Overview
Services
POT Update vs RN Reassessment
Newly Open Case Management (NOCM)
100

This procedure allows to verify if patient/applicant's Medi-Cal is active and running. The results should have the color yellow on the page. The OCM SW uploads this onto the patient's NetSmart chart. OCM/Intake RN can also complete this procedure as needed. 

What is Medi-Cal eligibility check? 

*Bonus - where does this get uploaded on NetSmart? 

100
The applicant/patient must have these services in place in order to qualify for WPCS? 

What is In-Home Supportive Services (IHSS)? 

100
When scheduling the RN reassessment appointment, the OCM SW must complete this procedure to gather preliminary information about the patient. (Hint: Biopsychosocial assessment) 
What is an acuity tool? 
100

This is when applicants have applied for the HCBA Waiver Program for the first time and are waiting for DHCS to make final determination for eligibility. 

What is pending enrollment? 

200

When checking Medi-Cal, the dollar amount should not be shown on their Medi-Cal information.

What is a Share of Cost (SOC)? 

200

When a patient has this level of acuity, the OCM SW must conduct a vidoe call once a month as a monthly follow-up and complete the acuity tool. 

What is a level 3 patient? 
200

When reviewing services authorized through the HCBA Waiver Program, this document can be requested to review hours authorized through IHSS. 

What is an IHSS Authorization Summary?* 

*Bonus: Who do you have to email to request this? 

200

If an applicant is admitted at the hospital by the time they are officially enrolled into the HCBA Waiver Program, they have these number of days to discharge from the facility to still be eligible for the HCBA Waiver Program. 

What is 90-day period? 

300
Once a client turns 21 years-old, their eligibility for these programs will terminate which can effect the approved services. 

What is California Childrens Services (CCS) and Early Periodic Screening Diagnositc Testing (EPSDT)? 

300
The patient must gather 2 invoices from licensed contractors, letters from their doctor and physical/occupational therapist, and a letter from the home owner stating their consent to have the home remodeled to cater the patient's needs. 
What is home modification?* 

*Bonus - how much can each patient spend per lifetime on home modification? 

300

The OCM/Intake RN completes this document during their video calll appointments.

What is a case report? 

300
The Plan of Treatment (POT) gets uploaded here which is the one that DHCS reviews for applicant's eligibility for the HCBA Waiver Program. 

What is MedCompass?*

*Bonus - where can you find this on MedCompass? 

400

When a patient is not eligible for Medi-Cal due to their spouse's income being too high, they can go through this procedure to be eligible for Medi-Cal based on their medical condition? 

What is Spousal Impoverishment? 

400

If a patient is admitted at the hospital for more than 60 days or if the patient's family decides to have patient remain in a long-term care facility, the OCM SW or RN can request this procedure. 

What is a Notice of Action (NOA)? 
400
OCM - This type of appointment is set for 2 hours and is a video call for the RN.

What is a RN reassessment? 

400

This date will be included in the state nurse's case note on MedCompass when stating the applicant's approval for the HCBA Waiver Program. (Ex: “[Insert age, diagnosis, medical condition] … Client qualified for NF-AB LOC, acuity level 2, enrolled in the HCBA wavier program [answer] 11.8.2022. WA notified”)

What is an effective date? 

500

This waiver program is also managed by Department of Health Care Services (DHCS) and Regional Centers that authorizes services for those with physical, motor, social, and cognitive disabilities. 

What is Developmental Disabilities Waiver (DD Waiver)?*  

*Bonus - can clients double dip in more than two waiver programs? 

500

When requesting a NOA, reporting a death, or stating a patient is tranferring out of Libertana's jurisdiction, the OCM/Intake SW and/or RN inputs the applicant's/patient's name on this spreadsheet. 

What is the Lead Tracking? 

500

This is where the SW inputs the scheduled RN appointment and for the RN to show availability and review their appointments for the upcoming week. 

What is NetSmart Business Operations (5A-Prefill Process OCM)? 
500
Once the applicant gets enrolled into the HCBA Waiver Program, the OCM SW sends this welcome letter to the applicant/legal rep? It states roles and responsibilities of all parties involved in the patient's care. 
What is an Informing Notice? 
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