DD Waiver Responsibilities
This is the primary role of a Support Coordinator in helping individuals with developmental disabilities under the DD waiver.
Assisting individuals to develop, implement, and monitor their Individual Support Plan (ISP)?
DBHDS requires Support Coordinators to report this type of event immediately if it involves harm or risk to the individual.
How do we report?
When do we report?
A Critical Incident.
-Complete a critical incident report, email to Adam Sass and cc supervisor.
-We report within 24 hours of becoming aware of critical incident whether by phone or email, even if you checked phone messages and emails on the weekend.
By what time must face-to-face (F2F) notes be completed to remain in compliance with DMAS and DBHDS regulations
Within two days after the face-to-face visit occurred.
BI, FIS, CL
Building Independence Waiver
Family and Individual Supports Waiver
Community Living Waiver
What credible services are completed after face-to-face visits?
F2F note
OSVT
CAT
ECM (if change in status).
Support Coordinators must ensure services under the DD waiver align with this plan created with the individual and their team. (Name the Plan)
The Individual Support Plan (ISP)
Under DBHDS regulations, Support Coordinators must participate in this process to ensure quality and compliance of services provided.
Quality Assurance and Monitoring reviews (HSAG, SCQRs, Supervisor QAs)
DMAS requires Support Coordinators to verify this before authorizing services under the Medicaid DD waiver.
Eligibility and Medicaid enrollment
QR
Quarterly Report
What documents are required to be signed during a DD waiver ISP meeting?
Consent for Services
Code of Conduct
Financial Agreements/Assignment of Benefits
Human Rights
Voter's Registration
SC Choice Form
VA Informed Choice
ISP Signature Sheet
ROIs
Credible Plan (Support Coordination Plan)
This requirement under the DD waiver ensures Support Coordinators perform visits to monitor the individual's health and welfare.
List the 2 types of case management and the corresponding visit requirements (days).
-Visits occur every 90 days
2. Enhanced Case Management (ECM)
-Visits occur every 30 days
Support Coordinators must ensure ____and ____ are protected according to DBHDS rules.
Individual's choice and Human Rights
According to DMAS, Support Coordinators must submit these documents to authorize or update services.
The Individual Support Plan (ISP) and Service Authorization request.
WSAC
Waiver Slot Assignment Committee
- It is a group of impartial volunteers responsible for determining the urgency of a person's need for a Developmental Disabilities (DD) Medicaid waiver slot.
What credible service is used to document "SC constructed WAMS ISP plan"?
Collateral NB (DD or ID depending on individual's assigned program)
Support Coordinators must assist individuals in accessing these services that are covered under the DD waiver, which may include day support, residential, and respite. What types of services are these?
DD Waiver Services
Before a Service Authorization can be submitted to our DBHDS PA authorizer what is needed from providers?
What section in WAMS is important for providers to include support instructions for?
Service Authorization and Part V for each service requested.
Essential Supports and Routine Supports (to include exceptional medical and behavioral supports outlined in SIS assessment).
DMAS regulations require Support Coordinators to track and report this to prevent service duplication or fraud. (What to we ensure providers, including ourselves, are doing)
Utilization of services and Billing compliance
IFSP
WWL
Individual and Family Support Program
-Provides direct financial assistance and community coordination to individuals and families on the waiting list for developmental disability waivers
Waiver Waiting List
-The waiver waitlist in Virginia refers to the waiting list for services through the state's Medicaid Developmental Disability (DD) Waivers, which provide support for individuals with developmental disabilities to live in the community instead of in institutions. There is a waitlist because there are more people who qualify for these waivers than there are available slots, and those on the list are prioritized by urgency of need.
What credible services are used to document the ISP meeting? What has to be updated in Credible after the ISP is complete?
F2F note
OSVT
CAT
ECM
Falls Risk
Gen Referral External/Internal or both
-Client Ext. Profile
What system does Support Coordinators utilize to enter ISP Plans, VIDES, Priority Needs Checklist, Critical Needs Summary, and SARFS. In addition, to review provider Part Vs and Service Authorizations.
Virginia Waiver Management System (WAMS)
List one of the 10 SCQR indicators tracked by DBHDS.
1. Choice of SC/CM
2. Choice of Providers
3. Measurable outcomes including employment
4. ISP development participation
5. ISP conflict resolution
6. SC/CM assists with developing comprehensive ISP
7. Risk assessment and mediation
8. ISP includes necessary supports and services
9. Change in status and plans modified
10. Appropriately implemented services
Support Coordinators must ensure DD waiver providers meet this DMAS standard before delivering services.
DBHDS Provider enrollment and licensing requirements.
HSAG?
NCI?
SCQR?
Health Services Advisory Group (HSAG)
Hired by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) to evaluate the quality of services provided through the state's Developmental Disabilities (DD) Waivers. This evaluation, called a Quality Service Review (QSR), includes reviewing providers and individuals to ensure services meet person-centered planning and integrated setting requirements.
National Core Indicators (NCI)
It is a voluntary, nationwide program that state agencies use to measure and track their performance in supporting people with intellectual and developmental disabilities (IDD) and their families.
The NCI program helps states evaluate whether DD waiver services are meeting the desired outcomes for individuals by collecting data through standardized surveys.
The Support Coordination Quality Review (SCQR)
Its purpose is
What document has to be updated and signed anytime there is a change in providers, interest in providers, or tours completed?
VA Informed Choice