DDD S SYSTEM REFORM: UNDERSTANDING WHAT IT MEANS FOR SOMEONE ENTERING DDD SERVICES
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1 The New Jersey Department of Human Services Division of Developmental Disabilities 1 DDD S SYSTEM REFORM: UNDERSTANDING WHAT IT MEANS FOR SOMEONE ENTERING DDD SERVICES Jennifer Joyce Director, Employment, Transition and Day Services
2 Overview of System Reform Medicaid-Based System Support Coordination Model Fee-for-Service Consistency Across the System Employment First 2
3 Two Waiver System Medicaid-Based System Community Care Waiver (CCW) Supports Program (DDD Initiative in the Comprehensive Medicaid Waiver) Maximize federal reimbursement Serve more people Expanded services Individual must maintain Medicaid eligibility Disability services that are tied to the individual 3
4 Support Coordination Provided by Medicaid/DDD Approved Support Coordination Agencies (SCAs) SCA chosen by individual, changed upon request Assist/facilitate person centered planning process Person Centered Planning Tool (PCPT) Develop Individualized Service Plan (ISP) specifies outcomes, service needs, providers Link individual to services and providers (DDD-funded and other community resources) Conduct monitoring 4
5 DDD s Role in Care Management Oversight & quality monitoring Support Coordination Agencies Service Providers Intensive Case Management 5
6 Fee-for-Service (FFS) Standardized rates for services Payment rendered after services are delivered Increased flexibility Increased choice Increased quality 6
7 Policies Consistency Across the System Accessing services Assessment NJ Comprehensive Assessment Tool (NJ CAT) Tiering/Budgets like budgets for like support needs Service Plan ISP Rates Provider approval, qualifications 7
8 Employment First Competitive employment in the general workforce is the first and preferred post education outcome for people with any type of disability Creates an expectation for employment Pathway to Employment - PCPT Employment outcome(s) - ISP Expansion of employment services Resources for employment services Training and technical assistance Data collection 8
9 Entering DDD Services Years Old 18 Years Old 21+ Years Old
10 Transition Planning Years Old Get to know current skills & preferences Identify adulthood goals & dreams Build skills needed to achieve goals Make connections, identify supports, use resources 10 Participate in Planning for Adult Life student groups, parent groups, training sessions, webinars, provider fairs, etc.
11 18 Years Old Supplemental Security Income (SSI) Eligibility Medicaid DDD Intake/Eligibility Determination 11 Contact DDD Community Services Office or download application from the DDD website Complete NJ Comprehensive Assessment Tool (NJ CAT) Continue to receive services from the school system, Department of Children & Families (DCF)
12 21+ Years Old 12 Ensure the individual is eligible for DDD & Medicaid Support Coordination Agency (SCA) Assignment Research Support Coordination Agencies Submit Support Coordination Agency Selection Form in February/March of graduation year _coordination.html Initial meeting with Support Coordinator Complete Participant Enrollment Agreement Enrolled onto waiver
13 Accessing DDD Services 13 Plan Development Selecting Service Providers Service Delivery
14 Plan Development Person Centered Planning documented on the Person Centered Planning Tool (PCPT) Identify outcomes, service needs, service providers 14 Development of the Individualized Service Plan (ISP) Must be written (by SC) and approved (by SC Supervisor) within 30 days of enrollment Identifies outcomes, services, chosen providers Prior authorization for services
15 Selecting Service Providers Identify potential service providers Provider fairs, transition fairs, etc. Provider database Support Coordinators Determine capacity, interview, tour, intake, submit provider required information, match provider to individual needs, etc. Select providers by including in the ISP 15
16 Service Delivery 16 Authorization of services - approved ISP, prior authorization letter, and service detail report will be sent to the selected providers Begin services Services are monitored via monthly SC monitoring and DDD quality reviews/audits Services and/or providers can change by revising the ISP
17 Disenrollment/Discharge 17 From Waiver Program From DDD
18 Disenrollment from Waiver Circumstances are outlined in Participant Enrollment Agreement and policy manuals Written notification from DDD Signed documentation to voluntarily disenroll 30 days notice when issue is submission of documentation, participation in monitoring Fair Hearing 18
19 Discharge from DDD No longer meets functional criteria necessary to be eligible for DDD Chooses to no longer receive services from DDD Does not maintain Medicaid eligibility No longer resides in NJ Does not comply with DDD policies or waiver program requirements Go back through intake process to be reinstated 19
20 Information & Resources 20 Division Update DDD Website Help Desks Policy Manuals
21 E-news bulletin Division Update Subscribe by sending to and writing Division Update Subscribe in the subject line 21
22 DDD Website 22 FFS Implementation lementation.html Support Coordination coordination.html Medicaid Eligibility eligibility.html
23 Help Desk 23
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