RHS daily service rate implementation

For the original publication, please click here. The following is a text version of the original publication.
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To: Bureau of Developmental Disabilities Services case managers and stakeholders
From: Cathy Robinson, Director, Bureau of Developmental Disabilities Services (BDDS)
Re: RHS daily service rate implementation
Date: August 3, 2015

For more than a year, the Bureau of Developmental Disabilities Services (BDDS) has worked with provider agencies and stakeholders to design the new Residential Habilitation Services (RHS) daily service rate. With the daily rate conversion now complete, it is the expectation of BDDS that case managers will take this opportunity to meet with participants, families and the Individualized Support Teams to discuss individuals’ service needs and address any questions they may have.

It will be helpful to incorporate the following information into your conversations:
• Implementation of the daily rate should increase the time providers will have to support participants to more fully access the community by allowing for additional flexibility in how residential services are delivered. It is also expected to lessen the administrative burden on provider direct support staff and decrease the focus from the budget while increasing focus on the participants needs. 

• Implementation of the daily rate should be seamless for participants with residential staffing continuing as is unless, after reviewing the participant’s current services and needs, the Individualized Support Team (IST) determines otherwise. The residential provider may sometimes provide more or less staffing than what a participant has been receiving based on the Individualized Support Plan (ISP), while still adhering to services hours outlined in IAC 460, Article 13. 

• It is important to note the RHS daily rate was not developed to reduce the quality of services rendered and expectations of residential providers have not changed. Services being delivered under RHS daily should continue to meet the residential needs of the participant as documented in their ISP. Providers of RHS daily rate services will continue to communicate with the IST when changes to staffing levels are necessary. On behalf of the IST, case managers can contact BDDS for case by case guidance and technical assistance. 

• The IST continues to be vital in the support of participants. ISTs are encouraged to meet with participants within the 30 days following the daily rate implementation on August 1, 2015. During these meetings the ISP should be evaluated to review the individuals’ service needs and determine the most appropriate service delivery approach going forward. Items of discussion should include the following: 
  • Identification of the available services under the Days and BMAN Reserve 
  • The priority needs of the individual in terms of day and other services 
  • Informal supports that have been developed to assist with community integration 
  • Whether or not the participant wishes to seek employment 
  • A consensus on what combination of services, employment and natural supports will best meet the needs of the individual.

After discussing the points above, case managers should be prepared to develop an action plan. The action plan may consist of scheduling the next 90 day meeting, making referrals to community agencies, or making changes to the Cost Comparison Budget (CCB). In all situations, case managers should be prepared to provide clear information on what can be provided within the Days Reserve. At the conclusion of the meeting, case managers should have an understanding of what adjustments need to be made to the CCB and be prepared to update accordingly.

BDDS continues to value the relationship we have with case managers and are here to support you as needed. Should you require additional information on RHS daily, please refer to the information posted on the DDRS Announcements web page.