| What You and Your Service Facilitator Should be Discussing |
| 1. New for this period: If you are on the CCC Plus Waiver, did you know that you could also be on the waiting list for one of the three DD Waivers (Building Independence, Family and Individual Supports or Community Living)? How to apply for the FIS or CL Waiver. Review Mobility and Behavior/Orientation levels as noted on our reports. – Are they accurately reflecting your reality? Which of the three Fiscal Agents are you using? |
| 2. At every visit: Are you enrolled in CCC Plus (Commonwealth Coordinated Care Plus) Waiver? If so, which Managed Care Organization (MCO) are you currently using? Let us know if it changes! Is your child/are you on HIPP for Kids/HIPP? Who is the Employee of Record (EOR)? Is that accurately reflected in your Fiscal Agent’s portal? Changes: Any medical and/or functional changes since our last visit? Any recent hospitalizations? Who is your current Primary Care Physician (PCP)? Who are your attendants and are they getting paid? Do you have a back-up caregiver? A back-up caregiver can not be the Primary Care Giver (PCG) or the Employer of Record (EOR). Turning 18? There are steps you need to take to not lose services. Our amazing Resource Page for Young Adults will guide you through it and more! Review time sheets. Make sure hours noted by attendant matches the hours worked 🙂 Confirm your authorizations via your Fiscal Agent’s Portal. |
| Waivers |
| Facts about The CCC Plus Wavier The CCC Plus Waiver is a Medicaid program for elderly and individuals with disabilities to receive services in their homes and communities. These services can be consumer directed. Moms In Motion can be your Service Facilitator for consumer direct services. You are able to choose your attendant with consumer directed services. Read Moms In Motion’s CCC Plus Waiver Resource Page. Contact any one of Moms In Motion’s Family Resource Specialists to get your Waiver process started. They can guide you though the application process. View what services and funding are covered by the CCC Plus Waiver. To request a screening to determine eligibility for a CCC Plus Waiver, contact your local Department of Social Services (DSS) (adults) or Department of Health (DOH) (kids). Assessments are completed by representatives of the Heath Department and Social Services to determine if the individual is at risk of Nursing Home placement. If an individual meets that determination they most likely qualify for a CCC Plus Waiver. You can not be denied a screening. Screenings can take place when the individual is hospitalized. You do notneed Medicaid to be screened. |
| Personal Care is Now Under EPSDT for Individuals Under 21 In a Medicaid Bulletin it states that starting September 1, 2018, individuals under the age of 21 that are enrolled in the CCC Plus Waiver, must receive personal care, private duty nursing, and assistive technology through the Early Periodic Screening and Diagnostic Treatment (EPSDT)benefit. This change is being made to comply with the Centers for Medicare and Medicaid Services’ (CMS) requirement that certain Medicaid funded services for individuals under the age of 21 be accessed through the EPSDT benefi in lieu of a 1915 (c) Home and Community Based Services waiver. Since Personal Care has been moved under EPSDT (a Medicaid program not a Waiver), that will no longer be a Waiver service. Because of this, you will need to have at least one other service in addition to EPSDT personal care hours. Respite meets that requirement for most, but if you do not receive respite hours you will need to make sure you are using another waiver service. Some examples of other services are: Adult Day Health Care Assistive Technology Environmental Modifications Medication Monitoring Personal Emergency Response System (PERS) Private Duty Nursing Services Respite Care Skilled and Intermediate (custodial) nursing facility or long stay hospital Transition Services (moving into the community and out of a nursing facility) Resources: Read more in Moms In Motion’s Special Edition Newsletter. Blank DMAS-7 and a sample of a filled out DMAS-7. Moms In Motion’s Questions and Answers Video. Tips/Notes: Unfortunately, Moms In Motion cannot complete the DMAS-7. Therefore it falls to you to make sure the DMAS-7 is complete, correct and received on time to your Moms In Motion Service Facilitator. We have noticed that hours are being reduced in general. While we are the ones that submit the doctor’s documentation for you, please note that Moms In Motion does not have control over how many hours get approved. It is up to the authorizing agency (DMAS, DBHDS, and/or one of the 6 MCO’s) to approve Personal Care Attendant hours. In order to prevent a lapse or delay in service, please discuss your authorization renewal dates with your Service Facilitator to figure out when it makes sense to start talking to your doctor about this document. A specialist cannot complete the DMAS-7, it needs to be filled out by a pediatrician, developmental pediatrician, or a primary care physician. It is important that the doctor fills out the form properly! HERE IS A SAMPLE DMAS-7that is already filled out that you can show to your doctor to guide them. If you already have an authorization in place for Respite, you can use your respite hours until your personal care hours are authorized in order to bridge any sort of gap. Without the DMAS-7 from the doctor there may be a delay in approval of authorizations and/or attendants may not be paid on time. It is important for parents to advocate to their doctor what supports their child needs, so no attendant hours are lost. Authorizing entities (MCO’s, KePRO, DBHDS) make the final decision on hours approved. These requests are scrutinized each time they are submitted and a previous approval of X amount of Personal Care hours is not a guarantee to have the same hours regardless of the what the doctor puts on the DMAS-7. If your Personal Care services are denied or reduced and you disagree, please consider filing an appeal. If denials and reductions are happening frequently and there are no appeals, Department of Medical Assistance Services (DMAS) will not know the magnitude of the problem. Each managed care plan (MCO) has their own internal process to follow before filing an appeal with DMAS. When you were provided written notice about the reduction or denial of services, you should have received written directions about how to file an appeal. You can also contact your managed care plan for details about their appeal process. MCO contact information. If your request for reconsideration of the reduction or denial is not successful with the managed care plan, you can still file an appeal directly to DMAS. DMAS appeal process information. Even before you file an appeal, you can contact the Office of the State Long-Term Care Ombudsman for advocacy support. They have a contract with DMAS to provide advocacy assistance to people of all ages who are having problems getting services from their CCC Plus managed care plan. |
| Maximizing Your Benefits |
| DentaQuest If you are having trouble finding a dentist contact DentaQuest. DentaQuest is driven by their mission to improve the oral health of all, and to achieve a nation free of dental disease. They envision a nation where no child suffers from the pain of tooth decay, and where adults keep all their teeth for their entire lives. They believe every person should access to quality dental care. Read details such as, what dental procedures are covered and more information in the DentaQuest, LLC Virginia Medicaid Programs Office Reference Manual. Dentaquest: 855-208-6330 To find a dentist, call, Customer Service: 888-912-3456 Smiles for Children Provider Relations: 888-912-3456, Option 1 To Report Fraud and Abuse call: 800-237-9139 Mail suggestions, complaints, etc, to: DentaQuest P.O. BOX 2906 Milwaukee, WI 53201 Compare the adult dental benefits on the six CCC Plus MCOs Call your MCO to learn about what dental services are covered: Aetna Better Health of Virginia CCC Plus: 844-824-2018 Magellan Complete Care of Virginia CCC Plus: 844-824-2016 Virginia HealthKeepers CCC Plus: 844-824-2017 Virginia Premier Health Plan Member Services: 844-822-8115 Anthem HealthKeepers, Inc. Member Services: 855-208-6330 Tips: CCC Plus covers certain procedures that may be different than the procedures covered by your MCO. Get informed before making a dental appointment. Sample questions to ask the dentist office before you make an appointment. |
| Opportunities! VBPD The Virginia Board for People with Disabilities (VBPD) are currently looking for multiple new members to fill more than half a dozen vacancies. VBPD serves as Virginia’s Developmental Disabilities (DD) Council. DD Councils are in every state and territory of the United States. They work for the benefit of individuals with DD and their families to identify needs and help develop policies, programs and services that will meet these needs in a manner that respects dignity and independence. If you or someone you know would be interested serving with the Board, apply today! Board members serve four-year terms and can be reappointed once. The Board meets four times each year in the Richmond area. Applications for current vacancies should be submitted by May 1, 2019, for fastest review. Eligibility: Parent or guardian of an adult with a developmental disability Parent or guardian of a child 18 and under with a developmental disability Immediate relative or guardian of an adult with a developmental disability who cannot advocate for themselves A person with a developmental disability To be considered, simply complete and submit the required online application. If you’ve already applied in the past, a new application is not required. You can find the required online application at https://solutions.virginia.gov/OASYS/. The Board is located in the Health and Human Resources (HHR) Secretariat. For more information about serving on the Board, visit www.vaboard.org/aboutvbpd.htm#appointment. If you need help with the application, you can call the Secretary of the Commonwealth’s Office at (804) 786-2441 or use the TTY/TDD line at (800) 828-1120 Va-LEND The Va-LEND Program is currently seeking people who are interested in becoming Disability Advocacy Trainees in the 2019-2020 Va-LEND Program. Virginia Leadership Education in Neurodevelopmental Disabilities is accepting applications. The one- to two-year graduate level program, funded by the Partnership for People with Disabilities (within VCU’s School of Education), teaches trainees to work as leaders and advocates in the field of neurodevelopmental disabilities and disability leadership. Apply by June 1. For more information, contact Donald Oswald, Interim Associate Director at valend@vcu.edu or call (804) 828-0073. Application | Website | Video featuring a Medium-Term Trainee with a disability See Va-LEND Trainees presentations on May 1, 2019 4pm in Richmond. Flyer Medicaid Member Advisory Committee Are you a Medicaid member or does a member of your family have Medicaid coverage? Do you have ideas about how to improve the program to better serve you and your family and others? The Virginia Department of Medical Assistance Services (DMAS) is seeking participants for a new Medicaid Member Advisory Committee. This advisory committee will be made up entirely of Virginia Medicaid members, family members or other representatives and they will play a key role in the review of new and existing health policies and services, making recommendations to the DMAS Director. Why should you participate? You will have the opportunity to play an active role in improving Virginia Medicaid You will meet and work with other members from across the Commonwealth who are motivated to improve Virginia Medicaid for everyone who has coverage through the program Travel expenses will be covered by the agency Meals and parking will be provided for meetings The committee will hold its first meeting in mid-March 2019. DMAS is seeking individuals to participate in the four quarterly meetings taking place this year. If you are interested in being considered for membership on the committee, please contact Walter Burton at Walter.Burton@DMAS.Virginia.Gov or (804) 418-4529. View flyer. |
| Free Things, Resources & Grants for All Things Disability Related Blog – The Complete List of Free Things and Grants for Kids with Special Needs Facebook Album – Helpful Resources for Virginians with Disabilities Database – Custom Search Options to Disability Resources Tailored to You Facebook Album – Examples of what Ability Unlimited can request through Medicaid funding. (AT = Assistive Technology, EM = Environmental Modifications, DME = Durable Medical Equipment) Summer Camp List – Locations all over Virginia! Free lifetime passes to Virginia National Parks | Fishing, Hunting and Trapping Your local Parks & Recreation may have a reduced priced application for an annual membership for an adult/child with a disability. Your Recreation Center may offer Therapeutic Recreation programs. Or consider signing up for their regular programs for a great opportunity to practice inclusion! |
| Fiscal Agents (Attendant Payroll) One MCO (Magellan) and FFS Waivers have switched fiscal agents for the Medicaid waiver-funded Home and Community Based Services (HCBS) programs. Fiscal agents manage payroll and taxes for Personal Care Attendants. It’s important for you to know which fiscal agent you use. Please make sure your Moms In Motion Service Facilitator knows which fiscal agent you are using. The three have differences and it’s important you know which one you need to be registered with so your attendants will be paid on time. Which Fiscal Agent should you be using? Moms In Motion’s Guide with fiscal agents helpline contact information. Moms In Motion’s PPL Attendant Resource Page Moms In Motion Resources for all three fiscal agents Packets, payroll schedules, guides, etc. |
| Employee of Record (EOR) Manual March 2015 |
| Tips: Your back-up caregiver can not be the Primary Care Giver (PCG) or the Employer of Record (EOR). You may choose a family member, neighbor, friend, or paid employee willing and available to assist the individual when needed. Your Service Facilitator or Case Manager or Support Coordinator may not be the back-up person. A back-up caregiver is someone who is NOT the Primary Care Giver (PCG) and NOT the attendant. A backup caregiver is the secondary person who will assume the role of providing direct care to and support of the waiver individual in instances of emergencies and in the absence of the Primary Care Giver (PCG) who is unable to care for the individual. Failure to identify a back-up person/caregiver could result in termination of services. If you don’t have a back-up person, consider relationship building in your community. Watch this video series featuring Al Condeluci on building relationships for people with disabilities in their community. Please give your Moms In Motion Service Facilitator the name of your back-up caregiver. Attendants can not start working until authorizations are approved. Ask your Moms In Motion Service Facilitator the start date for time sheets. |
| Your Moms In Motion Service Facilitator will be happy to assist you with anything mentioned in this section. Ask during your next visit! |
| Job Opportunities at Moms In Motion |
| Join Our Team! Do You Want To: have a positive impact on people’s lives? see the joy in someone’s face when you tell them about a little resource that will make a big difference in their lives? have the chance to help people in your community on a day-to-day basis? Apply Today to Become a Service Facilitator Moms In Motion / At Home Your Way is looking for talented individuals to join our team! We are hiring Service Facilitators all across the state of Virginia. Apply today! Service Facilitators support eligible individuals and their families in properly using consumer-directed services so they can live in their home with assisted supports. We do this by routinely visiting people in their homes (your home will be your base office). Moms In Motion / At Home Your Way has been a leader in this industry for over nine years. We are a value added provider.We help families to administer their consumer-directed services & link them to additional services. If you can answer “Yes” to these questions we want you to Join our Team of ACES: Do I enjoy ADVOCATING? Am I COMPASSIONATE? Do I strive for EXCELLENCE in everything I do? Do I care about person-centered SERVICE? Skills and Qualifications include: Associate’s Degree or greater in Human Services or related field. Ability to work independently. Ability to communicate effectively both orally and in writing. We are currently hiring in all locations in Virginia!!! To ensure your Moms In Motion / At Home Your Way application is processed correctly, please use the the links on our Job Opportunities page to apply for the Service Facilitator position in or around your home area. Share this section with your network, friends and colleagues by copying this link: https://conta.cc/2AtA0Zv Email questions to: HR@MomsInMotion.net Get a gift for referring someone! If you know someone that would make a great Service Facilitator, please refer them to Moms In Motion. Ask them to put your name and contact info on their application. If they work out as an employee, you could receive a gift for your referral. Service Facilitators make a positive difference in the lives of the individuals and families they serve. Moms In Motion is in its tenth year as a Service Facilitation Provider! We are the Biggest because we are the Best! Come Work with the Best 🙂 |
| Advocacy |
| How the Changes to EPSDT are Impacting Families An eye opening news article was published about changes to the EPSDT Program which impacts children with disabilities in Virginia. Many parents have been scrambling to comply with new regulations that leave their children at risk due to cuts their Personal Care Services. Quote from the article, published by The Free Lance-Star in Fredericksburg, Virginia on March 16, 2019: “Yet as a result of recent changes, the amount of time Medicaid will pay attendants to help with her care has dropped from 80 hours to 49 hours a week. Similar reductions are happening statewide as the Virginia Department of Medical Assistance Services, which administers Medicaid, tries to cut costs.” Full article: As Medicaid Changes, Local Family Struggle Cuts impact ‘the most fragile in our Medicaid system’ |
| Free Training on The Americans with Disabilities Act The Rocky Mountain ADA Center is committed to educating everyone on both the spirit of the Americans with Disabilities Act (ADA) and the technical application of the law. Their team of dedicated staff members design training to inform and educate participants on the impact the ADA has on all Americans. Understanding how disability rights effect not only those living with a disability but everyone is the driving force behind all that the Rocky Mountain ADA Center does! The Center provides a wide range of training options. They have great ADA training source for individuals with disabilities, businesses, state and local agencies, transit agencies, architects and designers, disability organizations, or anyone who want to know how the ADA affects them. Current classes cover: Service Animals and the ADA Title I, II, and III Disability Awareness and Etiquette Accessible Voting Places 2010 ADA Standards Sign up for free Rocky Mountain ADA Center Online Training. “… Civil rights are not a guarantee of the good life, but an equal opportunity and responsibility to participate in producing the good life for oneself and for all. Government alone cannot implement ADA; this is a responsibility of all Americans…” – Justin Dart. Dart is known as the father of the ADA. |
| The Case for Inclusion The Case for Inclusion 2019 is a comprehensive data tool that examines how well programs in all 50 states and the District of Columbia are serving residents with intellectual and developmental disabilities. The data collected is designed to equip advocates with the data and resources they need to advocate on behalf of deeper investments in the long-term supports and services that enable people with intellectual and developmental disabilities to be included, supported and empowered in the community. |
| Virginia Mental Health Access Program The Virginia Mental Health Access Program (VMAP) will help close the gap in care for the children and adolescents in our state who are without access to the best mental health services. VMAP has received three separate grants and has partners and supporters throughout the state committed to helping children get the treatment they need. The program is already providing services in some regions. The $1.23 million allocated in the Governor’s budget will get VMAP off the ground and enable it to fully expand statewide. More details here. Other Resources: NAMI Virginia – the National Alliance on Mental Illness of Virginia REACH – Regional Educational Educational Assessment Crisis Response and Habilitation |
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