Home Based Waiver
LIFE Program
Family Directed Model
BQM
One Time Funding
100
What are the CHBS and AHBS monthly allotments as of January 1st, 2013?
CHBS: $1420

AHBs: $2130

100
When is it OK if staff training is expired?
NEVER!
100
What is the maximum 55A that can be billed per month, for Family Directed clients (with a few exceptions)?
3.5 hours
100
What does BQM stand for?
Bureau for Quality Management.
100
How many days does a client have to appeal a denial for a One-Time Funding request?
10 calendar days
200
1. When is the ISP due to the client/guardian and ISSA?

2. When is the guardian approval and ISSA approval due to the Service Facilitator?

1. 14 days

2. 21 days

200
What is the current Clearbrook agency fee?
$380
200
What percentage of taxes is the employer obligated to pay through ACES$?
10.5%
200
What does HRAC stand for?
Human Rights Advisory Committee
200
What do each of the following billing codes stand for: 53H, 53V, 53E, 53T
53H: Home Modification

53V: Vehicle Modification

53E: Adaptive Equipment

53T: Assistive Technology

300
What are the Level 1 and Level 2 behavior rates?
Level I: $77.86

Level II: $62.28

300
How many counties does the LIFE program serve?
13
300
What percentage of taxes is the employer is obligated to pay through PPL?
12.35%
300
How often, at minimum, must an Individual Service Plan be completed?
Every 365 days
300
Which item requires a written denial from HFS?

a. Van Lift

b. Wheel chair

c. Walk in shower

b. Wheel Chair
400
How many hours per fiscal year can a day program bill for services?
1100 hours per year
400
1. Admission Memo is due within _________ days of receiving a new client.

2. A family must be contacted within _________ days of receiving a new client.

1. 5 business days

2. 2 business days

400
After submitting the enrollment packet, what are the requirements for a Personal Support Worker to obtain a start date?
Background check comes back clear and Personal Support Worker completes fingerprinting requirements.
400
1. Whose Service Agreement is required to be updated every year?

2. Whose Service Agreement is required to be updated every six months?

1. AHBS clients

2. CHBS clients (flexible spending)

400
In addition to the documents required for a One-Time Funding request, what document must also be completed when using Creating Opportunities for your lowest bid?
Creating Opportunities Condition of Purchase.
500
Which one(s) can be billed under the CHBS Waiver? Chose all that apply.

A. Service Facilitation

B. Personal Support Work

C. Day Programming

D. Behavior Therapy

E. Physical/Occupation/Speech Therapy

F. Family Training

A, B, D, F
500
1. What is the maximum 55A that can be billed per month, for Agency model clients?

2. What is the maximum 55A that can be billed per month, for Family CILA clients?

1.12

2. 0

500
In the Family Directed Model, who of the following can be the employer for an individual over 18 who is not their own guardian? Choose all that apply.

A. Individual

B. Guardian

C. Other friends or family over 18

D. All of the above can be the employer

B, C
500
If a client has a behavioral, safety or medication restriction, what steps must you take during and after the Individual Service Plan meeting?
An adaptive goal must be developed and the Right's Restriction form must be completed by the Service Facilitator and reviewed by the Human Rights Advisory Committee.
500
What must be included, when submitting a request for approval of a One-Time Funding Home Modification over $5,000?
1. DHS Request Cover Sheet (page 1 & 2)

2. Letter of Need from Service Facilitator

3. Letter of Need from physician/therapist

4. Letter of Need guardian/client (not required but helpful)

5. Bids from two different providers for all modifications requested (lowest bid must be enrolled as a Medicaid Waiver provider)

6. Individual Service Plan

7. Proof of home ownership (only needed for home modifications that are more than $5,000)

8. Permission from landlord (if home is rented/leased)

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