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Individual Assisted Living Planning and Rate Negotiation Tool Testing Version Sponsored by Aging and Adult Services MN Department of Human Services Testing.

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Presentation on theme: "Individual Assisted Living Planning and Rate Negotiation Tool Testing Version Sponsored by Aging and Adult Services MN Department of Human Services Testing."— Presentation transcript:

1 Individual Assisted Living Planning and Rate Negotiation Tool Testing Version Sponsored by Aging and Adult Services MN Department of Human Services Testing 1…. 2….. 3…. Testing 1…. 2…. 3….

2 2 To Access Documents Stored as PDF documents. Download Acrobat Reader 5.0 to view

3 3 Testing Version l Looking for counties and providers –To learn how to best use this tool. –Best applications and limitations of this tool. –How to improve its performance so that it works well for the intended users. –If interested, email l Anticipate additional video conference training in September based on input and feedback.

4 4 Why? Why now? Quality Assurance - –Need to be accountable for EW/AC expenditures. Demonstrate link between individual need and services provided. Delineate services purchased and the amount of each. Assure AL/AL+ is as cost-effective a manner of purchasing services as fee-for-service.

5 5 Individualized Plan Assesse d Need ServiceRate Units X Negotiated Component Rate

6 6 Residential Care Expenditures EW Program 2000 Total R.C. $20,000.000 % of Total 37 % AL$ 3,400,000 AL+$ 9,500 RC$ 7,400.000 Corp AFC$ ---- Family FC$ 9,000.000 2002 Total R.C. $42,000.000 % of Total 51 % AL$ 2,300,000 AL+$33,000,000 RC$ 480.000 Corp AFC$ ---- Family FC$ 6,000.000

7 7 Technology l Designed to Link with Screening Document l Requires Acrobat READER to see form. –(Allows you to enter data, but not save it.) l Requires Full Adobe Acrobat or Acrobat Approval 5.0 to save data

8 8 The Tool What it is. l Individualized care planning tool l Calculates rate based on planned services What it isn’t. l Doesn’t “Set” rates l Doesn’t create a base set of services

9 9 Three Documents 1. Information on Proposed AL AL+ Services 2. A Worksheet for Computing the Costs of Supervision 3. Individual Assisted Living Planning and Rate Negotiation Tool.

10 10 Process Provider Completes “Information on Proposed AL AL+ Services” County and Provider Negotiate Component Rates Agreed Upon Component Rates are applied to Individual Assisted Living Plan

11 11 Information on Proposed AL AL+ Services l Basic Information About Provider l Proposed Component Rates l Identification of Proposed Services l Description of Socialization and Supervision Services Available Completed by provider for each site

12 12 Computing a Rate for Supervision Services This worksheet is an example of how supervision rate might be developed. –Avoid duplication of payments for supervision and other AL services. –Account for staff time providing needed supervision when no other AL/AL+ services are being provided

13 13 County and Provider Negotiate Component Rates

14 14 Agreed Upon Rates are Entered on Individual Assisted Living and Rate Negotiation Tool l Page 4 - Negotiated Component Rates l Suggestion: Develop “Naming Convention” e.g. –Save Pages 2 - 4 containing provider information under provider site name –Save Individual client data under their PMI or name followed by date

15 15 Reminder…. HIPAA Compliance Work processes that are changing to electronic documents and data streaming need to be HIPPA compliant. Check with your HIPAA compliance person.

16 16 Import Client Data l Open “ABC Assisted Living” l Choose File-Import-Form Data l Double click on the Form Data file name that you wish to transfer to the Tool. –Note: You must “tab through” the document to populate fields Voila!

17 17 Magic….. l Client information automatically populates –either from the screening document –or from the first time entered anywhere on the form l Assessment score is pulled from the Screening document (or can be entered manually) l “Standardized description of need” and “Typical level of AL/AL+ service” populates automatically once assessment score is entered. l “$ per month” automatically computes rates based on frequency and negotiated rates

18 18 Complete Individual Plan Navigation Tips –Tab through fields on the page or use mouse and click on desired field –Click on Back or Next Arrows to change page –Click on Home to access Page Menu

19 19 Case Manager Enters l Assessment item scores (if not linked to screening document). l Describes individual need and preferences. l Indicates if all or part of need is met outside of the AL package. l Indicates frequency/# of units. l Provides additional information, if needed. l Click on “next arrow” or home to navigate to other page.

20 20 Special Features l Laundry –Cost per load and/or time to assist l Socialization –Guides process with fields for *Outcome *Goal *Activities *Frequency *Support Needed

21 21 Special Features (cont’d) l Medications –All services related to meds are on one page –Allows for a variety of options l Dressing and Grooming –Integrated as tasks are usually done at the same time.

22 22 Special Features (cont’d) l Meal Preparation –Offers option for congregate meals and/or assistance in preparing individual meals l Communication, Hearing and Vision –Offers space to indicate needs

23 23 Supervision l Pulls information from related domains and indicates whether there is documentation of the need for supervision l Fields provide the basis for describing the supervision needed by the individual

24 24 Rate Calculation l Need to enter data –Client program code to generate case mix cap –Total for other authorized service l If Rates for proposed AL/AL+ services exceeds service limit or individual cap –Look for duplication of planned services. –Double check case mix for accuracy –Re-examine other services authorized –Re-examine number of units authorized –Re-think negotiated component rates.

25 25 More Magic l Summary is automatically generated. l Final Rate calculation l Documentation of supervision needs is pulled from various fields (wheeling score must be entered manually)

26 26 Questions/Input/Feedback l Component Rates l Technical glitches with the tool l User friendliness of tool l Potential uses

27 27 Forming a Work Group l Interested counties and providers l If interested, contact –

28 28 Questions?

29 29 Thanks for coming!

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