ncinnovations waiver - north carolina › ncdma › documents › medicaid › ...optional footer to...

29
NC Innovations Waiver Monica Hamlin and Kenneth Bausell Division of Medical Assistance

Upload: others

Post on 24-Jun-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

NC Innovations Waiver

Monica Hamlin and Kenneth Bausell Division of Medical Assistance

Page 2: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• To provide an overview of Innovations Waiver

• Let you know what just happened…

• Let you now what’s coming up…

• Get feedback

2OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Goals of Presentation

Page 3: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

NC Innovations

3

Page 4: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Provides an array of services and supports

• Provides an alternative for Intermediate Care Facility for

Individuals with Intellectual Disabilities (ICF-IID)

• Statewide

4OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Innovations overview

Page 5: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Goals As a Staring Point

5

Page 6: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Increase community

integration

• Real life outcomes

• Living in homes of their

choice

• Engaging in purposeful day

/ week

• Opportunity to direct

services

• Maximize self-

determination, self-

advocacy and self-

sufficiency

• Ensure wellbeing and

safety

6OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Goals snapshot

Page 7: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Enhancing person centered planning

• Aligning services and supports with person centered

plans

• Smaller community congregate living situations

• Living and working in the most integrated settings

7OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Objectives snapshot

Page 8: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

The Tool Boxes

8

Page 9: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

The Toolboxes

ServicesNC Innovations + =

Other Services

Other Supports

Other Resources

Page 10: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Technical Amendment

• Weeding out inefficiencies and barriers

• Plant seeds of flexibility, integration and opportunity

• New Service definitions are new tools but we have

to let them grow and mature

1

0

OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

What just happened???

Page 11: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Pruning / Listening

• Listening Sessions

• Webinars

• Statewide Stakeholder Group

• Innovations Waiver Email

• We want to hear from people what is working and

what is not working

1

1

OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

What’s coming up!!!

Page 12: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Supported Living and Self Direction

• Supported Living Levels and Technology

• Supported Living and Finding Housing

• Clarify when Relatives can provide services

• Address Residential Supports and Therapeutic

Leave

• Provide more guidance around Back-up Staffing

• Community Transition and Money Follows the

Person Functions.

1

2

OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

What we’ve heard???

Page 13: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Questions / Feedback

1

3

Page 14: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Resource Allocation Overview

1

4

Page 15: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• It is a system for the allocation of resources based on a

the Supports Intensity Scale - reliable assessment of

intensity of need – and other factors

• Resources are allocated to people based on their

assessed level of need so that each person receives

what they need – no more and no less.

• It is a ‘best fit’ solution so care must be taken to

accommodate individuals with extensive needs.

15OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

What is Resource Allocation?

Page 16: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

$

Little

Support Needed

Little ALot

We are starting to move

from a low correlation like

THIS…

…to a high

correlation like THIS

$

Little

Support Needed

16OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Little ALot

ALot

ALot

Page 17: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Levels

17

Page 18: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

The SIS Assessment

1

8

Page 19: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Assessment tool to measure the support an individual

needs to live a meaningful life in the community

• Used to inform supports planning and resource allocation

• Questions about:

• Home Activities

• Community Activities

• Health and Safety

• Medical and Behavioral Challenges

19OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

For information on SIS reliability, validity & use:

https://aaidd.org/publications/supports-intensity-scale#.WTmTUNy1umw/

Supports Intensity Scale ®

Page 20: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Three sections to the assessment:

• Section 1: support needs for home living, community living,

lifelong learning, employment, health and safety and social

activities

• Section 2: support needs for speaking up for him/her self and

others (advocacy), managing money, making choices and staying

safe

• Section 3: support needs for medical and behavioral challenges

20OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Supports Intensity Scale

Page 21: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Questions / Feedback

2

1

Page 22: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Services

22

Page 23: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Community Networking Services

• Supported Employment

• Day Supports

• Community Living and Supports

• Respite

23OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Base Budget Services

Page 24: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Community Navigator

• Community Transition

Services

• Crisis Services

• Financial Support

Services

• Home Modifications

• Residential Supports

• Supported Living

24OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Non-Base Budget Services

• Individual Goods and Services

• Natural Supports Education

• Specialized Consultation

Services

• Vehicle Modifications

• Assistive Technology Equipment

and Supplies

Page 25: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Individual Budget Tool

Individual Budget

Guideline

LivingArrangement

SIS

Age

25OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Historical

Spending

Page 26: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Annual Budget

26OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

Page 27: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Questions / Feedback

2

7

Page 28: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

• Pruning / Listening

• Listening Sessions

• Webinars

• Statewide Stakeholder Group

• Innovations Waiver Email

• We want to hear from people what is working and

what is not working

2

8

OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE

What’s coming up…

Page 29: NCInnovations Waiver - North Carolina › ncdma › documents › Medicaid › ...OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE |DATE 2 Goals

Email [email protected]

Voice Mail: 919-855-4968

52

Innovations Wavier Questions/Feedback

OPTIONAL FOOTER TO REPEAT ON EACH PAGE: INSERT AUDIENCE | PRESENTATION TOPIC OR TITLE | DATE