# 64 NOW/COMP Waiver - Important Information!

[Guest guest]

Dearest Advocates:

On Friday, Heidi Fernandez and I had a meeting with the Office of Developmental Disabilities to discuss concerns (from a parents perspective) regarding the transition of the NOW/COMP disabilities waivers since 11/1/08. Please remember there are over 11,000 disability waivers that are being impacted by this transition!

Some of the issues/concerns/solutions we discussed included the following:

-Prior Authorization (PA) status (your budgets).

-Self direction- Acumen

- Independent contractor vs. vendors.

- SMS costs and using Promed.

- Initial new enrollment packages – access issue.

- Customer service concerns- Not returning phone calls/voice mail being full, etc.

-Rate caps and maximum amounts per service categories.

-Communication and training needs for Support Coordinators (SC), families and providers. Including process flow diagrams so everyone understands their responsibilities in the waiver system.

Below is a brief summary of what was discussed on the above topics. Due to limited time, I will not be able to get into a lot of specifics but I hope you find this information helpful.

1. Family Meetings with MHDDAD Staff: Office of DD STRONGLY suggests that families attend the upcoming December 8 (Atlanta) and Dec. 15 (Macon) meetings. (Go to my website www.heidijmoore.com under “events” for the flyer). The first meeting is TONIGHT! Th

ey plan on getting into more details on the process, responsibilities, etc. There will also be a question/answer period as well. How are they going to know our concerns if we don’t vocalize them?

2. Acumen / Self Direction: Due to the transition of the waivers, there have been some process changes with Acumen (the fiscal agent that handles self directed families in GA). ALL new requests to go self directed needs to go through your SC. They will get you the new enrollment package and submit the necessary forms to Acumen directly (this is different than in the past where the families did this). In addition, they plan to address Acumen’s customer service concerns (not returning phone calls, voice mail being full, etc). You will need to work with your employe

es/contractors/vendors regarding if they will be an independent contractor or vendor.

3. Family Transition Stories: Thank you so much for the 40 families that submitted your transition stories in the last 1.5 weeks. It really validated the concerns families have and the “real” issues that need to be addressed. Based on the 40 families stories, the following is a summary of their concerns: process/communication, sudden loss of services and providers, rate caps, no PA’s and ISP Addendums approved, SMS flexibility, Acumen process, and decrease of budgets. We did

submit all the stories to Office of DD and they did state that they will be working on the concerns. The good news is – many of the stories had already been addressed! Once again, this helped show them that there are concerns with the families regarding this transition that need to be addressed immediately. This is why going to the upcoming family meetings is so important. THEY NEED TO HEAR FROM FAMILIES REGARDIG THE CONCERNS WE HAVE IN ORDER TO MAKE NECESSARY CHANGE!

4. Specialized Medical Supplies (SMS) – In the family transition stories, there was global concerns regarding the utilization of Promed (SMS supplier) and how much more expensive they are for their products (30-40%). Families are NO longer allowed to purchase SMS directly and seek reimbursement. This is a change in process as well. BUT- you can work with your local vendors/stores like Walmart, Publix, Target, etc to see if they will allow you to put your items in “lay away” for a minimum amount and Acumen will cut the check directly to them. Then you can go to pick up the supplies. This is another option that we were not aware of – hope it helps.

5. Rate Caps- We did discuss the issue with rate and caps not being realistic for all the services under the NOW/COMP waivers – especially for services that fell under the old NSE services. We will be working with the Office of DD in the next few months (after this transition process) to address this issue and work with the appropriate parties to make sure this is evaluated well before the one year timeframe that is stated in the new waivers for a cost effectiveness study. More to come on this issue.

In addition- There will be a DD Advocates Meeting on December 9th at 10am-12pm at 2 Peachtree on the 26th floor. This meeting is for parent and self advocates This is not a case management meeting. We would like to hear generalized positives and negatives and give answers. This is a great way to get your questions addressed if you don’t get your answers on Monday night!

Many thanks again to Loving Care Family Service, LLC. for helping us put together the family transition stories. This is truly a team effort during these times!

I hope you find this information helpful as we continue to go through this transition process and help all the families impacted. Hope to see you at the meeting tonight!

“UNITED – WE WILL MAKE A DIFFERENCE!”

Sincerely,

Heidi

--Heidi J. (Proud Mother to - 8 years old with Down syndrome & - 7 years old) For more information about how Heidi can help you maximize your child's potential, please go to www.heidijmoore.com "Help The Children Now, So They Can Help Themselves Later!" The material contained in this e-mail is for general information only. It is not intended in any way to provide or offer legal advice. To obtain legal advice, please consult with your attorney or a qualified legal representative.