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February 1, 2013

Open Line

This edition of Open Line includes important information I want to share with you:

Self-Determination Waiver Renewal: On January 28, the Bureau of TennCare notified DIDD that the Self-Determination Waiver renewal to include Semi-Independent Living Services has been officially approved. Semi-Independent Living Services are appropriate for people who need intermittent or limited support to remain in their own home and do not require staff that lives on site.  The Circle of Support must consider the person’s level of independence and safety prior to establishing a semi-independent living arrangement. Services provided in semi-independent living include training and assistance in managing money, preparing meals, shopping, personal appearance and social skills building, and other activities needed to maintain and improve the capacity of an individual to live on his own in the community.  The person may choose to live with one or two other people or to live alone as long as sufficient financial resources are available to do so.  This service was available in the past only as a state funded service but has been now been approved as a waiver service.

Exit Plan:  As a result of a January 15, 2013 hearing in the United States District Court, Western District of Tennessee, Chief Judge Jon Phipps McCalla approved the Exit Plan and signed the Agreed Order in the Arlington Lawsuit.  During the hearing, positive comments were made by the parties and the judge regarding the significant changes in the delivery of services for former ADC residents and many other individuals who were deemed at-risk of placement at ADC.

The Exit Plan addresses, among other things, the potential enrollment of additional class members, the education of class members in nursing homes regarding opportunities to transition to community placements, and new service delivery models.  If you wish additional information about the Exit Plan, a copy of the Exit Plan and Agreed Order is on record with the United States District Court, and is posted on the website of the Department of Intellectual and Developmental Disabilities at the following location: http://tn.gov/didd/newsroom/announcements/Exit%20Plan%20and%20Exhibits.pdf.

Governor’s Residence Appreciation Luncheon: As most of you are aware, in the summer and fall of 2012, I launched a statewide awareness tour to recognize those who have given their time and own resources to support persons with intellectual and developmental disabilities.  On January 31, First Lady Crissy Haslam hosted an appreciation lunch for all these honorees at the Governor’s Residence.  She graciously greeted the honorees as they arrived at the Residence.  They toured the Executive Residence and participated in a Luncheon Reception in Conservation Hall.  Additionally, the honorees legislators were there to show their support and appreciation for their constituents who were the guests of honor.  The event was a huge success and we sincerely appreciate the First Lady for her hospitality, all honorees, as well as the legislators who attended the day’s events.  Special thanks also to the DIDD staff who volunteered their time to coordinate and organize the luncheon.

FY 2013-2014 Haslam Budget Details:  On January 28, Governor Haslam released his budget proposal for the next fiscal year to the legislature, state agency commissioners, and the public.  Below are details of how the Governor’s budget affects services and supports DIDD provides, as well as persons supported:

•   Allows for enrollment of 286 more people in home and community based services (HCBS)

  • Funds net growth of 96 people in the home and community based waiver program (recurring state cost of $4,448,200)
  • Funds the Arlington lawsuit exit plan including adding an estimated 191 people into HCBS waiver services (recurring state cost of $10,704,100; non-recurring state cost of $475,000)
  • Continues funding for the Family Support Program at the FY2013 level of $7,383,600 ($2,681,500 is in non-recurring funds)
  • Provides funding for the temporary continuation of operations at the Clover Bottom Developmental Center through 6/30/2014 (non-recurring cost of $1,309,200)
  • Provides funding for state employee salary adjustments
  • 1.5% pay increase for all state employees
  • salary market adjustment for state employee job classifications that do not compete with the marketplace
  • Reduces 120 authorized DIDD positions (47 are estimated to be vacant):
    • 15 Central Office
    • 35 Regional Offices
    • 35 Resource Centers
    • 31 Greene Valley Developmental Center
    • 4 Community Homes
  • Facilitates programmatic changes at the Harold Jordan Center enabling the collection of Medicaid funding (estimated at $2,873,800)
  • Provides for capital project maintenance and improvements
  • Harold Jordan Center interior renovations ($2,850,000)
  • Arlington campus cottages demolition ($2,350,000)
  • Ruilman Center exterior and interior renovations ($720,000)
  • Greene Valley Developmental Center essential maintenance ($3,620,000)
  • Arlington Campus essential maintenance ($2,800,000)

I will continue to work with administration and legislative officials on the state’s financial support for services for persons supported.  Legislative budget hearings are scheduled for March 20 and March 21.  I expect the final FY 2013-2014 budget will be approved by the legislature near the end of April or early May.

State Land Acquisition Policy and Procedures Change:  On Thursday, I attended a meeting of the Executive Subcommittee (ESC) of the State Building Commission where the ESC approved a change to policy and procedures that would permit a more expedited process for certain types of land acquisitions.  This policy change is a tremendous advancement for the state in the management of its many land transactions and will greatly improve DIDD's ability to acquire appropriate property for any future homes constructed for the benefit of the population served by this department.  This new policy is projected to reduce the average land acquisition time for the state from 225 days to 90 days.

As you may know, DIDD has been active in acquiring property for the construction of state-owned ICF/IDDs.  This land acquisition experience has proven long, difficult, and frustrating, including numerous and expensive delays in vacating the Arlington and Clover Bottom Developmental Centers, losing desirable tracts due to other entities buying the property while the state moved through a cumbersome process, and overbuying land tracts to hedge against deals inevitably falling-through because of the long road to closing.  I have expressed these concerns on many occasions over several months to officials within state government, including Governor Haslam.
Responding to the concerns that I have raised, Commissioner Steve Cates of the Department of General Services and Commissioner Mark Emkes of the Department of Finance and Administration instructed staff to work together to come up with ideas to speed up the land acquisition process while still maintaining the appropriate level of State Building Commission oversight.  Their work, reviewed and approved by the Comptroller of the Treasury, the State Treasurer, and the Secretary of State, and ESC staff has been an example of collaboration among several state agencies working together to make state government more efficient and effective.  I am proud of DIDD's role in raising this issue and thankful to the many state officials and state agency staff who have made this permanent improvement to state processes.

Family Model Residential Services:  Recently, there has been an increase in the number of allegations regarding recruitment, misuse of funds, and exploitation in Family Model services.  These violations are taken very seriously by DIDD. It is imperative that we provide the highest quality service to the people supported in Family Model to ensure they are receiving those services in a manner that improves their quality of life.  If you have ideas or suggestions on how to eliminate these problems, I’d like to hear them.  We will consider calling a panel of providers and other key stakeholders together to discuss this issue in greater depth.  We would also welcome providers to volunteer to join the group for input.

Grant Approval:  In partnership with the Vanderbilt Kennedy Center and the Boling Center, Tennessee’s two University Centers for Excellence in Developmental Disabilities (UCEDDs), the department was successful in the competition for a Special Hope Foundation grant.  The grant will fund adapting the Canadian Tools for the Primary Care of People with Developmental Disabilities to reflect Tennessee primary care, and develop electronic versions and apps for some of them.  The tools will provide evidence-based information to assist primary care providers, families, direct support professionals, and others in achieving optimal health for the persons we serve.

Loaned Executive Program:  This week, Mickey Atkins, President of D&S Community Services, joined Central Office to participate in meetings and discussions with department staff.  Of his experience, Mickey noted, “The CEO Loan Program was a terrific experience that provided an eye-opening view into the Central Office workings.  I found everyone to be extremely open and eager to share information with me.  Everyone was also very willing to listen to my concerns and ideas and even encouraged me to continue communicating these things to them.”

“I think being present during the release of the Governor’s budget was a unique opportunity.  Seeing the efforts being made gave me a new perspective on their workloads.  An added bonus was being able to put a face to the names and voices I have worked with over the years.  I want to express my gratitude to the Commissioner and his entire staff for their hospitality and for taking time out of their busy days to welcome me.  I’m excited about the positive changes that will come out of the open dialogue that the CEO Loan Program has created, which will greatly benefit the individuals we serve and their families.”

Note to Service Providers:  As of January 16, 2013, all Fiscal Accountability Reviews (FAR) for 2012 have been issued.  As a reminder, all providers that received $300,000 or more in funding from DIDD in Fiscal Year 2011 – 12 were required to have a FAR during Calendar Year 2012.  Reports that were issued late in 2012 are now in the resolution part of the FAR process; our goal is to have all 2012 reports closed out by the end of February.  Should you have questions about this process, please contact Pat Nichols at Pat.Nichols@tn.gov or 615-532-6548.

Employee Nomination: Congratulations to Paul Ford, DIDD Distributive Programmer/Analyst IV.  Paul has been asked to serve on the Metropolitan Transit Authority ACCESSRIDE Policy Advisory Committee and has been appointed as the department’s designee.  Paul expressed that he was proud to be nominated and appreciated the opportunity to represent the department on this vital committee.

An Ounce of Prevention:  In October 2012, “Reporting Changes in Agency Information” was the covered topic.  Since then, more than one provider has neglected to follow proper procedures.  To avoid potentially severe consequences, please be reminded that when an agency has a change in name, address, ownership, legal structure, and/or FEIN number, such changes must be reported to the department before they occur.  A memo explaining the steps to take was issued in late 2010 and is still in effect.  This memo is available for your review on the department’s website within the Commissioner’s Correspondence page (10-01-10 Reporting Changes in Agency Info ) at http://www.tn.gov/didd/provider_agencies/CommisionerCorrespondence.shtml#2010 
For agencies providing a licensed service, such changes must also be reported to the respective licensing entity.  Now that DIDD is the licensing authority for ID (formerly MR) services, please note that changes in the ownership or operator of a currently licensed facility or service, the relocation of a currently licensed facility or service, or a major change in use or occupancy of a currently licensed facility or service requires new application processes and the prior approval of the DIDD Office of Risk Management and Licensure.  Contact information for your Regional DIDD Licensure Coordinator can be found on the DIDD website at: http://www.tn.gov/didd/Licensure/Licensure.shtml.   

Customer-Focused Services:  Attached, is a flyer of the Customer Focused Services Division.  Please post it in your offices or as appropriate.

 

Jim

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