DBHDS Vision: A life of possibilities for all Virginians Settlement Agreement Update Peggy Balak DOJ Settlement Advisor Virginia Department of Behavioral Health and Developmental Service

Slide 2 6 th Court Reporting Period A second status meeting was held with Judge Gibney on 12/16/14. Requested a timeline for compliance with the Settlement Agreement by March 15, The Independent Reviewer made 14 recommendations in his 12/06/14 Report to the Court and requested an update on them by March 30, During this reporting period the Independent Reviewer and his consultants will be interviewing 32 individuals on the DD Waiver. This is the first time that his individual reviews have included individuals on the DD Waiver

Slide 3 6 th Court Reporting Period The Independent Reviewer’s Consultants are conducting the following studies: – Licensing – Case Management – Crisis – Integrated Day/Supported Employment – Individual and Family Support DOJ Attorneys have retained a consultant and begun their visits with 11 individuals with I/DD who have been involved with the criminal justice system.

Slide 4 Individual Support Plan In January revisions to the required elements of the Individual Support Plan were announced. Revisions were necessary for many reasons including compliance with the 2014 CMS Final Rule, expectations of the Settlement Agreement and to address concerns expressed by the Independent Reviewer The revised ISP elements and guidance on the changes can be found: service-providers/developmental-disability-services- for-providers/provider-development [person centered planning tab] service-providers/developmental-disability-services- for-providers/provider-development

Slide 5 PC ISP Refresh 2015 Roll-Out January – model PC ISP on website; guidance on changes in elements; answer questions/take comments February – video outlining and explaining changes; train DMAS QMR & DBHDS OL/OHR; regional ISP Train-the- Trainer sessions scheduled; take comments March – complete initial training sessions with supervisors and managers; enlist PC ISP Specialists; review comments; produce FAQs April – begin use for individuals with planning meetings held in April; provide ongoing TA and training of PC ISP trainers and PC ISP Specialists

Slide 6 DDHSN Highlights Two Central Office based RNs as of January 2015 – Initiated community based nursing “staff meetings” in December 2014 to build intra-disciplinary support and establish appropriate and agreed upon practice guidelines. – Two meetings held in Regions II&IV – Onsite meetings with nursing staff of NVTC & CVTC Dentistry – Services provided for former TC residents at HDMC – Emergency services available at HDMC Region IV – Dental pilot Region IV pending (multiple meetings with safety net clinics Mobile Engineering project initiated – Equipment quotes gathered and purchase agreements pending – Ten individuals seen in four residences 2/9/=2/25/15– equipment serviced – Team assembled Region IV; building team Region II

Slide 7 Highlights & PASRR Region II Funding provided for existing RCSC through FY2015 Region 2 RNCC interviews by February 2015 Community-based nursing staff meetings – Two thus far, third scheduled - very engaged Preadmission Screening & Resident Review (PASRR) RN hired to coordinate the PASRR process Establishing a new relationship and contract expectations with contracting agency (ASCEND) for PASRR II screenings Establishing a process to redirect individuals to appropriate community settings even when PASRR II requirements are met for SNF admission Re-evaluations no later than 90 days following a respite or rehab admission for community placement Plan to perform resident reviews statewide on all individuals not seen in last 3 months

DBHDS Vision: A life of possibilities for all Virginians QUESTIONS?