Presentation on theme: "Consumer Choices Option"— Presentation transcript:
1Consumer Choices Option Today is just to give you a brief overview of this new option that we anticipate will be available this summer more in depth training will come later. As some of you may recall this option was made possible by a RWJ grant that Iowa received in the fall of At one time we were calling it developing choices empowering Iowans, we are now calling is Consumer choices option
2What is Consumer Choices Option? An option that gives people who are eligible for Medicaid Home and Community Based Services (HCBS) Waivers more choice and control in managing their daily lives.
3Who is eligible? All HCBS waiver consumers statewide Aids/HIV (40 consumers)Brain Injury ( 557 consumers)Elderly (7465 consumers)Ill and Handicapped (1965 consumers)Mental Retardation (8945 consumers)Physical Disabilities (445 consumers)This option will be available for the six waivers,these numbers are from November 2005 data. Please note that this does not include the children’s mental health waiver, since that is a new waiver it was decided wait until that waiver is running for a while before adding this option. Basically to add this option Iowa has to request an amendment to all six of this waivers.
4Traditional service plan What is new?Traditional service planHomemaker from provider AHome delivered mealsPara-transit transportationMore choiceHomemaker provided by your daughterPurchase of a microwaveTransportation provided by your neighborObviously this is just an example of what this new option will look like. Just as consumer’s individual service plans or individualized this new option will be too. But basically with this option people will convert some of their traditional services into an individual budget where they can have more choice in how their services and supports are provided. They can purchase personal care services, goods and services and other community and employment support
5What remains the same?All consumers will have a service plan based on their needsAll consumers will continue to work with their service worker/case managerSkilled services and other group services will continue to be provided by Medicaid providersSo Nursing services, services that provide nursing oversight or a require a licensure will still be provided as they are today.
6What remains the same?There will be no effect on non-waiver Medicaid servicesConsumers will still be offered the full array of Medicaid services they are eligible forMedicaid financial eligibility standards will remain the same
7Why is Iowa offering this option? More choice is worth the effortThis policy change supports the 1999 Supreme Court Olmstead DecisionEvaluations conducted in states with self-direction options show:Consumers feel safer and are more satisfied when they hire their own workersSelf direction expands consumers access to careWorkers hired directly by consumers report higher job satisfactionDHS, the department of Elder affairs, the senior living coordinating unit and other disability advocacy groups support this movement and felt that this was worth the effort.There were three pilot states, Arkansas, New Jersey and Florida have been providing this option since the late 90’sExpands access by expanding workers.
8ChallengesIowa wants to protect the integrity of the HCBS waiver programsWe want to provide more choice and control without impacting the number of HCBS consumers servedWhile offering more choice and control we want to continue to meet consumers’ needsChange is never easy, so by changing the waivers we face some challenges we face Basically we don’t want this option to mean less people receive waiver services and we know that is a concern
9How do we address those challenges? This option will not cost more, nor less than traditional servicesThis option will offer a financial management service provider to help the consumer manage their budget &Additional counseling/advice through an independent support brokerTo assure that consumers have help in making good choices and do not have unmet needs, consumer will work with both an independent support broker and a financial management service.The independent support broker will be hired by the consumer after completing a training and the financial management service will be a credit union
10AssumptionsWe anticipate 10-15% of eligible consumers will choose this optionIf we convert to dollars authorized, it will cost more to offer this option SoConsumers’ individual budget amount will be based on dollars utilized, therefore we expect it to cost the sameEventually we anticipate 10-15% will choose this option based on data from other statesServices available for people to use will be based on the individual service plan, Many consumers for a variety of reasons do not use all of the services provisioned under their plan
11What remains to be done?CMS approval of the HCBS waiver amendments-expected March 1st 2006Administrative rules promulgated- May 1st 2006Enroll Financial Management services as providers-May 1st 2006Train and educate Independent Support Brokers, consumers and families – May 15th 2006
12Consumer Choices Option will be available June 2006 starting in one DHS service area at a time. It will be available statewide by March 2007