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QUA RTERLY DIVISION UPDA TE FOR PROVIDERS
M a r c h 2 1 , 2 0 1 7
The New Jersey Department of Human Services Division of Developmental Disabilities
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Elizabeth M. Shea Assistant Commissioner
Overview
Division Updates FY’18 Proposed DDD Budget Supports Program Community Care Waiver Renewal Recent Policy Changes Fee-for-Service Provider Readiness Comprehensive Medicaid Waiver (CMW) Quality Improvement
PCG Public Partnerships
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FY’18 Proposed DDD Budget
Community spending proposed to increase by $89.7 million, broken down as follows: $10 million to fund community-based services for
individuals currently on the Community Care Waiver Waiting List
$8.6 million to fund community-based residential placements for 54 individuals currently living in one of the Division’s five developmental centers, consistent with the U.S. Supreme Court’s Olmstead decision
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FY’18 Proposed DDD Budget
$1 million to fund 125 new housing vouchers $46.2 million to fund service expansion for new and existing
Supports Program participants $23.9 million to fund general Division growth (e.g.,
young adults turning 21 and aging out of special education services, emergencies, self-direction, annualized cost from prior year placements, etc.), in addition to funds available from prior-year CCW recoveries
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Supports Program
1,440 individuals enrolled It is anticipated that all 2017 graduates not on the
Community Care Waiver (CCW) will be enrolled in the Supports Program this year Public Partnerships should be in place to handle Self-Directed
Employees Camp concerns have been addressed and it is anticipated that
DDD-funded camps will have completed the Combined Application and be Medicaid/DDD approved providers this summer
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Community Care Waiver (CCW) Renewal
Commitment from the federal Centers for Medicare and Medicaid Services (CMS) to approve CCW renewal by March 31, 2017
State staff have been working very closely with CMS to finalize renewal language
Once CCW renewal is approved, the Division will release information regarding a timeline for the shift of CCW-enrolled individuals into fee-for-service
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Recent Policy Changes – Camp
Camps must complete the Combined Application and become Medicaid/DDD approved providers for “Respite” Day Camp (Considered respite rather than day habilitation)
Utilized for camps that only provide day camp services $114.72 per day (up to six hours per day) Up to 2 hours per day of additional base respite can be offered by
the same provider if needed Overnight Camp
Utilized for camps that provide day and overnight camp services $229.20 per day/night
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Recent Policy Changes – Classes
Class still must meet description and general criteria of Goods & Services
Added the option of funding a class that is not attended by the general public if it is Provided by an entity that does not primarily serve individuals
with disabilities and offers comparable classes to the general public Limited to no more than 12 individuals with I/DD attending the
class at the same time Individuals can attend the class for up to 3 hours per day and 10
hours per week
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Fee-for-Service Provider Readiness
Continuing to meet with contracted providers 160+ meetings held to date 90+ meetings scheduled
Webinars scheduled for qualified providers Camp and Respite – March 30 Day Habilitation – April 5 Individual Supports – April 11 Transportation – May 4
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Fee-for-Service Provider Readiness 10
Medicaid/DDD approval status Readiness to bill through Molina Understanding of aligning “old” services with FFS definitions Readiness to document services according to FFS policies Housing / STP readiness (shared bedrooms, accessibility, vouchers) Medicaid eligibility of individuals served NJ CAT status of individuals served Representative Payee status of individuals served Engagement with Support Coordinators / SCAs Level of service provision to individuals enrolled in Supports
Program Fee-for-Service timeline and cohort developments
Comprehensive Medicaid Waiver (CMW)
The Comprehensive Medicaid Waiver renewal application was submitted to the federal Centers for Medicare and Medicaid Services (CMS) and was posted for a 30-day Federal Public Comment Period on March 10, 2017
https://public.medicaid.gov/connect.ti/public.comments/view?objectId=1889699
After 30-day comment period closes, CMS / DHS renewal negotiations will begin
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Quality Improvement
National Core Indicators (NCI) Survey Project
Surveys completed to date
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• Adult Family Surveys (online/paper) 227
• Family Guardian Surveys (online/paper) 168
• Adult Consumer Surveys (face-to-face) 69
Quality Improvement
Council on Quality and Leadership (CQL) Certified Interviewer Project First step to infusing Personal Outcome Measures into
DDD system Reflects individuals’ own definition of outcomes and progress
towards those outcomes Project involves CQL training of 14 DDD staff and 2 Boggs
Center staff to become Certified Interviewers March – DDD and CQL kickoff meeting May 18 – CQL will present at The Boggs Center DD Lecture Series
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New Jersey Department of Human Services Division of Developmental Disabilities
Self-Directed Employee Option Provider Presentation March 21, 2017
www.publicpartnerships.com | www.mychoiceNJ.com
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Agenda Introduction to PCG Public Partnerships Services to NJ DHS-DDD Leveraging Technology Current NJ Agency Payment Process Provider Payment Coordination Expectations and Next Steps
New Jersey Management Team David Horvath, Account Manager Kimberly Smith, FMS Manager Nicole Buckley-Mormello, Senior Program Manager Lori Webber, Assistant Program Manager Opening local offices in: Princeton Newark Hammonton
Public Partnerships, Who We Are...
Subsidiary of Public Consulting Group. Our team of employees comes from diverse fields and backgrounds.
PPL was established in 1999 to support the Robert Wood Johnson (RWJ) Foundation National Self-Determination Demonstration. Choice Control
Services Supports
PPL has served the New Jersey Department of Human
Services Division of Aging Services since 2006.
Currently PPL supports Individuals with Intellectual/
Developmental Disabilities in 13 states.
PCG Public Partnerships’ National Experience
www.publicpartnerships.com | Example PCG Public Partnerships Presentation
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Serving participant-directed programs operated by 50 state agencies in 25 states
PCG Public Partnerships’ Services to NJ DHS
DIVISION PROGRAMS SERVICES
Division of Developmental Disabilities (DDD)
Community Care Waiver Vendor F/EA Third-Party Administrator Supports Program
Interim
Division of Disability Services (DDS)
Personal Preference Program (PPP)
Vendor F/EA Third-Party Administrator Financial Counseling
Division of Aging Services (DoAS)
Jersey Assistance for Community Caregiving (JACC)
Vendor F/EA Third-Party Administrator
Veteran-Directed Home and Community-Based Services (VD HCBS)
Vendor F/EA Third-Party Administrator Financial Counseling
www.publicpartnerships.com | Example PCG Public Partnerships Presentation
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PCG Public Partnerships’ Support for NJ DHS-DDD Self-Directed Employee Option
We are committed to: Supporting transition from Agency with Choice to Vendor F/EA Supporting transition from Contract Funding to Fee-for-Service Partnering with Support Coordinators Principles of Self-Determination
www.publicpartnerships.com | www.mychoiceNJ.com 20
FREEDOM
AUTHORITY
SUPPORT
RESPONSIBILITY
CONFIRMATION
BetterOnline™ Technology
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Stakeholder access to program information 24-7 in HIPAA secure environment Interface with existing client databases Pay controls and provider credentials tailored to program requirements Real-time timesheet validation at point of submission Fraud, waste, and abuse prevention, detection, and reporting
DDD Launch/Implementation Plan
www.publicpartnerships.com
March
• Support Coordination Supervisor and Support Coordinator Training
April/May
• Support Coordination Supervisor and Support Coordinator Training
• Participant and Family Orientation and Training
• Participant Enrollment (Online, Group, In-Home)
• Self-Directed Employee Enrollment and Credentialing
• Agency/Vendor and Independent Contractor Enrollment and Credentialing
June
• Payments begin for enrolled employees and providers
System & Process Design
Service Matrix (Units, Rates, Provider Types, Service Codes, Limitations)
Participant and Employee Demographic Data (Supplied by Easter Seals of New Jersey)
Service Authorization Data (In Process) (iRecord system for Supports Program, eRecord for CCW)
www.publicpartnerships.com
Current Invoice Process for DoAS
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1. Agency/Vendor enrolls with PPL 2. Agency/vendor submits invoice via fax or email using PPL MS
Excel format or own format
Required Fields Participant ID Medicaid # or JACC # Participant Name Service Begin and End Date Service Code Service Description Units Rate TOTAL PPL intends to migrate to on-line invoicing for DDD providers
What to Expect from Public Partnerships During the Transition
www.publicpartnerships.com
Engaged business partner who will work with agencies to optimize operational efficiencies for all parties
Vendor Welcome Packet • Request for IRS Form W-9 • Form ST-5 • Direct Deposit Set-Up (optional) • Payment Request Form
MS Excel Payment Request Form Commitment to offer online invoicing in the future Excellence in customer service
Customer Service Locations
Newark, NJ
Phoenix, AZ
Sea-Tac, WA
Tampa, FL
Features
100% Calls Recorded
100% Documented
Interactive Voice Response
Blaze Calls
Bi-Lingual Agents
Translation Service
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Program Management
Customer Service
Financial Operations
Finance & Billing
Information Technology
www.publicconsultinggroup.com
