TCM Meeting by OC8MU8M


									                           Shawnee County CDDO
                            TCM Affiliate Meeting
                             September 3, 2009

Present: Ali Pontious, Sunflower Supports; Celeste Hund, Sunflower Supports; Rachel
Kuehn, CDDO; Anita Staats, Dream Catchers; Nancy Rhone, Dream Catchers; Marvin
Branch, Monaco & Associates; Linda Selbach, Dream Catchers; Kelly Zink, Dream
Catchers; Coleen Hernandez, CDDO; Michele Heydon, Sunflower Supports; Ashley
Anne Wells, sunflower Supports; Paula O’Brian, Dream Catchers; Sara Dinkel, Dream
Catchers; Don Richardson, TARC; Ann Barr, TARC; Ramona Macek, CDDO

The meetings began with the announcement of guest speaker, Beth Simpson, Office
manager at Heartland Pharmacy.
CDDO Updates:
   1) Ramona reminded everyone that the BASIS services page needed to be completed
      for individuals that are private pay and turned into Sandy Jenkins.
   2) She expressed her appreciation to everyone for all their assistance transitioning
      individuals to HCBS services. And stated that the definition of “family” does
      include the individual’s spouse and that their services would have to be supportive
      home care rather than residential as per the definition of family in the HCBS
      MR/DD Waiver handbook.
   3) Timili (Quality Management Coordinator) will be contacting TCM agencies to set
      up appoints for the annual TCM review in October.
   4) Effective Oct. 1, 2009 Target Case Managers required training hours will change
      from 36 hours to 20 hours annually per CDDO policy 06-011 (Training
      Requirements). Newly hired case managers are to receive all training
      requirements as identified in the Shawnee County CDDO Case Management
      curriculum form 06-011.001 within 6 months of employment. TCM agencies may
      need to revise the own agency required hours if so desired.
   5) The CDDO continues to advocate that SRS allow supportive home care hours be
      based upon the Needs Assessment.
   6) Sandy Jenkins, CDDO, attended a three-day seminar on Medicare Part A,B,C
      & D.
   7) Ramona spoke of the local Emergency Preparedness work group that is
      developing a plan in case of emergency mostly focused on a possible outbreak of
      the H1N1 virus. The plan will identify how to maximize available resources of
      staff and space if needed. The plan may also include staff going to residences and
      how billing day services will be allowed for those situations. It is hoped to have a
      Memorandum of Agreement between service providers by the end of September.
      The workgroup currently includes representatives from Individual Support
      Systems, Equi-Venture Farm, TARC and Sunflower Supports.
   8) Ramona stated there have been a lot of Crisis requests submitted to the CDDO
      Funding Committee and is frustrating when the crisis request is approved and
      three weeks later the person has not accessed the service requested or additional
      information requested does not come back in a timely manner. The CDDO
       Funding Committee will be following the 30 day limit of keeping an approved
       crisis open. If at the end of 30 days services haven’t been accessed, the crisis
       request will be closed and the case manager will be asked to resubmit a new
       request outlining the crisis.
   9) BASIS – Behavior tracking is required for all behaviors. This is important to
       impress on parents. It was stated the hardest to gather documentation from is
       those who are not receiving any services and don’t see the benefit. These families
       need to be encouraged to do so for the HCBS waiver eligibility. The CDDO will
       continue to advocate non-waiver eligible, Tier 0, individuals be funded with State
       General Funds. Although there are no guarantees funding for State General Funds
       will continue. Dream Catchers requested the CDDO send something in writing
       about the status of the family support grant being paid to individuals’. Rachel
       (Community Support Associate) is working on another letter.
   10) SRS/CDDO/CSP – families need to continue advocating to legislatures to not cut
       funding. CDDOs were asked to submit information to SRS showing the number
       of individuals affected by the reductions to SGF.
   11) It was asked if Tier 0 individuals change to Tier 5 if they will be refinanced to
       HCBS. It was stated that the CDDO will request the person be funded with
       HCBS which will then have to be approved by SRS.

Guest Speaker: Beth Simpson, Office Manager at Heartland Pharmacy. Heartland
Pharmacy is a closed door pharmacy and not open to the general public. Heartland
Pharmacy serves approximately 2,000 special needs individuals which are under long-
term care such as assisted living, HCBS waivers etc. Beth explained the packaging
system for the prescription system was originally developed for persons with Alzheimer
disease. All prescriptions have the person’s name, day and time when the prescriptions
should be taken. Beth stated that if you have an individual whose schedule is different
than the standard to let them know so the times can be adjusted accordingly. She also
stated that the packagings are color coordinated to show the different types such as short-
term (red) and PRN (green). The benefit of an individual’s non-prescription medications
going through Heartland Pharmacy is to use as a tracking system in case of
hospitalization or an emergency as well as a record of out-of-pocket expense. The daily
individual packaging also assists if a prescription is changed either discontinued or a
dosage has been increased to use in conjunction with medications already purchased.
They offer 4 doses a month free due to lost or dropped medications. She advised that if an
individual loses or drops a dosage they should take that days dosage from the last day of
the month and use the replacement.
Heartland Pharmacy is located in Lawrence and Wichita; there are three full-time
pharmacists at the Lawrence location. They are also on the University of Kansas
pharmacy list and accept one pharmacy student a semester.

Beth discussed Medicare Part D and Medicaid insurance. Every year plans change and
the individual with dual eligibility can incur a premium that they had not ever had
previously if they are not enrolled in one of the benchmarked companies. If an individual
chooses a non-benchmark plan they can be billed the difference between what Medicare
covers and what the national average for that prescription is. Individuals have to watch to
see if there is a premium, deductible or co-pay. Heartland Pharmacy will be sending out a
copy of the top three benchmark companies to agencies they contract with. Heartland
Pharmacy takes care of all the pre-authorizations which include prescription changes.
The CDDO IT Consultant and CDDO IT Assistant worked with Heartland Pharmacy on
the web based system (BCI) so affiliates approved may access an individual’s current
prescription list which mirrors their MARS report. Affiliates that are interested in having
access to this MUST have yearly authorization on record with Heartland Pharmacy. This
includes residential providers, case managers, day service providers and the SNCDDO.
The read-only link is updated daily at 4 p.m. In the BCI you would go to Basic
Information, under the tab Medical Management (MM) all necessary information should
be listed including current doctor orders and the date written. There also is a program
which allows charting medication given on-line. You will also have the capability to print
off medication sheets which are useful for doctor appointments. It s also advised to have
a written description of what a medication is used for as some are prescribed for different
diagnosis than what the prescriptions are normally used for.
For more information contact Beth Simpson, 1025 N. 3rd Street, Suite 110, Lawrence, KS
66044. Phone – (888) 331-0807; Fax – (785) 331-0878 or email


      September 24th – CDDO Quarterly Training (flyer to be emailed)


      Food & Water in an Emergency – Federal Emergency Management Agency &
       American Red Cross

                       The next meeting is November 5th at 3 pm.

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