THE CHILDRENS MENTAL HEALTH WAIVER

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THE CHILDRENS MENTAL HEALTH WAIVER

• An introduction to the concept of a Medicaid
  waiver program
• The services and parameters of the Childrens
  Mental Health (CMH) Waiver

• Lin Christensen
• IME Program Manager

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What is a Medicaid Waiver?

• A person eligible for a Medicaid waiver waives
  his(her) entitlement to receive services in an
  institution.
• Approximately 2/3 of the cost of waiver services
  is covered by the Federal govt. and 1/3 of the
  cost of waiver services is covered by the county
  or the state.

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History of Medicaid Waivers in Iowa

• Began implementation in 1984
• Iowas Medicaid waiver program is referred to as
  Home Community Based Services (HCBS).
• Over 15,000 persons currently receive waiver
  services
• Nearly 7,000 waiver service providers

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Iowas Medicaid WaiversHome Community Based
Services

• Ill and Handicapped
• Elderly
• Aids/HIV
• Mental Retardation
• Brain Injury
• Physical Disability
• Childrens Mental Health Waiver

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The Basic Concepts of a Medicaid Waiver

• Funded through Title XIX
• Offers a menu of services from which an
  individualized service plan is developed to meet
  the support needs of each individual
• Each individual is supported by an
  interdisciplinary team in which the individual is
  the focus and the main source of information

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The Childrens Mental Health Waiver

• General Parameters
• Individual Eligibility Criteria
• Service Descriptions
• Environmental Modifications, Adaptive Devices
  Therapeutic Resources
• Family and Community Support Services
• In Home Family Therapy
• Respite
• Application Process

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Supporting The CMH Waiver Eligible Child

• State Plan Services
• Iowa Plan Services
• CMH Waiver Services

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Teamwork

• Teamwork is an integral part of providing quality
  services.
• Each child approved for the CMH Waiver and
  his/her family is part of an interdisciplinary
  team (IDT).
• Each child, as a requirement for the CMH
  Waiver,must receive service oversight and service
  coordination from a Medicaid targeted case
  manager.
• Other IDT members
• Service providers
• Teachers /or education personnel
• Iowa Plan
• Other persons that the child and family would
  like to participate

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The Crisis Intervention Plan(Mental Health
Wellness Plan)

• This plan will be developed during IDT planning.
• The targeted case manager will write the plan.
• All members of the IDT will use the same crisis
  intervention plan.
• If changes occur or become necessary, the TCM
  must be contacted.
• The TCM will redistribute the dated and revised
  plan to IDT members.

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The Crisis Intervention Plan(Mental Health
Wellness Plan)

• The focus should be on wellness not crisis.
• This plan should include the following for the
  child
• Things to do everyday to maintain wellness or
  feeling right
• Things that need to be done (or would be good to
  be done)
• Triggers
• What to do if triggers happen
• Early warning signs
• Symptoms of breaking down
• What to do if symptoms occur
• Supporters-family and friends
• Medical Information
• Professionals involved in care
• Medications
• Treatment centers and/or facilities
• The targeted case manager will write the plan.
• All members of the IDT will use the same crisis
  intervention plan.

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The Crisis Intervention Plan(Mental Health
Wellness Plan)

• This plan should also include these components
• Supporters
• Family, friends, neighbors
• Medical Information
• Professionals involved in care
• Medications
• Treatment that must be provided or must be
  avoided
• Treatment centers and/or facilities

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If you want to play the game . . . .

• You have to follow the rules!

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Iowa Administrative Code Rulesfor the CMH Waiver

• Chapter 77
• Service Provider Standards
• Chapter 78
• Service Descriptions
• Chapter 79
• Service Reimbursement Rates
• Chapter 83
• Recipient Eligibility and Appeal Rights

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Where Can I Find the Iowa Administrative Code
Rules Online?

• www.dhs.state.ia.us
• Click on A-Z services.
• Click on Administrative Rules.
• Click on Policy Analysis.
• Click on Medical Assistance book icon.
• Click on desired IAC chapter.

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Im overwhelmed!!! I need help!

• Do not fear! Your friendly HCBS-CMH Waiver
  specialist is near.
• Geri Derner
• Mary Jacobs (Jake)
• Lori LaCarte
• Cheri Reisner
• Susan Slauson
• Annie Volker (or The Boss)

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Two Ways To Contact Your HCBS-CMH Specialist

• By email
• On the CMH Waiver website http//www.ime.state.ia.
  us/HCBS/CMH Waiver.html
• click on the link in the Questions box. An
  email message is automatically created to the
  specialist assigned to each county.
• By telephone
• Refer to the telephone listing by county. It is
  also posted on the website.