2015 ANNUAL HOME AND COMMUNITY BASED WAIVER CONFERENCE

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1 The Michigan Department of Health and Human Services & The Michigan Association of CMH Boards Present: 2015 ANNUAL HOME AND COMMUNITY BASED WAIVER CONFERENCE November 17 & 18, 2015 Kellogg Hotel & Conference Center East Lansing, Michigan

2 Layout of the Kellogg Center Rooms we are using: BIG TEN A/B (On the North End of Kellogg) Centennial Rooms (On the North End of Kellogg) Lincoln Room (On the South End of Kellogg) Room 103 (On the South End of Kellogg) Room 104 (On the South End of Kellogg) Room 105 (On the South End of Kellogg) Heritage Room (Tuesday Only) (South End of Kellogg)

3 Tuesday, November 17, 2015 CONFERENCE AGENDA 8:00am 4:15pm 8:00am 8:45am 9:00am 9:15am 9:15am 10:15am Conference Registration (South Lobby) Group Networking Breakfast (full breakfast buffet will be served until 8:45am) (Big Ten A/B) Conference Welcome and Introduction (Big Ten A/B) Plenary Session: Shaping Change (Big Ten A/B) Qualifies for 1 CEU hour - Sara Grivetti, MA, Rehabilitation Counseling; Certified Rehabilitation Counselor, Chief Executive Officer, Disability Network/Michigan People are very open to change, as long as they are not the ones being asked to change. This opening session is designed to re-shape your thoughts about change, explore your own personal challenges to change and learn strategies that can not only impact yourself, but the culture you are working within. Participants will be able to: 1. Learn Strategies to Shape and Embrace Change; 2. Explore Resistance to Change; and 3. Apply the Strategies to the Current Changes in our World. 10:15am 10:30am Coffee Break (Big Ten A/B and South Lobby)

4 10:30am 12:00pm 10:30am 12:00pm Concurrent Workshops: 1. Guidelines to Comprehensive Diagnostic Evaluations of ASD and Other Developmental Disabilities (Room 103) - Sarah Witherell, PhD, LP, Developmental Disabilities Services Staff Psychologist, The Children s Center of Wayne County Comprehensive diagnostic evaluations completed by well-trained professionals are crucial to accurate diagnoses of ASD and other developmental disabilities. In this presentation, the core symptoms of ASD and other developmental disabilities will be described. A particular emphasis will be on helping community-based providers appropriately identify children and adolescents who should be referred for a diagnostic evaluation. Diagnostic evaluation procedures for ASD will also be discussed, with a focus on how agencies can best conduct comprehensive evaluations that serve the needs of individuals aged 0 to 21 and their families in the community. Finally, similarities and differences between ASD and other disorders, including Intellectual Disabilities, ADHD, and severe mental illness, will be presented. Participants will be able to: 1. Identify the core symptoms of ASD; 2. Determine when a referral for an evaluation for ASD and other developmental disabilities is needed; 3. Describe components of a comprehensive diagnostic evaluation of ASD; and 4. Describe at a basic level how to differentiate symptoms of ASD from other disorders, including Intellectual Disabilities and severe mental illness. 2. HSW Overview (Lincoln Room) - Charlyss Ray, OTR-L, Specialist for Services and Supports for Persons with Developmental Disabilities, Michigan Dept. of Health and Human Services - Belinda Hawks, Bachelor of Science, Psychology, QIDP, Master of Public Administration, Federal Compliance Manager, Michigan Dept. of Health and Human Services This session is intended for supports coordinators and others who are new to the Habilitation Supports Waiver (HSW) or who desire a refresher. The session will specifically focus on the eligibility requirements and how to identify habilitation needs in the plan of service. The topics to be covered include the federal rules upon which the HSW is authorized, the eligibility requirements, and how to apply for the HSW on behalf of a beneficiary. The session will also discuss the concurrent 1915(b) Managed Specialty Supports and Services Plan and 1915(c) HSW to help participants understand the service array available to HSW enrollees, including differences in services between the 1915(b) and 1915(c) waivers. Participants will be able to: 1. List four eligibility requirements for the HSW; 2. List three documentation requirements for applying to the HSW; 3. Describe Intermediate Care Facility for Intellectual Disability (ICF/ID) level of care services as defined in the Code of Federal Regulations; and 4. Identify two differences between 1915(b) waiver services and 1915(c) HSW services. 10:30am 12:00pm 3. Michigan Autism Spectrum Disorder Program Update (Room 104) - Lisa Grost, MHSA, PAPHS, Autism Administrator, Michigan Dept. of Health and Human Services - Morgan VanDenBerg, MA, BCBA, Autism Behavioral Specialist, Michigan Dept. of Health and Human Services - Brie Elsasser, MSEd, BCBA, Autism Behavioral and Transition Specialist, Michigan Dept. of Health and Human Services The growing prevalence of individuals with Autism Spectrum Disorder (ASD) has increased the demand for effective supports, resources, and services to address each child s individual needs in the public Community Mental Health system. There are a wide range of challenges for, children and adolescents with autism and their families, including transportation, peer relationships, behavioral and language barriers, and inclusion throughout their community and educational systems. Michigan continues to strive to be a leader in opportunities, services, and supports for individuals with Autism Spectrum Disorder. The presenters will emphasis the importance of system collaboration and coordination and provide updates on provider capacity for Behavioral Health Treatment, including ABA in the Medicaid system. Participants will be able to: 1. Identify three current Medicaid and MIChild services in Michigan for individuals with developmental disabilities, including Autism Spectrum Disorder (ASD); 2. List two initiatives in Michigan to increase access to early intervention and evidence based supports for children with DD and ASD; and 3. Describe two ASD supports and family resources available in Michigan across service systems and potential points of collaboration.

5 10:30am 12:00pm 4. Employment First in Michigan: Strategies for Systems Transformation (Centennial Room) - Yasmina Bouraoui, DrPH, Deputy Director, Michigan Developmental Disabilities Council Individuals with disabilities continue to be underemployed and unemployed when compared to individuals without disabilities. The National Core Indicators survey showed that in Michigan, 60% of individuals with disabilities want a job in the community, however only 17% of them have one. Employment First is the expectation that individuals with disabilities can, with proper training and support, earn a fair and prevailing wage alongside individuals without disabilities, in fully integrated settings. This session will explore what is and what systems change strategies can be implemented at various levels to implement Employment First policies and practices in Michigan. It will also describe initiatives currently underway through an ODEP technical assistance project to support systems transformation related to Employment First. Participants will be able to: 1. Describe the status of employment for persons with developmental disabilities in Michigan; 2. Define the concept of Employment First and its core principles; 3. Identify various systems strategies that will prioritize employment for persons with disabilities; and 4. Describe initiatives currently underway through an ODEP technical assistance grant to support systems transformation related to Employment First. 10:30am 12:00pm 5. Choice Voucher System in the Children s Waiver Program (Room 105) - Audrey Craft, MS, LLP Specialist, Federal Specialist, Michigan Dept. of Health and Human Services - Terri Nekoogar, MA/LPC, Program Supervisor, Specialized Children and Family Services, Macomb County CMH Services - Virginia O'Donnell, BA/SW, Case Manager, Specialized Children & Family Service, Child Waiver, Macomb County CMH Services - Jane Giannattasio, Parent The Choice Voucher System allows families in the Children s Waiver Program to choose and directly hire providers to implement the supports and services for their children. Families have control over resources allocated to the child s individual plan of service and supports, and greater flexibility in tailoring supports to meet individual needs. This presentation will describe the differences between self-determination for adults and the Choice Voucher System for Children. It will also identify and describe the steps to implementing the Choice Voucher System, and advantage and responsibilities of families. Participants will be able to: 1. Identify two differences between self-determination for adults and the Choice Voucher System for children; 2. List seven steps to implementing the Choice Voucher System; and 3. List three advantages for families using the Choice Voucher System. 10:30am 12:00pm 6. Children s Waiver Program Decision Guide (Heritage Room) - Kathy Neville, BA, JD, MDiv; Insurance Advocate, Penultimate Ltd. The Children s Waiver Program Decision Guide session provides training in the core skills needed to determine the appropriate, medically necessary range of hours for Community Living Supports (CLS) as defined in the Medicaid Provider Manual. These skills include assessment of the each child s needs, significant family resources to meet those needs, and evaluation of appropriate hours using the Decision Guide Table. As a result of this session, participants will also be able to meet standards reviewed during Children s Waiver Program Site Reviews including writing a Category of Care narrative for each child and will be able to provide documentation that Category of Care training has been completed. Participants will be able to: 1. Identify three key factors in assessing the child s needs, family circumstances, and available resources that are used to determine whether or not Community Living Supports (CLS) are medically necessary; 2. Determine which one of the six Category of Care definitions in the Medicaid Provider Manual (four categories for challenging behavior and two categories for medically/physically complex needs) most accurately reflects the current needs of the child; 3. Understand and use the Decision Guide Table in the Medicaid Provider Manual to identify the appropriate range of CLS hours for each of six areas of Additional Family Resources ; 4. Describe two fact patterns of school participation that affect CLS authorization maximums; and 5. Identify three elements required for the written Category of Care narrative summary that will satisfy Individual Plan of Service requirements during a Site Review. 12:00pm 12:45pm Group Lunch (Big Ten A/B)

6 Concurrent Workshops: 1:00pm 2:30pm 7. Children s Waiver Program Overview (Room 103) - Audrey Craft, MS, LLP Specialist, Federal Compliance, Michigan Dept. of Health and Human Services - Joan Deschamps, Specialist, Children s Waivers, Retired This session is intended for case managers, administrators and parents who are new to the Children s Waiver Program or desire an elementary overview of the program. The session will be a brief look at the prescreen, application and approval process, budget and funding allocations, and waiver and state plan Medicaid coverage. There will be a focus on required documentation and timelines, implementation instructions and a question and answer period. Participants will be able to: 1. List five eligibility requirements for the Children s Waiver Program; 2. Identify four Children s Waiver Services; and 3. Describe four steps in the waiver prescreen through approval process. 1:00pm 2:30pm 1:00pm 2:30pm 8. HSW Advanced Issues (Lincoln Room) - Belinda Hawks, Bachelor of Science, Psychology, QIDP, Master of Public Administration, Federal Compliance Manager, Michigan Dept. of Health and Human Services - Yingxu Zhang, BA, MPP, Analyst, Federal Compliance Section, Michigan Dept. of Health and Human Services This session is for the Habilitation Supports coordinators for the PIHPs and their designated staff who perform HSW functions. While others are welcome to join, the discussion will be geared specifically to advanced topics relevant to the HSW coordinators in their day-to-day operations of the HSW. We will focus on processes and use terminology that may be unfamiliar to someone new to the HSW (recommend HSW 101 as a prerequisite). Topics discussed will include Quality Improvement Strategy and performance measures, update on HSW procedural changes, Federal oversight of the HSW and potential changes as well as how to improve the content of the initial HSW applications and some common reasons for pending packets. Participants will be able to: 1. Identify a minimum of 3 performance measures where there are opportunities for improvement based on data for FY13 and FY14; 2. List the evidence required for three performance measures; and 3. List two primary reasons that initial applications pend and the additional documentation required to resolve those issues. 9. Peer Mentoring (Centennial Room) - Tracy Vincent, BBA, Resource Analyst, MI Developmental Disabilities Council - Robert Spruce, Certified Peer Mentor, Detroit Wayne Mental Health Authority - John Argo, Certified Peer Mentor - Ray Schuholz, Certified Peer Mentor This workshop will increase awareness of the benefits of peer mentoring for individuals with developmental disabilities, provides opportunities to listen to Peer Mentors share their unique experiences, and offers examples of how to request Peer Mentors to be part of your person-centered plan. The Medicaid peer code, and structure and content of peer mentor trainings will be discussed, as well as additional training and certification to support peer mentors in both identification and practice of this emerging profession. Participants will be able to: 1. Learn and understand how Peer Mentors can support individuals; 2. Know how to request a Peer Mentor in the person-centered plan; and 3. Hear from Certified Peer Mentors.

7 1:00pm 2:30pm 10. Early Intensive Behavioral Intervention Program at Michigan State University (Room 104) - Joshua Plavnick, PhD, BCBA-D, Assistant Professor, Michigan State University - Kate LaLonde, PhD, BCBA-D, Clinical Director and Assistant Professor, Michigan State University Despite many recent publications describing early intensive behavioral intervention (EIBI) for children with autism spectrum disorders (ASD), confusion exists surrounding the critical components to include within comprehensive early intervention programs. This presentation will describe the difference between focused and comprehensive interventions for children with ASD, and explicitly discuss the essential core components for an effective EIBI program. The Early Learning Institute, a new program for children with ASD at Michigan State University, will be described as an example of a comprehensive EIBI program. Features of the Early Learning Institute, including the curricula, opportunities for inclusion, parent training, and consultation for the transition to Kindergarten will be discussed. Participants will be able to: 1. Describe the difference between focused and comprehensive interventions for children with autism spectrum disorders; 2. Identify the core components of an early intensive behavioral intervention program for children with autism spectrum disorders; and 3. Explain the advantages of and potential barriers for incorporating behavioral therapy in an inclusive environment. 1:00pm 2:30pm 11. Person Centered and Outcome Focused: Writing Measurable and Person Centered Goals and Objectives (Room 105) - Suzanne M. Gipperich, BA Psychology, LLBSW, Supervisor, Supports Coordination, MORC, Inc. This presentation covers the basic concept of goal and objective development as embodied by the concept of person centered planning. We will cover the concepts of medical necessity as it relates to supports and services within goal development. How the Supports Intensity Scale, Life Domains, etc can support and assist with goal development and the components of goals versus objectives. Goals relevant to Habilitation Waiver services will be discussed. Developing personalized methodologies with measurable and time sensitive outcomes will be covered along with relevant data collection sheets. Finally, training and troubleshooting will be covered to allow for maximum success. Participants will be able to: 1. Identify areas of need (i.e Life domains, SIS, etc.) that assist in the Person Centered planning process that go toward developing relevant goals and objectives within the Person Centered Plan; 2. Identify basic components of measurable goals and objectives-goals versus objectives, methodology, completion criteria; 3. Develop data sheets that capture and measure data relevant to goal or objective completion criteria; and 4. Relate goals and objectives back to the concept of Medical Necessity and Habilitation Waiver. 1:00pm 2:30pm 12. Individual and Family Interventions for Children with Autism and Other Developmental Outcomes (Heritage Room) - Candice M. Lake, PhD, BCBA-D, Clinical Supervisor of EIBI Services, Wedgwood Christian Services - Glenn Kutzli, MA, LPC, Team Leader/Therapist for Wedgwood Christian Services Parramore and VanderArk Homes, Wedgwood Christian Services New changes to the diagnostic criteria for autism spectrum disorder may create a challenge for providers and families. We will discuss the changes to the diagnostic criteria and the treatment implications of these changes. We will discuss evidence-based treatment interventions for individuals with autism spectrum disorders and intellectual/developmental disabilities, and discuss the differences between targeted and comprehensive treatment. We will discuss circumstances, in which a child may need more intensive intervention such as residential placement, as well as discuss treatment options for children with these needs. Participants will be able to: 1. Identify diagnostic criteria for autism spectrum disorder, as outlined in the DSM-5; 2. Discuss the common foundation of empirically supported treatments for individuals with autism spectrum disorders; and 3. Determine when more intensive treatment resources (e.g., residential support) may be needed. 2:30pm 2:45pm Refreshment Break (South and North Lobby Area)

8 Concurrent Workshops: 2:45pm 4:15pm 13. Children s Waiver Program Solution Focused Roundtable (Room 103) No CE Offered - Audrey Craft, MS, LLP Specialist, Federal Specialist, Michigan Dept. of Health and Human Services - Joan Deschamps, Children s Waiver Specialist, Retired - Kathy Neville, BA, JD, MDiv; Insurance Advocate, Penultimate Ltd. This session will not have a formal presentation format, but will be an opportunity for case managers and CMHSP administrators to dialogue with state staff and other CMHSPs regarding topics of interest or concern related to the Children s Waiver Program. Please bring your questions regarding areas of concern to the session. State staff will be prepared to provide an update on the operational impact of transitioning the Children s Waiver Program from the 1915(c) waiver authority to an 1115 waiver authority. 2:45pm 4:15pm 14. University Partnership and Behavior Technician Training (Room 105) - Nicole Bauer, BS, Behavior Analysis Graduate Student, Department of Psychology, Western Michigan University - Mindy Newhouse, MA, BCBA, TLLP, Department of Psychology, Western Michigan University - Jessica Frieder,Ph.D.,BCBA-D, Assistant Professor, Department of Psychology, Western Michigan University - Thomas Edward Ratkos, MA, BCBA, Doctoral Student, Behavior Analysis, Western Michigan University - Emily S.L. Curiel, Western Michigan University Early Intensive Behavior Intervention has been demonstrated to be an effective treatment for children diagnosed with autism and developmental disabilities. The process of training behavior aides to conduct behavior intervention sessions is essential in teaching children with disabilities functional skills and communication. This presentation provides an overview of the process for both initial and ongoing training of behavior aides in an early intervention clinic. In addition, it will demonstrate how a University supports community mental health providers. Participants will be able to: 1. Identify important skills that need to be taught to behavior aides and explain these skills; and 2. Understand the importance of ongoing training and supervision. 2:45pm 4:15pm 15. Moving Through Grief As a Person With Intellectual Disabilities (Heritage Room) - Janice Cobbs, MSW, LMSW, Psychotherapist in private practice - Charlyss Ray, OTR-L, Specialist for Services and Supports for Persons with Developmental Disabilities, Michigan Dept. of Health and Human Services Moving through grief can be a daunting task for people with typical cognitive abilities. Depending on the type of loss, neurotypicals may find it difficult to focus, solve problems, make plans, console others affected by the loss, or even just stop crying! Participants will learn about challenges that people with below average cognitive abilities face when they experience losses, and how to effectively provide support. Participants are encouraged to bring examples of their work with people with I.D. who are grieving for discussion so we can learn from each other. Participants will be able to: 1. Identify types of losses for Neurotypicals; 2. Identify additional losses for people with intellectual disabilities; 3. Recognize strategies used by people with I.D.; and 4. Learn ways to support people with I.D. as they grieve.

9 2:45pm 4:15pm 16. Understanding the Medicaid Administrative Fair Hearing Process (Room 104) - Lisa Gigliotti, J.D. Administrative Law Judge, Michigan Administrative Hearing System An overview of Medicaid Fair Hearings will be given, including the federal regulation requirements impact on Home & Community-Based waiver recipients. The types of notice of action that must be provided to a Medicaid beneficiary, when and which notice must be used will be explained. Practical tips and online resources will be offered regarding how to prepare for and present during a Medicaid Fair Hearing. A handout and an opportunity for questions and answers will be provided. Participants will be able to: 1. Identify a Medicaid provider s Medicaid Fair Hearings obligation and the federal regulations that set forth the obligation; 2. Identify which provider actions trigger a right to a Medicaid Fair Hearing; 3. List the types of notice that must be provided to a Medicaid beneficiary and recognize when and which notice to use; 4. Describe how to request a Medicaid Fair Hearing; 5. Describe the steps to prepare for a Medicaid Fair Hearing; 6. Describe the general steps during an administrative hearing; 7. List the basics of how to present a Medicaid beneficiary position and to present a Medicaid provider position during the hearing; and 8. Identify online resources for a pamphlet or forms related to a Medicaid Fair Hearing. 2:45pm 4:15pm 2:45pm 4:15pm 17. Legislation, Acts, Waivers and Actions Impacting/Expanding Medicaid Eligibility that Enhance the Home & Community-Based Rule (Lincoln Room) - Joe Longcor, BBA. Marketing, Davenport University, Supported Employment Specialist, Behavioral Health & Developmental Disabilities Administration This interactive discussion will provide both a State and National overview of legislation, acts, and waivers promoting increased competitive integrated employment for individuals with disabilities. Brief snapshots will be provided on: Michigan Medicaid eligibility categories most specifically related to employment; Parallels between the Home & Community-Based Services (HCBS) Rule and Workforce Innovation & Opportunity Act (WIOA); and the Status of Michigan s Achieving a Better Life Experience (ABLE) Act. Participants will be able to: 1. Share key factors for SSI/Medicaid and/or SSDI/Medicare eligibility; 2. Identify at least three methods of becoming and sustaining Medicaid eligibility; 3. Know the earning threshold for at least three employment programs; 4. Recognize the definition of competitive integrated employment; and 5.Reference websites relative to legislation, acts, or waivers promoting competitive integrated employment. 18. Parent Support Partners-A Medicaid Service Which Provides Support to Parents of Children with Serious Emotional Disturbance and Intellectual/Developmental Disabilities (Centennial Room) - Kim Batsche-McKenzie, LMSW, Manager of Services to Children with Serious Emotional Disturbances, Michigan Dept. of Health and Human Services - Amy Shears, Statewide Parent Support Partner Coordinator, Association for Children s Mental Health - Mary Beth Seefelt, MA, Parent Support Partner Lead Trainer, Association for Children s Mental Health - Amy Helmuth, Family Support Coordinator, Parent to Parent of Southwest Michigan The Michigan Department of Health and Human Services (MDHHS), in partnership with the Association for Children s Mental Health (ACMH), a statewide family organization in Michigan, will describe the Parent Support Partner service and discuss its importance and benefits. The Parent Support Partner (PSP) is a Medicaid state plan Early Periodic Screening, Diagnostic and Treatment (EPSDT) covered service listed as Family Support and Training. This service is designed to support parents/family of children with serious emotional disturbance or intellectual/developmental disabilities as part of the treatment process to be empowered, confident and have skills that will enable them to assist their child to improve in functioning. The trained Parent Support Partner, who has or had a child with special mental health needs, provides education, training, and support and augments the assessment and mental health treatment process. MDHHS and ACMH have developed a curriculum, informed by family members and professionals, for training parents to become certified Parent Support Partners. Participants will be able to: 1. Explain the Parent Support Partner service found in the Michigan Provider Medicaid Manual; 2. List three impacts and/or benefits of providing the Parent Support Partner Service; and 3. Identify three components of organizational and agency readiness.

10 Wednesday, November 18, :00am 2:30pm 8:15am 9:00am 9:00am 10:00am 10:00am 10:15am 10:15am 11:45am 10:15am 11:45am Conference Registration (South Lobby) Group Networking Breakfast (full breakfast buffet will be served until 9:00am) (Big Ten A/B) Plenary Session: Update on the Children s Waiver Program, Habilitation Waiver Program and Autism Benefit (Big Ten A/B) Qualifies for 1 CEU hour - Tom Renwick, JD, Director of the Bureau of Community Based Services within Michigan s Department of Health and Human Services Behavioral Health and Developmental Disabilities Administration This plenary will provide an update related to the plan by the Behavioral Health and Developmental Disabilities Administration at the Michigan Department of Health and Human Services to move the current 1915 (b) and 1915 (c) waivers to an 1115 waiver. The update will provide detail on the proposed timeline approval of the 1115 waiver and the implications of the move for the HSW, CWP and autism benefit. Participants will be able to: 1. Identify one reason the Department of Health and Human Services is working with the Centers for Medicare and Medicaid Services to move the behavioral health 1915 (c) waivers to an 1115 authority; 2. Identify one way the move to the 1115 waiver authority will impact the autism benefit; and 3. Identify two ways the proposed 1115 waiver will impact the site review process. Coffee Break (Big Ten A/B) Concurrent Workshops: 19. Children s Waiver Program Beyond the Basics (Lincoln Room) - Audrey Craft, MS, LLP Specialist, Federal Specialist, Michigan Dept. of Health and Human Services - Joan Deschamps, Children s Waivers Specialist, Retired This session is intended for supervisors, case managers and parents who already have an understanding of the basic elements of the Children s Waiver Program (CWP). Topics to be discussed include how the transition of the CWP from the 1915(c) waiver authority to the proposed 1115 waiver authority will impact the site review process, how the WSA can help you manage CWP case maintenance activities in a timely manner, and what your agency can do to be paid for ABA services provided to a child on the CWP who is also eligible for the Medicaid Autism Benefit. Participants will be able to: 1. Describe one way the transition of the Children s Waiver Program (CWP) from the 1915(c) waiver to the proposed 1115 waiver authority will impact the site review process; 2. Describe three ways the Waiver Support Application (WSA) can help CMHSPs manage required CWP case maintenance activities in a timely manner; and 3. Identify two things your CMHSP must do to be paid for ABA services provided to a child on the CWP who is also eligible for the Medicaid Autism Benefit. 20. Private Duty Nursing (PDN) as a Component of the Individual Plan of Service for Case Managers and Supports Coordinators (Room 103) - Linda L. Fletcher, MS, CPNP, Nurse Consultant, Michigan Dept. of Health and Human Services This presentation will attempt to assure consistent implementation of private Duty Nursing (PDN) State Plan for Medicaid beneficiaries under age 21 and Habilitation Supports Waiver (HSW) policy for enrollees 21 and older. Components of the Individualized Plan of Care as it relates to PDN will be outlined. Essential components of the PIHP Nursing PDN Eligibility Determination Assessment will be presented. Participants will be able to: 1. Identify Case Manager and Supports Coordinator responsibilities for integrating Private Duty Nursing (PDN) Services into the Individualized Plan of Service (IPOS); 2. Identify the differences between State Plan Private Duty Nursing policy and HSW Private Duty Nursing policy; and 3. Identify the importance of including Private Duty Nursing and the health care plan into the IPOS.

11 10:15am 11:45am 21. Laugh Until it Doesn t Hurt (Room 104) - Iris Zink, Adult Rheumatology Nurse Practitioner, Nurse Practitioner, Beals Institute This will be a fun presentation on the benefits of laughter for health and learning environments. Participants will be able to: 1. Acknowledge at least 3 physical benefits of laughter; 2. Recognize other patient s strategies for incorporating laughter for healing; 3. Recite the 5 stages of grief and 5 stages of moving on; 4. Verbalize the name of the Dali Lama of laughter; 5. Verbalize 3 sources of things that make people laugh; and 6. Laugh at least once during this presentation. 10:15am 11:45am 22. Environmental Modifications (Room 105) - Mary Jo Kurily, BS Occupational Therapy, OTR, Owner, Priority Rehabilitation - Charlyss Ray, OTR-L, Specialist for Services and Supports for Persons with Developmental Disabilities, Michigan Dept. of Health and Human Services Presentation to include education in the process of assessment, research and request for equipment and home modifications through the Children s Waiver program from the Occupational Therapists point of view. Participants will be able to: 1. Become familiar with the process to request equipment or home modifications through the Children s Waiver program; and 2. Have the tools to plan and prepare a complete packet for submission to Children s Waiver Review Team. 10:15am 11:45am 12:00pm 12:45pm 23. PIHP Roundtable (Centennial Room) No CE Offered - Lisa Grost, MHSA, PAPHS, Autism Administrator, Michigan Dept. of Health and Human Services - Morgan VanDenBerg, MA, BCBA, Autism Behavioral Specialist, Michigan Dept. of Health and Human Services The agenda will highlight MDHHS expansion updates, communication with providers, utilization management, coordination, and workforce capacity. Facilitators will step by step walk through the new state plan service for children with ASD under 21 from eligibility, including tools and qualified providers to ABA service delivery. Participants will be able to: 1. Describe two tools that will be utilized for determination of eligibility 2. Identify three levels of qualified providers for behavioral health treatment (BHT) services including ABA 3. Discuss three key components of assessing medical necessity for BHT including ABA Group Lunch (provided) (Big Ten A/B)

12 Concurrent Workshops: 1:00pm 2:30pm 24. Hiring and Retaining VIPS (Very Important Personal Staff) (Room 104) - Terri Nekoogar, MA/LPC, Program Supervisor, Specialized Children and Family Services, Macomb County CMH Services - Lia McInerney, BA/SW, Case Manager, Specialized Children & Family Services, Macomb County CMH Services - Julie Cyman, Parent - Paul Cyman, Parent Hiring and Retaining VIPS (Very Important Personal Staff) will explore the methods in recruiting staff, interviewing tips, and how to create a successful environment for both your child, family, and the staff person. These tips have been proven to be successful over the long haul for both families that choose to voucher, and for families that work with an agency. Participants will be able to: 1. Identify at least three resources for recruiting staff; 2. Families and case managers will be able to list at least three key factors to long term retention; and 3. Participants will learn key factors in managing staff schedules vs. family needs. 1:00pm 2:30pm 25. Let s Talk About Sex Again!: Running a Group for People with Developmental Disabilities to Explore Relationships and Sexuality (Room 103) - Erin M. Parcell, MA, LPC, Master s in Counseling; Licensed Professional Counselor, Supervisor Senior Developmental Disabilities Clinician, CEI-CMH Transitions Grand Ledge - Sherrie Donnelly, MA, LBSW, Master s in Counseling, Licensed Bachelor s Level Social Worker, Senior Developmental Disabilities Clinician, CEI-CMH Life Consultation - Rebecca Jones-Henry, MA, LLPC, Master s in Counseling, Developmental Disabilities Clinician, CEI- CMH Life Consultation Excited to be asked back to update the group, Erin M. Parcell, MA, LPC and Sherrie Donnelly, MA, LBSW have been involved the past three years in developing a group to meet the identified need of education for people with developmental disability in the area of healthy relationships and sexual health. The group was piloted in the Summer of 2013 and has since been run six times (including at Peckham Lansing) with positive results. The two are basing the group on a curriculum Sexuality Across the Lifespan developed by Florida Developmental Disabilities Council, Inc. (2005, Rev 2011) that is free to use and has been utilized in groups all over the United States. The curriculum has been recommended by the START team as the most effective tool to use with youth/adults with Autism Spectrum Disorder. Sherrie, Erin and Rebecca bring a personcentered and fun perspective to a topic that is often anxiety provoking and difficult to approach. Come join us to learn how to bring this necessary group to your school or program! Participants will be able to: 1. Identify the needs of people with developmental disability to have education in healthy relationships and sexual health; 2. Identify a curriculum to work with in order to lead a group addressing healthy relationships and sexual health; 3. Describe the process from referral to graduation; 4. List at least three ways to address concerns that arise from care givers/guardians in response to people wanting to participate in the group; 5. Describe attributes that would make a person a good/poor candidate for the group; and 6. Describe the role of trauma in the group and how to address that as a group facilitator.

13 1:00pm 2:30pm 1:00pm 2:30pm 26. Planning for Transition from State Plan Private Duty Nursing: MI Choice vs. Habilitation Supports Waiver (Centennial Room) - Elizabeth Gallagher, MPA, Manager, Home & Community Based Services Section, Michigan Dept. of Health and Human Services - Belinda Hawks, BS, Psychology, QIDP, Master of Public Administration, Federal Compliance Manager, Michigan Dept. of Health and Human Services This presentation will assist supports coordinators and other CMH staff with assisting families to make informed decisions related to transition from State Plan private duty nursing at age 21. The presenters will provide a summary of the services available through the MI Choice Waiver and Habilitation Supports Waiver and the differences between the two waivers. We will also describe methods to access MI Choice and how to determine which waiver will be the best for participants making this transition. Participants will be able to: 1. List four services offered for each: MI Choice and HSW; 2. Describe three differences between MI Choice and HSW; 3. Explain the process for accessing MI Choice or HSW; and 4. Describe the process for assisting families with transition planning from State Plan PDN. 27. Interviewing Individuals with Complex Communications Needs (Lincoln Room) - Lynn A. Sweeney MA, CCC-SLP, Speech-Language Pathologist and Graduate Faculty Member, Sweeney Communication & Consultation, and Central Michigan University Many consumers experience medical, psychological, developmental, or situational conditions that make communication challenging for them, their significant others and those who provide services for them. Understanding the status, experiences, wishes, and needs of such consumers is a critical first step to provision of meaningful intervention/resolution of problems and establishing trust, education, selfdetermination and ultimate wellbeing. Some consumers are able to communicate if provided adequate supports but may not be able to speak/use traditional communication methods. Some develop significant behavioral challenges because they are misunderstood. This session will review medical, neurologic, motoric, developmental and situational conditions that challenge communication between consumers and those who strive to help them. Attendees will be provided with ways to help determine status and improve outcomes, determine needs/choices, and collect information in interview and interactions. Key examples from working with individuals with Autism Spectrum Disorder, developmental and acquired brain injury, and a variety of sensory, motor, psychological and neurological conditions will be used to demonstrate opportunities to improve understanding whether or not a person is able to use traditional speech/language. Modeling and real case examples will help improve understanding of the elements of successful receptive and expressive communication in an interview or basic interaction process. Participants will be able to: 1. Identify frequent challenges in communicating with consumers with special needs; 2. Describe successful strategies for presenting and receiving information with individuals with communication challenges; 3. Select one or more strategies or tools appropriate for improving and/or augmenting communication with those who have limited speech; and 4. Practice one or more communication strategies within the session or identify best practices of others.

14 1:00pm 2:30pm 28. Maximizing Prescreen Scores in the WSA (Web Support Application) (Room 105) - Kathy Neville, BA, JD, MDiv; Insurance Advocate, Penultimate Ltd. By including specific factual details in the Waiver Support Application (WSA), prescreen workers can achieve the highest appropriate score for each child s Children s Waiver Program (CWP) prescreen. This session will review facts to include about private insurance as a resource for services, evidence that documents substantial functional limitations that support a diagnosis of a developmental disability, and how to effectively document details of health care and behavioral needs of the child as well as the family s needs for supports. The session will also cover the current process for issuing invitations to apply for the CWP and how to handle and resolve an notification that a Hold has been placed on a prescreen. Participants will be able to: 1. Describe three sequential steps for documenting private insurance coverage of autism services in Factor 10; 2. Explain two reasons why the parent needs to contact the insurer each year after the private insurance policy renews to determine the current insurance autism benefit; 3. Identify one key factual detail to provide in Factor 9 for each of the five substantial functional limitation areas that document a diagnosis of a developmental disability; 4. List two significant elements to include for an effective description of behavioral challenges in Factor 9; 5. Describe the five primary reasons for placement of a Weighing List Hold and describe two steps the case manager completes to remove the Hold ; and 6. Identify three important Factor 6 family details to include to achieve a maximum appropriate prescreen score. 2:30pm 2:45pm Refreshment Break (South Lobby Area) Concurrent Workshops: 2:45pm 4:15pm 29. Accessible Community Design (Room 103) - Charlyss Ray, OTR-L, Specialist for Services and Supports for Persons with Developmental Disabilities, Michigan Dept. of Health and Human Services An accessible community has the characteristics of universal design built in as well as a welcoming atmosphere with diverse and friendly people. The presenter will cover the increasing use of Universal Design in public places as well as residential and business settings. The workshop will touch on the importance placed upon relationship building for persons of diverse abilities in the community and how this can be promoted and enhanced. Participants will be able to: 1. Name 4 of the 7 Principles of Universal Design; 2. Provide 3 examples of important aspects of an accessible community; 3. Describe the benefits of community inclusion for a person with a disability; and 4. Give an example of a welcoming community in their lives. 2:45pm 4:15pm 30. Communicating in Conflict (Room 104) - Margaret Rohr, Outreach Representative, MSEMP This interactive presentation engages participants in the process of communicating effectively when emotions run high. By increasing awareness about one s responses to conflict, the chance for effective communication is improved. By increasing awareness and understanding of others responses to conflict, empathy is increased. Improved communication and increased empathy help all disputants work more effectively toward resolution of the conflict. Participants will be able to: 1. Identify personal triggers to conflict; 2. Identify sources of conflict and how to deal with them appropriately; 3. Learn about the mediation and facilitation processes; and 4. Learn about MSEMP s services and programs. 2:45pm 4:15pm 31. Michigan Autism Spectrum Disorder Program Update This session is Repeated (Centennial Room) - Lisa Grost, MHSA, PAPHS, Autism Administrator, Michigan Dept. of Health and Human Services - Morgan VanDenBerg, MA, BCBA, Autism Behavioral Specialist, Michigan Dept. of Health and Human Services - Brie Elsasser, MSEd, BCBA, Autism Behavioral and Transition Specialist, Michigan Department of Health and Human Services The growing prevalence of individuals with Autism Spectrum Disorder (ASD) has increased the demand for effective supports, resources, and services to address each child s individual needs in the public Community Mental Health system. There are a wide range of challenges for children and adolescents with autism and their families, including transportation, peer relationships, behavioral and language barriers, and inclusion throughout their community and educational systems. Michigan continues to strive to be a leader in

15 opportunities, services, and supports for individuals with Autism Spectrum Disorder. The presenters will emphasize the importance of system collaboration and coordination and provide updates on provider capacity for Behavioral Health Treatment, including ABA in the Medicaid system. Participants will be able to: 1. Identify three current Medicaid and MIChild services in Michigan for individuals with developmental disabilities, including Autism Spectrum Disorder (ASD); 2. List two initiatives in Michigan to increase access to early intervention and evidence based supports for children with DD and ASD; and 3. Describe two ASD supports and family resources available in Michigan across service systems and potential points of collaboration. 2:45pm 4:15pm 32. Community Coordination of ABA Services (Room 105) No CE Offered - Conny Raaymakers, LLP BCBA, Director of ABA Services, Developmental Enhancement PLC - Amy Hund 2:45pm 4:15pm 4:15pm 33. Update on the Implementation of the Home and Community-Based Services Rule (Lincoln Room) - Belinda Hawks, BS, Psychology, MPA, University of Michigan, Manager Federal Compliance, Behavioral Health and Developmental Disabilities Administration, Michigan Dept. of Health and Human Services - Phillip Kurdunowicz, BA, Public Policy, University of Michigan, Health Information Analyst, Office of Health Policy and Innovation In 2014, the Centers for Medicare and Medicaid Services promulgated a new rule regarding Home and Community-Based Services within Medicaid Waiver programs. The new rule requires residential and nonresidential settings to meet a set of characteristics in order to be considered home and community-based under a Medicaid waiver. The Michigan Department of Health and Human Services is currently implementing a statewide transition plan for bringing all waiver settings in Michigan into compliance with the rule. The Department would like to provide an update to stakeholders on this process and identify opportunities and strategies for achieving compliance with this rule. Participants will be able to: 1. Understand where the Michigan Department of Health and Human Services is currently in the implementation process for the Home and Community-Based Services rule; 2. Use the knowledge from the session to understand how and when their organizations or agencies will be affected by the rule; and 3. Discuss opportunities and strategies for coming into compliance with the rule and improving the delivery of home and community-based services in residential and non-residential settings. Conference Adjourns Social Work: The Michigan Association of Community Mental Health Boards (MACMHB), provider #1140, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) through the Approved Continuing Education (ACE) program. MACMHB maintains responsibility for the program. ASWB Approval Period: 11/10/13-11/10/16. Social workers should contact their regulatory board to determine course approval. Social Workers who attend this training will receive maximum of 11 Clinical Continuing Education Clock Hours. Course Delivery Method: Face to Face Conference Certificate Awarded: At the conclusion of this training, you will turn in your Verification of Attendance form to the MACMHB Staff to be initialed. You will turn in the top sheet and retain the bottom sheet which serves as your certificate of participation. Evaluation: There will be an opportunity for each participant to complete an evaluation of the course and the instructor. If you have any issues with the way in which this training was conducted or other problems, you may note that on your evaluation of the training or you may contact MACMHB at or through our webpage at for resolution. Who Should Attend: This conference contains content appropriate for case managers, supports coordinators, clinicians, behavior analysts, administrative staff, providers, autism coordinators, people receiving services and family members and social workers at all levels of practice (beginning, intermediate and/or advanced). Revised 11/12/15

16 Save the Date! 2016 ANNUAL HOME AND COMMUNITY BASED WAIVER CONFERENCE November 15-16, 2016 Kellogg Hotel & Conference Center East Lansing, Michigan Visit us online at

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