The Individual and Family Support Program

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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Individual and Family Support Program
Cindy Gwinn
Community Resource Manager
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
The Individual and Family
Support Program (ISFP)
Assists individuals with intellectual disability (ID) or
developmental disabilities (DD) and their family
members currently on the ID or DD Waitlist to
support and maintain the continued residence of
an individual in his own home or the family
home.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Support Amount
Based on funding availability, DBHDS will
established an annual maximum individual
financial support limit of $3000.
For Fiscal Year 2012-2013:
825 individuals were funded for a total of 1.9
million dollars
Fiscal year 2013-2014:
1000+ families are to be funded with an available
total budget of 3.2 million dollars
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Basics
• Program is administrated by DBHDS.
• Individuals and families can access application
directly from the DBHDS website.
• They do not have to go through their Case
Manager/Support Coordinator
• Case managers/support coordinators are
strongly encouraged to share the information
about the IFS Program with their waitlist
individuals and assist with filing out the
application if an individual needs assistance.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Basics
• Individual and Family Support Program funds
shall not supplant or in any way limit the
availability of services provided through a
Medicaid Home and Community-Based Waiver,
Early and Periodic Screening, Diagnosis and
Treatment (EPSDT), or similar programs.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Basics
Individuals who are on the waiting list for ID or DD
Waiver and currently on the
• Elderly or Disabled with Consumer Direction,
• Day Support, or
• Technology Assisted Waivers
May apply for funds if needed items are not
available through these waiver programs,
EPSDT or Medicaid State Plan Option.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Program eligibility requirements
Eligibility is limited:
• to individuals who are living in their own home or a
family members home
• are on the statewide waiting list for the Intellectual
Disability (ID Waiver) Medicaid Waiver or the
Individual and Family Developmental Disabilities
Services (DD Waiver) Medicaid Waiver
• or to family members that are assisting those
individuals and the request supports that
assistance.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Covered services and supports
Services and items that may be funded through
the IFSP may include:
• Professionally provided services and supports,
such as respite, transportation services,
behavioral consultation, and behavior
management;
• Assistive technology and home modifications,
goods, or products that directly support the
individual;
• Temporary rental assistance or deposits;
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Covered services and supports
• Fees for summer camp and other recreation
services;
• Temporary assistance with utilities or deposits;
• Dental or medical expenses of the individual;
• Family education, information, and training
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Covered services and supports
• Peer mentoring and family-to-family supports;
• Emergency assistance and crisis support; or
• Other direct support services as approved by
DBHDS.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Next Funding Cycle
• Applications for this program will be
accepted starting September 3, 2013.
• FAX or E-mail applications will NOT be
accepted.
• IF applications arrive in this manner a
denial and request to resubmit via proper
method letter will be sent to the applicant
and application will be destroyed.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Accessing Applications
Applications can be downloaded from the DBHDS
website and mailed in. Mailed applications will
be sorted based on postmark date. OR
Access our web-based on-line application system
that will become available September 3, 2013.
www.dbhds.virginia.gov/ODS-default.htm
All updates concerning the program will also be
posted at this location.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Application Information
Completed applications shall include the following
information:
• A detailed description of the services or items for
which funding is requested;
• Documentation that the requested services or
items are needed to support the continued
residence of the individual with ID/DD in his own
or the family home and no other public funding
sources are available;
• The requested funding amount and frequency of
payment;
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Application Information
• Written acknowledgement of participant
responsibilities
• The signature of the individual (unless the
individual is a minor or has a legal guardian) and
financially responsible person.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Participants Responsibilities
• Individuals and Families will be required to
submit supporting documentation to verify that
funds have been used for the purpose stated in
their application.
• Directions will be provided to families when
funding is approved.
• Fulfillment of participant responsibilities is a
requirement to participate in the program in
future years.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Participant Responsibilities
If money is spent on non-approved items
DBHDS has the legal right to:
• Stop payments for additional funding.
• Deny future applications from being
funded
• Garnish tax refunds or pay against the
fiscally responsible person.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Participants Responsibilities
If you are approved for one thing and your
needs change by the time your receive
your funds, CALL or write IFSP and
request a change in approval.
Documentation must be in your file that
matched what you are approved for and
what you have spent on funding.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Application Review
The Department will assure compliance with
program regulations and policies
1. Verify that the individual is on ID or IFDDS
Waiver waiting list;
2. Confirm that the services or items for which
funding is being requested are eligible for
funding
3.Determine that the services or items for which
funding is requested are needed to support the
continued residence of the individual with ID/DD
in his own or the family home
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Application Review
The Department shall provide a written notice to
the individual or family member who submitted
the application indicating the funding decision.
Approved
Pended or
Denied
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Approval
Approvals - Approval notices shall include:
• The services, supports, or other items for which
funding is approved;
• The amount and timeframe of the financial
allocation;
• The expected date that the funds should be
released; and
• Documentation requirements for submitting
receipts to the Department and the date
documentation shall be provided to DBHDS.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Approval
In general, receipts or other documentation to
verify expenses for which IFSP funds have been
requested shall be submitted to the Department
within 30 days of receipt of funds
OR
Upon the completion of the purchase of approved
items/delivery of approved services and shall
include the name of the provider of the
goods/services and the individual’s name.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Approval
Applications may be approved at a reduced
amount when the amount requested exceeds a
reasonable amount as determined by
Department staff as being necessary to
purchase the services or items.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
PEND
Pended Requests
• When requests for IFSP funds cannot be
immediately approved due to missing information or
there are questions about the application contents,
DBHDS staff will “pend” the request. In that event
the following procedures will be followed:
• DBHDS staff will send a letter requesting additional
information to the individual or fiscally responsible
family member provided on the application in order
to acquire the additional information needed in order
to approve the request.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
PEND
• DBHDS staff will wait for the requested
information from the individual or family member
for up to 30 days from the date of the mailed
letter.
• If the additional requested information is
received, DBHDS staff will continue to process
the application
• If the additional requested information is not
received, DBHDS staff will deny request and
send a letter following the denial procedure.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Denials
Denials - Applications shall be denied if the
Department determines that:
• The service or item for which funding is
requested is not eligible for funding in
accordance with 12 VAC 35-230-50 (See
Section V, “Covered Services and Supports,” in
Guidelines.
• This program does not fund clothing, food,
purchase of a vehicle or down payments for a
home.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Denials
• The requesting individual or family member has
not used previously received IFSP funds in
accordance with the Department’s written notice
approving the request or has failed to comply
with IFSP policies or regulations; or
• The total annual IFSP funding appropriated by
the General Assembly has been expended for
the applicable fiscal year.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Denials
The request was pended and the family did not
respond to request for additional information in a
timely manner (i.e., 30 days);
For applications for which funding is denied or
approved at a reduced amount, the
Department’s notice shall state the reason or
reasons why the requested services, supports,
or other items were denied or approved at a
reduced amount and the process for requesting
the Department to reconsider its funding
decision.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Requests for reconsideration
Individuals or family members who disagree with a
determination of the Department may submit a
written request for reconsideration to the
Program Manger, Cindy Gwinn.
If the issue can not be resolved then the applicant
has the right to ask for an appeal to the
Commissioner, or his designee, within 30 days
of the date of the written notice of denial or
approval at a reduced amount.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Post Funding Review
• Utilization review of documentation or
verification of funds expended may be
undertaken by Department staff. Reviews may
include home visits to view items purchased or
services delivered.
• Funds that are not used for agreed upon
services, may result in recovery of such funds by
the Department and denial of all future
application requests.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Termination of funding
Funding through the Individual and Family Support
Program shall be terminated:
• when the individual is enrolled in the ID or
IFDDS (DD)waiver,
• or if approved funds are used for purposes not
approved by the Department in its written notice.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Quality Measures
• We look forward to hearing how these
funds have assisted participants to
continue to live in their community.
• A yearly satisfaction survey will be sent to
each participant to assist in measuring
satisfaction and effectiveness of the
program.
• Outcomes will be published in the annual
report and program reviews.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Assistance
Program Regulations and Sample Application can
be downloaded at:
www.dbhds.virginia.gov/ODS-default.htm
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Assistance
For additional information or questions
please contact:
Cindy Gwinn - IFS Program Manager
[email protected]
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