Maryland Developmental Disabilities Administration
Creating a flexible, person-centered, family-oriented system of supports so people can have full lives. 
DDA Transformation Update
The DDA Transformation Newsletter | October 15, 2018 8
Developmental Disabilities Administration (DDA) Waiver Programs   
The DDA administers, on behalf of Maryland Medicaid, three home and community-based services waiver programs including the Family Supports Waiver, Community Supports Waiver, and the Community Pathways Waiver. The DDA previously administered the New Directions Waiver until it was merged with the Community Pathways Waiver in 2013. When the waivers merged, the New Directions Waiver participants were included within the Community Pathways Waiver under the self-directed service delivery model. Please note that self-directed service delivery is available in all DDA waivers. For additional information about the DDA's waivers please visit:
Site Based Medical Assistance Enrollment
Maryland Medicaid's new electronic Provider Revalidation and Enrollment Portal (ePREP) is live! ePREP is the one-stop shop for provider enrollment, re-enrollment, revalidation, information updates and demographic changes. There are two phases of ePREP implementation. Phase 1 included most solo practitioners, rendering only providers and group practices. Phase 1.1 included dentists, dental groups, individual and group 1915(i) intensive behavioral health services for children, youth and families, and Federally Qualified Health Centers (FQHCs). Phase 2.1 go-live in August included inpatient facilities. Phase 2.2 go-live in September included most clinics and other outpatient facilities. Finally, Phase 2.3 go-live in November will include pharmacies, DMS/DME, laboratory and long-term services and supports waiver providers.

The DDA has been notified that the automated Medical Assistance (MA) provider application and enrollment system, ePREP, will go live Thursday, Nov. 15 for all Maryland Medicaid providers. The DDA will send out more information about the process and helpful hints on completing the MA application and DDA-specific addendum prior to Nov. 15.  For more additional information about ePREP, clink on this link: ePREP.
Employment First Summit
The DDA recently held its annual Employment First summit to celebrate National Disability Employment Awareness Month (NDEAM). The day served as an opportunity to reflect on the accomplishments of the last year and hear from stakeholders and partners about their work toward alignment with Employment First values and outcomes. 

Nearly 200 people attended the event held in Columbia. DDA Deputy Secretary Bernard Simons started the day with highlights from the past year related to competitive employment outcomes, as well as ongoing capacity building efforts supported by the DDA.
 
In the morning, the audience heard from Bette Ann Mobley from Maryland Achieving a Better Life Experience (ABLE) who informed the audience about Maryland ABLE accounts and how they could be of value for employed people with disabilities.  
National subject matter expert, Rick McAllister, spoke about the importance of the right kind of employer engagement on the part of job seekers and employment agencies. McAllister's presentation and experience in the development and management of complex service organizations and organizational sustainability was valuable to the participants.
The afternoon started with the audience hearing directly from Maryland artist/business owner, Mara Clawson about how her varied services, supports, and partnerships have helped her achieve her identified "good life." Mara highlighted her artwork as well as her business: When Colors Get Along .

Secretary Carol Beatty from the Maryland Department of Disabilities (MDOD) presented the DDA with a Governor’s Proclamation, proclaiming October Maryland Disability Employment Awareness Month. Secretary Beatty also shared a video called, " EmployAbility ." The video was created to raise awareness across the state about the contributions people with disabilities can make to the work place. 
Somerset Community Services Executive Director Sandy Adkins and Deputy Director Katie Gell shared their organization’s journey which led to the closure of their sheltered workshop. Sandy and Katie’s stories highlighted how strong leadership and values have increased employment outcomes and community participation for the people they are supporting.

The afternoon ended with presentations from the DDA’s state-level partners: Christy Stuart of Maryland State Department of Education, Jill Pierce and Sharon Plump of Division of Rehabilitation Services (DORS) and Jade Gingrich of MDOD. Partners highlighte how their agencies are collaborating at the state level to improve collaboration, particularly around supporting transitioning youth with disabilities.
 
Person-Centered Planning (PCP)
PCP are being developed within Maryland’s Long-Term Services and Supports (MDLTSS) system for people in the Community Pathways Waiver and State Funded Services.  People in the Family Supports and Community Supports Waivers will be included in February 2019.  Person-centered planning is a process that begins with the understanding that all people have the right to live, love, work, play and pursue their aspirations in their community.  To that end, people have the right to figure out and pursue their "good life."  What defines a good life is as individual and unique as the person being supported.  Many people also have family and others in their lives who play a meaningful role as the person explores potential interests and opportunities not considered before.  Although supports and needs may change across the lifespan, pursuit and enjoyment of what is important to the person remains the guiding force.
 
Person-centered planning is a continual process of listening and learning (e.g. exploration and discovery) to create a meaningful and relevant plan that may be adjusted according to life circumstances.  In a person-centered system, the person and people that support them have critical roles and responsibilities in the PCP process. These various roles and perspectives are described in the MD LTSS PCP Overview, which also includes descriptions of the various PCP elements and supporting documents and tools.
 
The new process for developing the PCP requires considerable collaboration and communication. As with any major change, this one will also require patience as everyone adapts and builds proficiency. We strongly encourage people receiving services, families, and providers to contact the director of the relevant Coordinator of Community Services (CCS) agency if they are having concerns regarding the PCP or the annual meeting so they have an opportunity to address them with you. You may also contact your DDA Regional Office with concerns, challenges, questions, and training needs related to the person-centered process.
 
The DDA will continue to provide additional information, technical assistance, training, and oversight of the person-centered planning process to ensure appropriate supports and quality plans for Marylanders with developmental disabilities.  For more information on the PCP roles and responsibilities, elements, tools and supporting documents, and suggested planning timelines, please view this link MD LTSS PCP Overview.
Long-Term Services and Supports (LTSS)
As the DDA continues to actively work with CCS Agencies to clarify processes and address lingering system issues (via interim releases of functionality), it has simultaneously been focused on the future releases of LTSS functionality. These future releases will help complete the process of creating a more flexible, person-centered, and family-oriented system of supports so that people can lead full lives.

The next release of functionality is currently planned for 2019 and will include functionality in LTSS for the DDA’s Community Supports and Family Supports Waivers which are currently managed outside of the system. It will also include detailed service planning and authorization functionality necessary to support the provision of new services authorized in the waivers and the coming transition of the provider payment system. Functionality is being designed to help people and families plan for service needs that may vary across the plan year and understand their service authorization.

Concurrent to this development effort, DDA is actively working to build out functionality for provider acceptance of plans, billing of services, and payment for services rendered under the new rates and payment process. This functionality is targeted for deployment in 2020. As part of this effort, DDA is engaged with a small work group of providers. Through these meetings, DDA has received feedback on the process to properly setup providers for payment under the new system and the specific functionality that providers will need in LTSS to effectively manage this process. While much work remains, we are appreciative of the support provided by this group.

As work continues on both of these future efforts, we will provide additional details to all providers as well as other stakeholders to help prepare for this transition. 
Case Management — Coordination of Community Services
The DDA is pleased to introduce a new and exciting way to identify the needs of people who are on the DDA’s waiting list by using a new process called the Services and Supports Planning (SSP) tool, which will replace the PCP for people on the DDA waiting list.

The Coordinator of Community Services (CCS) will facilitate the completion of this process during a face-to-face visit with the person (on the waiting list only), the authorized representative, and people the person identifies as knowing them well. This tool will also identify what is  currently  working for the person (or not), life goals, and current natural and local community resources of what a person's "good life" looks like. The CCS will help the person align those needs with community resources and DDA services that may address them  if they are selected to apply for and are approved for waiver services

The SSP tool is to be completed within 45 days of the person being placed on the waiting list. If already on the waiting list, the CCS will complete the tool by the next quarterly monitoring visit. Moving forward, the SSP tool will only be updated if there is a change in the person's current service and support needs. The tool will go live Friday, Oct. 19. For more information please contact your CCS.
Did You Know?
The DDA is using the Health Risk Screening Tool (HRST) and the Supports Intensity Scale ® (SIS) and the person’s team to identify the need and support a participant may need.

The SIS measures the person’s support needs in personal, work-related, and social activities in order to identify and describe the types and intensity of the supports a person requires. The SIS was designed to be a part of the person-centered planning (PCP) process to help a person identify their unique preferences, skills and life goals. The SIS is helpful as one assessment to guide the person’s team in determining what supports the person may need to be successful.

The HRST is used to detect health risks and destabilize early considering the overall quality of life which is directly impacted by the status of a person’s health. The HRST assessment tool was designed to be a part of the PCP process to inform the person and their team of any health and behavioral related considerations or risk. The information gathered in the HRST screening process plays a pivotal role in the development and content of an effective PCP. This information can be included in the health and safety sections of the PCP, making these sections more robust and useful especially with regards to triggering other evaluations, assessments, or staff training that may be needed. This information can even be used to create meaningful goals and action plans that foster overall better health and greater quality of life for the person. For additional information, please contact your regional office or your Coordinator of Community Services.
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