1. T HE T RANSITION OF HCS C ASE M ANAGEMENT TO MRA S ERVICE C OORDINATION

2.  Introductions  Purpose of the Transition  Timelines and Activities 1. DADS 2. Texana Center MRA  Role Clarification 1. HCS Provider and MRA SC Responsibilities 2. Frequently Asked Questions (FAQs) 3. Comparison of MRLA and HCS SC  Proposed Next Steps/Meeting Evaluation M EETING A GENDA

3. P URPOSE OF T RANSITION Senate Bill 1, Section 48 SB 1, Sec. 48 provides $207 million General Revenue to provide additional community services to over 7,000 people contingent upon reshaping and improved oversight of the state system of IDD services. Contingencies include mandate to transfer case management functions in the HCS program from the HCS provider to the Mental Retardation Authorities (MRAs). Requires changes to the HCS Rule and the Service Coordination to People with Mental Retardation Rule.

4. DADS/HHSC T RANSITION T IMELINE September 2009  Proposed rule drafts were made available to stakeholders 09/01/09.  Stakeholder meetings were held on 09/14/09. January 2010  Proposed rule drafts are presented to MCAC and the DADS Council for approval to publish in the Texas Register. February 2010  Proposed rule drafts are published in the Texas Register for thirty days. March 2010  Public comments regarding the proposed rule drafts are received and reviewed. April 2010  Proposed rule drafts are revised as necessary in response to the public comment and responses to public comment are developed. May 2010  Multiple trainings are held for HCS providers and MRAs. June 2010  HCS case management is transferred to the MRAs.

5. DADS T RANSITION A CTIVITIES During months prior to transfer of case management DADS is conducting additional activities in preparation for this change, including: development of a program handbook, forms and templates; includes PDP, Implementation Plan changes to CARE; communication with individuals receiving services and their families; and development of training for MRAs and HCS providers.

6. TEXANA CENTER MRA TRANSITION TIMELINE November 2009  Initial HCS CM transition meetings between Providers and Texana Center MRA  Develop local case numbers for HCS consumers identified in DADS report December 2009  Develop Texana Center MRA dedicated webpage to post information and updates on local transition planning  Arrange for office space for HCS-MRA Service Coordinators January 2010  Create Job Descriptions for HCS-MRA Service Coordinators  Revise Policies & Procedures as needed  Develop HCS-MRA Service Coordination Training Plan, Curriculum, and Manual

7. TEXANA CENTER MRA TRANSITION TIMELINE, CON’T February 2010  Second HCS CM transition meeting between Providers and Texana Center MRA  Begin hiring process of SCs March 2010  Participate in provider sponsored consumer/family relation meetings with Texana Center MRA  Caseload assignments by position based on county/location/provider April 2010  With DADS and Providers, develop a process to manage May and June PDPs and IPCs  Create Provider/MRA contact lists  Notify providers and consumers of Caseload assignments

8. TEXANA CENTER MRA TRANSITION TIMELINE, CON’T May 2010  Third HCS CM transition meeting between Providers and Texana Center MRA  Participate in DADS Sponsored training  Train HCS-MRA Service Coordinators in Texana Center policy, HCS and Service Coordination rules  Consumer Relations—HCS-MRA SC to begin building relationships with providers and consumers TBD  Build Authority Records with Provider documents

9. TEXANA CENTER MRA ACTIVITIES Primary goals between now and June 1, 2010:  Clearly delineate MRA HCS Service Coordination function from HCS Provider function  Establish effective communications among Texana Center MRA, the HCS Provider network and HCS Participants.  Minimize disruption to HCS Participants

10. C LARIFICATION OF MRA, P ROVIDER & DADS R OLES Following are 3 perspectives to help clarify roles:  Responsibilities set in Draft HCS Rule Revision  DADS Frequently Asked Questions document  Comparison of MRLA & Draft HCS Rule NOTE: Draft HCS Rule 1) is subject to change before final adoption, and 2) will be accompanied by a DADS Handbook (in early development) with operational detail, templates, etc. In other words, following role delineation will be further clarified prior to implementation.

11. R ESPONSIBILITIES OF MRA S ERVICE C OORDINATOR  Continue to conduct enrollment activities for individuals entering the HCS Program  Conduct person directed planning activities and complete the PDP  Coordinate completion of the IPC with HCS provider  Agree or disagree with proposed IPC renewals and revisions that provider has submitted to DADS for approval  Provide ongoing monitoring of the provision of the individual’s program services.

12. P ROVIDER R ESPONSIBILITIES After enrollment:  Complete assessments and submit requests for LON to DADS  Complete IPC document and submit to DADS  Coordinate completion of the IPC with MRA Service Coordinator  Develop Implementation Plan for delivery of individual’s program services based on PDP  Deliver services according to authorized IPC

13. DADS R ESPONSIBILITIES  WS&C will conduct certification review activities for HCS providers.  Utilization Review (UR) will continue to approve IPCs and LONs.  The DADS MRA Contract Accountability and Oversight unit will be expanding their current role to oversee service coordination activities for individuals in the HCS Program.

14. “F REQUENTLY A SKED Q UESTIONS ”  A document developed by DADS to clarify HCS rule revisions  Will be updated on a regular basis by DADS, and to be posted on the DADS website.  Email updates available through GovDelivery by signing up on DADS website see hand-out

15. MRLA-N EW MRA S ERVICE C OORDINATION C OMPARISONS MRLA  MRA completed survey/certification activities  Service Coordination provided by the MRA  Service Coordinator facilitated PDP and documented the outcome  Provider submitted strategies to MRA for approval Draft HCS Rule  DADS completes survey/certification activities  Service Coordination provided by the MRA  Service Coordinator facilitates PDP and documents the outcome  Provider develops the Implementation Plan based on PDP

16. MRLA-N EW HCS C OMPARISONS MRLA  MRLA was responsible for the initial IPC and entered the IPC into CARE  MRA responsible to complete IPC renewals and revisions and enter in CARE  MRA completes initial ICAP and renews every three years Draft HCS Rule  MRA responsible for the initial IPC and enters the IPC in CARE  Provider responsible to complete IPC renewals and revisions and enter in CARE. MRA agrees or disagrees and signs in CARE  MRA completes initial ICAP; Provider completes renewed ICAP every three years

17. MRLA-N EW HCS C OMPARISONS MRLA  MRLA completed initial MRRC and entered MRRC into CARE  MRLA completed MRRCs annually and entered into CARE  DADS assigned LON  MRLA submitted UR to DADS for approval Draft HCS Rule  MRA completes initial MRRC and enters MRRC into CARE  Provider completes MRRC annually and enters into CARE. MRA reviews, signs in CARE  DADS assigns LON  Provider submits UR and DADS approves

18. T RANSITION O VERVIEW  HCS Case Management will become MRA Service Coordination effective June 1, 2010  The Private Provider Association of Texas, The Texas Council of Community MHMR Centers, Local providers and local MRAs are committed to effectively to achieve a transition process that ensures working relationships, cooperation in planning, consistency of processes, and positive outcomes for consumers  DADS will develop the new HCS Rule, an HCS Handbook based on the new rule (including templates for Person-Directed Plans and Implementation Plans) and provide clarification to questions that arise among MRAs, Providers and Consumers as transition and implementation progress.  MRA-Provider and MRA-Provider/Consumer meetings will be used to steer the transition process, adapt universal tools in ways that benefit local MRAs and Providers, provide a forum for questions and discussion regarding the CM change.

19. M EETING E VALUATION AND N EXT S TEPS What worked in this meeting? What should change in the next meeting? What do we know now that will need to be discussed at the next meeting (Agenda Items)?