OASIS update
We encourage families to talk with their case managers to address any questions/concerns they might have about how OASIS will impact them.
From DDRS:
FREQUENTLY ASKED QUESTIONS
Question: When will OASIS start and when do the services standards and definitions apply?
Answer: The launch date for OASIS (i.e. Uniform Rate Methodology) is January 1, 2009 and the effective date will vary for each consumer. From January 1, 2009 and forward, OASIS will be in effect for each consumer beginning with the implementation date of their annual plan review (refer to the OASIS Implementation Plan file attached).
Question: When does a consumer who is currently on Annual Plan begin to use the new Service Definitions and Documentation Standards?
Answer: This will vary for each consumer based upon the date of their annual plan renewal. A consumer will begin to use the new Services Definitions and Documentation Standards when they begin to use the uniform rate methodology. Please note that effective January 1, 2009, all consumers in BDDS District 4 will begin to use the Services Definitions and Documentation Standards.
Question: Is there an annual cap for Respite Services?
Answer: No, there is no annual cap for Respite Services. There is a common misunderstanding about a $2,000 annual cap for respite services—this is not true. Reimbursement for respite is allowed for any number of hours provided the total cost of all combined services does not exceed a consumer’s annual allocation amount (DD and AU waiver) or annual cap (SS waiver). The rate for Respite Services is $25.00 per hour effective January 1, 2009.
Question: Is there a monthly cap on Community Habilitation—Individual services for consumers on the Support Services waiver?
Answer: No. There is no monthly cap for Community Habilitation—Individual services for individuals on the Support Services (SS) waiver. However, there is a cap of 25 hours per month for this service for consumers on the DD and AU waivers.
Question: Can a provider bill for Community Habilitation—Individual services for time when a consumer is not present (i.e. drive time to pick up the consumer)?
Answer: No. A provider may not bill for indirect (non face-to-face) time where there is no consumer present. However, the state acknowledges that there are certain costs, such as transportation, associated with providing services. We have set the rate at $25.00 per hour for Community Habilitation—Individual services to allow for these costs.
Question: When will DDRS announce rates for RHS?
Answer: As soon as we have finalized the rates and rate structure, we will release the Residential Habilitation and Support (RHS) Rate and Rate Structure in a bulletin. Other pending decisions include the use of Transportation in conjunction with RHS. Question: Can a consumer receive Pre-Vocational services on the same plan as SEFA? Answer: Yes. A consumer may receive Pre-Vocational services at the same time as Supported Employment Follow Along (SEFA) services. However, a consumer who is working in a sheltered employment workshop (facility or community-based) can receive SEFA, but may not receive Pre-Vocational services.
Question: How will OASIS impact Behavior Management services?
Answer: OASIS will have no direct impact on Behavior Management services. Billing for this service will change from a monthly billing unit to a quarter hour unit. A consumer will be able to continue to purchase this service within their allocation. If a consumer previously used Behavior Management (BMAN) services and it is not on the consumer’s newly submitted plan, the BDDS Waiver Unit will review the plan and ask for justification. Similarly, the BDDS Waiver Unit will review the plans of consumers identified to have high behavior needs to ensure BMAN is included, and if not, ask for justification.
Question: Explain DDRS definition of the terms ‘consumer’, ‘waiver’, and ‘staff’?
Answer: When we refer to these terms in our communications, they are defined as follows:
Consumer(s): Refers to an individual or group of individuals receiving disability services from DDRS. Unless a specific district is listed in this bulletin, such as “consumers served in BDDS District 4 OASIS pilot, this term refers to individuals statewide.
Waivers: Refers to Home and Community Based Services (HCBS) Medicaid waivers administered by DDRS including the Developmental Disabilities (DD),
Autism (AU), and Support Services (SS) waivers. Learn more about waivers by reviewing the consumer’s Waiver Guide online at http://www.in.gov/fssa/files/ConsumerWaiverGuideW200703.pdf.
Staff: Refers to any qualified staff member employed by a BDDS and Medicaid approved service provider.
OASIS UPDATE
As stated in the DDRS bulletin released September 22, 2008 (Reference #: OA20080922), our current waiver consumers will not be included in the initial statewide roll-out of OASIS. Please refer to the chart below for information about when current and new consumers on each waiver type will begin utilizing the uniform rate methodology and allocations. This change is to ensure that the following systems, policies and procedures are properly tested. Assess the impact of rates Review the allocation process Define the transition policy (including a plan for consumers with budgetary changes) Finalize the service planner used for individual planning
As the new rates get underway, we will be closely tracking individual outcomes as well as how the changes are affecting the system overall. Between six (6) and nine (9) months into the implementation process we will conduct a large scale assessment of the impact of the new rates and service categories on the system and usage of the RHS Invoicing Tool to determine if further review or adjustments will be necessary.
DDRS will continue to partner with the Self-Advocates of Indiana, IN-ABC, INARF, IPMG and The Arc of Indiana to ensure a smooth transition to this new system. Together, we are currently planning a training session for consumers, families, providers, case managers and all stakeholders who support individuals with disabilities. During this session, attendees will have the opportunity to ask questions and gather more information about the implementation of this process. We will release a separate bulletin to announce details on the presentation soon. OASIS is a monumental step toward a system that helps people with disabilities to achieve their hopes and dreams, while creating a rational business environment that can support the individuals we serve. We hope you will continue to join us as we take the next steps in this transformational journey. Thank you.
We have included attachments and links that will be important to understand as we move into the new system. If you are unable to view them, please email the OASIS-ICAP Help Line at OASIS-ICAPHelp@fssa.IN.gov or call (317) 234-5222 for assistance.
Attachments will be stored at fvindiana@yahoogroups.com
From DDRS:
FREQUENTLY ASKED QUESTIONS
Question: When will OASIS start and when do the services standards and definitions apply?
Answer: The launch date for OASIS (i.e. Uniform Rate Methodology) is January 1, 2009 and the effective date will vary for each consumer. From January 1, 2009 and forward, OASIS will be in effect for each consumer beginning with the implementation date of their annual plan review (refer to the OASIS Implementation Plan file attached).
Question: When does a consumer who is currently on Annual Plan begin to use the new Service Definitions and Documentation Standards?
Answer: This will vary for each consumer based upon the date of their annual plan renewal. A consumer will begin to use the new Services Definitions and Documentation Standards when they begin to use the uniform rate methodology. Please note that effective January 1, 2009, all consumers in BDDS District 4 will begin to use the Services Definitions and Documentation Standards.
Question: Is there an annual cap for Respite Services?
Answer: No, there is no annual cap for Respite Services. There is a common misunderstanding about a $2,000 annual cap for respite services—this is not true. Reimbursement for respite is allowed for any number of hours provided the total cost of all combined services does not exceed a consumer’s annual allocation amount (DD and AU waiver) or annual cap (SS waiver). The rate for Respite Services is $25.00 per hour effective January 1, 2009.
Question: Is there a monthly cap on Community Habilitation—Individual services for consumers on the Support Services waiver?
Answer: No. There is no monthly cap for Community Habilitation—Individual services for individuals on the Support Services (SS) waiver. However, there is a cap of 25 hours per month for this service for consumers on the DD and AU waivers.
Question: Can a provider bill for Community Habilitation—Individual services for time when a consumer is not present (i.e. drive time to pick up the consumer)?
Answer: No. A provider may not bill for indirect (non face-to-face) time where there is no consumer present. However, the state acknowledges that there are certain costs, such as transportation, associated with providing services. We have set the rate at $25.00 per hour for Community Habilitation—Individual services to allow for these costs.
Question: When will DDRS announce rates for RHS?
Answer: As soon as we have finalized the rates and rate structure, we will release the Residential Habilitation and Support (RHS) Rate and Rate Structure in a bulletin. Other pending decisions include the use of Transportation in conjunction with RHS. Question: Can a consumer receive Pre-Vocational services on the same plan as SEFA? Answer: Yes. A consumer may receive Pre-Vocational services at the same time as Supported Employment Follow Along (SEFA) services. However, a consumer who is working in a sheltered employment workshop (facility or community-based) can receive SEFA, but may not receive Pre-Vocational services.
Question: How will OASIS impact Behavior Management services?
Answer: OASIS will have no direct impact on Behavior Management services. Billing for this service will change from a monthly billing unit to a quarter hour unit. A consumer will be able to continue to purchase this service within their allocation. If a consumer previously used Behavior Management (BMAN) services and it is not on the consumer’s newly submitted plan, the BDDS Waiver Unit will review the plan and ask for justification. Similarly, the BDDS Waiver Unit will review the plans of consumers identified to have high behavior needs to ensure BMAN is included, and if not, ask for justification.
Question: Explain DDRS definition of the terms ‘consumer’, ‘waiver’, and ‘staff’?
Answer: When we refer to these terms in our communications, they are defined as follows:
Consumer(s): Refers to an individual or group of individuals receiving disability services from DDRS. Unless a specific district is listed in this bulletin, such as “consumers served in BDDS District 4 OASIS pilot, this term refers to individuals statewide.
Waivers: Refers to Home and Community Based Services (HCBS) Medicaid waivers administered by DDRS including the Developmental Disabilities (DD),
Autism (AU), and Support Services (SS) waivers. Learn more about waivers by reviewing the consumer’s Waiver Guide online at http://www.in.gov/fssa/files/ConsumerWaiverGuideW200703.pdf.
Staff: Refers to any qualified staff member employed by a BDDS and Medicaid approved service provider.
OASIS UPDATE
As stated in the DDRS bulletin released September 22, 2008 (Reference #: OA20080922), our current waiver consumers will not be included in the initial statewide roll-out of OASIS. Please refer to the chart below for information about when current and new consumers on each waiver type will begin utilizing the uniform rate methodology and allocations. This change is to ensure that the following systems, policies and procedures are properly tested. Assess the impact of rates Review the allocation process Define the transition policy (including a plan for consumers with budgetary changes) Finalize the service planner used for individual planning
As the new rates get underway, we will be closely tracking individual outcomes as well as how the changes are affecting the system overall. Between six (6) and nine (9) months into the implementation process we will conduct a large scale assessment of the impact of the new rates and service categories on the system and usage of the RHS Invoicing Tool to determine if further review or adjustments will be necessary.
DDRS will continue to partner with the Self-Advocates of Indiana, IN-ABC, INARF, IPMG and The Arc of Indiana to ensure a smooth transition to this new system. Together, we are currently planning a training session for consumers, families, providers, case managers and all stakeholders who support individuals with disabilities. During this session, attendees will have the opportunity to ask questions and gather more information about the implementation of this process. We will release a separate bulletin to announce details on the presentation soon. OASIS is a monumental step toward a system that helps people with disabilities to achieve their hopes and dreams, while creating a rational business environment that can support the individuals we serve. We hope you will continue to join us as we take the next steps in this transformational journey. Thank you.
We have included attachments and links that will be important to understand as we move into the new system. If you are unable to view them, please email the OASIS-ICAP Help Line at OASIS-ICAPHelp@fssa.IN.gov or call (317) 234-5222 for assistance.
Attachments will be stored at fvindiana@yahoogroups.com
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