THE CHILDREN’S MENTAL HEALTH WAIVER ATTACHMENT A THE CHILDREN’S MENTAL HEALTH WAIVER An introduction to the concept of a Medicaid waiver program The services and parameters of the Children’s Mental Health (CMH) Waiver Lin Christensen IME Program Manager rev. 1-06

What is a Medicaid Waiver? ATTACHMENT A What is a Medicaid Waiver? A person eligible for a Medicaid waiver “waives” his(her) entitlement to receive services in an institution. Approximately 2/3 of the cost of waiver services is covered by the Federal govt. and 1/3 of the cost of waiver services is covered by the county or the state. Special Medicaid programs provided to maintain person in their own homes or communities who would otherwise require care in a medical institution. Intent was to redirect Medicaid dollars into community-based settings. AND enabling the consumer to return to or remain in their communities and/or home Vs. Costs in an RCF-MR – all county dollars. rev. 1-06

History of Medicaid Waivers in Iowa ATTACHMENT A History of Medicaid Waivers in Iowa Began implementation in 1984 Iowa’s Medicaid waiver program is referred to as Home & Community Based Services (HCBS). Over 15,000 persons currently receive waiver services Nearly 7,000 waiver service providers I/H 1984; Elderly 1990; A/H 1991; MR 1992; BI 1996; PD 1999 Nationally, it is the first time more people are receiving HCBS services than are receiving ICF/MR services Iowa services continue to shift to the HCBS Model rev. 1-06

Iowa’s Medicaid Waivers Home & Community Based Services Ill and Handicapped Elderly Aids/HIV Mental Retardation Brain Injury Physical Disability Children’s Mental Health Waiver rev. 1-06

The Basic Concepts of a Medicaid Waiver Funded through Title XIX Offers a menu of services from which an individualized service plan is developed to meet the support needs of each individual Each individual is supported by an interdisciplinary team in which the individual is the focus and the main source of information rev. 1-06

Supporting The CMH Waiver Eligible Child State Plan Services Iowa Plan Services CMH Waiver Services rev. 1-06

Teamwork Teamwork is an integral part of providing quality services. Each child approved for the CMH Waiver and his/her family is part of an interdisciplinary team (IDT). Each child, as a requirement for the CMH Waiver,must receive service oversight and service coordination from a Medicaid targeted case manager. Other IDT members: Service providers Teachers &/or education personnel Iowa Plan Other persons that the child and family would like to participate rev. 1-06

The Crisis Intervention Plan (Mental Health Wellness Plan) This plan will be developed during IDT planning. The targeted case manager will write the plan. All members of the IDT will use the same crisis intervention plan. If changes occur or become necessary, the TCM must be contacted. The TCM will redistribute the dated and revised plan to IDT members. rev. 1-06

The Crisis Intervention Plan (Mental Health Wellness Plan) The focus should be on wellness not crisis. This plan should include the following for the child: Things to do everyday to maintain wellness or feeling right Things that need to be done (or would be good to be done) Triggers What to do if triggers happen Early warning signs Symptoms of breaking down What to do if symptoms occur Supporters-family and friends Medical Information Professionals involved in care Medications Treatment centers and/or facilities The targeted case manager will write the plan. All members of the IDT will use the same crisis intervention plan. If changes occur or become necessary, the TCM must be contacted. The TCM will redistribute the dated and revised plan to IDT members. rev. 1-06

The Crisis Intervention Plan (Mental Health Wellness Plan) This plan should also include these components: Supporters Family, friends, neighbors Medical Information Professionals involved in care Medications Treatment that must be provided or must be avoided Treatment centers and/or facilities rev. 1-06

If you want to play the game . . . . You have to follow the rules! rev. 1-06

Iowa Administrative Code Rules for the CMH Waiver Chapter 77 Service Provider Standards Chapter 78 Service Descriptions Chapter 79 Service Reimbursement Rates Chapter 83 Recipient Eligibility and Appeal Rights rev. 1-06

Where Can I Find the Iowa Administrative Code Rules Online? www.dhs.state.ia.us Click on A-Z services. Click on Administrative Rules. Click on Policy Analysis. Click on Medical Assistance book icon. Click on desired IAC chapter. rev. 1-06

I’m overwhelmed!!! I need help! Do not fear! Your friendly HCBS-CMH Waiver specialist is near. Geri Derner Mary Jacobs (Jake) Lori LaCarte Cheri Reisner Susan Slauson Annie Volker rev. 1-06

Two Ways To Contact Your HCBS-CMH Specialist By email: On the CMH Waiver website http://www.ime.state.ia.us/HCBS/CMH Waiver.html click on the link in the Questions box. An email message is automatically created to the specialist assigned to each county. By telephone: Refer to the telephone listing by county. It is also posted on the website. rev. 1-06