HCBA waiver:
Why San Ysidro Health has been assigned by the department of Health Care services?
To provide administrative services and Comprehensive Care Management services, under the Medi-Cal Home- and Community-Based Alternatives (HCBA) Waiver Program to San Diego County participants.
The NOA form must advise the participant of the decision and the reason(s) to:
A single WPCS provider can only claim how Many hours per week?
70.45hrs
Guide me how to find the Updated POT checklists in the xdrive.
X:\Teams\HCBA Waiver\Private\4. Training\4. POT Training-Policy\b. POT Guideline
Tell me what to include in the Email Subject line template when Adding Initial Hours and providers
Subject Line (Last name, First name (CIN#) (ADDING INITIAL HOURS AND PROVIDERS)
Fill in the blank:
SYH will process undisputed service authorization requests within ___ days of submission from the Waiver service provider.
30 days
Case managers must give justification in their request when asking for a WPCS provider to be added with a Start of Care Date this number of days in the past.
60 DAYS
Level 2 requires visualization?
Yes for level 2 , visualization is every other month and level 3 is every month.
When was the last updated for the New paid Sick leave program for Waiver personal care services?
Last update July 1 2020
In the MF Template, What is requested to add after Services? HINT 3 Sections
BUPS REFERRAL: n/a
OTE: n/a
IHSS AUTH SUMMARY (NOA):
Name 3 of the enforced waiver participant Rights
Freedom of Choice
•Circle of Support
•Backup Waiver Service Providers
•Continuity of Care
•Safe Home Environment
•Community Integration
The State of California requests approval for a Medicaid home and community-based services (HCBS) waiver under the authority of ____ of the Social Security Act (the Act).
§1915(c)
True or False: The HCBA Waiver Comprehensive Care Management service includes participant assessment, care planning, except service arrangement, and Waiver participant and service provider monitoring.
False,
The HCBA Waiver Comprehensive Care Management service includes participant assessment, care planning, service arrangement, and Waiver participant and service provider monitoring.
For caregivers where do they look online To set up and register your account to begin claiming sick leave time
If you would like to re fax a POT -Guide me where to find the folder in the private folder
Xdrive-HCBA Waiver-Private-Select B. POT faxed
The participant must request a State Fair Hearing within _calendar days after the date the NOA is mailed.
90 Days
True or False:HCBA Waiver participants or their legal representative have the opportunity to select and dismiss licensed and unlicensed care providers who, under the direction of the participant or legal representative, can provide waiver services.
True
If a PCG is obtaining OT how many hours can they claim per month?
360 per month or 12 hours per day
Do providers have a way to verify if they qualify for PTO?
They have to work 100 hours for it to appear in their portal and then an additional 200 hours OR 60 calendar days- whichever comes first.
Without using a calculator convert 19 minutes into hour decimal
0.32
Fill in the blank:
The _____ refers to a system or scale that determines the complexity and intensity of a client's needs, assigning a score to tailor care plans and manage workloads more effectively.
The Case Management Acuity
When was the last DHCS 2279 (OT exemption request) Form Revised
02/21
To request provider effective date change (Public Authority): Who do we sent the email to? and who should be CC.
To: providerenrollment@sdcounty.ca.gov
CC: Deborah.Grepo@sdcounty.ca.gov; (YOUR SUPERVISOR)
Bonus point: Make Encrypted Message
Provide 3 urgent needs per DHCS?
Any hospitalizations where members have lost WPCS hours, need to be manually reinstated and providers have lost WPCS as welL
3rd OTE violationS
Intercounty transfers - need to be manually reinstated
Timesheet issues d/t death of the member, if issue with signing timesheets
Physical paycheck that has been lost, stolen or never receiveD
Loss of housing within 30 days
Loss of provider within 30 days
If there is a fair hearing decision
ase where may be a grievance
Any cases that are still not processed after 6 months from date of initial request
BUPS related issues
In the POT what would you find in section 19?
Treatment period goal and discharge plan.