources will be offered regarding how to prepare for and present during a Medicaid Fair Hearing. A handout and an opportunity for questions and answers will be provided. Participants will be able to: 1. Identify a Medicaid provider’s Medicaid Fair Hearings obligation and the federal regulations that set forth the obligation; 2. Identify which provider actions trigger a right to a Medicaid Fair Hearing; 3. List the types of notice that must be provided to a Medicaid beneficiary and recognize when and which notice to use; 4. Describe how to request a Medicaid Fair Hearing; 5. Describe the steps to prepare for a Medicaid Fair Hearing; 6. Describe the general steps during an administrative hearing; 7. List the basics of how to present a Medicaid beneficiary position and to present a Medicaid provider position during the hearing; and 8. Identify online resources for a pamphlet or forms related to a Medicaid Fair Hearing.

2:45pm – 4:15pm 17. Maximizing Pre-Screen Scores for CWP Qualifies for 1.5 CEU hours - Kathy Neville, BA, JD, MDiv; Insurance Advocate, Penultimate Ltd.

This session will include updated detail on the core skills that prescreen workers need to help families achieve a maximum appropriate prescreen score. In addition, process details will be addressed including documentation of a developmental disability, initial and update prescreen requirements, and the schedule used for issuing invitations to apply for the CWP. Participants will be able to: 1. Identify two resources to help parents understand the CWP prescreen process; 2. Describe three key components to effectively document that an applicant has three or more areas of “substantial functional limitations” that support a developmental disability and needs at the ICF/IID level of care. (Factor 9); 3. List three key factual details to include when describing behavioral challenges. (Factor 9); 4. Identify four required details to document for a child with a current private insurance ABA benefit. (Factor 10); 5. Identify three specific events that require an ABA private insurance coverage update. (Factor 10); 6. Explain two elements to document when a parent reports (a) a health condition that limits capacity to provide care for the child, (b) current counseling, or (c) parent/family member injury resulting from behavior. (Factor 6); 7. Identify the WSA location of documents that describe additional prescreen documentation requirements for children currently in residential treatment. (Factor 8); 8. Describe the processes for removing Holds, Removing a Prescreen from the Weighing List, and Transferring a Prescreen to another county or agency in your county; and 9. Explain three methods to identify the due dates for prescreen updates.

2:45pm – 4:15pm 18. What is the Parent Support Partner Medicaid Service? Qualifies for 1.5 CEU hours - Kim Batsche-McKenzie, LMSW, Manager of Services to Children with Serious Emotional

Disturbances, Michigan Dept. of Health and Human Services - Amy Shears, Statewide Parent Support Partner Coordinator, Association for Children’s Mental Health - Amy Helmuth, Parent Support Partner Supervisor, Kalamazoo Community Mental Health and

Substance Abuse Services The Michigan Department of Health and Human Services (MDHHS), in partnership with the Association for Children’s Mental Health (ACMH), a statewide family organization in Michigan, will describe the Parent Support Partner service and discuss its importance and benefits. The Parent Support Partner (PSP) is a Medicaid state plan Early Periodic Screening, Diagnostic and Treatment (EPSDT) covered service listed as Family Support and Training. This service is designed to support parents/family of children with serious emotional disturbance or intellectual/developmental disabilities as part of the treatment process to be empowered, confident and have skills that will enable them to assist their child to improve in functioning. The trained Parent Support Partner, who has or had a child with special mental health needs, provides education, training, and support and augments the assessment and mental health treatment process. MDHHS and ACMH have developed a curriculum, informed by family members and professionals, for training parents to become certified Parent Support Partners since 2009. There are currently approximately 100 PSP’s employed throughout the State of Michigan. Participants will be able to: 1. Explain the Parent Support Partner service found in the Michigan Provider Medicaid Manual; 2. List three impacts and/or benefits of providing the Parent Support Partner Service; 3. Identify the role and function of the Parent Support Partners providing the service; and 4. Describe the process to hire a Parent Support Partner.

Wednesday, November 16, 2016

8:00am – 2:30pm Conference Registration (South Lobby)

8:15am – 9:00am Group Networking Breakfast (full breakfast buffet will be served until 9:00am) (Big Ten A/B)

9:00am – 10:00am Plenary Session: BHDDA Update: Forces at Play in Shaping Our Operational Environment (Big Ten A/B)

Qualifies for 1 CEU hour - Tom Renwick, JD, Director of the Bureau of Community Based Services within Michigan’s

Department of Health and Human Services’ Behavioral Health and Developmental Disabilities Administration

Mr. Renwick will provide updates on key issues within the Michigan Department of Health and Human Services and the Behavioral Health and Developmental Disabilities Administration. He will provide updates on state and federal activities including selected MDHHS strategic priorities, the federal Excellence in Mental Health Act planning grant application, Home and Community Based Services rule implementation, and other recovery oriented, integrated, and transformational efforts. Participants will be able to: 1. Participants will be able to: 1. List at least two key goals MDHHS BHDDA plans to achieve in the coming year; and 2. Restate two or more projects driven by federal opportunity, law or rule.

10:00am – 10:15am Coffee Break (Big Ten A/B)

Concurrent Workshops: 10:15am – 11:45am 19. Children’s Waiver Program – Advanced Issues

Qualifies for 1.5 CEU hours - Audrey Craft, MS, LLP Specialist, Federal Specialist, Michigan Department of Health and Human

Services - Kathy Neville, BA, JD, MDiv, Insurance Advocate Consultant, Michigan Department of Health and

Human Services Contractor, Penultimate Ltd. - Kelli Dodson, BS, Analyst, Federal Compliance, Michigan Department of Health and Human Services

This session will focus on significant issues identified in the last year and anticipated coming changes in the Children’s Waiver Program in the areas of the 1115 waiver authority, documentation issues in the areas of developmental disability and ICF/IID level of care, and the Waiver Support Application. Participants will be able to: 1. Describe one way the transition of the Children’s Waiver Program (CWP) from the 1915(c) waiver to the proposed 1115 waiver authority will impact the site review process; 2. Describe three ways the Waiver Support Application (WSA) can help CMHSPs manage required CWP case maintenance activities in a timely manner; and 3. Identify two things your CMHSP must do to be paid for ABA services provided to a child on the CWP who is also eligible for the Medicaid Autism Benefit.

10:15am – 11:45am

20. Environmental/Home Modification Process Start to Finish Qualifies for 1.5 CEU hours - Mary Jo Kurily, BS Occupational Therapy, OTR, Macomb County CMH - Charlyss Ray, BSOT, QIDP, Specialist for Services and Supports for Persons with Developmental

Presentation to include education in the process of assessment, research and request for equipment and home modifications through the Children’s Waiver program from the Occupational Therapists point of view. Participants will be able to: 1. Become familiar with the process to request equipment or home modifications through the Children’s Waiver program; and 2. Have the tools to plan and prepare a complete packet for submission to Children’s Waiver Review Team.

10:15am – 11:45am 21. Michigan ASD Services and Supports Updates Qualifies for 1.5 CEU hours - Lisa Grost, MHSA, PAPHS, Autism Administrator, Michigan Department of Health and Human

Services - Brie Elsasser, MSEd, BCBA, Autism Behavioral Specialist, Michigan Department of Health and

Human Services The growing prevalence of individuals with Autism Spectrum Disorder (ASD) has increased the demand for effective supports, resources, and services to address each child’s individual needs in the public Community Mental Health system. There are a wide range of challenges for children and adolescents with autism and their families, including transportation, peer relationships, behavior and language barriers, and inclusion throughout their community and educational systems. Michigan continues to strive to be a leader in opportunities, services, and supports for individuals with Autism Spectrum Disorder. The presenters will emphasize the importance of system collaboration and coordination and provide updates on provider capacity for ABA services in the Medicaid system. Participants will be able to: 1. Identify three current Medicaid services in Michigan for individuals with developmental disabilities, including Autism Spectrum Disorder (ASD); 2. List two initiatives in Michigan to increase access to early intervention and evidence-based supports for children with DD and ASD; and 3. Describe two ASD supports and family resources available in Michigan across service systems and potential points of collaboration.

10:15am – 11:45am 22. MI Choice and HSW – Parallels and Differences Qualifies for 1.5 CEU hours - Elizabeth Gallagher, BS, MA, Manager, Home and Community Based Services Section, Michigan

Department of Health and Human Services - Belinda Hawks, BS, MPA, Manager of Federal Compliance, Michigan Department of Health and

Human Services This presentation will assist supports coordinators and other CMH staff with assisting families to make informed decisions related to transition from State Plan private duty nursing at age 21. The presenters will provide a summary of the services available through the MI Choice Waiver and Habilitation Supports Waiver and the differences between the two waivers. They will also describe methods to access MI Choice and how to determine which waiver will be the best for participants making this transition. Participants will be able to: 1. List four services offered for each: MI Choice and HSW; 2. Describe three differences between MI Choice and HSW; 3. Explain the process for accessing MI Choice or HSW; and 4. Describe the process for assisting families with transition planning from State Plan PDN.

10:15am – 11:45am 23. Private Duty Nursing (PDN) Policy Updates for Case Managers and Supports Coordinators Qualifies for 1.5 CEU hours - Linda L. Fletcher, MS, CPNP, Project Director/Nurse Consultant, Michigan Department of Health and

Human Services This session is designed for case managers, supports coordinators, CMHSP staff and nurses. Current Medicaid PDN policy medical eligibility criteria will be reviewed. The PDN approval process change effective October 1, 2016 for children enrolled in the Children’s Waiver Program (CWP) and the children under age 21 enrolled in the Habilitation Supports Waiver (HSW) will be reviewed. The proposed change in the PDN approval process for those over 21 enrolled in the HSW will be discussed. Participants will be able to: 1. Identify Medical Eligibility Criteria for PDN; 2. Identify the change in the PDN approval request process effective October 1, 2016; 3. Identify the role of the PDN agency in the PDN approval change process; 4. Identify health care goals must be included on the individualized person centered plan (IPOS); and 5. Discuss the proposed change in the PDN approval and renewal process for those enrolled in the HSW.

10:15am – 11:45am 24. Improving Parents Involvement in ABA for Their Children Qualifies for 1.5 CEU hours - Krista Clancy, MS, LLP, BCBA, PhD Candidate, Director of Behavioral Services, University

Pediatricians Autism Center Parent involvement in ABA is a necessary part of treatment that is recommended in order for children to get the maximum potential benefit from ABA. However, adherence by parents to these recommendations is often low. Parents may choose not to participate in therapy or may not have their child participate in therapy due to barriers they encounter with ABA. This presentation will discuss ways to assess, interpret and change intervention strategies to help parents reduce barriers to involvement and increase motivation to be more involved in ABA treatment with their child. Participants will be able to: 1. Understand how parent's adherence to treatment effects the outcome for children's treatment in ABA; 2. Learn to use tools to assess and interpret parent motivation for involvement; and 3. Learn techniques to use during parent meetings to improve parent involvement.

12:00pm – 12:45pm Group Lunch (provided) (Big Ten A/B)

Concurrent Workshops: 1:00pm – 2:30pm 25. Hiring and Maintaining Staff

Qualifies for 1.5 CEU hours - Terri Nekoogar, MA/LPC, Program Supervisor, Specialized Children and Family Services, Macomb

County CMH Services Hiring and Retaining VIPS (Very Important Personal Staff) will explore the methods in recruiting staff, interviewing tips, and how to create a successful environment for both your child, family, and the staff person. These tips have been proven to be successful over the long haul for both families that choose to voucher, and for families that work with an agency. Participants will be able to: 1. Identify at least three resources for recruiting staff; 2. Families and case managers will be able to list at least three key factors to long term retention; and 3. Participants will learn key factors in managing staff schedules vs. family needs.

1:00pm – 2:30pm 26. Peer Mentoring for Individuals with I/DD Qualifies for 1.5 CEU hours - Tracy Vincent, BBA, Resource Analyst, MI Developmental Disabilities Council - Robert Spruce, Peer Mentor Coordinator, Detroit Wayne Mental Health Authority

This workshop will increase awareness of the benefits of peer mentoring for individuals with developmental disabilities, provides opportunities to listen to Peer Mentors share their unique experiences, and offers examples of how to request Peer Mentors to be part of your person centered plan. The Medicaid peer code, and structure and content of peer mentor trainings will be discussed, as well as additional training and certification to support peer mentors in both identification and practice of this emerging profession. Participants will be able to: 1. Learn and understand the supports and services Peer Mentors provide; 2. Know how to request a Peer Mentor in the person centered plan; 3. Learn the process of certification; and 4. Hear from Certified Peer Mentors on their individual experiences.

1:00pm – 2:30pm 27. Interviewing Individuals with Complex Communication Needs: Part I - Features and Strategies Related to Common Disorders, Part One of Two Sessions

Qualifies for 1.5 CEU hours - Lynn A. Sweeney, CCC- SLP, Speech-Language Pathologist and Graduate Faculty, Sweeney

Communication & Consultation and Central Michigan University Many consumers experience medical, psychological, developmental, or situational conditions that make communication challenging for them, their significant others and those who provide services for them. Understanding the status, experiences, wishes and needs of such consumers is a critical first step to provision of meaningful intervention/resolution of problems and establishing trust, education, self-determination and ultimate wellbeing. Some consumers are able to communicate if provided adequate supports but may not be able to speak or use traditional communication methods. Some develop significant behavioral challenges because they are misunderstood. This session will review medical, neurologic, motoric, developmental and situational conditions that challenge communication between consumers and those who strive to help them. Attendees will be provided with ways to help determine status and improve outcomes, determine needs/choices, and collect information in interview and interactions. Key examples from working with individuals with Autism Spectrum Disorder, developmental and acquired brain injury, and a variety of sensory, motor, psychological and neurological conditions will be used to demonstrate opportunities to improve understanding whether or not a person is able to use traditional speech/language. Modeling and real case examples will help improve understanding of the elements of successful receptive and expressive communication in an interview or basic interaction process. Participants will be able to: 1. Identify frequent challenges in communicating with consumers with special needs and a variety of diagnoses (e.g. stroke, CP, Head trauma, ASD, etc.); 2. Describe successful strategies for presenting and receiving information with individuals with communication challenges; and 3. Select one or more strategies or tools appropriate for improving and/or augmenting communication with those who have limited speech.

1:00pm – 2:30pm

28. An Update on the HCBS Rule: The State Transition Plan Qualifies for 1.5 CEU hours - Belinda Hawks, BS, Psychology, QIDP, Master of Public Administration, Federal Compliance

Manager, Michigan Department of Health and Human Services - Angela Martin, LMSW, Community Support Specialist, Developmental Disabilities Institute, Wayne

State University In 2014, the Centers for Medicare and Medicaid Services promulgated a new rule regarding Home and Community-Based Services within Medicaid Waiver programs. The new rule requires residential and non-residential settings to meet a set of characteristics in order to be considered home and community-based under a Medicaid waiver. The Michigan Department of Health and Human Services is currently implementing a statewide transition plan for bringing all waiver settings in Michigan into compliance with the rule. The Department would like to provide an update to stakeholders on this process and identify opportunities and strategies for achieving compliance with this rule. This session will highlight how the transition to compliance will advance Person Centered Planning and result in Conflict-free Case Management/Supports Coordination. Participants will be able to: 1. Understand where the Michigan Department of Health and Human Services is currently in the implementation process for the Home and Community-Based Services rule; 2. Use the knowledge gained from this session to understand how and when their organizations or agencies will be affected by this rule; 3. Discuss opportunities and strategies for coming into compliance with the rule and improving the delivery of home and community-based services in residential and non-residential settings; and 4. Utilize findings from Michigan’s Pilot Study to prepare for compliance with the HCBS rule.

1:00pm – 2:30pm 29. Resolving Conflicts: Parents, Schools and Special Education Services Qualifies for 1.5 CEU hours - Margaret Rohr, LMSW, MA, Outreach Representative, Michigan Special Education Mediation

Program Join us to learn more about free, supportive services designed to assist parents and schools effectively manage and negotiate conflicts about special education services. A certain amount of conflict is inevitable! The IDEA recognizes this and so mandates the offer of free mediation for special education disputes. As the service providers for MI, join us to learn to identify when and how disputes would benefit from the assistance of a mediator. Our highly successful services are benefitting schools, parents and children all over MI. Participants will be able to: 1. Identify federal & state level support for MSEMP services; 2. List 3 services provided by MSEMP; 3. Differentiate mediation from facilitation services; and 4. Identify local provider for services AND for additional education/outreach for parents and staff.

2:30pm – 2:45pm Refreshment Break (South Lobby Area)

Concurrent Workshops: 2:45pm – 4:15pm 30. Interviewing Individuals with Complex Communication Needs: Part II – Learn and Practice

Strategies – Part Two of Two Sessions Qualifies for 1.5 CEU hours - Lynn A. Sweeney, CCC- SLP, Speech-Language Pathologist and Graduate Faculty, Sweeney

Communication & Consultation and Central Michigan University Some consumers are able to communicate if provided adequate supports but may not be able to speak/use traditional communication methods. Some develop significant behavioral challenges, anxiety, and/or depression because they are misunderstood and have no apparent options for control and choice making. Following from Part I of this topic, this session will review, demonstrate, and allow practice using various communication strategies to improve interaction with individuals experiencing significant communication challenges. Attendees will be provided with ways to help determine status and improve outcomes, determine needs/choices, and collect information in interview and interactions. Key examples from working with individuals with a variety of disorders will be modeled and then practiced by participants. Modeling and real case examples will help improve understanding of the elements of successful receptive and expressive communication in an interview or basic interaction process. We will explore and practice basic alternatives for choice making, "speaking", spelling, partner-assisted scanning, timing for asking and answering, use of visual displays and communication technology, etc. The goal of the session is to provide each participant with a variety of ways to communicate with consumers who seem unable to do so. Participants will be able to: 1. Select one or more strategies or tools appropriate for improving and/or augmenting communication with those who have limited speech and/or complex communication needs; 2. Practice one or more augmentative communication strategies within the session and identify best practices with others; 3. Alter communication behavior in response to one or more communication partners; and 4. Complete at least one basic functional interaction using an augmentative communication tool or strategy within the session.

2:45pm – 4:15pm 31. HCBS & Employment: Challenges and Opportunities

Qualifies for 1.5 CEU hours

- Joe Longcor, BBA, Supported Employment Specialist, Behavioral Health and Developmental

Disabilities Administration, Michigan Department of Health and Human Services, This conversational session will allow participants to discuss their key concerns and gain perspectives on how they might address challenges to achieve integrated employment. Joe will share proposed changes to the Medicaid Provider Manual intended to further promote integrated employment. He will also provide “myth busting” handouts about earnings and savings to raise expectations for individuals. Brief updates on Michigan’s “MI ABLE” accounts and Freedom to Work/Medicaid Buy-in will also be provided. Participants will be able to: 1. Share concerns and gain perspectives on addressing challenges to meet the HCBS rule for integrated employment; 2. Know proposed focus areas to update the Medicaid Provider manual to better promote and support integrated employment; 3. Know three myth busters about how much a person can make and save as resources; and 4. Two other major legislations supporting integrated employment.

2:45pm – 4:15pm 32. Beyond the Myths: The Value of Using Arrangements that Support Self-Determination Qualifies for 1.5 CEU hours - Ellen Sugrue Hyman, Behavioral Health and Developmental Disabilities Administration, Michigan

Department of Health and Human Services Arrangements that support self-determination are required or encouraged by CMS in every program that supports people to live in the community. However, implementation has been hindered by misconceptions and liability concerns. This presentation will describe the steps to develop and implement arrangements that support self-determination, the role of the PIHP./CMHSP in implementing arrangements, and address the myths that hinder implementation. The technical assistance materials, research and best practices will be discussed. In addition, the impact of the new FLSA minimum wage and overtime rules will be described. Participants will be able to: 1. Specify 5 steps to implement arrangements that support self-determination; 2. Identify 5 roles that the PIHP/CMHSP has in implementing arrangements that support self-determination; and 3. Describe at least 5 myths that hinder the availability of arrangements that support self-determination.

2:45pm – 4:15pm 33. Rethinking the IPOS: Creativity in Person Centered Planning Qualifies for 1.5 CEU hours - Erin King, LMSW, QIDP, Director, Customer and Provider Services, Centra Wellness Network

The expectation of writing a person centered plan that not only embraces the spirit of the person we support but also meets the requirements of our accrediting bodies and funders is challenging to say the least! With our high demand positions, many of us develop a “routine” around how we approach person centered planning that gets the job done but, at times, can lead to losing creativity and passion for the process. This presentation will briefly review the basics of person centered planning and components of the plan of service itself while also giving attention to being creative with writing measurable/observable objectives. Intended for all audiences, this presentation aims to provide take home ideas that can be put into practice right away. Participants will be able to: 1. Recognize the difference between the concepts of amount, scope and duration; 2. Identify two components of a measurable and observable treatment goal objective; and 3. Describe three life domains for goal development.

2:45pm – 4:15pm 4:15pm

34. Changing the Culture of your Agency to Incorporate Integrated Health Care Qualifies for 1.5 CEU hours (PENDING) - Cyndi Blair, RNBH, Clinical Director, HealthWest - Suzanne Beckeman, RN, Integrated Health Supervisor, Integrated Health, HealthWest

Health Care Reform has clearly indicated that Primary Care and Behavioral Health need to be integrated. All indications are that the goal is for individuals to find a Patient -Centered Home in order to provide necessary holistic care. This is less expensive in the long run and there are more positive, measurable outcomes for the people being served. Multiple barriers currently exist in the health care system that prevents individuals from accessing care and continuing the type of care they require to improve their health and functioning. This is the time for all of us to make certain that Integrated Health Care with Primary Care Physicians and Behavioral Health is one of the top priorities within our agency. Changing the culture within the integrated care system requires multi-disciplinary team members to acknowledge their roles and necessary involvement in making the outcomes positive. Participants will be able to: 1. Identify a working definition of an Integrated Healthcare clinic within a Behavioral HealthCare setting; 2. Identify tools that will assist staff to incorporate their role in Integrated Care; 3. Successful Methods to Engage the consumer; and 4. Utilize data to Evaluate the results of your integrated health efforts. Conference Adjourns

Save the Date!

2017 ANNUAL HOME AND COMMUNITY

BASED WAIVER CONFERENCE

November 14-15, 2017 Kellogg Hotel & Conference Center

East Lansing, Michigan

Visit us online at www.macmhb.org

Revised 11/11/16

Social Work: The Michigan Association of Community Mental Health Boards (MACMHB), provider #1140, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program. MACMHB maintains responsibility for the program. ASWB Approval Period: 10/10/2016 to 10/10/2019. Social workers should contact their regulatory board to determine course approval. Social Workers who attend this training will receive maximum of 11 Clinical Continuing Education Clock Hours. Course Delivery Method: Face to Face Conference Certificate Awarded: At the conclusion of this training, you will turn in your Verification of Attendance form to the MACMHB Staff to be initialed. You will turn in the top sheet and retain the bottom sheet which serves as your certificate of participation. Evaluation: There will be an opportunity for each participant to complete an evaluation of the course and the instructor. If you have any issues with the way in which this training was conducted or other problems, you may note that on your evaluation of the training or you may contact MACMHB at 517-374-6848 or through our webpage at www.macmhb.org for resolution. Who Should Attend: This conference contains content appropriate for case managers, supports coordinators, clinicians, behavior analysts, administrative staff, providers, autism coordinators, people receiving services and family members and social workers at all levels of practice (beginning, intermediate and/or advanced).