This is an email from a parent who asked me to pass on this information to anyone who receives services from the Washtenaw County Community Mental Health agency using Self-Determination arrangements. To learn more, a contact phone number and email is provided below:
This email contains some very important information for individuals and their families who are receiving community living support services (CLS) using a self - determination (SD) arrangement in Washtenaw County. Was your CLS budget reduced in May of 2015? Are you currently not receiving an adequate level of CLS services? Are you paying out of pocket for transportation, CLS services, community activity, or training expenses?
If yes, you are probably aware that in 2015, CMH changed the way in which they determine the self - determination budget. Instead of basing the SD budget on the individual's needs, they have essentially "capped" the SD budget and are forcing everyone to fit into a budget based solely on the number of CLS hours. CMH previously determined individual needs in the Person Centered Plan (PCP) and then authorized them in the Individual Plan of Service (IPOS.)
There is no longer "individualization". Instead the number of hours determine the budget, not the needs for transportation, training, or community activity. Although you may not feel a huge impact at the present, in the future if you or your loved one needed additional supports, such as double staffing due to an injury, there would be no additional funds or method to accommodate the need using self-determination. This method of calculating self- determination budgets is contrary to federal law and just plain wrong.
You do not have to accept this. If you did not file an appeal in May of 2015, you can still join other families in Washtenaw county who are fighting CMH to revert to the former, correct way of determining the SD budgets based on individual needs and medical necessity.
There is currently a lawsuit against Washtenaw CMH, not for monetary damages, but to force them to follow the law and perform the budgetary process correctly. This may greatly impact us and our loved ones in the future, You can join the lawsuit at no expense to you or your loved one.
For further information please call 734-665-7303 or email email@example.com.
Thank you for taking the time to consider helping all the 150+ families in Washtenaw County who are affected by this.
From The DD News Blog:
See also, Michigan Medical Necessity Criteria for Medicaid-funded services.
Take note of the last paragraph: "A PIHP may not solely deny services based solely on present limits of the cost, amount, scope, and duration of services. Instead, determination of the need of services shall be conducted on an individualized basis."
The MI Dept. of Health and Human Services offers guidance on self-determination policy on this Website.
See also Self Determination Policy from 2012 from the MI Dept. of Community Health (now the MI DHHS).