UofL_Logo_Curtain_Inside UofL_Stripe Show Me The Money: Navigating Funding Sources Heidi Cooley-Cook UofL_Logo_Curtain_Inside Kentucky Autism Training Center Today’s Agenda •House Bill 159 – coverage by insurance •Medicaid Waivers •KY IMPACT •IMPACT Plus •Hart-Supported Living Program •Social Security – SSI & PASS •Employment and the Office of Vocational Rehabilitation (OVR) UofL_Logo_Curtain_Inside •Took effect January 1, 2011 •Guaranteed coverage for other services as treatment for Autism Spectrum Disorders •Defined several terms •Mandated licensure for ABA House Bill 159 This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? •Habilitative or Rehabilitative Care •Medical Care •Pharmacy Care •Psychiatric Care •Psychological Care •Therapeutic Care House Bill 159 This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? •Large Group Plans –Enacted by 1/31/11 •Maximum annual benefit ages 1-7=$50,000 •Maximum monthly benefit ages 7-21=$1,000/month •No limits on number of visits to an autism services provider •Services may be subject to a co-pay and/or deductible •Individual and Small Group Plans •Maximum monthly benefit ages 1-21=$1,000/month House Bill 159 This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside For Additional Information: •View webinar hosted by KATC •Autism and Private Insurance –January 19, 2012 https://louisville.edu/education/kyautismtraining/videos House Bill 159 This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside Types of Waivers •Supports for Community Living (SCL) •Home and Community Based (HCB) •Michelle P Medicaid Waivers This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Have a diagnosis of intellectual disability or developmental disability and •Must meet requirements for residence in an Intermediate Care Facility for persons with intellectual disabilities and •Meet other Medicaid requirements Eligibility Requirements Supports for Community Living (SCL) For Additional Information: http://dbhdid.ky.gov/ddid/scl.asp This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? Supports for Community Living (SCL) This presentation was created from information that was obtained from secondary resources on 1/19/12 Consumer Directed Option (CDO) available •Adult Day Training •Behavior Supports •Case Management •Children’s Day Habilitation •Community Living Supports •Occupational Therapy •Physical Therapy •Psychological Services •Residential Supports •Respite •Speech Therapy •Supported Employment UofL_Logo_Curtain_Inside •Currently a waiting list – apply early •Complete MAP 620 form –http://dbhdid.ky.gov/ddid/files/MAP620Form.pdf –Mail or Fax form to: The Division of Developmental & Intellectual Disabilities 100 Fair Oaks Lane, 4W-C Frankfort, Kentucky 40621 Fax: 502-564-8917 How to Apply Supports for Community Living (SCL) This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Elderly or disabled and •Meet nursing facility level of care – without services would be admitted to a nursing facility and •Are financially eligible for Medicaid services Eligibility Requirements Home and Community Based (HCB) For Additional Information: http://chfs.ky.gov/dms/hcb.htm This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Assessment •Re-assessment •Case Management •Minor Home Adaptation •Adult Day Health Care •Homemaker •Personal Care •Attendant Care •Respite Care What’s covered? Home and Community Based (HCB) This presentation was created from information that was obtained from secondary resources on 1/19/12 Consumer Directed Option (CDO) available UofL_Logo_Curtain_Inside •Complete a financial application –Local Department for Community Based Services •Complete a physician-ordered assessment –Contact a home health agency or adult day health center How to Apply Home and Community Based (HCB) This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Diagnosed with a developmental or intellectual disability and •Require a protected environment while learning living skills, educational experiences, awareness of their environment and •Are financially eligible for Medicaid services Eligibility Requirements Michelle P For Additional Information: http://chfs.ky.gov/dms/mpw.htm This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Case Management •Adult Day Training •Supported Employment •Community Living Supports •Behavior Supports •Occupational Therapy •Physical Therapy •Speech Therapy •Respite •Homemaker Service •Personal Care •Attendant Care •Environmental/Minor Home Adaptation •Adult Day Health Care What’s covered? Michelle P This presentation was created from information that was obtained from secondary resources on 1/19/12 Consumer Directed Option (CDO) available UofL_Logo_Curtain_Inside •Schedule a Michelle P. Waiver assessment –Contact local Community Mental Health Center (CMHC) •Link on website includes contact information How to Apply Michelle P This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside –Allows waiver eligible members to choose a provider for their non-medical waiver services –Greater freedom of choice, flexibility, and control over their supports and services –Can choose to direct all or some of their non- medical waiver services Why? Consumer Directed Option (CDO) This presentation was created from information that was obtained from secondary resources on 1/19/12 For Additional Information: http://chfs.ky.gov/dms/Consumer+Directed+Option.htm UofL_Logo_Curtain_Inside •Under age 18 and •Diagnosis of a psychiatric disorder –intellectual disability or other brain disorder may be present, but cannot be primary diagnosis and •Must be severely limited in at least 2 of the following areas: Eligibility Requirements KY IMPACT For Additional Information: http://dbhdid.ky.gov/dbh/ky%20impact.asp This presentation was created from information that was obtained from secondary resources on 1/19/12 Self Care Interpersonal Relationships Family Life Self-direction Education UofL_Logo_Curtain_Inside •Service Coordination – assists with coordination and service planning from 2 or more agencies at the same time –Social Services, Family Resources, Juvenile Justice, Medicaid, School, Physicians, other providers and a Parent Representative •Since no two children are alike, the services coordinated by IMPACT are different for each child •Services differ from community to community, depending on the resources available What’s covered? KY IMPACT This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •You may contact the state office for Kentucky IMPACT, and you will be directed to the appropriate regional office: –502-564-4456 •Contact your local Community Mental Health Center How to Apply KY IMPACT This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •21 years old or younger and •Medicaid eligible and •At risk for immediate/extensive institutionalization or have a clinically significant behavioral health disorder other than intellectual disability, dementia, or personality disorder and •Disorder documented throughout a 6 month period Eligibility Requirements IMPACT PLUS For Additional Information: http://dbhdid.ky.gov/dbh/Impact%20Plus.asp?sub1 This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? IMPACT PLUS This presentation was created from information that was obtained from secondary resources on 1/19/12 •After-School or Summer Program Service •Behavioral Health Evaluation •Collateral Service •Crisis Stabilization Service •Day Treatment Service •Group Therapy •Individual Therapy •Intensive Outpatient Behavioral Health Service •Parent-to-Parent Support •Partial Hospitalization Service •Targeted Case Management •Therapeutic Child Support Service •Therapeutic Foster Care Service •Therapeutic Group Residential Service UofL_Logo_Curtain_Inside •Visit the Online Provider Directory –Select IMPACT PLUS –Select your city or region to narrow results or •Contact KY Department of Mental Health, Developmental Disabilities, and Addiction Services – (502) 564-5777 How to Apply IMPACT PLUS This presentation was created from information that was obtained from secondary resources on 1/19/12 http://dbhdid.ky.gov/ProviderDirectory/OnlineProviderDirectory.aspx UofL_Logo_Curtain_Inside •Any person with a disability - and •Individual, family, or guardian is a Resident of Kentucky and •Living with a family member, independently or in a congregate setting Eligibility Requirements Hart-Supported Living Program For Additional Information: http://chfs.ky.gov/dail/HartSupportedLiving.htm This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Examples of one-time requests –Adaptive and therapeutic equipment –Home modifications –Vehicle modifications –Start-up grants – related to living in a house or rental property in the community What’s covered? Hart-Supported Living Program This presentation was created from information that was obtained from secondary resources on 1/19/12 •Examples of on-going requests -Attendant Care/Personal Care/Companionship services -Community Resource Developer -Homemaker Services -Respite -Recreation/Leisure -Liven-In Support -Trainer in home management and independent living skills -Support broker or personal agent -Consultation -Transportation -Employment related expenses Not obtainable from another source: private insurance, Medicare, Medicaid or another program UofL_Logo_Curtain_Inside •April 1 – annual deadline for submitting complete application –http://chfs.ky.gov/dail/HartSupportedLiving.htm –Select Hart-Supported Living Application in top right corner –Complete application –Submit application and supporting documents •Regional Hart-Supported Living Coordinator (listed on website) How to Apply Hart-Supported Living Program This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Meet Social Security’s definition of disability for children and •Income and resources fall within the eligibility requirements (child and family members) – until 18 and •Child’s condition results in ‘marked and severe functional limitation’ for at least 12 continuous months If a child did not qualify due to parents’ earnings or assets – individual may want to reapply at age 18 Eligibility Requirements Social Security – SSI For Additional Information: http://www.ssa.gov/pubs/10026.pdf This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? Social Security – SSI This presentation was created from information that was obtained from secondary resources on 1/19/12 •Monthly subsidy •Automatically eligible for Medicaid UofL_Logo_Curtain_Inside •http://www.ssa.gov/applyfordisability/child.htm Or •Call 1-800-772-1213 –Ask for an appointment over the phone or in an office How to Apply Social Security – SSI This presentation was created from information that was obtained from secondary resources on 1/19/12 Link to the SSI Child Disability Starter Kit – forms and additional info: http://www.ssa.gov/disability/disability_starter_kits_child_eng.htm UofL_Logo_Curtain_Inside •You want to work; •You get SSI (for can qualify for SSI by having this plan) because you are disabled or blind; and •You have other income and/or resources to use to get a job or start a business Plan for Achieving Self-Support (PASS) Social Security – PASS For Additional Information: http://www.ssa.gov/pubs/11017.html#1 This presentation was created from information that was obtained from secondary resources on 1/19/12 Under SSI rules, any income that you have may reduce your SSI payment. But, if you have an approved plan, you can use that income to pay for the items you need to reach your work goal. Money set aside under this plan does not count when we decide your SSI payment amount. This means you may get a higher SSI payment. Also, resources you set aside for a plan do not count against the $2,000 per individual or $3,000 per couple limit. This could help you qualify for SSI. UofL_Logo_Curtain_Inside What’s covered by the plan? Social Security – PASS This presentation was created from information that was obtained from secondary resources on 1/19/12 A plan can help you set aside money for most work expenses. With an approved plan, you can set aside money to pay expenses to reach your work goal. For example, the money you save can be used for: •Transportation to and from work; •Tuition, books, fees and supplies needed for school or training; •Child care; •Attendant care; •Employment services, such as job coaching and resume writing; •Supplies to start a business; •Equipment and tools to do the job; or •Uniforms, special clothing and safety equipment. UofL_Logo_Curtain_Inside •The plan must be in writing, and Social Security must approve it. To start, contact your local Social Security office for an application (Form SSA-545-BK) •Social Security must evaluate and approve your plan How to Apply Social Security – PASS This presentation was created from information that was obtained from secondary resources on 1/19/12 The Center for Accessible Living in Louisville or Independence Place in Lexington has individuals trained to assist individuals with this process – WIPA – Work Incentives Planning and Assistance http://www.hdi.uky.edu/setp/Materials/WIPA-counties_served_Center_for_Accessible_Living_Jan_2011.pdf UofL_Logo_Curtain_Inside •Must be an individual with a disability and •Must require VR services to be employed Presumed eligible if •Receiving SSI and/or SSDI •Intends to achieve employment •Is capable of achieving employment Eligibility Requirements Office of Vocational Rehabilitation For Additional Information: http://ovr.ky.gov/ This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? Office of Vocational Rehabilitation This presentation was created from information that was obtained from secondary resources on 1/19/12 •See a qualified Vocational Rehabilitation Counselor •Individualized assessment and career exploration •Develop the Individualized Plan for Employment Services may include: •Reader services •Transition services •Personal assistance •Rehabilitation Technology •Supported Employment •Tools & equipment •Job placement •Assessment •Counseling and guidance •Referral •Restoration •Vocational training •Maintenance & transportation •Interpreter services UofL_Logo_Curtain_Inside •Contact the local branch manager –http://ovr.ky.gov/programservices/district.htm or –Call 800-372-7172 How to Apply Office of Vocational Rehabilitation This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside •Must be an individual with a disability and •If your disability has interfered with getting and/or keeping a job, you may be eligible Presumed eligible if •Receiving SSI and/or SSDI •Intends to achieve employment •Is capable of achieving employment Eligibility Requirements Supported Employment via OVR For Additional Information: http://www.ovr.ky.gov/programservices/se This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside What’s covered? Supported Employment via OVR This presentation was created from information that was obtained from secondary resources on 1/19/12 •Assistance finding employment •Person-centered job selection •Job development services •Job-site training and/or ongoing follow-up and support •Individual Plan for Employment (IPE) •Person-centered employment plan •Long Term Support Plan UofL_Logo_Curtain_Inside –Call Kentucky Office of Vocational Rehabilitation • 800-372-7172 or 502-564-4440 •Specify Supported Employment How to Apply Supported Employment via OVR This presentation was created from information that was obtained from secondary resources on 1/19/12 UofL_Logo_Curtain_Inside Questions? Contact info: Heidi Cooley-Cook hacool01@louisville.edu C:\Documents and Settings\djvitt01\Desktop\Space Camp.jpg Center contact info: Telephone: (502) 852-2467 or 800-334-8635 ext. 852-4631 Fax: (502) 852-7148 E-mail: katc @ louisville.edu https://louisville.edu/education/kyautismtraining