DDD
Service Providers – Update for Families
Table of contents
Background
Glossary
What
are the options available when choosing a provider
What
you should know about the new system for providing services
New
approach to contracting for services and choosing providers
BACKGROUND
Until recently, the Division of
Developmental Disabilities had been required to follow the State of Arizona
Procurement Code. This process is designed to purchase supplies and equipment
and is not always sensitive to the purchasing services for people with
developmental disabilities.
The Division has specific
authority to be exempt to the Arizona Procurement Law and Rules. The Division
has developed rules for streamlining the purchasing of services, which
simplify the way the Division contracts with service providers (respite,
habilitation, attendant care, therapy, etc.).
THE GOAL
The process implemented by the
Division to contract with providers is called the Qualified Vendor. An
applicant may become a Qualified Vendor if they meet all requirements and
enter into a Qualified Vendor Agreement with the Division. The goal is to
simplify and expedite the development of new and existing agreements with
providers in order for individuals and families to access most services
quickly.
HOW DOES THIS PROCESS INCREASE AND IMPROVE INDIVIDUAL AND FAMILY
CHOICE?
Once the team has completed the
Individual Support Plan (ISP)/Individualized Family Service Plan (IFSP)
process where needs, goals and outcomes are identified, natural and community
supports are exhausted, a funding source is identified and services are
approved, individuals and their families can choose their provider. The goal
is to place the individual and family squarely in the driver’s seat.
Individuals and families may choose to use a Qualified Vendor and/or use an
Individual Independent Provider.
WHAT IS THE DIFFERENCE BETWEEN A QUALIFIED
VENDOR AND AN INDIVIDUAL INDEPENDENT PROVIDER
Qualified Vendors are public or private non-profit agencies
or independent professionals that enter into a formal agreement including
specific requirements i.e. employees, insurance, audits etc.
Individual Independent Providers are individuals who become
“qualified” by meeting required qualifications, completing a certification
process, entering into an Individual Service Agreement and being assigned a
provider identification number.
The Individual/Family may identify a person such as a friend,
neighbor or family member to become an Individual Independent Provider. The
potential provider may choose to work for a Qualified Vendor or become
certified and enter into an Independent Service Agreement and become an
Individual Independent Provider.
Changes
to the Division’s Service Contracting Process
An
update for Families
WHAT
ARE THE OPTIONS AVAILABLE WHEN CHOOSING A PROVIDER?
When services have been approved, the Individual/Family may:
1.
Identify their own Individual Independent Provider or
a person to become an Individual Independent Provider.
2.
Obtain a list from the Division of Individual
Independent providers to select from.
3.
Choose a Qualified Vendor they know.
4.
Obtain a Qualified Vendor Directory from the Division
to select from.
5.
Decline to select a provider and prefer to be
automatically assigned to an available Qualified Vendor.
WHAT TO
LOOK FORWARD TO
- A
directory listing of Qualified Vendors and Individual Independent
Providers which will be available on-line.
- The
directory will include information about the provider’s experience,
community access, references, recruitment and training, management
systems, complaint process, consumer involvement etc.
- Providers
will have the ability to update their directory information as needed.
- An
automated process to match potential service providers to
individuals/families.
- The
ability to add new providers throughout the year, as they are needed.
WHERE
CAN I GET A COPY OF THE RULES?
A copy of the administrative
rule is available on the Division of Developmental Disabilities Home Page at http://www.de.state.az.us/ddd
. The Division’s statutory exemption to the service purchasing process is in
the Arizona Revised Statutes: A.R.S. & 36-557. The rule is found in the
Arizona Procurement and Rate Setting – Qualified Vendors.
Changes
to the Division’s Service contracting Process
GLOSSARY
“Application”
means the Qualified Vendor application, including any amendments, supplements
or updates submitted by the applicant.
“Individual Support Plan
(ISP)” means a flexible
person/family centered communication and decision making process, not
paperwork. The Individual Support Plan forms are designed to guide the team to
discuss four questions regarding the assistance desired from the Division:
a)
Where have we been?
b)
Where are we now?
c)
Where does the person want to go?
d)
How are we going to get there?
“Individual Independent
Provider” means a person who is
qualified to provide service, has a provider
identification number and an
individual service agreement or a qualified vendor agreement to provide
community developmental disability services.
“Individual Service Agreement”
means the legally binding contract between the Division and the Individual
Independent Provider to provide community developmental disability services.
“Individualized Family
Service Plan (IFSP)” means a written
plan for providing early intervention services to children from birth to age
thirty-six months and their families.
“Provider”
means a Qualified Vendor or an Individual Independent Provider.
“Qualified Vendor”
means a provider of community developmental disability services that has
applied for Qualified Vendor status, meets the criteria for Qualified Vendor
status, and has entered into a Qualified Vendor Agreement with the Division.
“Qualified Vendor
Agreement” means the legal, binding
document between the Division and a Qualified Vendor describing the services
the Qualified Vendor is qualified to provide and the terms and conditions
governing the relationship between the Division and the Qualified Vendor
including any amendments, attachments, schedules, or exhibits
At
the Division of Developmental Disabilities
One of the key parts of the new
system (Qualified Vendor System) is consumer and family choice. All consumers
and families receiving services are encouraged to be informed, and to expect
the highest quality of support and service.
Consumers
and families have certain rights and responsibilities:
1.
Your participation in the development of the Individual Support Plan is
important. Families and consumers can agree or disagree with the plan.
2.
You will need to provide required information and to contact your
Support Coordinator about any change in that information.
3.
You have the right to choose a provider or to have a provider
automatically chosen for you.
4.
You have the right to choose a Support Coordinator or to have a Support
Coordinator automatically chosen for you.
5.
You may request a change of provider, for any reason, at the annual
Individual Support Plan meeting.
6.
If you are not satisfied with services, you must give the provider an
opportunity to make you satisfied. If you are still not satisfied, you may
request a change in the provider through your Support Coordinator. You must
provide evidence that you gave the provider a chance to improve.
7.
Always treat the provider(s) as one would treat an employee, that is,
with respect and dignity.
8.
Check on and notice the quality of the support or service, and provide
your comments to the provider(s) and caregivers.
9.
You have the right to have your complaints, or grievances, heard
according to the rules of the Division of Developmental Disabilities.
New
Approach to Contracting for Services And Choosing Providers
Frequently
asked Questions
Question:
What is “557”?
Answer:
“557” refers to the Division’s statutory exemption to the service
purchasing process. The Division is exempt from the requirements of the
procurement code. This allows for the streamlining of service purchasing and
contracting with providers.
Question:
How does the rule impact the system?
Answer: It simplifies the way that the division
contracts with providers and eliminates much of the amendment process. This will
be accomplished through establishing a Qualified Vendor and Rate Setting System.
The Division believes that it will significantly ease the burdens for providers
responding to Requests for Proposals every 3 – 5 years. It allows the Division
to recruit and establish agreements with new service providers throughout the
year. It clarifies the process by which consumers choose the provider who will
deliver their services.
Question:
What is a Qualified Vendor?
Answer: A Qualified Vendor is the new term for a
“provider”. The provider will apply to become a Qualified Vendor and if they
meet the criteria, they will enter into an Agreement with the Division and
become a “Qualified Vendor”.
Question:
Can an individual/family continue to choose an Individual Independent
Provider?
Answer:
Yes, this will continue to be an option for the individual/family.
Question:
What is the difference between a Qualified Vendor and an Individual
Independent Provider?
Answer: Qualified Vendors are public or private
non-profit or for-profit agencies that enter into a formal agreement process
including specific requirements i.e. employees, insurance, audits etc.
Individual
Independent providers are individuals who become “qualified” by meeting
required qualifications, completing a certification process, entering into an
Independent Service Agreement and being assigned a provider identification
number.
The
Responsible Person may identify a person such as a friend, neighbor or family
member to become an Individual Independent Provider. The potential provider may
choose to work for a Qualified Vendor or become certified and enter into an
Independent Service Agreement and become an Individual Independent Provider.
Question:
Can Independent Providers be Qualified Vendors?
Answer:
Yes an independent provider can apply to be a Qualified Vendor, but they must
meet the application/agreement requirements. Independent home-based service
providers may continue to contract with the division through the Individual
Service Agreements.
Question:
What is the Division’s new Published Rate system?
Answer: Published Rate
System established the payment amount per unit of service purchased.
Background:
During the 2002 Legislative
session, the Legislature approved a provider rate increase and further
legislated on the matter of a published rate system which is to be phased-in,
and fully implemented by 2004/2005 fiscal year.
The Division retained an
independent consultant to assist in development of the rates. The rates proposed
for the published rate system would have necessitated an increase in the general
fund appropriation of 8.3 million dollars. In light of the state’s current
budget situation, the Division scaled back the rates to stay within our budget.
Question:
Will the Published Rate System impact the Independent Provider?
Answer: No.
The Published Rate System will not impact the Individual Independent Provider.
Rates will continue to be set by the districts’ assessment process. The
Division is utilizing a standardized rate assessment process that will result in
new rates for Individual Independent Providers, effective January 4, 2004.
Question:
What are the advantages to the Qualified Vendor System/Published Rate System?
Answer:
For Families and People with Disabilities:
