DDES INFO MEMO 2005-07
August 17, 2005
TO:
Area Administrators/Human Services Area Coordinators
Bureau Directors
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Tribal Chairpersons/Human Services Facilitators
From:
Sinikka Santala
Administrator
Re:
Target Group Determination Team
Background
Regional and central office experts are often consulted on the
appropriate target group designation for applicants for home and
community-based waiver services. While this informal consultation is
appropriate, some Department employees have reported situations in which
a more formal process should be available.
Several situations have occurred in counties with split social
services and community programs or developmental disability agencies
where agency responsibility is at issue. In some of these situations,
the inability to come to a resolution on a target group question has
been detrimental to the consumer and has forced the consumer to request
an administrative hearing for a determination.
To address these situations fairly, it is essential that the
Department have sufficient balanced information that reflects all of the
available documentation as well as the needs of the consumer. The
Division of Disability and Elder Services (DDES) in conjunction with the
regional office Area Administration staff in the Office of Strategic
Finance has formed a Target Group Determination Team to evaluate
disputed cases and formulate a single Department response. This group
may also review target group/waiver assignment issues that arise
internally through waiver case reviews, PASAAR, etc.
Team Make-up
Target Group Determination Team membership will be determined based
on the issue in question, including the age of the consumer, the target
groups being considered, the county presenting the issue and the need
for specialized expertise. The members will be drawn from the following:
Regional Representatives
- Human Services Area Coordinator for county requesting review
- Community Integration Specialist (child or adult) for the county
requesting review
Statewide/Central Office Representatives
- Developmental Disabilities Services Section
- Children's Services Section
- Community Options Section
- Bureau of Mental Health and Substance Abuse Services
- Managed Care Section
- Other staff as needed for particular area of expertise
Process
- Cases should be referred to the Target Group Determination Team
only when all relevant local agencies have been involved and they
cannot resolve the target group determination locally or with
routine consultation with the Department. County agencies are
reminded that applicants for the Community Options Program are
eligible for an assessment as provided in Section 4.02 of the
Community Options Guidelines. Agencies should not let target group
disputes unreasonably delay the provision of an assessment.
- Area Coordinators are the point-of-contact for referral of cases
to the Target Group Determination Team, except that target group
issues from Family Care and PACE/Partnership agencies should be
directed to the Managed Care Section for resolution. Family Care and
PACE/Partnership cases may be referred to the Team if additional
consultation is needed.
- Area Coordinators will determine that there is a legitimate
question, that all relevant agencies have had input and that efforts
at local resolution have been exhausted.
- Area Coordinators will assist county agencies in determining what
information is necessary for review.
- The Team will review information, meet to discuss the material and
make a determination. Team members may request additional
information if they are not able to make a determination.
- The DDES Team facilitator will summarize the Team consensus in a
memo to be signed by the appropriate DDES manager (depending on
nature of the target group dispute). The memo will go to the
Director of each relevant local agency with a copy to each Team
member. The Team will issue its determination within 30 days of
receipt of all necessary information.
Information Needed
While each case will differ based on what is available, the following
are types of records that are helpful to the review process.
- Functional Screen
- Any clinical evaluations (psychiatric evaluations, IQ tests, etc.)
- Social and functional history (e.g., work history, adaptive
behaviors)
- Physician records
- School records
- Disability Determination information
- Proposed ISP or services needed by the individual
- Any preferences expressed by the consumer relevant to the outcome
The Area Coordinator will help the county to assess that they have
sufficient information and submit the documentation to the other members
of the Target Group Determination Team. The Target Group Determination
Team members may ask for additional information or consult directly with
local staff if they cannot make a determination based on the information
provided.
REGIONAL OFFICE CONTACT:
Human Services Area Coordinator
CENTRAL OFFICE CONTACT:
Gail Propsom
Bureau of Long Term Support
P. O. Box 7851
Madison, WI 53707-7851
608-267-2455
propsgf@dhfs.state.wi.us
MEMO WEB SITE:
http://dhfs.wisconsin.gov/partners/local.htm
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