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Jan. 16, 2008 Meeting Notes

Represented in attendance:
3 – DHS/DDSD
1 – OHCA (Oklahoma Health Care Authority)
1 – TARC
12 – Parent, Family member or Self advocate
Total – 17

Areas represented:
Norman
Oklahoma City
Pawnee
Stillwater
Tulsa

DDSD is currently working applications from April 7, 2004.  We were told the waiting list is virtually stalled at this time.  The only person’s moving onto Waiver services are those who are in DHS custody, those who meeting the Emergency guidelines or those in the Public Guardian program.  We were also told that during the month of December 2007 that a total of 34 people were removed from the waiting list.  Of those taken off the waiting list 21 began receiving services and 13 were either closed, declined, or were not eligible.  Also in the month of December 93 people were added back to the waiting list.  You need to note that some of those who “declined” did so because they were receiving the Family Support Payment which meets their needs at this time.  Thus would then be added to the bottom of the waiting list.  It was also said that of those on the waiting list only about 15% have been waiting for more than three years.Jim Nicholson discussed the issue of high cost to agencies for required training of HTS staff, and the high turnover/retention rate of staff as well.  One of the ways DDSD is trying to help with this issue if by contracting with an online training program what would allow HTS staff and agencies to train at times convenient to both.  The online training would also allow for the HTS to have access to all previous completed courses which will make moving from agency to agency a smoother and less costly transition.  This project is estimated to be released in the next 30 days.  Additionally, he said this training would be available to families as well.

Jim Nicholson explained that there is a Rate Review Committee which has met two times already.  The committee has prepared a report to take to the legislators suggesting a rate increase of $18 an hour for HTS.
Regarding the Self Directive Services pilot Jim Nicholson said that it is a slow process to begin offering the SDS to the IHSW.  Currently the Health Care Authority is finalizing what they need and then the amendment (request to add this to the IHSW) will be send to the National Centers for Medicare/Medicaid (CMS) for their approval.  Once the amendment is sent to CMS DDSD will begin training of their staff so when approval is received the next plan of cares will have the ability to choose SDS. 

One more note of interest.  It was said that dental services were added as eligible services for those on the Community Waiver as of October 2007.

Sue Robertson with the Oklahoma Health Care Authority,  Child Health Program Coordinator spoke about a request that has been sent to CMS requesting the expansion of eligibility for children (birth – 19) applying for Medicaid.  CMS is still in the process of reviewing and has not made a decision as of yet.  If the request is approved it will change the income eligibility from 180% of poverty to either 250% or 300%.  What this could mean to families, if you had applied for Medicaid in the past and were denied do to your families income being too high, you may qualify once this program comes into effect.  This would help many people waiting for services on the waiting list.

Someone had mentioned to Sue Robertson the difficulties some families are having at qualifying for TEFRA.  The point was made that to qualify for TEFRA under the ICF/MR (Intermediate Care Facility for persons with MR) the person must have an IQ score of 70 or below.  When a child under that age of 6 is applying they are having 1) difficulty in finding someone who will give an IQ score for a person that young and 2) affording the cost of these evaluation.  Director Hendrick said if the problem is affording a Psychologist to perform the evaluation, that DHS could possibly afford to have a Psychologist on staff to do these.  Also, he has asked Jim Nicholson and Sue Robertson get together and figure out what is the issue with getting kids qualified if they should qualify.

The next meeting is scheduled for April 30th at 1:30.