Individual and Family Support Program Cindy Gwinn Community Resource Manager
The Individual and Family Support Program (ISFP) Assists individuals with intellectual disability (ID) or developmental disabilities (DD) and their family members currently on the ID or DD Waitlist to support and maintain the continued residence of an individual in his own home or the family home.
Basics • Program is administrated by DBHDS. • Individuals and families can access application directly from the DBHDS website. • They do not have to go through their Case Manager/Support Coordinator • Case managers/support coordinators are highlyencouraged to share the information about the IFS Program with their waitlist individuals.
Basics • Individual and Family Support Program funds shall not supplant or in any way limit the availability of services provided through a Medicaid Home and Community-Based Waiver, Early and Periodic Screening, Diagnosis and Treatment (EPSDT), or similar programs.
Basics • Individuals who are on the waiting list for ID or DD Waiver and currently on the Elderly or Disabled with Consumer Direction, Day Support, or Technology Assisted Waivers may apply for funds if needed items are not available through these waiver programs, EPSDT or Medicaid State Plan Option.
Program eligibility requirements Eligibility is limited: • to individuals who are living in their own home or a family members home • are on the statewide waiting list for the Intellectual Disability (ID Waiver) Medicaid Waiver or the Individual and Family Developmental Disabilities Services (DD Waiver) Medicaid Waiver • or to family members that are assisting those individuals and the request supports that assistance.
Covered services and supports Services and items that may be funded through the IFSP may include: • Professionally provided services and supports, such as respite, transportation services, behavioral consultation, and behavior management; • Assistive technology and home modifications, goods, or products that directly support the individual; • Temporary rental assistance or deposits;
Covered services and supports • Fees for summer camp and other recreation services; • Temporary assistance with utilities or deposits; • Dental or medical expenses of the individual; • Family education, information, and training
Covered services and supports • Peer mentoring and family-to-family supports; • Emergency assistance and crisis support; or • Other direct support services as approved by DBHDS.
Application Process • Eligible individuals or family members who choose to apply for Individual and Family Support Program funds can submit a completed application to DBHDS. Applications can be downloaded from the DBHDS website at:
Support Amount Based on funding availability, DBHDS will establish an annual maximum individual financial support limit. • 2012-2013 fiscal year this amount is $3000.00. • 700 families are to be funded in the first year of the program • 1000 families to be funded each additional year
Support Amounts Individuals or families may apply for additional supports and services each fiscal year the program is funded. However the total amount approved during each fiscal year cannot exceed the annual individual financial support limit.($3000) Funds may be provided to individuals or family members in varying amounts, as requested and approved by DBHDS, up to the established annual maximum individual financial support limit per fiscal year.
Application Process Applications will be considered by DBHDS on a first-come, first serve basis until the annual allocation by the General Assembly for the applicable fiscal year has been expended. Applications will be stamped with their date of receipt by DBHDS upon arrival to the Office of Developmental Services and reviewed in that order.
Participants Responsibilities • Individuals and Families will be required to submit supporting documentation to verify that funds have been used for the purpose stated in their application. • Directions will be provided to families when funding is approved. • Fulfillment of participant responsibilities is a requirement to participate in the program in future years.
Application Information Completed applications shall include the following information: • A detailed description of the services or items for which funding is requested; • Documentation that the requested services or items are needed to support the continued residence of the individual with ID/DD in his own or the family home and no other public funding sources are available; • The requested funding amount and frequency of payment;
Application Information • Written acknowledgement of participant responsibilities • The signature of the individual (unless the individual is a minor or has a legal guardian) and financially responsible person.
Application Review The Department will assure compliance with program regulations and policies 1. Verify that the individual is on ID or IFDDS Waiver waiting list; 2. Confirm that the services or items for which funding is being requested are eligible for funding 3.Determine that the services or items for which funding is requested are needed to support the continued residence of the individual with ID/DD in his own or the family home
Application Review The Department shall provide a written notice to the individual or family member who submitted the application indicating the funding decision.Approved Pended or Denied
Approval Approvals - Approval notices shall include: • The services, supports, or other items for which funding is approved; • The amount and timeframe of the financial allocation; • The expected date that the funds should be released; and • Documentation requirements for submitting receipts to the Department and the date documentation shall be provided to DBHDS.
Approval In general, receipts or other documentation to verify expenses for which IFSP funds have been requested shall be submitted to the Department within 30 days of receipt of funds or upon the completion of the purchase of approved items/delivery of approved services and shall include the name of the provider of the goods/services and the individual’s name.
Approval • Applications may be approved at a reduced amount when the amount requested exceeds a reasonable amount as determined by Department staff as being necessary to purchase the services or items. • Funding for approved requests will be distributed by DBHDS semi-monthly.
PEND Pended Requests • When requests for IFSP funds cannot be immediately approved due to missing information or there are questions about the application contents, DBHDS staff will “pend” the request. In that event the following procedures will be followed: • DBHDS staff will call the individual or family member via the phone number provided on the application in order to acquire the additional information needed in order to approve the request.
PEND • DBHDS staff will wait for the requested information from the individual or family member for up to 14 days from the date of the telephone call. • If the additional requested information is received, DBHDS staff will continue to process the application • If the additional requested information is not received, DBHDS staff will deny request and send a letter following the denial procedure.
Denials Denials - Applications shall be denied if the Department determines that: • The service or item for which funding is requested is not eligible for funding in accordance with 12 VAC 35-230-50 (See Section V, “Covered Services and Supports,” in Guidelines.); • The request was pended and the family did not respond to request for additional information in a timely manner (i.e., 14 days);
Denials • The request exceeds the maximum annual individual financial support limit for the applicable fiscal year; • Other viable public funding sources have not been fully explored or utilized; • The requesting individual or family member has not used previously received IFSP funds in accordance with the Department’s written notice approving the request or has failed to comply with IFSP policies or regulations; or
Denials • The total annual IFSP funding appropriated by the General Assembly has been expended for the applicable fiscal year. • For applications for which funding is denied or approved at a reduced amount, the Department’s notice shall state the reason or reasons why the requested services, supports, or other items were denied or approved at a reduced amount and the process for requesting the Department to reconsider its funding decision.
Requests for reconsideration Individuals or family members who disagree with the determination of the Department may submit a written request for reconsideration to the Commissioner, or his designee, within 30 days of the date of the written notice of denial or approval at a reduced amount.
Appeal The Commissioner, or his designee, shall provide an opportunity for the person requesting reconsideration to submit for review any additional information or reasons why the funding should be approved as originally requested. The Commissioner, or his designee, after reviewing all submitted materials shall render a written decision on the request for reconsideration within 30 calendar days of the receipt of the request for reconsideration and shall notify all involved parties in writing. The Commissioner's decision shall be binding.
Post Funding Review • Utilization review of documentation or verification of funds expended may be undertaken by Department staff. Reviews may include home visits to view items purchased or services delivered. • Funds that are not used for agreed upon services, may result in recovery of such funds by the Department and denial of all future application requests.
Termination of funding Funding through the Individual and Family Support Program shall be terminated: • when the individual is enrolled in the ID or IFDDS waiver, • or if approved funds are used for purposes not approved by the Department in its written notice.
Quality Measures • We look forward to hearing how these funds have assisted participants to continue to live in their community. • A yearly satisfaction survey will be sent to each participant to assist in measuring satisfaction and effectiveness of the program. • Outcomes will be published in the annual report and program reviews.
Assistance • Program Guidelines can be reviewed at: • ______________________________ • Application can be downloaded at: • ______________________________
Assitance For additional information or questions please contact: Cindy Gwinn, IFS Program Manager firstname.lastname@example.org