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Changes at Developmental Pathways

posted Jun 19, 2012, 12:35 PM by Dicia Kemp

We understand that many of you are concerned about the decision Developmental Pathways made to discontinue the option of independent contractors in CES and SLS. We also understand that many of you have long standing relationships with your independent contractors. We are unable to explain the reasoning behind this decision, and suggest folks plan to attend one of the following meetings held by Developmental Pathways Community Meetings:

  • Monday June 18th at 4:00 at the Inverness office (325 INVERNESS WAY ENGLEWOOD, CO 80112)
  • Wednesday June 27th at 4:00 at the Aurora office (11111 E. MISSISSIPPI AVE AURORA, CO. 80012).

However, regardless of why this is happening, we want you all to know you do have choices. The following is provided to help you make informed choices. Also, please take a moment to email Dicia Kemp, dkarcaurora@aol.com,, at our office to let her know you would like to receive additional information over the next few weeks regarding this issue including how to create a budget to help individuals and families figure out how many hours of support the eligible individual (or "client") might receive.

Summary of Events

(Definitions are included below)

Announced on June 11 and effective July 15, 2012, Developmental Pathways (DP) will discontinue the use of Independent Contractors (ICs) working with Children's Extensive Support (CES) and Supported Living Services (SLS) clients. DP has the authority to take this action.

This change will potentially affect the way services are chosen and delivered.

Options for individuals and families receiving CES or SLS via an IC include:

  • changing to a CCB that allows ICs;
  • hiring a PASA to provide services;
  • becoming a PASA to hire your current IC as an employee;
  • appealing as appropriate.

Options for ICs include:

  • becoming an employee of Continuum of Colorado (a subsidiary organization under Developmental Pathways);
  • becoming a PASA;
  • becoming an employee of another PASA;
  • applying to work as an IC at another CCB.

Please note that Denver Options (CCB) does have information on how to become an IC as well. http://bit.ly/DOICap

Definitions and Acronyms

CES (Children's Extensive Support) A Medicaid Waiver program designed for children with disabilities ages birth to 18 years, who have significant medical conditions and/or challenging behaviors.

CCB (Community Centered Board) A private non-profit organization which is authorized to determine the eligibility of individuals with developmental disabilities within a specific geographical area. A CCB provides case management and authorized services.

CDASS (Consumer Directed Attendant Support Services) A Medicaid benefit under the Home and Community Based Services-Elderly, Blind, and Disabled (HCBS-EBD) and Persons living with Mental Illness (MI) waivers that allow clients to manage their attendant services. This is not a current option for CES or SLS.

IC (Independent Contractors) A service provider that is not employed by the CCB or PASA to provide services. However, IC's must bill for services through the CCB.

PASA (Program Approved Service Agency) A private organization approved by Developmental Disability Services to provide direct services. PASA's can bill for services either through the CCB or through their own Medicaid provider number.

SIS (Supports Intensity Scale) An assessment tool to identify support needs. The SIS determination is used to identify level of support.

SLS (Supported Living Services) A program that provides services based on an Individualized Plan (IP) that supplement already available supports for adults who either can live independently with limited supports or who, if they need extensive support, are principally supported from other sources, such as their family. This program is funded through the State and Medicaid.

SPAL (Service Plan Authorization Limits) An annual upper payment limit of total funds available to purchase services to meet the client's ongoing needs. Purchase of services not subject to the SPAL are in accordance with the Department of Health Care Policy and Financing rules in Section 8.500.102, B (10 CCR 2505-10). A specific limit is assigned to each of the six support levels in the HCBS-SLS waiver. The SPAL is determined by the Department based on the annual appropriation for the HCBS-SLS waiver, the number of clients in each level, and projected utilization. Each SPAL is determined by the Department and Operating Agency based on the annual appropriation for the HCBS-SLS waiver, the number of clients in each level, and projected utilization.

Understanding the Options

How do I change CCBs?

CCB's have a specific geographical area they work within; so, whether the transfer to a different CCB is approved might depend on where you live and where you apply. This is decided case by case based on approval of the receiving CCB. The only CCB to serve people with intellectual and developmental disabilities that live in the City of Aurora, Arapahoe and Douglas counties is Developmental Pathways.

Steps include:

1. Contact Resource Coordinator at current CCB and request a transfer to another identified CCB.

2. The current CCB would call the identified CCB to discuss the request.

3. If the new CCB agrees to the transfer, the current CCB would get a release and send the client's records over to the new CCB.

4. The new CCB would schedule a new Service Plan and decide on an official transfer date.

How do I find a PASA?

A 14-page chart of approved PASAs for children and adults, providing contact information and detailed services delivered, can be found at http://1.usa.gov/PASA2012.

How do I become a PASA?

The process to become a PASA is complicated, but not impossible. If this is best decision for you and/or your family then the following link provides you specific steps and paperwork. DDD does ask that 30 business days be allowed after the receipt of application is submitted to allow for reviewing and processing. After the application has been reviewed, the DDD will notify the agency in writing of the application status. http://1.usa.gov/PASAapDDD

There is a group of parents currently exploring the possibility of creating a joint parent-controlled Program Approved Service Agency (PASA). If you would be interested in exploring with us, please contact padcoweb@aol.com.

What are my appeal rights?

DP is authorized to make the decision to no longer contract with ICs. Their decision is not appealable.

Waiver participants and/or their legal guardians must receive information about their rights to dispute resolution. All waiver participants and their legal guardians must receive a standardized form whenever services are denied or reduced. This form gives them information about how to file a complaint if they do not agree with the decision that was made about the services available to them.

Please contact the following advocacy organizations to learn more about your appeal situation:

The Arc of Aurora (if you live in Aurora) - 720.213.1420

The Arc of Arapahoe & Douglas (if you do NOT live in Aurora) -- 303.220.9228

The Colorado Cross Disability Coalition -- 303.839.1775

The Legal Center for Person with Disabilities and Older Persons -- 303.722.0300

or 1.800.288.1376
Please know we are here to help.

Sincerely,

Darla Stuart, Executive Director
The Arc of Aurora
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