Your input matters! These tips from families can help as you craft your own comments on the TennCare/DIDD plan to integrate Medicaid Services. Comments are due November 13th, 2020.
To read and review the plan, go to: https://tn.gov/didd/for-consumers/didd-waiver-information/idd-program-integration.html
- Are you concerned the services your family member receives from the DIDD waiver will be changed or reduced after July 1, 2021?
The latest wording from DIDD says people on the waiver will not have their services changed or reduced on July 1, 2021. However, the MCO’s will decide what services your family member receive moving forward.
If you or someone you know needs all the services they are currently getting, tell DIDD this and explain why. To comment, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Program and Benefit Structure”, page 10 and “Concern”. The deadline to comment is November 13.
- Do you want your MCO to consider more than a number score when making decisions about the services you or your family member will receive? In addition, do you want an exception process established regarding MCO level of support decisions that will impact the services your family member gets?
DIDD says residential services like supported living will not be funded based on staffing ratios and the number of persons in the home. Instead, a Level of Support will be decided based on a Supports Intensity Scale (SIS) score. The people who designed the SIS say there needs to be a process to ask for an exception from the score. If you think there should be an exception process, you can tell DIDD.
To tell DIDD that you want the right to ask to for an exception, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Assessing the Level of Supports Needed”, page 16 and “Recommendation”. The deadline to comment is November 13.
- Do you want the right to ask DIDD to review MCO decisions regarding denial or reduction of services?
Beginning July 1, 2021, MCOs will review and approve services for people on the DIDD waiver. Currently, policies and decisions vary among MCO’s. If you want to protect your loved ones’ care, you can ask for the right to appeal an MCO decision with DIDD.
To tell DIDD that you want the right to ask them to review an MCO decision, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Person-Centered Support Plans”, page 16 and “Recommendation”. The deadline to comment is November 13.
- Do you want to protect people on the DIDD waiver who are not able to perform competitive work from being penalized (or forgotten) under the new system?
DIDD says that there will be a new way to pay providers called value-based reimbursement. Under this system, providers may get more pay if a person on the waiver is able to perform competitive work. However, there are many people on the waiver that are unable to perform competitive work. If you think the value-based reimbursement should not penalize people who are unable to work, you can tell DIDD.
To comment, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Network Development and Management”, page 16 and “Recommendation”. The deadline to comment is November 13.
- Do you want to keep an ISC for more than one year?
DIDD says they will evaluate Independent Support Coordinators (ISCs) for one year beginning July 1, 2021 to decide if they should keep them. ISCs do not work for TennCare or DIDD, they work for the individual.
If you think it is important to keep ISCs, you can tell DIDD by going to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Support Coordination”, page 16 and “Recommendation”. The deadline to comment is November 13.
- Is it important to get and keep good direct service providers?
DIDD knows that there is a crisis with respect to workers for people living at home and direct support staff for people living in supported living. However, their Overview plan does not say what they will do so that direct service staff can be paid enough so providers can hire and keep good people.
If you think it is important for DIDD to have a plan to do this, you can tell DIDD by going to https://stateoftennessee.formstack.com/forms/iddoverview. Choose ”Value Based Reimbursement, page 22 and “Recommendation”. The deadline to comment is November 13.
- Are you concerned about a reduction in nursing services?
DIDD says caregivers will perform routine health care tasks instead of nurses. If you or someone you know gets nursing services that you think only a nurse should provide, you can tell DIDD.
To comment, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Program and Benefit Structure”, page 11-12 and “Recommendation”. The deadline to comment is November 13.
- Are you concerned about a reduction or loss of direct therapy services (OT, SLP, PT, ABA) due to the proposed consultative model?
DIDD says they plan to move from direct therapy services to a consultative model where caregivers are trained to provide these skilled services. If you think you or someone you know needs direct services, tell DIDD and explain why.
To comment, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Program and Benefit Structure”, page 11 and “Concern”. The deadline to comment is November 13.
- Are you concerned your MCO may refuse to contract with your current provider?
DIDD says that six months after July 1, 2021, the MCO that decides you or your family members’ services can refuse to contract with the provider you have now, even if that provider has already been approved by DIDD. You can tell DIDD that the MCOs should accept any provider that has been approved by DIDD.
To comment, you can go to https://stateoftennessee.formstack.com/forms/iddoverview. Choose “Continuity of Care”, page 19 and “Recommendation”. The deadline to comment is November 13.