Office of DEVELOPMENTAL SERVICES
Virginia Department of BEHAVIORAL HEALTH AND dEVELOPMENTAL SERVICES
QUARTERLY Report of office activities
january – march 2010
1
1220 Bank Street
P.O. Box 1797
Richmond
VA, 23218-1797
Phone: (804) 786-0580
Voice TDD: (804) 371-8977
Toll Free: (800) 451-5544
Fax: (804) 692-0077
Office of DEVELOPMENTAL SERVICES
Quarterly Report
The Office of Developmental Services (ODS) in the Virginia Department of Behavioral Health and Developmental Services (DBHDS) is dedicated to joining in partnership with all available state and local resources toward the development of communities that support and affirm all persons with intellectual disability and their families as participating and contributing members. This report provides an overview of the activities and accomplishments of the ODS in the third quarter of Fiscal Year (FY) 2010.
Highlights of the Quarter
Contact person: Lee Price
The Virginia General Assembly session and the changes that are always a part of any new administration guided many of the activities conducted by the ODS during much of the third quarter. Even so, it was still a busy quarter with the normal routines of the office. In this report, please find information related to these activities.
We have included, at the end of this report, a chart that profiles where we are at this time with regard to the Medicaid funded supports provided to individuals with intellectual disability. We hope to make this part of our regular reporting to help answer questions you may have about the services that are currently provided. As the system continues to evolve, this report can be offered as an historical record of the services and supports that Virginians with developmental disabilities are seeking and are being provided.
The staff of ODS joins all of the DBHDS staff in welcoming Jim Stewart as our new commissioner and looks forward to working with him and our new administration.
Regulation and Policy Contact person: Dawn traver
· DMAS related activity:
o Worked with DMAS staff on desired revisions for the “final” regulations to take effect upon the expiration of the current Emergency Regulations.
o Worked with DMAS staff on needed edits to the next version of the MR/ID Community Services Manual (to be based on the current emergency regulations).
· CMS related activity:
o Prepared an amendment to the June 2009 ID Waiver Application to request acceptance of the uniform, statewide ID Waiver slot assignment process to be effective 1/1/10.
o Participated in a conference call with CMS representative regarding needed policies/amendment to the ID Waiver Application for second–tier medication monitoring.
· Continued participation on the workgroup to update the facility Admissions/
Discharge Protocol.
· Participated in a committee to revise the Department’s policy on Residential Services.
· Prepared annual communication to CSBs regarding individuals to be supported through OBRA for FY 2011.
pre-authorization
contact person: Cynthia smith
Pre-Authorization
Waiver / Total *Processed / Approved / Denied / Appeals** / Reconsiderations / Pended
3485 / 3295 / 6 / 6 / 21 / 341
* *Received and resolved
* Difference between approved and total processed:
- Total processed: total ISARs approved, denied and reduced
- Approved: ISARs authorized as requested
PENDED ISARS
More Information / Incorrect Provider Name/Number / Provider Not MR Waiver Eligible / Not MR Waiver Eligible / No Medicaid Number; Invalid/Pended Medicaid Number261 / 2 / 4 / 4 / 5
data management and Quality assurance
contact person: Dr. cheri stierer
The Data Management and Quality Assurance Team is working on the following tasks:
· ODS continues to update reports from the Medicaid database and work on quality indicator data for the Centers for Medicare and Medicaid Services’ (CMS) ID/DS Waiver application quality assurances. We meet quarterly with DMAS to review outcome measures and data collection processes.
· The January quarterly Waitlist Report was sent to CSBs for updates. LOF Status of Completion Report was also sent out in January to the CSBs.
· In March we began SIS interviewer training for the field test of the Children’s Supports Intensity Scale with 4 new interviewers being trained. Training was also provided to current interviewers in Regions 2 and 4, and also the statewide Master Trainers. There were 20 trained in Region 2 and 28 trained in Region 4 and 20 individuals trained as Master Trainers for the Children’s SIS. We trained 25 new Adult SIS Interviewers, 42 had Interviewer refreshers, and 22 had SIS Administrator refreshers.
· Systems Transformation Grant for the new electronic ID Waiver System includes the Preauthorization, Waitlist, and Enrollment processes. The work group has completed the draft of the detailed requirements for the IDS electronic system. The group is reviewing the marketing strategies for roll out in August/September of 2010.
· The 2009 Family Survey data scan was completed and data analyzed for the calendar year 2009 showing a return of over 1800 surveys. A report has been drafted, is in review, and will be sent out soon.
ODS DataTYPE OF DATA / Count
As of 4/2/2010
Number on Urgent Waitlist (Including DS Waiver) / 2878
Number on Non-Urgent Waitlist (including DS Waiver) / 2385
Number of slots obligated from the 69 Facility FY 08 Slots / 50
Number of slots obligated from MFP 09 / 75
Number of Day Support Waiver Slots Obligated / 283
Number of MR Waiver Slots Obligated / 7949
Training Center CENSUS as of 3/25/2010
Northern Virginia Training Center / 169
Central Virginia Training Center / 422
Southeastern Virginia Training Center / 142
Southside Virginia Training Center / 262
Southwestern Virginia Training Center / 189
Training Center Total / 1184
Training and technical assistance
contact person: gail rheinheimer
Person-Centered Individual Support Plan
Through requests for additional support, the Community Resource Consultants have provided 24 training and technical assistance sessions across the state on the new PC ISP during this quarter. These were attended by 411 support coordinators/case managers and Waiver providers.
Additional materials and samples are in development and will be added to the website during the spring: a children’s sample, with in-home residential and CD services, a support coordinator “script,” an instruction manual, a PC planning meeting agenda template, signature guidance and an example for someone receiving Targeted Case Management only.
Regional Support Coordinator/Case Manager Teams
Regional SC/CM team meetings were held in 4 of the 5 regions during this quarter. The agenda covered the PC ISP and SIS, PCT and SIS refresher training, other resources available, the new slot assignment process, MFP slots, changes in Waiver emergency regulations, status of revised manual and final regulations, recent DMAS Quality Management Reviews, the DMAS 225 form, Office of the Inspector General recommendations, discussion about the value of these regional meetings and networking with other SC/CMs around particular issues.
Person-Centered Thinking
A Person-Centered Thinking training session was held in all 5 regions of the state during this quarter. Six more are available during April, May and June around the state. Registration for these sessions can be found at http://www.vcu.edu/partnership/PCT/ or from our webpage under Announcements. Contact Dawn Machonis at: or 804-828-1335 if you are interested in learning more about Person-Centered Thinking training opportunities or becoming a Virginia PCT trainer.
David Meadows (ODS), Barry Seaver (Middle Peninsula-Northern Neck CSB) and Jill White (Virginia Beach CSB) are Virginia’s PCT mentor candidates and held two 3-day Plan Facilitation training sessions for approximately 40 people. The 3 candidates have successfully completed all their training activities, are in the process of submitting plans and expect to be endorsed by The Learning Community as PCT mentors. Virginia will be able to begin endorsing our PCT trainers without needing out-of-state consultants/mentors. DMAS Long-Term Care division received PCT training in March. Two Person-Centered Family Assessment Trainings were also provided by Support Development Associates and attended by 28 support coordinators and state staff.
The “Virginia Gathering” for PCT trainers and trainer candidates on May 18 and 19 in Virginia Beach is the first “Gathering” to be held on the East Coast. A “Gathering” is held by “The Learning Community” in Oregon annually for trainers internationally, and has approved Virginia’s event as meeting the requirement for attendance at a “Gathering” for PCT mentors and trainers. It is sponsored by ODS and the Partnership for People with Disabilities and is open to PCT trainers in other states. Sessions are facilitated by Virginia mentor candidates and Virginia trainers, along with TLC mentors, Michael Smull (Support Development Associates) and Amanda George (Sanderson and Associates).
“Becoming a Person-Centered Organization” Projects (6-State PCP Implementation Grant)
ODS participated in another round of Leadership/Coaches meetings at Mount Rogers and Rappahannock Area CSBs and at Central Virginia Training Center. Stories using the PCT tools and changes made and needed at the individual, organizational and system levels were identified. The monthly “Community of Practice” calls that include providers and leadership from the 6 states participating in the project focused on how state employees use person-centered thinking tools in their work, how states create opportunities for informal mentoring and how states are communicating system level changes that are needed. DBHDS and DMAS will be reviewing these during the quarterly operations meeting.
Targeted Case Management Training Modules
The Targeted Case Management modules that incorporate the new person-centered planning process and Individual Support Plan are in their final stages and will be available to CSBs on the DBHDS Leaning Management System (LMS) in late spring.
facility and community resources
contact person: susan elmore
Work continues, involving CSB representatives, training center Social Work Directors and Virginia Protection and Advocacy (VOPA) staff, on updating the Admission/Discharge Protocol for the training centers and CSBs.
employment & Housing for persons with dEVELOPMENTAL dISABILITies
CONTACT PERSON: EMILY HELMBOLDT
· State Employment Leadership Network Project: The SELN Advisory Group met twice this quarter, including the site visit from the staff of the Institute for Community Inclusion at University of Massachusetts, Boston. The Advisory group is assessing and addressing many areas related to integrated employment for persons with developmental disabilities including:
o Strategic goals and operating policies,
o Leadership, financing and contracting methods,
o Training and technical assistance,
o Interagency collaboration,
o Services and service innovations,
o Employment performance measurement,
o Quality assurance and program oversight.
The group’s next steps are to finalize core beliefs, vision and create strategic plans relative to each element listed.
· Housing studies and initiatives: ODS takes part in the Housing Expansion Task Force which was formerly lead by the director of the Office of Community Integration (aka, Olmstead office). Since that person retired, Ed Turner is assuming leadership and will resume the meetings in early spring. ODS staff will continue to follow up on the 318Z Housing study, which was completed in November 2009, to determine action steps required as a result of the recommendations. Also, we will continue to assess the needs of persons with DD in regards to housing issues via various stakeholder groups and conferences to further the goal of improving services.
· Served on a DMAS Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) Behavioral Treatment committee which looked at best practice clinical credentials for providers and licensing requirements for agencies. This service is aimed at assisting children with DD who have challenging behaviors and are at risk of out of home placement.
autism spectrum disorders issues
CONTACT PERSON: CINDY GWINN
· Facilitated Part C Autism Guidance Document Group
· Spoke to Lynchburg, Blacksburg, Fredericksburg & Culpeper Autism Action Groups concerning the role of DBHDS and the JLARC
· Spoke at the Virginia Tech T/TAC Abingdon Autism Conference on the state of autism in Virginia
· Collaborated with the DMAS Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) staff on licensure for In-home services
· Facilitated JLARC workgroups
· Participated in the Partnerships Family to Family Network Grant (“360”)
· Attended the Commonwealth Autism Services annual conference
· Spoke to the Long-Term Care Coordination Council of Northern Virginia
Commonwealth Autism Services
contact person: John toscano, PRESIDENT and CEO
With DBHDS:
During this quarter we have continued our activity with Department staff in the planning with TACIDD designed to address the J-LARC autism study recommendations. Commonwealth staff members are assigned to each of the work groups as the groups completed their reports as of 3/31/10.
Some highlights of other CAS statewide activities are as follows:
· Completed our 9th Annual Autism Conference – Autism in Virginia: It’s a New Day. The conference was very well received by attendees and was rated a 3.69 out of a 4 point scale.
· In-house discussions underway to plan the 10th Annual Autism Conference for March 8th and 9th, 2011.
· Substantive planning underway to create an Asperger College Model with local Richmond area partners. The project is looking to begin with a smaller scale summer program as a lead-in to a full scale model.
· CAS Behavioral Learning Institute will offer its inaugural training event – Ethics for Behavior Analysts on April 27th.
· Continuing progress being made on CAS Public Safety Training initiative with the work group’s interim report being submitted to DBHDS on 3/31/10.
· CEO presented an autism “state of the state” overview to House of Delegates democratic caucus and an Autism 101 presentation to DMAS staff
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Training Center Census as of March 2010 / ID Waiver Census as of Apr 14, 2010 / ICF/MRCSB Name / NVTC / SWVTC / SEVTC / SVTC / CVTC / CVTC Skilled Care / Individuals Receiving ID Services / Urgent Waitlist / Non-Urgent Waitlist / Total Waitlist / CSB/Private Community Certified Beds
Alexandria CSB / 14 / 0 / 0 / 0 / 7 / 3 / 82 / 21 / 2 / 23 / 3
Alleghany-Highlands CSB / 0 / 0 / 0 / 0 / 3 / 2 / 45 / 13 / 8 / 21 / 0
Arlington CSB / 29 / 0 / 0 / 0 / 10 / 1 / 76 / 24 / 34 / 58 / 24
Blue Ridge Behavioral Health CSB / 0 / 1 / 0 / 0 / 39 / 7 / 291 / 79 / 103 / 182 / 0
Central Virginia CSB / 0 / 0 / 0 / 0 / 33 / 9 / 431 / 149 / 34 / 183 / 14