Dear Consumers, Families, Guardians, Staff, and Concerned Others:
Integrity, Inc. is taking this opportunity to update you on what we know so far about the changes in Waiver Services to the PASSE Model of Managed Care.
- Most of our consumers were assessed in the first 5 working days of August.
- The results of the assessments should now have been sent out to the consumers/guardians of the individuals who were assessed.
- The assessment determines the consumer’s level of care, so IT IS VERY IMPORTANT THAT YOU PAY ATTENTION TO THE LETTER.
- You have the right to request a copy of the assessment, if you are not provided one.
- If you have questions about the assessment/assessment process/results, you can contact OPTUM directly at (844) 809-9538
- Please take a moment to call Integrity and tell us what your letter says. We are not being directly notified of the results. We would like a copy of the letter and the assessment for the consumer’s file if you would share those with us.
- Based on the results we are seeing thus far, some of the assessments do not fully show the abilities and needs of the individual assessed.
- Those results will need to be appealed so the individual receiving services will be appropriately served based on his or her needs. There is a very short window of time to appeal the results.
- Last and very importantly, if you think that there is a need for an appeal, please take special note and document everyone you talk to in the process of getting results of the assessment and filing the appeal. Names, dates, times and what you are told will be critical in your appeal.
Once the assessments are done then the attribution to a PASSE occurs. Here is what we know about that process.
- Upon the completion of the assessment, the individual is attributed to a PASSE in the middle of the month on or around the 15th.
- Integrity will continue to provide the Case Coordination (what was called Case Management) until the end of the month in which the consumer was attributed to his or her PASSE.
- The PASSE assumes the Care Coordination role for that person on the beginning of the next calendar month. The PASSE will then become the paid entity to handle Care Coordination and Integrity staff will have to back out of that role.
- Consumers/Families/Guardians have 90 days to change PASSES if they are not pleased with the attribution selected PASSE.
- DHS has set up a Beneficiary Support Unit to which calls may be directed with any questions/concerns about the process 1-833-402-0672.
- DHS has also set up an Ombudsman specifically for the purpose of dealing with concerns or issues that arise as part of this process. Dena Perry is the name of the ombudsman, and she is available by email at email@example.com or phone at 501-686-9178
As we know more about the move to managed care, we will issue more updates. Follow us on our website and social media outlets for notifications.