Plan of Service
How often is a Level of Care determined?
The Level of Care is determined initially when the individual is applying and annually thereafter
What are the two types of Monthly Contacts?
1. Telephonic
2. Site Visit
What is a reportable event?
An allegation or an actual occurrence of an incident that adversely impacts or has the potential to adversely impact the health, welfare or safety of a participant
When should the "Waiver Eligibility Coordination" drop down in activities be used?
When checking eligibility for those enrolled in the waiver using only CFC services
AERS
Adult Evaluation and Review Services
After receiving an initial referral what three services need to be submitted before approval can be reviewed by MDH?
1. Level of Care
2. InteRAI Assessment
3. Plan of Service
How many attempted contacts should be completed before sending an Unable to Contact letter?
2 contacts should be attempted before sending the UTC letter to the client
What are the two types of complaint RE's?
1. Quality of Care
2. Service Issue
What are examples of activities you can log? (List 3)
Phone Calls, Consults, Research, Monthly Contacts, Home/site visits, Reportable events.
ATP
Authorization to Participate
What are services are specific to Community Options Waiver recipients? (at least three)
Adult Medical Day Care, Nutritionist/dietician, family training, behavioral consultation, assisted living, sr. center plus
What are the ongoing Supports Planner Tasks? (at least 2)
Monthly Phone Contacts, Quarterly Visits, Monthly Eligibility, POS revision/development, Annual Visits
What is the timeline for reporting RE's?
The incident must be resolved by the SP within 45 calendar days of the event
What does S02 MA coverage mean?
SSI Recipient
Bonus: Do SSI Recipients have a redetermination due date?
CPAS, CFC, CO
CPAS: Community Personal Assistance Services
CFC: Community First Choice
CO: Community Options
How long do you have to submit the Plan of Service after the inteRAI is submitted?
The Supports Planner should have the Plan of Service submitted no longer than 20 days after the receipt of inteRAI.
Why do we complete monthly contacts? (at least 1)
"Status Report" on our client's health and well being
"Report Card" on our client's activities
Great opportunity to document hard work
Measure outcomes and track progress
When should minor incidents be reported?
You should report minor incidents if they happen repeatedly
Bonus 100: What is the standard for reporting incidents?
A: The standard is to report anything that requires treatment beyond first aid
What are the two HIPAA consents?
1. Notification of Privacy Practice
2. Authorization for the release of protected health information
DDA
Developmental Disability Administration
When you receive a new client how long does the Health Department have to submit the inteRAI before the Supports Planner should follow up?
The inteRAI should be submitted within 15days. After this 15 days SP should contact the LHD to determine if assistance is needed.
If the inteRAI is not submitted after 20 days the Supports Planner should contact MDH CO admin unit
What should you check when reviewing eligibility monthly? (at least 3)
Check ATP status, Check for approved POS, Check active LOC, Check EDD letters, EVSing, Program status, insurance (MA/MC, Medicare, other), Name of NF if client is pending in NF, and note any issues on the client's file
How long do you have to visit a client if they report an immediate jeopardy RE?
If you are unsure whether the situation is under control you have 24hrs to make a home visit.
If you feel the situation is undercontrol and the client is known to be safe an onsite visit must be completed within 2 business days.
What does SMART stand for?
S-Specific and clear
M-Measurable
A- Attainable and Adequate to improve the participants situation
R-Realistic-Congruent with the participants value and cultural system
T- Timely-Have a timeframe
EDD
Eligibility Determinations Division (Previously known as DEWS)