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Physical Disabilities Waiver – Resource Utilization Improvement Mandatory Information Sessions for Targeted Case Managers: April 11, 13, 17 or 19, 2012.

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Presentation on theme: "Physical Disabilities Waiver – Resource Utilization Improvement Mandatory Information Sessions for Targeted Case Managers: April 11, 13, 17 or 19, 2012."— Presentation transcript:

1 Physical Disabilities Waiver – Resource Utilization Improvement Mandatory Information Sessions for Targeted Case Managers: April 11, 13, 17 or 19, 2012 Kansas Department of Social & Rehabilitation Services ~ Disability & Behavioral Health Services 1

2 Agenda Welcome; attendees; goals; commitment Today’s subject matters/action items 1.Standardization: Estimated normative utilization a.Attendant Care Worksheet (ACW) review b.Action if not within estimated norms 2.Waiting list management 3.Crisis service access 4.Focused review – today’s subjects + FMS 5.Post-attendance survey 2

3 Standardization: Information The Attendant Care Worksheets (ACWs) you use should be developed within the estimated normative ranges that are published. t%20Care%20Worksheet% %20%20PM%20DRAFT.pdf If the person’s needs cannot be met within the identified ranges, specific need must be identified and documented, and SRS program approval obtained. 3

4 Standardization: Action Items 1. Within five business days from this session, you should review the ACWs for each person you support. 2. If any ACW category of service utilization is outside the standardized norms, within 10 business days from this session, either  Develop a revised ACW and submit a revised POC; or  Develop and submit an ACW Exception Form with specific consumer-related details. ** Note: If you need more time to complete your review, please contact to discuss your 4

5 Standardization: How To Request Exceptions In order to get approval for ACW time exceptions: 1. Develop specific consumer-related justification and time requirements, by completing the ACW Exception Form. 2. The TCM must directly submit the ACW Exception Form, with the ACW, as attachments, to: 3. Response will be sent back via . 5

6 Additional Reminders Confine the creation of the POC to the identified needed hours. Temporary hours can always be added should the need arise. Plans must reflect consumer needs without regard to staff preferred schedules and must follow the provider manual definitions/descriptions. Sleep cycle support must be utilized, when appropriate, focusing only on demonstrated consumer nocturnal needs. 6

7 Waiting List Management: Information Every person who has been determined eligible for PD waiver services and is waiting for those services must: ◦ Be reassessed annually (this is an existing requirement and will be enforced) ◦ Have follow up check-ins quarterly ◦ Receive information as to how to access crisis service TCMs must document these processes 7

8 Waiting List Management: Action Items 1. Ensure that every person you serve who is waiting for PD waiver services has written information about the waiting list process and crisis service exceptions. 2. Ensure that notice of action is provided at time of initial evaluation and annually thereafter. 3. Check in (telephone is fine) with each person waiting once per quarter, to determine whether a change of circumstances requires action. 4. Document each of these actions in the person’s case file. 8

9 Crisis Exceptions: Information These are the crisis exception criteria: Confirmed by APS abuse, neglect or exploitation (this includes self-neglect), with documentation from the APS worker. Risk of family dissolution - interpreted to be children at risk of state custody or consumer at risk of institutionalization or both, with documentation from social worker, physician, law enforcement or other. End Stages of terminal illness - can be documented by physician’s order to hospice, physician’s statement or ARNP with statement as to end stages of life. Victim of domestic violence within the recent past documented by social worker, APS worker, physician, ER or law enforcement. 9

10 Crisis Exceptions: Information When one of these criteria are met, the person will be allowed immediate access to PD waiver services Deterioration of health or safety, environmental concerns, or other negative situations should be viewed carefully for crisis exception need. 10

11 Crisis Exceptions: Action Items 1. Ensure that each person waiting for services has information about the crisis exceptions. 2. In each quarterly interaction with people waiting for services, evaluate whether any of these criteria are met. 3. Contact the SRS program manager immediately to request a crisis exception if you think a crisis exception applies. 11

12 Focused Review: Information Starting in May 2012 the SRS Quality Management Staff will be conducting a focused review of the issues that have been addressed in this information session. In addition, we will be including targeted probes on issues related to FMS practices, and direct service worker pay rates. 12

13 Focused Review: Action Items 1. Ensure that you understand the information in this session. ◦ If you have questions, please confer with your supervisor or submit the question via to 2. Ensure that you have followed up on the action items identified in this session. 3. Cooperate fully when contacted for the focused review. 13

14 Post-Session Survey: Information In order for you to complete the process of this mandatory information session, you should complete the survey located at: This includes contact information for you, as well as caseload and subject matter information. 14

15 Post-Session Survey: Action Items 1. Please complete the survey within 3 business days of this session. ◦ The survey is brief and should take only minutes to complete. ◦ After completion, we will send you the ACW Exception Form. 2. If you have additional questions, you can contact Elizabeth Phelps, SRS/DBHS Medicaid/Program Oversight;

16 Summary/Next Steps Remember to complete your survey within 3 days, and review all of your ACWs within 5 days. Follow up on all “action items” in this session. ◦ The presentation document is available online at Cooperate with focused review activities in May. Thank you for participating! 16


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