Does anyone understand detailed the concept of the program and its do s and don't s. "Consumer Choice Options" under the waiver program for the state of iowa. Ive been told changes occurred since first implemented. However those changes are not listed for public view. Trying to bring my situation before the iowa supreme court
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yes im interested in finding someone to advise me with my situation as well as knows resources to direct me towards for documentation
will this be confidental
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I would like to help you with this question. It is a rather complicated program to explain because it is flexible for each waiver program (Iowa has 6) and each consumer.
Iowa was one of 12 states in October 2004 to receive fundssupported by the XXXXX XXXXX Johnson Foundation and the USDepartment of Health and Human Services Office of the Assistant Secretary forPlanning and Evaluation to develop the infrastructure needed to supportCash and Counseling (self direction) options in the HCBS waiver programs. There are three states (Arkansas, New Jerseyand Florida) that have implemented this model and now provide technicalassistance through RWJ and the Centers for Medicare and Medicaid Services (CMS)to support the 12 new states to set up the infrastructure needed for Cash andCounseling. Iowa's Cash and Counseling program "Consumer Choices Option" will provide services to individuals eligible for one of the six Home andCommunity Based Services waivers (Mental Retardation, Elderly, PhysicalDisability, Ill and Handicapped, Brain Injury, and AIDS/HIV).
The Cash and Counseling approach provides consumers with aflexible monthly budget that is based on functional and service needs to allowconsumers to direct and manage their own personal assistance and other supportservices. In addition, this innovative option offers counseling (through anindependent support broker) and financial assistance (through a financialmanagement service) to help consumers manage their individual budget andresponsibilities by themselves or with the aid of a representative to assist withmaking decisions. These main featuresare adaptable to consumers of all ages and various types of disabilities andchronic conditions. People who areenrolled in one of Iowa's 6 waiver programs will be eligible for theself-direction waiver option.
Many Medicaid recipients want more choice, control, andflexibility over personal daily activities. With an individual budget, people have the ability to decide when, bywhom, and how services are provided, and are able to better meet their needsand use funds more creatively. According to the 2003 Mathematic report, "Lessons Learned from theImplementations of Cash and Counseling in Arkansas, Florida and New Jersey,"self-direction options increase consumer satisfaction, quality, and efficiencyin the provision of personal assistance services and other support services.This option can increase access to care, thus enabling participants to stay asindependent as possible for as long as possible in their community.
An individual budget is a spending plan for the fundingallocated for services and supports for an individual consumer that iscontrolled by the consumer and/or their family or representative. All consumers choosing this option willcontinue to have a service plan developed by their services worker/casemanager. The individual budget amountwill be developed from their service plan. The individual budget allocation amount will be based on the level ofneed as well as what has been used previously.
If I can help you with anything further, please let me know.
Over 15 years experience
Yes plz helpI was on the dhs webssite for 3 yrs. as a success story promoting the cco program. I was told it provided funds for independent living things that meddddicaiid would not pay forFor 6 tyrs cco provided the funding for feldenkrais therapy thru physical ttherapistt, specialized personal trainer and a chiropracter who went thru addlitional training for me specifically. All this approved with my doctor. Thru broker ime had aapproved these monthly payments. I improved so much that I was able to walk without walker. Mayo cliinic calls me a unicorn " its not that ur not supposed to be able to do these things. Its that we have never met anyone that can do the thiings u do with your condition"I have a new case manager. She told me she works for the state and not for me. She told the judge all I had to do was go to the YWCA and id be fineI've gone 3 judges petitioning me case. The first one agreed with me and I got to keep my therapies. Dhs didn't like the answer so they pushed again. Second judge sat.on case for 18 mo til 3 dhs workers literally cornered him same day as my hearing again So he signed off on it in their favor. I got a third judge to listen to my case last summer via phone hearing There wwere 7 dhs workers siitting in a room passing notes to each other for answers and I was alone on phone. The hearing went for 4 hrs. They kept adding things to my case before the judge. They wouldn't stay tto their original reason as to why they were going further funding But when I would ask them questions they all said they forgot their computers and their files on me. So they would say they couldn't answer the questions I presented. The judge rreprimanded them seeveral times but never stopped themEventiually it was ruled innaproppriate use of funnnds because what medicaid won't pay for cco is not allowed to pay for eitherI found a lawyer who told me these things last dec in a 3 hr consultation
What a terrible situation! Don't get me started on DHS!! They make life decisions for people such as yourself, when they are not doctors, and act like it is coming out of their own pockets. Let me ask you how long ago did you receive the last decision? I assume it was from an Administrative Law Judge? What county are you in?
For 6 yrs I was approved for 103 units 2700.00. Three jidges all on determination papers have stated I qualify for skilled care But dhs says judges don't get to make that decision I went from 103 hrs per mo in home service care to 40 per month 900.00 in home health care. My case manager tells them I get by just fine I found a lawyer in dec who consulted for 3 hrs with me. She told me that if ever a case could go to iowa supreme court. This one should. She said iowa has dtrong nursing home lobbyists. They want those beds filled. She said noticed high volume of calls reporting people on wsivers whose only alternative is nursing home were being targeted for auditingI have 3 different doctors and 2 doctorate physical thrapists all wrofe to state. presenting my case telling I ll go to a nursing home without these thrrapies. Lawyer state is broke. They pay for the waivers. But when a person goes into nursing home. Thrn state stops paying client. And insteadd. They receive. 6000.a month from fedetal monies
I forgot to tell you. I saw lawyer in dec and thats last I spoke with her she never returns my phone cslls. Her assistant speaks with me but never a definitive amswer about case
The judges you talked about were ALJ's or district court judges?
Also, have you talked to the State of Iowa Ombudsman?
Yes all aljOmbudsmanSee when I ask my case manager for links websites legal paper. Anything written of the new changes preauthorization preapproved exception to policy and changes to cco her response is ..... There s nothing out there on any websites or resource books etc. Nothing tangible to allow me to read of these changes. She said its all coming from up above. I have dealt with ombudson hefore. They were not helpful. It appears to me that judges, seem perplexed. They not know where to go for updated info either. Dhs seems to be only ones who understand. I'm on my smartphone typing all this. I know you're putting in much time.
I just want my therapies backWhat are the appropriate steps to jump throughMy case manager is not helping at allSo I don't know if I'm missing a step
I just want my therapies backWhat are the appropriate steps to jump throughMy case manager is not helping at allSo I don't know if I'm missing a stepThe last 3 yrs in a row brought before a. Judge
I see you're online
Yes. What can I do for you?
im so sorry i fell asleep
i wanted to know if you had anymore advise to add to help me or if you had completed this
there was no more response from you regarding this so i wasnt sure
I just want you to know you can appeal and even go to the district and Supreme Court of Iowa to get this settled if the case manager and the other DHS "professionals" will not budge. Call the State Ombudsman, and if you have to, go to the Des Moines Register and tell them your story. I wish I could fix this for you. It's always a fight, isn't it. My dear, I wish you the best!
I Understand that you cannot fix this but maybe I gave too much information and it became garbled my case managers will not budge The case has been presented before 3 judges And I am not allowed to bring it before any more judges I took it to a lawyer a yr ago She said that it is a case for the supreme court of iowa she has been sitting on the case for a year and refuses to take my phone calls but she has all my case file I cannot take it to the newspaper has that will disqualify it for it any further court case I'm feeling very stuck between a rock and a hard place this is why I was asking for your advice where are you from I'm in iowa I live in story county thank you for your timeJan
I tried to find out from you, however, what types of judges were the 3 of them? There are administrative law judges, and there are associate district judges, district court judges---it makes a huge difference what type of judge heard your evidence? Story county--did you go to the courthouse in Nevada in front of a district court judge?
I'm sorry I hought I had explained that to u alreadyThey are alj sTwice I met in DSM and once a phone hearing where the judge presided in DSMPLZ don't be frustrated with meHow Are the judges differentI've been told I cannot appeal this anymore by dhs case manager I must abide by this ruling nowYet they did not have to abide by judge s ruling til they got it changedI'm sorry I'm so emotional about this but I used be able to walk 2 miles now I barely can walk down the block. I used to have 100 % oxygen level now I have 90% oxygen levelTYJan
The ALJ's are just lawyers who preside over things like DHS or unemployment hearings. They are not court judges, like in divorces or criminal matters. Those are actual courts. That is where you need to go now.
You're not upsetting me at all, I just wanted to make sure that you had gotten all your appeal rights. When you have asked for a reconsideration (you probably have done that already) and disagree with the results, you have 30 days to petition the district court in Nevada (the county seat of Story county). Then you can have a regular court hearing.
Have you talked to the Ombudsman? Have you talked to Legal Aid of Iowa?
I've been fighting this for 3 years My 30 day notice is long gone I was never told the difference between the judges the lead me to believe these were the only judges that could help me with my appeal and the third 1 said no more appeals Now that I know there a different judges I can try that route as well as Ombudson. thank you
I just wish you the best of luck. You just keep fighting!!
Can you be hired or are there rules on this website
I'm sorry, we do have rules against representing any of our customers. You should be able to find someone who could help you with this. You might have to look outside Story county, but DSM is fairly close. My best to you.
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