00:10:57 Marc Wilson: Marc Wilson, WVU CED Specialized Family Care program. 00:10:58 gillian mccarty: Gillian McCarty from ABC Case management 00:11:07 Melina Danko: Melina Danko, CED and WV Family to Family Health Information Center 00:11:13 Suzanne Messenger: Suzanne Messenger, State Long-term Care Ombudsman 00:11:14 Veronica Handsome: Veronica Handsome Behavior Specialist Savin Grace Selma NC 00:11:20 Mary Wilson: Mary Lea Wilson, QI/Compliance Director with PAIS/Pathways. 00:11:21 Stacy Broce: Stacy Broce, IDDW Program Manager, BMS 00:11:21 Karen ketz: Karen Ketz, SW with ResCare Beckley 00:11:24 Jennifer Logan: Jennifer Logan, Aetna Clinical Case Manager 00:11:24 Rachel Aker: Rachel Aker, Coordinating Council for Independent Living 00:11:25 Lori McGinnis: Lori McGinnis- BSP with Russell Nesbitt Services in Wheeling, WV 00:11:32 Susan Buskirk: Susan Buskirk, Valley Healthcare System Program Manager 00:11:33 Heather Dodge: Heather Dodge Russell Nesbitt Services BSP 00:11:34 Julianna Hayden: Julianna Hayden A Journey Case Management and Advocacy 00:11:41 Cassandra Lee: Cassandra Lee - Aetna RN Case Manager 00:11:41 Jodi Calissie: Jodi Calissie, Disability Rights of WV 00:11:47 Kiersten Coleman: Kiersten Coleman, I/DD Division Director 00:11:52 Kiersten Coleman: Southern Highlands 00:12:05 Shannon Papp: Brittney Nichol, Clinical Services Director at Russell Nesbitt Services 00:12:05 Dawn Meeks: Dawn Meeks Ohio Valley Area Clinical Assessor Acentra ISS/GH HCBS Review Team I would like a certificate of attendance. 00:12:07 Crystal Norman: Crystal Norman DCI, CM 00:12:11 Jerri Drake: Jerri Drake, Disability Rights of WV 00:12:19 Charity Carroll: Charity Carroll Northwood Health Systems Manager of CM Services 00:13:00 Ruza Papeskov: Ruza Papeskov 00:13:03 Charity Carroll: Charity Carroll. I would like a certificate also. 00:13:16 Lesley Cottrell: Reacted to "Dawn Meeks Ohio Vall..." with 👍🏻 00:13:19 Tina Wiseman: Tina Wiseman 00:13:23 Ruza Papeskov: Ruza Papeskov, Center for Service Coordination 00:13:27 Lesley Cottrell: Reacted to "Charity Carroll. I w..." with 👍🏻 00:13:27 Meredith Seibert: Meredith Seibert, BSP/Operations Coordinator with WorkAble Industries in Stonewood 00:14:09 Lori McGinnis: Lori McGinnis would like a certificate also. 00:14:15 Lesley Cottrell: Reacted to "Lori McGinnis would ..." with 👍🏻 00:14:48 Patricia Morgan: Does a certificate = CUs? I would like a certificate either way. 00:15:39 Jason Bowlick: Is it true that 1 in 44 children has autism? Autism Prevalence 1 in 36 children in the U.S. have autism, up from the previous rate of 1 in 44. 1 in 45 adults in the U.S. have autism. In the U.S., about 4 in 100 boys and 1 in 100 girls have autism. Boys are nearly 4 times more likely to be diagnosed with autism than girls. 00:16:04 Lesley Cottrell: Reacted to "Is it true that 1 in..." with 👍🏻 00:16:31 Jessica Noel: Jessica Noel, with ABC Case Management 00:18:42 Lesley Cottrell: If you are using a phone number, please provide your name and affiliation as well. 00:19:50 Sherry Zachwieja: Sherry Zachwieja Case Manager Supervisor Diversified Assessment & Therapy Services (Scott Depot Branch) 00:20:27 Mena Seyed-Ashraf: Mena Seyed-Ashraf, LPC. Aetna BH Clinical Case Manager with the CSED Waiver Program 00:26:48 Emily Jordan: Emily Jordan BS/QIDP- ResCare NE Agency ICF 00:27:08 Julianna Hayden: I would like a certificate and more information on Dr. Clayman's upcoming autism seminars as I am working with law enforcement and emergency services 00:27:51 Jason Bowlick: In the new draft manual to CMS, eligible diagnoses were revised to: Examples of related conditions which may, if severe and chronic in nature, make an individual eligible for the IDDW program include but are not limited to, the following: •Autism Spectrum Disorder (Level 3); Was the intent for I/DD Waiver for Level 2 and Level 1 be passed off to the judicial and state hospital systems? 00:28:15 Lesley Cottrell: Replying to "Is it true that 1 in..." Jason- are those rates thought to be underreported? 00:28:53 Carol Marcinek: Carol Marcinek, Russell Nesbitt Services. I would like a certificate 00:28:55 Jason Bowlick: Replying to "Is it true that 1 in..." CDC from this time last year: Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020 | MMWR (cdc.gov) 00:29:47 Lesley Cottrell: Reacted to "CDC from this time l..." with 👍🏻 00:30:06 Lesley Cottrell: Reacted to "Carol Marcinek, Russ..." with 👍🏻 00:30:35 Lesley Cottrell: Reacted to "I would like a certi..." with 👍🏻 00:31:00 Lesley Cottrell: Replying to "I would like a certi..." Julianna- we will be sure to include those with the follow up materials we have for attendees after the meeting. Thank you! 00:34:22 Heather Dodge: Does this correlate with introversion? 00:35:02 Susan Given: Susan Given, Disability Rights of WV. I would like a certificate of attendance. Also, I didn't get one from the last one. 00:35:53 Jason Bowlick: Replying to "Does this correlate ..." Withdrawn is one of the functional assessment problem behaviors assessed for eligibility and budget for services, so absolutely! 00:37:32 Stacy Broce: Jason - the IDDW eligibility criteria for autism has always been level 3 - the language has been updated from "severe" to "level 3" but the criteria is the same 00:37:40 Lesley Cottrell: Reacted to "Susan Given, Disabil..." with 👍🏻 00:37:52 Melina Danko: Reacted to "Jason - the IDDW eli..." with 👍 00:37:56 Karen ketz: Melissa Harris, Beckley DHS 00:37:59 Lesley Cottrell: Replying to "Susan Given, Disabil..." Thank you for letting me know Susan. I’ll send those your way this week. 00:38:32 Lesley Cottrell: Reacted to "Jason - the IDDW eli..." with 👍🏻 00:39:17 Jason Bowlick: Replying to "Jason - the IDDW eli..." Is Careconnection going to be updated to current diagnoses to match eligibility requirements in the manual? I think it currently says "Autism (Not Retarded)" 00:39:30 Lesley Cottrell: Replying to "Does this correlate ..." 100% several studies have shown a correlation between the two. 00:43:07 Stacy Broce: Replying to "Jason - the IDDW eli..." The system was built long before my time and I've learned that many of it's components cannot be changed. When the time comes for a new system, I believe there will be many changes/updates. 00:44:32 Jason Bowlick: Replying to "Jason - the IDDW eli..." It appears to me that it is more important to keep diagnoses to disqualify people than it is to keep the systems that maintain the program current. 00:45:24 Heather Dodge: Replying to "Does this correlate ..." I have had some of t... 00:45:46 gillian mccarty: I have several members that if truly had to reapply shouldn't qualify for waiver any longer, there are flaws in all the testing systems. 00:49:12 gillian mccarty: no one truly goes into these members home to actually teach the guardians how to physically address their loved ones 00:49:13 Jessica Noel: Reacted to "In the new draft man..." with 👍 00:49:47 Jason Bowlick: Replying to "no one truly goes in..." Or the solution is too hard to keep up with for required documentation. Hard to write behavior data if you cannot read/write. 00:50:04 gillian mccarty: Replying to "no one truly goes in..." also true 00:50:53 Jason Bowlick: Replying to "no one truly goes in..." Or the parents use discipline what their parents used to raise them, and it doesn't work like it should have. 00:52:21 Lesley Cottrell: Please feel free to unmute and ask any questions you may have/ comments you want to make. 00:52:54 Julianna Hayden: I would very much like Dr. Clayman's contact information 00:57:19 Julianna Hayden: Were both evaluated 00:57:54 Mena Seyed-Ashraf: What do Luke and Carlos want? 00:57:57 Melina Danko: I'm sure that you picked the ages of 26 on purpose because a lot of services stop prior to that age :( 00:58:15 Jessica Noel: What is happening before these behaviors occur? Is there a pattern of triggers? 00:58:21 Kelly King: Cooccurring conditions? Trauma? Verbal skills? 00:58:25 Lesley Cottrell: Reacted to "What is happening be..." with 👍🏻 00:58:45 Lesley Cottrell: Replying to "I'm sure that you pi..." Absolutely! 00:58:53 Brandon Kijewski: Exactly, what is happening right before the behaviors, the function 00:59:01 Lesley Cottrell: Replying to "Cooccurring conditio..." YES! 00:59:09 Kelly King: Responses to interventions? Function of these behaviors? 00:59:10 Melina Danko: What services/supports do they have in place? What do they do during the day? 00:59:33 Shannon Papp: Any medical trauma during birth for one or both? 01:00:01 Lesley Cottrell: What provider biases could occur in this situation over time? 01:00:51 Lesley Cottrell: Reacted to "Any medical trauma d..." with 👍🏻 01:01:11 Mena Seyed-Ashraf: My background isn't forensics. Starting where we are, I don't know anything about real about current function or goals. What is increased aggression? What is the damage to a bedroom? What motivated and preceded the aggression and damage? I view things from a "let's ensure safety" and then goals 01:01:19 Brandon Kijewski: Burnout for one if this has been an ongoing issue 01:01:33 Lesley Cottrell: Replying to "Any medical trauma d..." No significant events during pregnancy. Both brothers were exposed to secondary smoke. Family history: depression on mom’s side; no recollection on father’s side. 01:02:01 Jason Bowlick: Everything has to be person-centered, except for diagnostic testing, funding, access to services, availability of services, and preventative measures for services for people that cannot take care of themselves. 01:02:23 Lesley Cottrell: Replying to "What services/suppor..." I’m assuming you are thinking of the twins as well as their mom with your Family to Family hat, right? 01:02:44 Melina Danko: Replying to "What services/suppor..." Right 01:03:03 Lesley Cottrell: Replying to "Responses to interve..." Yes! Previous treatments and outcomes of those efforts. 01:03:37 Jessica Noel: To do one right is difficult with people of this demographic. 01:03:55 Kelly King: Medications? 01:04:00 Lesley Cottrell: Replying to "Everything has to be..." Great comment and absolutely necessary! Pilot models are available that are looking at cost-effectiveness of this….will be sending those after the meeting in case everyone wants to review. 01:04:21 Jason Bowlick: I called 5 counseling agencies within 10 miles of a member's home. 2 won't take Medicaid because they never get reimbursed for counseling, and 3 would only take managed care Medicaid pass-throughs, because straight Medicaid will not reimburse for counseling. 01:04:34 Lesley Cottrell: Reacted to "I called 5 counselin..." with ❤️ 01:04:39 Lesley Cottrell: Reacted to "Medications?" with 👍🏻 01:05:27 Lesley Cottrell: What assessments would everyone suggest? What other pieces of information are needed by providers? Families? 01:07:18 Jason Bowlick: My opinion is the models we use currently consider mental processes separate from biological processes. Fairly sure the brain is an organ also... 01:07:45 Brandon Kijewski: That is a very valid point about the training differences between the psychologist and a neuro; many of the folks that complete the psych evals are MA’s not MD’s; and I mean no disrespect but that level of training and knowledge is just different 01:08:29 Lesley Cottrell: Please share your evaluation of this session and offer your feedback to make this stronger: Https://wvu.qualtrics.com/jfe/form/SV_8ocdLY6h5RK6uW2 01:09:43 Jason Bowlick: Replying to "That is a very valid..." 20 years ago, a psychologist was required to attend IPP meetings. That cost too much to require and there was a shortage of professionals to meet the requirements. It is not a service code now, but it was supportive to have such a qualified person for such difficult issues to be planned for. 01:10:13 gillian mccarty: Replying to "That is a very valid..." you would never be able to schedule them now as well 01:10:31 Lesley Cottrell: We will be sending sources related to data in this presentation, articles about this topic, pilot models we could find elsewhere, Dr. Clayman’s contact information, and more in an email you will get after this meeting. Thank you for participating, sharing your thoughts, and spending time with us during your lunch break. 01:10:36 Jason Bowlick: Replying to "That is a very valid..." It was easier for agencies to contract with one and it was not hard to schedule. 01:10:50 Mena Seyed-Ashraf: Jail or mental hygiene 01:11:26 Brandon Kijewski: Replying to "That is a very valid..." The cost cutting thing is a real thing and ultimately impacts patient care, anyone who is familiar with what MedExpress is going through right now, its all bout the almighty dollar sadly 01:12:14 Lesley Cottrell: Long-term follow up on “Luke” and “Carlos”- Luke was institutionalized with his growing aggression (to others+property) when he started to exhibit aggression in other settings. Carlos- focused therapy. Stayed in home with supports. 01:12:32 Jason Bowlick: Replying to "That is a very valid..." We're all here because we are being paid. Yet, we are expected to do things for free to meet program requirements sometimes. It's not sad if you reimagine it as reality. 01:12:38 Kelly King: These situations are all too common. Diagnositc overshadowing; it’s just the autism or the ID. Psychiatrists guess (“I think it’s anxiety). The medical practitioners don’t cooperate, nor even talk and/or are afraid of these individuals. 01:13:16 Brandon Kijewski: That point about grandma and candy absolutely hits a trigger point for me, without full buy in from the entire team, its almost impossible 01:13:28 Melina Danko: What would have been the ideal course of action in this situation? 01:14:14 Melina Danko: Replying to "What would have been..." To clarify further- what steps would you have recommended to mom to help get things moving in a positive direction? 01:14:21 Kelly King: Once they move into the residential settings with inadequately trained staff they will fare far worse ; I see it frequently. 01:14:25 Jason Bowlick: I predict that resources were not available or accessible, both ended up being detained into state custody, deemed incompetent, and now are placed in residential treatment. 01:14:55 Emily Jordan: Once adjudication is complete, program coordinator and myself have found that ICF not being able to administer chemical restraints is an important part. We are trying to explore options related to the member having access to the same psychiatrist/psychologist that’s been treating them in the state institution so that they may have access to psychotropic medications since it takes time to get set up with a new psychologist which may not prescribe any new psychiatric medications until they see them for the first time. 01:15:00 Kelly King: I genuinely live this; want to help with our complex case? 01:15:36 Kelly King: Services and supports in rural communities are poor 01:16:08 Shannon Papp: Why don't we have more behavioral respite for people with disabilities of most ages? Why must we wait until there is a crisis? We aren't preventing issues this way.. 01:16:12 Lesley Cottrell: FYI- this group also has the opportunity to identify solutions that may be out there for others to consider….think about that and share thoughts. 01:16:35 Melina Danko: Reacted to "FYI- this group also..." with 👍 01:16:48 Julianna Hayden: Reacted to "FYI- this group also..." with 👍 01:17:11 Kelly King: Recent respite provider called police twice in weekend 01:17:41 Lesley Cottrell: DAC@claymanassociates.com 01:18:04 Shannon Papp: Replying to "Why don't we have mo..." Parents and staff ge... 01:18:55 Kelly King: PA has Dual Diagnosis Treatment teams but you have to leave for psychiatrist & they have met with poor success 01:18:55 Jessica Noel: Reacted to "Parents and staff ge..." with ❤️ 01:19:29 Kelly King: Replying to "Why don't we have mo…" And serious injury to parents and the individual. 01:20:03 Mary Wilson: Very helpful, Thank You! 01:20:20 Julianna Hayden: One issue is the sharing of information and HIPPA concerns - specifically getting access to medical information and sharing with those not on the team 01:20:22 Charity Carroll: I would like a certificate. I did not receive one from last month. Charity Carroll. 01:20:38 Sherry Zachwieja: Replying to "Why don't we have mo..." We want to be part of the solution 01:20:44 Lesley Cottrell: Reacted to "We want to be part o..." with ❤️ 01:20:55 Lesley Cottrell: Reacted to "I would like a certi..." with 👍🏻 01:21:19 Emily Jordan: I would like a certificate. Emily Jordan. 01:21:20 Shannon Papp: Reacted to We want to be part o... with "❤️" 01:21:35 Lesley Cottrell: Replying to "I would like a certi..." Charity- I sent it to your registration email for session 1. Should I use a different email 01:21:40 Mena Seyed-Ashraf: Are SES issues being addressed within the policy changes? 01:21:59 Lesley Cottrell: Reacted to "I would like a certi..." with 👍🏻 01:22:25 Kelly King: Agenies cherry pick those without aggressive tendencies 01:22:57 Julianna Hayden: Reacted to "Agenies cherry pick ..." with 👍