Important Note to Provider Organizations: Jan 1st 4% Rate Changes in eXPRS

What’s Changing?

In the last few weeks, Personal Support Workers and brokerage customers should have received information directly from the State of Oregon and/or SEIU regarding an important change just around the corner. For a good many years, TNT Fiscal Intermediary Services has issued paychecks for PSWs serving our customers. TNT’s contract with the state ends at the end of 2016 and a new agency, PCG Public Partnerships LLC (known as PPL) will be taking over this responsibility. So in the very near future, Personal Support Workers will stop getting payment from TNT and start getting payment from PPL.

 

What does this mean to Personal Support Workers and Customer-Employers?

Generally speaking, it means that Personal Support Workers and employers (be they a brokerage customer or a legal designee) have some paperwork to fill out. Right now, PPL is sending out mailers to three groups of folks:

  • Employers (customers or their designees) who employ PSWs (You’ll get a packet by mail on or around November 4th, 2016)
  • Personal Support Workers who work for one Employer (customer or their designee) (You’ll get a packet by mail on or around November 7th, 2016)
  • Personal Support Workers who work for two or more Employers (customers or their designees)  (You’ll get a packet by mail on or around November 8th, 2016)

Customer-Employers and Personal Support Workers can return their packets in a variety of ways: by mail, fax, or secure email.

 

What Help Is Available?

If you’d like some hands-on help, consider attending one of the optional Enrollment Information and Help Sessions for Employers and PSWs. Multiple sessions will be held here at Independence Northwest and there are sessions in all three metro area counties. RSVP for a session by clicking here. If you have received your packet, you can bring it to the session in your area to receive hands-on help. If you haven’t received it by the time the session you want to attend happens, they’ll print a packet for you there and assist you in person.

You can also call PPL Customer Services for help. Their number is listed on this flyer or you can visit this website.The state’s eXPRS Facebook page has a ton of resources related to the change as well.

 

Transition time is very tight on this, so be sure you’re responsive and get the help you need! If packets are not completed and processed by the end of the year, payment for services may be affected. If you have questions, don’t hesitate to reach out to PPL for help.

State to Hold Info Call for Families Re: Entry into Sheltered Workshops (06.17.2015)

The Office of Developmental Disability Services (ODDS) will be holding an informational phone call about the upcoming policy changes for entry into sheltered workshops for individuals and their family members/support people on Wednesday, June 17, 2015 from 9:00 – 10:00 AM.

The purpose of this call is to discuss:

  • Upcoming changes to entry into sheltered workshops
  • How these changes will affect you or your family members/support people
  • Effects on those already working in a sheltered workshop
  • Effects on those not working in sheltered workshops
  • Other employment services that are available
  • Answer your questions

To call in please use this conference line:  800-260-0702 and enter guest code 361647

Additional Resources:
Entry into Sheltered Workshops: Upcoming Policy Changes FAQ
Watch a Video of ODDS Director Lilia Teninty Answering FAQs About the Changes
Governor’s Executive Order

 

“Did You Get My Timesheet?”

Since the State of Oregon Department of Human Services began taking on Personal Support Worker and provider payment through its eXPRS system, one of the most common questions brokerages have received from providers is “Did you get my timesheet?”

There’s a relatively easy way for providers to access this information via eXPRS. ODDS’ Julie Harrison and her team have created a How To guide entitled “How to Find/View Plan of Care Service Claims”. Check out the guide by clicking here. You’ll learn how to read the eXPRS screens and determine where your payment claim is in the process. Be sure to bookmark this guide for future reference. (Of note: eXPRS refers to hours or miles keyed into its system as SDEs – Service Delivered Entries.)

One additional note: If you are sending invoices or timesheets via email, please be sure to use the billing@independencenw.org email address. If you are faxing invoices or timesheets, please be sure you receive a return confirmation that the fax was received.

Thanks for your continued partnership through the ongoing systemic changes. Your work is very much appreciated.

didyougetmytimesheet

Five Things That Are Working Well in Brokerage Support Services Today

By Larry Deal, Executive Director of Independence Northwest

Over the past year and a half, so much time has been spent deconstructing and reconstructing Oregon’s Intellectual and Developmental Disabilities system, there’s been little opportunity to sit back and celebrate some of the successes. Here are five things that are currently working well – and that deserve their moment in the sun.

People are getting more services. With the change from 100% Title XIX Waiver to a mix of K Plan and Waiver funding, Oregonians with intellectual and developmental disabilities are getting more services than ever before. This is a wonderful thing. Historically, people in crisis situations had limited resources and little option other than out of home placement (group homes and foster care homes) whether that was their preference or not. In the new system, many Oregonians now have the resources to continue living at home; the current design supports true individual and family choice. The importance of this change cannot be overstated. (That said, there’s still a very real fiscal sustainability discussion that must be had to support these efforts long-term.)

Providers are beginning to expand capacity. This one’s a slower burner, but it’s beginning. Customers, families, and professionals have all been highly concerned about the increase in funding since it came without an ounce of provider capacity expansion planning or incentives. Oregon put the funding before the resources. In recent weeks and months, many agencies have begun reaching out to brokerages and are expanding their services to our community in everything from in-home to employment supports; in 2015, I believe we will see a tangible increase in options for our customer base.

There’s a recent willingness for course correction when things aren’t working. If you haven’t heard of DSA (Day Support Activities,) consider yourself lucky. In short, DSA was an exercise in rushed change implementation. Ultimately, it changed rates, it changed processes, and it changed the definition of certain services. The process upended Brokerage, CDDP (Community Developmental Disabilities Program) and provider organization operations and damaged the integrity of reporting systems statewide. However, collaborative efforts (led by ODDS)  amongst brokerages, CDDPs (counties), providers, and state has made a real difference. Recent changes in leadership have assured a common sense, customer-first approach to problem solving. In other words, there’s strong collaboration happening again in Oregon. This is a very good thing – let’s do more of it.

We’re sticking with our current needs assessment tool. One of the major concerns brokerages have been facing while implementing the still-new functional needs assessment has been knowing full well we’d have to change assessments again at the beginning of 2015. Recent actions from the state suggest that we will be working to make the current brokerage tool (the Adult Needs Assessment) work well into the future. For brokerage customers, this is promising. We need consistency, stability, and some time to do some in-depth analysis on the efficacy of the current tool first. This decision deserves kudos.

Perhaps most significantly, Oregon is focusing on individual goals – again. If you have been working in the system or receiving services for the last year and a half, you’ve no doubt noted the troubling focus on deficits-based language and approach. I remember being in a meeting very, very early on in the K Plan implementation when it was announced by someone with significant influence that “this is no longer about goals, it’s about needs.” Soon, that refrain began to echo. Fortunately, that interpretation is no longer alive and well. What some people didn’t understand early on in the transition process was this: Brokerages have always addressed disability-related support needs. And we have done so while helping people reach their goals. You don’t provide publicly-funded services without making sure needs are documented and necessary. A sophisticated, supportive, holistic system addresses health and safety while placing a premium on the wants, needs, and goals of the individual. We know it can work because we’ve been doing it for thirteen years. I can’t say enough how pleasing it is to hear high-ranking leaders in our state stating that goals matter.

There are many issues we must continue wrestling with: the eXPRS payment system and pending Personal Support Worker entry, the monthly versus annual services issue, the ongoing review of Behavioral Supports, changes to supported employment, and many more. But as we inch ever closer to the new year,  it’s safe to say that we all hope for continued positive developments in the Oregon I/DD service delivery system. We’re a resilient, engaged, and growing community. Fingers crossed we can focus the coming year’s efforts on enhancing, expanding, and enriching the lives and experiences of the individuals, families, and communities we support. Oregon was once at the forefront of community-based services in our country; with continued focus, effort, and partnership there’s no reason that can’t be a reality again.

 

A Comment on Changing Rates and Service Definitions from Metro Brokerage Directors to Provider Organizations

Dear Portland Metro-Area Provider Organizations,

We, the six metro-area support services brokerages, wanted to send out a quick note regarding the current status of transitioning service codes, amending plans, and adjusting rates given the potential September 1st changes.

First, we’d like to briefly comment on our current understanding of DSA and Attendant Care services. Based on the DRAFT Expenditure Guidelines we received from the Department of Human Services just last week we believe that provider organizations can perform both Day Support Activities (DSA) as well as Attendant Care services. For details, follow this link to their current work-in-progress: August 2014 Expenditure Guidelines

We have been in talks with the state to request a delay of the September 1st implementation of these changes. Our primary reason for the delay request has to do with the impossible time frames we are faced with as a system to implement this latest sea change. Brokerages need appropriate time to do planning and coordination with customers prior to amending Individual Support Plans (ISPs) and  service agreements, and Providers need time to evaluate the changes and revise their business plans in order to meet the new regime. We hope to hear back from Interim DD State Director Trisha Baxter within the next day or so regarding our request for delayed implementation. (Please note: we are requesting to delay implementation of DSA, but we are not asking for a delay to implementation of Supported Employment changes.)

Our hope is to work with the State on a reasonable timeline for implementation this fall or winter in a thoughtful process that  includes  a stakeholder work group charged with leading and influencing the transition.

As always, we appreciate your patience and partnership as we manage such significant systemic change. Your recent and ongoing advocacy is very much appreciated. Surely, we all agree that a  thoughtful, proactive approach to transition is key to serving our customers and community in the most respectful and productive way possible.

We know there are scores of unanswered questions out there and we are preparing to gain the understanding necessary to respond to them given our limited resources during this transition. Without clarification and without the full participation of our customers, we are not able as of now to amend goals, plans, or service agreements.   Please stay tuned – more details shortly.

Best,

Dan (SDRI), Katie (Mentor), Jennifer (CPI), Larry (INW), Rachel (Inclusion), and Sarah (UCP)

State Delays eXPRS Implementation and Employment Rate Changes to Fall 2014

Late Friday afternoon (05.30.2014), Interim DD Director Trisha Baxter released the following statement to the I/DD community:

“As you are aware we have many priorities that we are focusing on, all with a July 1 implementation date. We have heard from many of you that these converging priorities are causing angst, stress and strain on you, and on the system. We, as well, are discovering the complexities of handling so many moving parts all at once.  As such, based upon feedback from many of you and weighing our internal priorities and commitments with SEIU, CMS and others, we have come up with the following strategy to delay portions of the work and to stage implementation in a more manageable way.  Additional information will be coming out over the coming weeks about the details behind these strategies so please pay close attention to emails and other communications over the coming days.

First, July 1 is a milestone for new employment services to be offered. These services are included in the Medicaid waivers that will be submitted for approval with a July 1 effective date. These new services will still be offered as of July 1. July 1 was also a targeted date for implementation of a new rate structure for employment services for both the comprehensive and support service system. The new rate structure will be finalized next week, however, at the request of multiple providers, we will hold off on implementation of those rates, with the exception of the rates for the new services, until September 1, 2014. The new services, which include Discovery and Job Development will be paid at the new outcome based rates. All other services will continue to be paid at the current, daily rate. This additional time will allow providers of employment services an opportunity to analyze how the new rates will apply to their service arrays. Additional information about the rate transition schedule, and expectations for tracking, billing and reporting of services provided during July and August will be coming shortly.

Additionally, we have been challenged to provide training to the large number of personal support workers, CDDP and Brokerage staff, and other providers on the new plan entry and claims process within the eXPRS system. In order to allow more time for training and other associated activities, we are delaying the implementation of Plan of Care functionality to September 1, 2014 as well. We will be working with partners, including SEIU and providers, to develop an implementation plan from September 1 forward, beginning with employment services. The delayed schedule and restaging of activities is important to assure successful implementation, but it does not deter or alter the strategic or programmatic outcomes the changes are designed to achieve.

There is much work to be done over the upcoming months to ensure that individuals experiencing intellectual and developmental disabilities continue to receive services and that those providing the services are paid accordingly. We thank all of you for your continued work with us as we pull together plans for full implementation. As always, if you have questions or concerns, please feel free to contact me.”  – Trisha Baxter

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