Wavier
Consents
Notes
Life Plans
Other Responsibilities
100

What does SARF stand for? 

Service Amendment Request Form 

100

What is the purpose of the Section 2 tracker? 

(Choose All that applies)

Child states they are not currently receiving minor protected services.

Child does not meet age requirement (10 or 12) 

Permission denied to meeting alone with the child by the Child parent.

Child not able/willing to complete.  

100

How many notes should be placed in Medisked Daily? 

3-In Office

2-Out of Office

100

What is the Narrative Section? 

Intro Me

My Home 

Let Me Tell You About My Day

My Health 

My Relationship

My Happiness 

My School 


100

What is the correct naming convention for documents? 

LastName_FirstName_TABS_YEAR_Month_Date_Name of Document

200

Where are documents uploaded when requesting services? 

CHOICES and Medisked 

200

Who can consent for a person that doesn't have the capacity or the family?  

(Choose All that Applies)

Court Appointed Advocate 

DEI Committe

200

On or around the 15th What Happens? 

CM need to be halfway billed. 

200

What Part of the Life Plan will not let you move forward without this changed? 

(Choose all that applies) 

POMS/IPOPS

Service Authorization Section

200

What is renewed every two years? 

DDP2

300

Who Is the Waiver Service Liaison Supervisor? 

Brenda Stallings 

300

What is a Consent? 

The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention.  Informed consent is both an ethical and legal obligation of medical practitioners in the US and originates from the patient's right to direct what happens to their body or quality of life.

300

Billable or non-billable?

CM received a call from Don who says he was bored and wanted to talk.  He said he didn't go to program but didn't want to discuss it.  CM asked about his plans for the week, and he stated he will sleep.  Don said bye CM is boring too

Non-Billable 

Its subjective not objective 

300

What is the Life Plan process? 

Schedule Meeting with Person /Providers

Email/Mail Life plan generated from IAM. 

Conduct the Life Plan Meeting/Review all Annual Documents 

Write ALP or SLP Note, 

Attach Attestation, add to or correct plan, submit to audit, email providers, contact person or family to review.

Complete Distribution Note and Annual Consent Review

Get Approval/Publish

300

What should be renewed every three years? 

Psychological Evaluations

400

What is the email address to submit SARFs in the Bronx? 

opwdd.sm.ccoalertmetrobronx@opwdd.ny.gov

400

What is the DOH Number for Three Consent Forms and What are the used for? 

DOH-5058-Withdrawal Forms for Adults

DOH 5201-Children Consent Form 

DOH 5202-Withdrawal Forms for Children

DOH-5055 -Adult Consent Form 

400

What is the Core for this note?      

"CM Clare received a call from Gail of AHRCNYC inquiring about Ibrah and if he will attend.  CM shared with Ms. Gail Ibrah's mother stated he wants to attend Daybreak and not AHRCNYC as when the vans come, he rather goes to Daybreak.  Ms. Gail shared no van never went to the house and the reason is because she never sent the inhaler or a script for an inhaler."

Comprehensive Transitional Care

400

What explains the Life Plan Process?  

STANDARD OPERATING PROCEDURE: LIFE PLANS

400

Who is Incident Management Coordinator? 

Kirstie Valdez, M.P.A

500

What is needed for wavier enrollment? 

CAS/CANS Assessment 

APPLICATION FOR PARTICIPATION IN THE OPWDD HOME AND COMMUNITY BASED SERVICES (HCBS) WAIVER AND DOCUMENTATION OF CHOICES FORM

Request for Service Authorization (RSA) 

Life Plan Updated Completed  


500

What is the DOH # for Basic Consent forms? 

There is no number for the Basic form.   Hahaha Read your documents!

500

What are the Five Core Services/Requirements? 

1.Comprehensive Care Management 

2. Care Coordination and Health Promotion 

3. Comprehensive Transitional Care 

4. Individual and Family Support 

5. Referral to Community and Social Support Services

500

Seven Required Documents needed at Annual Life Plan Meeting 

Attestation, Consent, Grievance form, HIPPA, Incident Reporting Form, Privacy Practice Form, Person Centered Planning

500

What have several columns, rows, and colors? 

A Tracker