Supports for community living Medicaid waiver program Scl 101 Supports for community living Medicaid waiver program

What is SCL? A home and community-based program funded by the Kentucky Department of Medicaid Services Developed for Kentucky citizens with intellectual/developmental disabilities as an alternative to institutionalization Focus is to allow a person to remain in or return to the community of their choice

What services are available? Case Management Community Access Community Guide Community Transition Consultative, Clinical, & Therapeutic Support Day Training Environmental Accessibility Modifications Goods and Services Natural Support Training Personal Assistance Person Centered Coach Positive Behavior Supports Residential Supports Respite Shared Living Specialized Medical Equipment and Supplies Supported Employment Transportation Vehicle Adaption

Participant-directed services (PDS) What does PDS mean? PDS means the participant is in control of service delivery; if a provider is not willing/able to provide a service to the participant, then PDS may be the solution.

Scl Participant directed services Community Access Community Guide Day Training Environmental Accessibility Adaptation Services Goods and Services Natural Supports Training Personal Assistance Respite Shared Living Supported Employment Transportation Vehicle Adaptation Services

Participant- directed PDS vs. traditional TRADITIONAL Participant- directed Participant is able to hire individuals as employees Participant manages employees’ duties and trains them on how duties shall be performed Agency determines who works with participant through staffing Agency determines what duties will be performed and how

PARTICIPANT- DIRECTED PDS vs. traditional TRADITIONAL PARTICIPANT- DIRECTED Participant develops schedule for employees Participant’s services are provided in locations of their choice. Agency determines when services are best available Agency provides facilities/property for service delivery

How can SCL benefit me? Person-centered service plans that focus on what is important to you and important for you Long-term services and supports in the community of your choice to support you in achieving your goals and dreams Opportunity to self-direct all or a portion of your services and supports

COMMUNITY ACCESS “PERSISTENCE PAYS OFF” Young man who loves all things outdoors Initially under state guardianship which limited access to activities of interest to him Person centered team was persistent and creative Developed relationship with a Fish & Wildlife Officer Accomplishments since he was featured in DDID Quarterly Webinar in 2014: Daniel is now his own guardian Developed relationship with his father and now has routine home visits with his father Maintains a relationship as a natural support with Fish & Wildlife Officer Enjoys hunting with friends Participates in Leatherwood Battle Re-enactments and continues to develop natural supports Daniel is the ultimate outdoorsman. He LOVES hunting, fishing, camping, knives, guns….pretty much anything you can find on the Outdoor Channel. When we first met Daniel in 2013, he had a state guardian. Daniel was not legally permitted to participate in a lot of the activities that he wanted to do. Every option that his Person Centered Team explored to get him connected in the community to such activities was at odds with state law. Daniel eventually became frustrated and wanted to quit!! The Team wouldn’t give up and came up with the idea of getting Daniel connected to the Department of Fish & Wildlife. They contacted the local hunting safety course instructor who was more than willing to allow Daniel to assist with teaching classes! When Daniel started assisting the Fish and Wildlife Officer, he had responsibilities that included: Signing class members into the roster Handing out instruction booklets Answering questions from the class Demonstrating proper hunting techniques Answering questions about firearm safety Assisting with cleaning the classroom after class ended Since 2013, using the SCL support of Community Access, Daniel and his team have made several accomplishments: Daniel is now his own guardian. Daniel has developed a relationship with his father and now has routine overnight visits with his dad. These were not available to him when he was under State Guardianship. He remains friends with Will, has assisted him with some of the Hunter Safety classes since 2013, and is now able to enjoy hunting privileges. Will has become a natural support for Daniel. In fact, Will recently asked that Daniel accompany him to a conference in Louisville for part of ongoing training. He has also become a very active member in the Battle of Leatherwood Re-enactments as a result of CA Supports. Currently the CA Supports are in the process of being faded for this particular activity and natural supports are being increased.

WHAT WE HAVE LEARNED ABOUT COMMUNITY ACCESS It takes Time Patience Persistence Entire Person Centered Team using their personal and professional networks to build relationships with people in the community Willingness to learn and experience new things You, the individual, working with your Team to express: Your likes and dislikes; and What you want to try Communication

Waiver Slots SCL 4,701 2,327 Waiver Slots Wait List Notes Waiver slots are unduplicated which means if a participant even uses one service in a waiver year, the slot cannot be reused or refilled until the following waiver year. Below is a summary of waiver slots and current wait lists. Waiver Slots Wait List Notes SCL 4,701 2,327 240 additional slots are approved to be added. The SCL waiver is on temporary extension without the ability to add slots due to the pending physical therapy (PT), occupational therapy (OT), and speech therapy (ST) changes Historical Context DMS submitted a waiver renewal application to CMS on June 1, 2015 The SCL waiver expired on September 1, 2015 Because of the outstanding PT/OT/ST issue, CMS has not approved the SCL waiver renewal DMS had to request a temporary extension for SCL; waivers that are on temporary extensions cannot be amended to add slots. Current extension to September 29, 2016 for SCL.

How do I apply for scl services? Application to the SCL Waiting List requires completion of an application and submission of required documentation. Two ways to submit an application to the SCL Waiting List Apply directly to DDID by faxing or mailing the “Application for SCL Waiver and Intellectual/Developmental Disability (I/DD) Services” form (MAP-620); or Submission of an electronic application in the Medicaid Waiver Management Application (MWMA) by a case manager or other person with an account for using MWMA. MAP 620 Mailing Address: Division of Developmental & Intellectual Disabilities 275 East Main Street 4CF Frankfort, KY 40621 MAP 620 Fax Number: 502-564-8917

Where can I get more information? For general information about the Division of Developmental and Intellectual Disabilities visit: https://dbhdid.ky.gov/ddid/ For general information about the SCL Medicaid Waiver Program visit: https://dbhdid.ky.gov/ddid/scl.aspx To view stories of individuals who receive SCL Supports and have become active members in their communities or who have achieved a goal of employment in a meaningful job, visit the following website and click on “DDID Recordings” and then select “DDID Provider Webinars. “Share our Stories” began in August 2014. https://dbhdid.ky.gov/ddid/scl-training.aspx MAP-620 (Application for SCL Supports/Services: 502-564-8917 For information about Participant Directed Services visit: http://chfs.ky.gov/dail/ For information about Kentucky’s Home and Community Based Services Waivers and Final Rule Updates visit: http://chfs.ky.gov/dms Problems with Benefind contact: MedicaidPartnerPortal.Info@ky.gov Questions about SCL: alice.blackwell@ky.gov