BASIS meeting locations – Case Manager’s have been asked to send BASIS meeting notices to the Screeners. There have been recent incidents when the location of the meeting was changed and the Screener was not informed.
NEW: Personal Awareness Satisfaction (PAS) Summary – Timili (Quality Management Coordinator) is in the process of revising the PAS Tool. The revised tool will be available January 1, 2007. The overall rating number will now be at the top of the form instead of the end and it will automatically tally the overall score. Please be aware there are some changes to the wording of questions. A summary section was added at the end of the PAS tool for CDDO use only. Timili will complete the summary which will include positive outcomes and any areas of needed improvement that were identified. The summary will be sent to the agency providing the service. Timili will be contacting the Directors of licensed providers to ask for a designated contact at their agency to send the PAS summaries. The CDDO will request the provider submit a written action plan whenever the overall PAS score is 2 or lower, when health/safety issues have been identified or when there is an area of needed improvement to meet regulation requirements.
POC 45 day rule – There have recent issues with POC’s being submitted late to the CDDO. Diane (Grant Coordinator) is required to call the DD Waiver Program Manager and request approval for each POC entered in the system past 45 days. Example: If the POC’s start date is November 1st, the CDDO must enter the POC into the system by December 15th. The CDDO requires that supporting documents are submitted to the Funding Committee with the POC so anytime the CDDO submits a POC for State approval without receiving supporting documents a notification will be sent to the Case Manager, TCM Supervisor, Agency Director, the person/guardian and the CDDO Quality Management Coordinator. (The CDDO will process POCs prior to the 45 day rule in order to avoid a delay in payment to the provider).
A provider expressed concerns that when TCM’s are late turning in POC’s, then the provider is late receiving their payment and attendants are upset because they can’t get paid. The provider also stated they don’t always get a copy of the approved POC from TCM’s.
Aging Coalition update – There was a meeting in November and the Coalition has identified education as a goal for the upcoming year. Dr. Kelly attended the last meeting and has agreed to attend future meetings as a resource. The Coalition is developing a form that will be made available to caregivers (family members and providers) who accompany individuals to the doctor. The form will include things such as, how to interact with the doctor, things you need to tell the doctor, questions to ask and what to bring with you to the appointment. Dr. Kelly mentioned that there is still a fear in the medical profession in regards to working with someone that has a developmental disability. This Coalition also would like to educate health care professionals, hospital staff and emergency room personnel. Ramona will share a draft copy of the form once it is developed. This group meets the 3rd Thursday of each month if anyone is interested in participating. The next meeting is Jan 18, 2007 from 9a-10a at the Library.
II. HCP/CSS Updates:
SRS/CDDO conference call 11/30/06 – Ramona highlighted areas discussed during the call.
Regional restructuring of Quality Improvement and Quality Enhancement staff. Staff will be supervised by the SRS Region. Liz Long was hired in a new position to train the field staff. HCP/CSS will seek stakeholder input in January for writing new policies regarding changes to the licensing and KLO process. Changes are to be effective July 1, 2007.
SRS applied for The Money Follows the Person Grant which was submitted to Centers for Medicaid & Medicare Services (CMS) for approval. This is a 5 year grant and would apply to individuals transitioning out of institutions and ICF/MRs into community based services. These monies would be used for start up funds for the person such as supplies, staff training, etc. The individual must move into a residence with 4 or less to be eligible for the grant. SRS has targeted 191 individuals from ICF/MRs and 120 individuals from SMRH moving into their home community over a 5 year time frame.
Certified Public Expenditures – Health Care Policy Authority is responsible for determining how case management activities are completed statewide. The CM definition has been re-written and CMS recommended that billable activities be in a 15 minute unit vs monthly encounter. CDDOs are currently the enrolled Medicaid provider for TCM billing. SRS contracted with Mercer to conduct a TCM rate study to determine actual costs for case management activities. The rate study will be conducted Jan 2nd through Feb 5th which is a very short turn around time. Tri-Valley & DPOK piloted the tool in December.
Waiver Definition Changes – HCP/CSS MRDD Program Manager submitted waiver definition amendments to CMS for approval on 8/23/06. CMS had a change in staff and this appears to have delayed the approval process. HCP will proceed with writing policies for Personal Assistive Services so it is ready for EDS upon approval from CMS.
Secretary Daniels resigned and Don Jordan is his replacement.
Closure of state hospitals – Closure is not on the agenda for SRS, although individuals may always transition out to community based services.
Foster care contractor meeting – SRS and the foster care contractor me to discuss roles and reimbursement for supporting kids in the foster care system with the DD. The reimbursement rate for children in foster care on the MR/DD Waiver is done differently in each CDDO area. The foster care system is supportive of developing a Needs Assessment tool as a standardized form to be used statewide for consistency. Shawnee County currently pays the tier rate to affiliated providers.
BASIS roundtable meetings – HCP/CSS plan to schedule a meeting soon. The Program Manager has been waiting for all revisions to be completed on the BASIS services page. CDDOs encouraged that the first meeting get scheduled to discuss the assessment section and to have a meeting regarding the services page at a later date.
Three eligibility roundtable meetings have occurred.
Sherrie Radcliffe is the QEC for the NE Region which includes Shawnee County – Sherrie will shadow and train the NE regional staff assigned to MRDD licensing and the KLO process.
Statewide Quality Oversight Committee – The committee is reviewing how to collect statewide data for performance outcomes identified in the contract. Committee members include SRS employees, CDDO Quality Improvement staff and advocacy representatives. The committee reviewed and discussed a draft format for licensing requirements at the last meeting.
A provider asked if someone was on the waiting list for services but then received crisis funding where would they go on the waiting list if it was determined they no longer were eligible for crisis funding after the 90 day review. Ramona stated that for Shawnee County no one has had there funding discontinued after the 90 day review and will get clarification regarding the waiting list question.