POC processing: 45 day rule – There have been some issues with POC’s being submitted late. 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 by December 15th. Whenever the CDDO submits a POC without supporting documents notification will be sent to the Case Manager, TCM Supervisor, Agency Director, the person/guardian and the CDDO Quality Management Coordinator. The CDDO has this system in place to avoid a delay in payment to providers.
Review Extraordinary Funding process/TCM responsibilities – Just a reminder for TCMs to collaborate with the provider on submission of required paperwork. There has been a delay with submission of EF documentation.
Location of BASIS meetings – When TCMs send out notice of the BASIS meetings please send a copy of the notice to the Screeners or send them an email. There have been recent incidents when the location of the meeting was changed and the Screener was not informed.
Personal Awareness Satisfaction Tool – Timili (QMC) is in the process of revising the PAS Tool. The revised tool will be available January 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. Timili will complete the summary which will include positive and negative comments noted in the tool and send it to providers. The CDDO will request the provider submit a Corrective Action Plan if the score on the PAS tool is 2 or lower, identifies health/safety issues or has an area of needed improvement per regulations.
CDDO Review – Area reviewed were based on Article 64. 15 of the 16 outcomes reviewed were present. The PAS summary has been added per the reviewers’ recommendation.
TCM Review in October - Ramona thanked Case Management providers for submitting copies of the requested documentation to Timili in a timely fashion.
Restructuring of regional office staff for quality assurance vs. quality improvement January 1, 2007. CSS will ask for stakeholder input for writing new policies to reflect these changes. Regional staff will complete licensing and KLOs. Margaret Zillinger, Director of Community Supports & Services, letter about the changes was forwarded to affiliates via email on 11/01/06. Sherrie Radcliff, SRS QEC, is the contact for the NE region since Liz Long accepted a new position. Ramona will continue to forward additional information as she receives it.
TCM/CPE: Health Care Policy Authority; Case Management definition has been rewritten. It has been suggested by CMS that Case Managers bill 15 minute unit vs monthly encounter. SRS will conduct a rate study for case management costs to begin January 2, 2007. (Tri-Valley & DPOK have piloted the tool). Mercer will conduct the rate study. CMS is currently reviewing Targeted Case Management services across all waivers and services i.e. Mental Health CM, DD CM, etc. The Mental Health system is anticipating major changes in their operations but nothing has been changed at this time. The CDDO continues to meet with several mental health agencies every other month to share updates on systems.
No CDDO sponsored trainings this month.
White Elephant gift exchange – A special thank you goes out to all the Targeted Case Managers for a great year. Your hard work and dedication is commended. Happy Holidays from the Shawnee County CDDO! – js