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DBHDS Virginia Department of Behavioral Health and Developmental Services Individual and Family Support Program Cindy Gwinn Community Resource Manager.

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Presentation on theme: "DBHDS Virginia Department of Behavioral Health and Developmental Services Individual and Family Support Program Cindy Gwinn Community Resource Manager."— Presentation transcript:

1 DBHDS Virginia Department of Behavioral Health and Developmental Services Individual and Family Support Program Cindy Gwinn Community Resource Manager

2 Page 2 DBHDS Virginia Department of Behavioral Health and Developmental Services The Individual and Family Support Program (ISFP) Assists individuals with intellectual disability (ID) or developmental disabilities (DD) and their family members currently on the ID or DD Waitlist to support and maintain the continued residence of an individual in his own home or the family home.

3 Page 3 DBHDS Virginia Department of Behavioral Health and Developmental Services Support Amount Based on funding availability, DBHDS will established an annual maximum individual financial support limit of $3000. For Fiscal Year : 825 individuals were funded for a total of 1.9 million dollars Fiscal year : families are to be funded with an available total budget of 3.2 million dollars

4 Page 4 DBHDS Virginia Department of Behavioral Health and Developmental Services Basics Program is administrated by DBHDS. Individuals and families can access application directly from the DBHDS website. They do not have to go through their Case Manager/Support Coordinator Case managers/support coordinators are strongly encouraged to share the information about the IFS Program with their waitlist individuals and assist with filing out the application if an individual needs assistance.

5 Page 5 DBHDS Virginia Department of Behavioral Health and Developmental Services Basics Individual and Family Support Program funds shall not supplant or in any way limit the availability of services provided through a Medicaid Home and Community-Based Waiver, Early and Periodic Screening, Diagnosis and Treatment (EPSDT), or similar programs.

6 Page 6 DBHDS Virginia Department of Behavioral Health and Developmental Services Basics Individuals who are on the waiting list for ID or DD Waiver and currently on the Elderly or Disabled with Consumer Direction, Day Support, or Technology Assisted Waivers May apply for funds if needed items are not available through these waiver programs, EPSDT or Medicaid State Plan Option.

7 Page 7 DBHDS Virginia Department of Behavioral Health and Developmental Services Program eligibility requirements Eligibility is limited: to individuals who are living in their own home or a family members home are on the statewide waiting list for the Intellectual Disability (ID Waiver) Medicaid Waiver or the Individual and Family Developmental Disabilities Services (DD Waiver) Medicaid Waiver or to family members that are assisting those individuals and the request supports that assistance.

8 Page 8 DBHDS Virginia Department of Behavioral Health and Developmental Services Covered services and supports Services and items that may be funded through the IFSP may include: Professionally provided services and supports, such as respite, transportation services, behavioral consultation, and behavior management; Assistive technology and home modifications, goods, or products that directly support the individual; Temporary rental assistance or deposits;

9 Page 9 DBHDS Virginia Department of Behavioral Health and Developmental Services Covered services and supports Fees for summer camp and other recreation services; Temporary assistance with utilities or deposits; Dental or medical expenses of the individual; Family education, information, and training

10 Page 10 DBHDS Virginia Department of Behavioral Health and Developmental Services Covered services and supports Peer mentoring and family-to-family supports; Emergency assistance and crisis support; or Other direct support services as approved by DBHDS.

11 Page 11 DBHDS Virginia Department of Behavioral Health and Developmental Services Next Funding Cycle Applications for this program will be accepted starting September 3, FAX or applications will NOT be accepted. IF applications arrive in this manner a denial and request to resubmit via proper method letter will be sent to the applicant and application will be destroyed.

12 Page 12 DBHDS Virginia Department of Behavioral Health and Developmental Services Accessing Applications Applications can be downloaded from the DBHDS website and mailed in. Mailed applications will be sorted based on postmark date. OR Access our web-based on-line application system that will become available September 3, All updates concerning the program will also be posted at this location.

13 Page 13 DBHDS Virginia Department of Behavioral Health and Developmental Services Application Information Completed applications shall include the following information: A detailed description of the services or items for which funding is requested; Documentation that the requested services or items are needed to support the continued residence of the individual with ID/DD in his own or the family home and no other public funding sources are available; The requested funding amount and frequency of payment;

14 Page 14 DBHDS Virginia Department of Behavioral Health and Developmental Services Application Information Written acknowledgement of participant responsibilities The signature of the individual (unless the individual is a minor or has a legal guardian) and financially responsible person.

15 Page 15 DBHDS Virginia Department of Behavioral Health and Developmental Services Participants Responsibilities Individuals and Families will be required to submit supporting documentation to verify that funds have been used for the purpose stated in their application. Directions will be provided to families when funding is approved. Fulfillment of participant responsibilities is a requirement to participate in the program in future years.

16 Page 16 DBHDS Virginia Department of Behavioral Health and Developmental Services Participant Responsibilities If money is spent on non-approved items DBHDS has the legal right to: Stop payments for additional funding. Deny future applications from being funded Garnish tax refunds or pay against the fiscally responsible person.

17 Page 17 DBHDS Virginia Department of Behavioral Health and Developmental Services Participants Responsibilities If you are approved for one thing and your needs change by the time your receive your funds, CALL or write IFSP and request a change in approval. Documentation must be in your file that matched what you are approved for and what you have spent on funding.

18 Page 18 DBHDS Virginia Department of Behavioral Health and Developmental Services Application Review The Department will assure compliance with program regulations and policies 1. Verify that the individual is on ID or IFDDS Waiver waiting list; 2. Confirm that the services or items for which funding is being requested are eligible for funding 3.Determine that the services or items for which funding is requested are needed to support the continued residence of the individual with ID/DD in his own or the family home

19 Page 19 DBHDS Virginia Department of Behavioral Health and Developmental Services Application Review The Department shall provide a written notice to the individual or family member who submitted the application indicating the funding decision. Approved Pended or Denied

20 Page 20 DBHDS Virginia Department of Behavioral Health and Developmental Services Approval Approvals - Approval notices shall include: The services, supports, or other items for which funding is approved; The amount and timeframe of the financial allocation; The expected date that the funds should be released; and Documentation requirements for submitting receipts to the Department and the date documentation shall be provided to DBHDS.

21 Page 21 DBHDS Virginia Department of Behavioral Health and Developmental Services Approval In general, receipts or other documentation to verify expenses for which IFSP funds have been requested shall be submitted to the Department within 30 days of receipt of funds OR Upon the completion of the purchase of approved items/delivery of approved services and shall include the name of the provider of the goods/services and the individuals name.

22 Page 22 DBHDS Virginia Department of Behavioral Health and Developmental Services Approval Applications may be approved at a reduced amount when the amount requested exceeds a reasonable amount as determined by Department staff as being necessary to purchase the services or items.

23 Page 23 DBHDS Virginia Department of Behavioral Health and Developmental Services PEND Pended Requests When requests for IFSP funds cannot be immediately approved due to missing information or there are questions about the application contents, DBHDS staff will pend the request. In that event the following procedures will be followed: DBHDS staff will send a letter requesting additional information to the individual or fiscally responsible family member provided on the application in order to acquire the additional information needed in order to approve the request.

24 Page 24 DBHDS Virginia Department of Behavioral Health and Developmental Services PEND DBHDS staff will wait for the requested information from the individual or family member for up to 30 days from the date of the mailed letter. If the additional requested information is received, DBHDS staff will continue to process the application If the additional requested information is not received, DBHDS staff will deny request and send a letter following the denial procedure.

25 Page 25 DBHDS Virginia Department of Behavioral Health and Developmental Services Denials Denials - Applications shall be denied if the Department determines that: The service or item for which funding is requested is not eligible for funding in accordance with 12 VAC (See Section V, Covered Services and Supports, in Guidelines. This program does not fund clothing, food, purchase of a vehicle or down payments for a home.

26 Page 26 DBHDS Virginia Department of Behavioral Health and Developmental Services Denials The requesting individual or family member has not used previously received IFSP funds in accordance with the Departments written notice approving the request or has failed to comply with IFSP policies or regulations; or The total annual IFSP funding appropriated by the General Assembly has been expended for the applicable fiscal year.

27 Page 27 DBHDS Virginia Department of Behavioral Health and Developmental Services Denials The request was pended and the family did not respond to request for additional information in a timely manner (i.e., 30 days); For applications for which funding is denied or approved at a reduced amount, the Departments notice shall state the reason or reasons why the requested services, supports, or other items were denied or approved at a reduced amount and the process for requesting the Department to reconsider its funding decision.

28 Page 28 DBHDS Virginia Department of Behavioral Health and Developmental Services Requests for reconsideration Individuals or family members who disagree with a determination of the Department may submit a written request for reconsideration to the Program Manger, Cindy Gwinn. If the issue can not be resolved then the applicant has the right to ask for an appeal to the Commissioner, or his designee, within 30 days of the date of the written notice of denial or approval at a reduced amount.

29 Page 29 DBHDS Virginia Department of Behavioral Health and Developmental Services Post Funding Review Utilization review of documentation or verification of funds expended may be undertaken by Department staff. Reviews may include home visits to view items purchased or services delivered. Funds that are not used for agreed upon services, may result in recovery of such funds by the Department and denial of all future application requests.

30 Page 30 DBHDS Virginia Department of Behavioral Health and Developmental Services Termination of funding Funding through the Individual and Family Support Program shall be terminated: when the individual is enrolled in the ID or IFDDS (DD)waiver, or if approved funds are used for purposes not approved by the Department in its written notice.

31 Page 31 DBHDS Virginia Department of Behavioral Health and Developmental Services Quality Measures We look forward to hearing how these funds have assisted participants to continue to live in their community. A yearly satisfaction survey will be sent to each participant to assist in measuring satisfaction and effectiveness of the program. Outcomes will be published in the annual report and program reviews.

32 Page 32 DBHDS Virginia Department of Behavioral Health and Developmental Services Assistance Program Regulations and Sample Application can be downloaded at:

33 Page 33 DBHDS Virginia Department of Behavioral Health and Developmental Services Assistance For additional information or questions please contact: Cindy Gwinn - IFS Program Manager


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