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Consumer Directed Services (CDS) Implementation Training for the Home and Community-based Services (HCS) and the Texas Home Living (TxHmL) Programs.

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Presentation on theme: "Consumer Directed Services (CDS) Implementation Training for the Home and Community-based Services (HCS) and the Texas Home Living (TxHmL) Programs."— Presentation transcript:

1 Consumer Directed Services (CDS) Implementation Training for the Home and Community-based Services (HCS) and the Texas Home Living (TxHmL) Programs

2

3 Consumer Directed Services HCS & TxHmL Enrollment Screens & Individual Plan of Care CHANGES

4 Presentation Agenda TopicTarget Audience Enrollments MRA Staff Revisions/Annual Provider and MRA Staff Renewals Transfers (Adding/ Provider and MRA Staff Changing providers - PE Staff)

5 MRA ENROLLMENT STEPS MRA ENROLLMENT STEPS (L01) - Enrollment (HCS &TxHmL) – Change (L23) - MR/RC – No Change (L02) - IPC (HCS &TxHmL) – Change (L03) - Enrollment Checklist - No Change (L09) - Register Client Update - No Change (L05) - Provider Choice - Change

6 Consumer Demographic Update Screens… NO CHANGES! (L11) Client Name Update (L11) Client Name Update (L12) Client Address Update (L12) Client Address Update (L10) Client Correspondent Update (L10) Client Correspondent Update (L20) Guardian Information Update (L20) Guardian Information Update

7 Permanency Planning Review (339) MRA Only Screen (If Applicable) MRA Only Screen (If Applicable) No Changes No Changes

8 L01 - CONSUMER ENROLLMENT

9 L01:CONSUMER ENROLLMENT: ADD/CHANGE/DELETE VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: __________ CLIENT ID: __________ COMPONENT CODE/LOCAL CASE NUMBER: ___ / __________ COMPONENT CODE/LOCAL CASE NUMBER: ___ / __________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: _ (A/ADD,C/CHANGE,D/DELETE) TYPE OF ENTRY: _ (A/ADD,C/CHANGE,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

10 L01:CONSUMER ENROLLMENT: ADD VC NAME: CAKE, PATTY CLIENT ID: MEDICAID NUMBER: LOCAL CASE NUMBER: (Contract Number-REMOVED) COMPONENT: 030 ENROLLMENT REQUEST DATE: (MMDDYYYY) WAIVER TYPE: 1 (1-HCS,4-TXHML) PRIOR DISCHARGE FROM A MEDICAID CERTIFIED NF OR ICF-MR?: N (Y/N) ADMIT FROM:1(1=COMM,2=ICF-MR,3=STATE SCH,4=REFINANCE,5=STATE HOSP) ENTER ONE OF THE FOLLOWING: SLOT TYPE :30_ (5-OBRA, 7-MDU, 9-ICF-MR, 12-PI, 13-PI4, 16-LA/REF, 18-TXHML/WL, 20-ICFMR#2, 25-PI#3, 26-CPS-HCS, 27-SM-MED ICFMR, 29-HOPE, 30-IL REDUCTION, 31-PI-08, 32-PI5, 33-SMICF2, 34-CPS-08, 35-NF-08) SLOT TRACKING NUMBER: MFP DEMO? N (Y/N) SLOT TRACKING NUMBER: MFP DEMO? N (Y/N) COUNTY OF SERVICE: 227 GUARDIAN: LAST NAME : *SELF*__________ SUFFIX : ____ LAST NAME : *SELF*__________ SUFFIX : ____ FIRST NAME: ____________ MIDDLE INITIAL: _ FIRST NAME: ____________ MIDDLE INITIAL: _ C/O : _____________________________ PHONE: ( ___ ) ___ - ____ C/O : _____________________________ PHONE: ( ___ ) ___ - ____ STREET : MUDPIE__________________ STREET : MUDPIE__________________ CITY : AUSTIN_______________ STATE: TX ZIP CODE: ____ READY TO ADD?: Y (Y/N) ACT:_ (L00/AUTH DATA ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRN

11 L05 - PROVIDER CHOICE L05 - PROVIDER CHOICE

12 L05:PROVIDER CHOICE: ADD/DEL VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: __________ CLIENT ID: __________ COMPONENT CODE/LOCAL CASE NUMBER: 030 / __________ MEDICAID NUMBER: _________ COMPONENT CODE/LOCAL CASE NUMBER: 030 / __________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: _ (A/ADD,D/DELETE) TYPE OF ENTRY: _ (A/ADD,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ___ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ___ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

13 L05:PROVIDER CHOICE: ADD VC L05:PROVIDER CHOICE: ADD VC NAME : CLIENT ID : MEDICAID NUMBER: LOCAL CASE NUMBER: COMPONENT : SLOT TYPE : SLOT TRACK NO: PROGRAM PROVIDER (PRGP): COMPONENT: ___ COMPONENT: ___ LOCAL CASE NUMBER: __________ CONTRACT NUMBER: _________ LOCAL CASE NUMBER: __________ CONTRACT NUMBER: _________ LOCATION CODE: ____ LOCATION CODE: ____ CONSUMER DIRECTED SERVICE AGENCY (CDSA): COMPONENT: ___ COMPONENT: ___ LOCAL CASE NUMBER: __________ CONTRACT NUMBER: _________ LOCAL CASE NUMBER: __________ CONTRACT NUMBER: _________ SERVICE BEGIN DATE: (MMDDYYYY) SERVICE COUNTY: 227 TRAVIS READY TO ADD? _ (Y/N) READY TO ADD? _ (Y/N) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

14 L02 - INDIVIDUAL PLAN OF CARE L02 - INDIVIDUAL PLAN OF CARE(HCS)

15 L02:INDIVIDUAL PLAN OF CARE VC L02:INDIVIDUAL PLAN OF CARE VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: CLIENT ID: COMPONENT CODE/LOCAL CASE NUMBER: 030 / __________ COMPONENT CODE/LOCAL CASE NUMBER: 030 / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: I I=INITIAL N=RENEWAL TYPE OF ENTRY: I I=INITIAL N=RENEWAL E=ERROR CORRECTION T=TRANSFER E=ERROR CORRECTION T=TRANSFER R=REVISION D=DELETE R=REVISION D=DELETE PLEASE ENTER FOR INITIAL PLANS ONLY: PLEASE ENTER FOR INITIAL PLANS ONLY: BEGIN DATE: (MMDDYYYY) BEGIN DATE: (MMDDYYYY) PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL _ 365 DAYS _ 270 DAYS _ 180 DAYS _ 365 DAYS _ 270 DAYS _ 180 DAYS *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

16 HCS L02:INDIVIDUAL PLAN OF CARE ENTRY:INITIAL VC060232A NAME: RANGERS, POWER A. CLCN: CLIENT ID: BEG DT: REV DT: (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CMM CASE MANAGEMENT 12 MONS SP SPEECH/LANGUAGE ___ HRS SHL SUPPORTED HOME LIV 900 HRS OT OCCUPATIONAL THERA HRS FC HCS FOSTER CARE DAYS PT PHYSICAL THERAPY HRS SL SUPERVISED LIVING DAYS DI DIETARY HRS RSS RES SUPPORT SVC DAYS PS PSYCHOLOGY HRS NU NURSING 20 HRS AU AUDIOLOGY HRS REH RESPITE HR 300 HRS SW SOCIAL WORK HRS RE RESPITE DAYS DE DENTAL DOL DH DAY HABILITATION 240 DAYS AA ADAPTIVE AIDS 100 DOL SE SUPPORTED EMP HRS MHM MINOR HOME MODS 1009 DOL SCV SUPPORT CONSULTAT 20 HRS FMSV FMS MONTHLY FEE 12 MO WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OHFH) READY TO ADD? Y (Y/N) ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

17 L02:INDIVIDUAL PLAN OF CARE ENTRY: INITIAL VC060234A NAME: RANGERS, POWER A. CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CMMB CASE MANAGEMENT 12 HRS SHLV SUPP HOME LIV 900 HRS REHV RESPITE (HOURS) 300HRS SCV SUPPORT CONSULT 20 HRS FMSV MONTHLY FEE 12 MO WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) CALCULATE?: N(Y/N) CDS ESTIMATED ANNUAL TOTAL: 20,121.00* READY TO ADD? Y (Y/N) ANNUAL COST: 36, COST CEILING: 78,967.75* ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

18 HCS L02:INDIVIDUAL PLAN OF CARE ENTRY: INITIAL VC060237A NAME: RANGERS, POWER A. CLCN: CLIENT ID:37613 IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CMMA CASE MANAGEMENT 12 MO NU NURSING 20 HRS CMMA CASE MANAGEMENT 12 MO NU NURSING 20 HRS DH DAY HABILITATION 240 DAYS AA ADAPTIVE AIDS 100 DOL MHM MINOR HOME MODS 1009 DOL PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 16,315.60* PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 16,315.60* READY TO CONTINUE? Y(Y/N) ANNUAL COST: 36, COST CEILING: 78,967.75* ACT:____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC) ACT:____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

19 HCS L02:INDIVIDUAL PLAN OF CARE ENTRY: INITIAL VC060238A NAME: RANGERS, POWER A. CLCN: CLIENT ID: PRGP:CONTRACT: COMPONENT: LOCAL CASE NUMBER: CDSA:CONTRACT: COMPONENT: LOCAL CASE NUMBER: IPC BEGIN DATE: 01/08/2008 REVISE DATE: 01/08/2008 END DATE: 01/06/2009 TOTAL ANNUAL COST : 36, COST CEILING: 78, TOTAL ANNUAL COST : 36, COST CEILING: 78, ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) CONTRACTED PROVIDER NAME: ______________ DATE (MMDDYYYY): ____________ CONTRACTED PROVIDER NAME: ______________ DATE (MMDDYYYY): ____________ IDT CERTIFICATION STATEMENT NAME DATE(MMDDYYYY) NAME DATE(MMDDYYYY) CASE MANAGER: FOREST SERVICE__________________ CASE MANAGER: FOREST SERVICE__________________ NURSE: NURSE JOANNE_____________ _______ NURSE: NURSE JOANNE_____________ _______ CONSUMER/LEGAL REPRESENTATIVE: QUACK, DUCKIE CONSUMER/LEGAL REPRESENTATIVE: QUACK, DUCKIE

20 L02 - INDIVIDUAL PLAN OF CARE L02 - INDIVIDUAL PLAN OF CARE(TxHmL)

21 L02:INDIVIDUAL PLAN OF CARE VC L02:INDIVIDUAL PLAN OF CARE VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: CLIENT ID: COMPONENT CODE/LOCAL CASE NUMBER: 010 / __________ COMPONENT CODE/LOCAL CASE NUMBER: 010 / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: I I=INITIAL N=RENEWAL TYPE OF ENTRY: I I=INITIAL N=RENEWAL E=ERROR CORRECTION T=TRANSFER E=ERROR CORRECTION T=TRANSFER R=REVISION D=DELETE R=REVISION D=DELETE PLEASE ENTER FOR INITIAL PLANS ONLY: PLEASE ENTER FOR INITIAL PLANS ONLY: BEGIN DATE: (MMDDYYYY) BEGIN DATE: (MMDDYYYY) PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL _ 365 DAYS _ 270 DAYS _ 180 DAYS _ 365 DAYS _ 270 DAYS _ 180 DAYS *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

22 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY - INITIAL VC060233A NAME: TURTLE,NINJA CLCN: CLIENT ID: NAME: TURTLE,NINJA CLCN: CLIENT ID: BEG DT: REV DT: ________ (MMDDYYYY) END DT: BEG DT: REV DT: ________ (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS AU AUDIOLOGY ___DOL OT OCCUPATIONAL THERAPY ___HRS AU AUDIOLOGY ___DOL OT OCCUPATIONAL THERAPY ___HRS BES BEHAVIOR SUPPORT 12 HRS PT PHYSICAL THERAPY ___HRS BES BEHAVIOR SUPPORT 12 HRS PT PHYSICAL THERAPY ___HRS CS COMMUNITY SUPPORT 100HRS RE RESPITE 10 DAYS CS COMMUNITY SUPPORT 100HRS RE RESPITE 10 DAYS DH DAY HABILITATION 120DAYS REH RESPITE HR 10 HRS DH DAY HABILITATION 120DAYS REH RESPITE HR 10 HRS DI DIETARY ___HRS SP SPEECH/LANGUAGE ___HRS DI DIETARY ___HRS SP SPEECH/LANGUAGE ___HRS EA EMP ASSISTANCE ___HRS SE SUPPORTED EMP ___HRS EA EMP ASSISTANCE ___HRS SE SUPPORTED EMP ___HRS NU NURSING 20 HRS DE DENTAL 500DOL NU NURSING 20 HRS DE DENTAL 500DOL MHM MINOR HOME MOD ____DOL AA ADAPTIVE AIDS ___DOL MHM MINOR HOME MOD ____DOL AA ADAPTIVE AIDS ___DOL MHMR MINOR HOME MOD RE ___DOL AAR ADAPTIVE AIDS REQ. ___DOL MHMR MINOR HOME MOD RE ___DOL AAR ADAPTIVE AIDS REQ. ___DOL SCV SUPPORT CONSULTAT 10HRS FMSV FMS MONTHLY FEE 12 MONS SCV SUPPORT CONSULTAT 10HRS FMSV FMS MONTHLY FEE 12 MONS WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OHFH) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OHFH) READY TO CONTINUE?: _ (Y/N) READY TO CONTINUE?: _ (Y/N) ACT: ____ F/FWD,B/BK,(L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

23 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY - INITIAL VC060234A NAME: TURTLE,NINJA CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS BESV BEHAVIOR SUPPORT 12 HRS REV RESPITE 10 DAYS BESV BEHAVIOR SUPPORT 12 HRS REV RESPITE 10 DAYS CSV COMMUNITY SUPPORT 100HRS REHV RESPITE HR 10 HRS DHV DAY HABILITATION 120DAYS DEV DENTAL 500 DOL DHV DAY HABILITATION 120DAYS DEV DENTAL 500 DOL NUV NURSING 20 HRS FMSV FMS MONTHLY FEE 12 MONS NUV NURSING 20 HRS FMSV FMS MONTHLY FEE 12 MONS SCV SUPPORT CONSULTAT 10HRS SCV SUPPORT CONSULTAT 10HRS WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) CALCULATE?: N (Y/N) CDS ESTIMATED ANNUAL TOTAL: 7,624.00* READY TO ADD? Y (Y/N) ANNUAL COST: 11, COST CEILING: 13, ACT:___ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

24 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY - INITIAL VC060234A NAME: TURTLE,NINJA CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS BESV BEHAVIOR SUPPORT 0 HRS REV RESPITE 10 DAYS BESV BEHAVIOR SUPPORT 0 HRS REV RESPITE 10 DAYS CSV COMMUNITY SUPPORT 100HRS REHV RESPITE HR 10 HRS DHV DAY HABILITATION 0 DAYS DEV DENTAL 0 DOL DHV DAY HABILITATION 0 DAYS DEV DENTAL 0 DOL NUV NURSING 20 HRS FMSV FMS MONTHLY FEE 12 MONS NUV NURSING 20 HRS FMSV FMS MONTHLY FEE 12 MONS SCV SUPPORT CONSULTAT 10HRS SCV SUPPORT CONSULTAT 10HRS WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) CALCULATE?: N (Y/N) CDS ESTIMATED ANNUAL TOTAL: 7,624.00* READY TO ADD? Y (Y/N) ANNUAL COST: 11, COST CEILING: 13, ACT:___ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

25 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY INITIAL VC060237A NAME: TURTLE,NINJA CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS BES BEHAVIOR SUPPORT 12 HRS DH DAY HABILTATION 120 DAYS BES BEHAVIOR SUPPORT 12 HRS DH DAY HABILTATION 120 DAYS DE DENTAL 500 DOL DE DENTAL 500 DOL PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 4, PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 4, READY TO CONTINUE? Y(Y/N) ANNUAL COST: 11, COST CEILING: 13, ACT: ___ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

26 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY: INITIAL VC060238A NAME: TURTLE,NINJA CLCN: CLIENT ID: PRGP:CONTRACT: COMPONENT: LOCAL CASE NUMBER: CDSA:CONTRACT: COMPONENT: LOCAL CASE NUMBER: IPC BEGIN DATE: 01/08/2008 REVISE DATE: END DATE: TOTAL ANNUAL COST : 11, COST CEILING: 13, TOTAL ANNUAL COST : 11, COST CEILING: 13, ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) CONTRACTED PROVIDER NAME: ___________________________ DATE (MMDDYYYY): _________ CONTRACTED PROVIDER NAME: ___________________________ DATE (MMDDYYYY): _________ IDT CERTIFICATION STATEMENT NAME DATE(MMDDYYYY) NAME DATE(MMDDYYYY) CASE MANAGER: FORREST SERVICE_________________ CASE MANAGER: FORREST SERVICE_________________ NURSE: NURSE JOANNE_____________ _______ NURSE: NURSE JOANNE_____________ _______ CONSUMER/LEGAL REPRESENTATIVE: SPLINTER CONSUMER/LEGAL REPRESENTATIVE: SPLINTER

27 HCS & TxHmL HCS & TxHmL IPC HARD COPY IPC HARD COPY

28 HCS IPC HARD COPY HCS: CDS SERVICES THAT CAN BE SELF-DIRECTED HCS: CDS SERVICES THAT CAN BE SELF-DIRECTED Supported Home Living Supported Home Living Respite Hourly Respite Hourly Respite Daily Respite Daily

29

30

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32 Entering the information from the hard copy IPC into CARE the hard copy IPC into CARE

33 TxHmL HARD COPY IPC TxHmL HARD COPY IPC TxHmL: CDS SERVICES THAT CAN BE SELF-DIRECTED AudiologyRespite AudiologyRespite Behavior SupportRespite Hourly Behavior SupportRespite Hourly Community SupportSpeech/Language Community SupportSpeech/Language Day HabilitationSupported Employment Day HabilitationSupported Employment DietaryDental DietaryDental Employee AssistanceMinor Home Mod Employee AssistanceMinor Home Mod NursingAdaptive Aids NursingAdaptive Aids Occupational Therapy Occupational Therapy Physical Therapy Physical Therapy

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35

36

37 Entering the information from the hard copy IPC into CARE the hard copy IPC into CARE

38 TxHmL & HCS RENEWALS & REVISIONS RENEWALS & REVISIONS

39 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY: RENEWAL VC060233A NAME: HAMMER, M C JR CLCN: CLIENT ID: NAME: HAMMER, M C JR CLCN: CLIENT ID: BEG DT: REV DT: (MMDDYYYY) END DT: BEG DT: REV DT: (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS AU AUDIOLOGY HRS OT OCCUPATIONAL THERAPY 2 HRS AU AUDIOLOGY HRS OT OCCUPATIONAL THERAPY 2 HRS BES BEHAVIOR SUPPORT 10 HRS PT PHYSICAL THERAPY HRS BES BEHAVIOR SUPPORT 10 HRS PT PHYSICAL THERAPY HRS CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAYS CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAYS DH DAY HABILITATION 104DAYS REH RESPITE HR HRS DH DAY HABILITATION 104DAYS REH RESPITE HR HRS DI DIETARY HRS SP SPEECH/LANGUAGE DOL DI DIETARY HRS SP SPEECH/LANGUAGE DOL EAV EMP ASSISTANCE 10 HRS SE SUPPORTED EMP _HRS EAV EMP ASSISTANCE 10 HRS SE SUPPORTED EMP _HRS NU NURSING 8_ HRS DE DENTAL DOL NU NURSING 8_ HRS DE DENTAL DOL MHM MINOR HOME MOD DOL AA ADAPTIVE AIDS DOL MHM MINOR HOME MOD DOL AA ADAPTIVE AIDS DOL MHMR MINOR HOME MOD RE DOL AAR ADAPTIVE AIDS REQ. DOL MHMR MINOR HOME MOD RE DOL AAR ADAPTIVE AIDS REQ. DOL SCV SUPPORT CONSULTAT 1_ HRS FMSV FMS MONTHLY FEE 12 MONS SCV SUPPORT CONSULTAT 1_ HRS FMSV FMS MONTHLY FEE 12 MONS WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) READY TO CONTINUE?: Y (Y/N) READY TO CONTINUE?: Y (Y/N) ACT: ____ F/FWD,B/BK,(L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

40 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY – RENEWAL VC060234A NAME: HAMMER, M C JR CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAY CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAY EAV EMP ASSISTANCE 10 HRS SCV SUPPORT CONSULTAT 1 HRS EAV EMP ASSISTANCE 10 HRS SCV SUPPORT CONSULTAT 1 HRS FMSV MONTHLY FEE 12 MON FMSV MONTHLY FEE 12 MON WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) CALCULATE?: N (Y/N) CDS ESTIMATED ANNUAL TOTAL: 9,011.30* READY TO ADD? Y (Y/N) ANNUAL COST: 12, COST CEILING: 13, ACT:___ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

41 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY – RENEWAL VC060237A NAME: HAMMER, M C JR CLCN: CLIENT ID: IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS BES BEHAVIOR SUPPORT 10 HRS DH DAY HABILTATION 104 DAYS BES BEHAVIOR SUPPORT 10 HRS DH DAY HABILTATION 104 DAYS NU NURSING 8 HRS OT OCCUPATIONAL THERAPY 2 HRS NU NURSING 8 HRS OT OCCUPATIONAL THERAPY 2 HRS PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 3, PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: 3, READY TO CONTINUE? Y(Y/N) ANNUAL COST: 12, COST CEILING: 13, ACT: ___ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

42 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY: RENEWAL VC060238A NAME: HAMMER, M C JR CLCN: CLIENT ID: PRGP:CONTRACT: COMPONENT: 9DS LOCAL CASE NUMBER: CDSA:CONTRACT: COMPONENT: OMY LOCAL CASE NUMBER: IPC BEGIN DATE: REVISE DATE: END DATE: TOTAL ANNUAL COST : 12, COST CEILING: 13, TOTAL ANNUAL COST : 12, COST CEILING: 13, ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) CONTRACTED PROVIDER NAME: _ICAN DUIT__________________ DATE (MMDDYYYY): _________ CONTRACTED PROVIDER NAME: _ICAN DUIT__________________ DATE (MMDDYYYY): _________ IDT CERTIFICATION STATEMENT NAME DATE(MMDDYYYY) NAME DATE(MMDDYYYY) CASE MANAGER: DON KING JR _________________ CASE MANAGER: DON KING JR _________________ NURSE: NURSE MIMI_____________ _______ NURSE: NURSE MIMI_____________ _______ CONSUMER/LEGAL REPRESENTATIVE: MIKE TYSON JR CONSUMER/LEGAL REPRESENTATIVE: MIKE TYSON JR

43 TxHmL L02:INDIVIDUAL PLAN OF CARE ENTRY: REVISE/RENEWAL VC060233A NAME: HAMMER, M C JR CLCN: CLIENT ID: NAME: HAMMER, M C JR CLCN: CLIENT ID: BEG DT: REV DT: (MMDDYYYY) END DT: BEG DT: REV DT: (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS AU AUDIOLOGY HRS OT OCCUPATIONAL THERAPY 2 HRS AU AUDIOLOGY HRS OT OCCUPATIONAL THERAPY 2 HRS BES BEHAVIOR SUPPORT 10 HRS PT PHYSICAL THERAPY HRS BES BEHAVIOR SUPPORT 10 HRS PT PHYSICAL THERAPY HRS CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAYS CSV COMMUNITY SUPPORT 80 HRS REV RESPITE 30 DAYS DH DAY HABILITATION 104DAYS REH RESPITE HR HRS DH DAY HABILITATION 104DAYS REH RESPITE HR HRS DI DIETARY HRS SP SPEECH/LANGUAGE DOL DI DIETARY HRS SP SPEECH/LANGUAGE DOL EAV EMP ASSISTANCE 10 HRS SE SUPPORTED EMP _HRS EAV EMP ASSISTANCE 10 HRS SE SUPPORTED EMP _HRS NU NURSING 8_ HRS DE DENTAL DOL NU NURSING 8_ HRS DE DENTAL DOL MHM MINOR HOME MOD DOL AA ADAPTIVE AIDS DOL MHM MINOR HOME MOD DOL AA ADAPTIVE AIDS DOL MHMR MINOR HOME MOD RE DOL AAR ADAPTIVE AIDS REQ. DOL MHMR MINOR HOME MOD RE DOL AAR ADAPTIVE AIDS REQ. DOL SCV SUPPORT CONSULTAT 1_ HRS FMSV FMS MONTHLY FEE 12 MONS SCV SUPPORT CONSULTAT 1_ HRS FMSV FMS MONTHLY FEE 12 MONS WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) WILL ANY SERVICES BE SELF DIRECTED? Y (Y/N) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) READY TO CONTINUE?: Y (Y/N) READY TO CONTINUE?: Y (Y/N) ACT: ____ F/FWD,B/BK,(L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

44 CHANGING SERVICE DELIVERY OPTION(SDO) FOR A SPECIFIC SERVICE REVISION & RENEWAL (currently TxHmL Only) PrgP SDOCDS SDO Behavior Support Community Support Day Habilitation Employment Assistance Nursing Respite Occupational Therapy

45 CONTACT INFO PATRICK MARTIN (512) GEOFF SHUTE (512)

46 BREAK

47 Questions and Answers

48 Transfers: adding, changing, and discontinuing an individuals participation in the CDS option

49 A transfer occurs whenever a contract number (vendor number) associated with an individual is added, ended, or changed. A transfer in CARE occurs when a individual moves from a 1. Program Provider (PrgP) to PrgP, 2. PrgP to Consumer Directed Services Agency (CDSA), 3. CDSA to CDSA, or 4. CDSA to PrgP.

50 When the individual has selected a PrgP and/or a CDSA, the transfer effective date must be agreed upon by the all of the appropriate entities involved: the transferring program provider, the receiving program provider, the current program provider, the CDS Agency (ies), and the individual/LAR.

51 The receiving/current PrgP or the MRAs service coordinator must mail or fax a copy of the Request for Transfer Form and a copy of the transfer IPC to the appropriate Program Enrollment (PE) staff person after the data entry has been completed.

52 Subchapter D § Transfer Process (a) An individual's CDSA must process a request by the individual or LAR to transfer from one CDSA to another CDSA in accordance with transfer procedures and requirements of the individual's program. (b), (d), and (e) apply to the transferring CDSA, employer or Designated Representative (DR), and the receiving CDSA, respectively.

53 (c) Within five working days after the receipt of a request to transfer, the case manager (HCS) or service coordinator must (TxHmL): (1) process the individual's request to transfer from one CDSA to another CDSA in accordance with the requirements of the individual's program and this chapter; (1) process the individual's request to transfer from one CDSA to another CDSA in accordance with the requirements of the individual's program and this chapter; (2) calculate the number of units or amount of funds needed to complete the service plan (IPC) period based on the individual's current service plan (use CDSA Transfer Information Form 1742/1743); (2) calculate the number of units or amount of funds needed to complete the service plan (IPC) period based on the individual's current service plan (use CDSA Transfer Information Form 1742/1743); (3) revise the service plan to indicate the number of units or amount of funds calculated in this subsection effective the date of transfer; and (3) revise the service plan to indicate the number of units or amount of funds calculated in this subsection effective the date of transfer; and

54 (A) approve only the units and funds calculated as needed if units and funds remaining in the budget meet or exceed the needed number or units or amount of funds to complete the service period, or approve only the amount remaining in the budget for the period remaining in the individual's service plan; and (A) approve only the units and funds calculated as needed if units and funds remaining in the budget meet or exceed the needed number or units or amount of funds to complete the service period, or approve only the amount remaining in the budget for the period remaining in the individual's service plan; and (B) provide a copy of the transferring service plan to the receiving CDSA and employer before the effective date of the transfer; and (B) provide a copy of the transferring service plan to the receiving CDSA and employer before the effective date of the transfer; and (4) provide a copy of the individual's revised service plan to the transferring CDSA, the receiving CDSA, and the employer or DR. (4) provide a copy of the individual's revised service plan to the transferring CDSA, the receiving CDSA, and the employer or DR.

55 HCS CARE Screen Sequence 1. C06: Transferring Provider 2. C09: Receiving Provider 3. C06: Receiving Provider 4. C02: Receiving Provider 5. C06: Receiving Provider TxHmL CARE Screen Sequence 1. L09: Transferring MRA 2. L06: Transferring MRA 3. L02: Transferring MRA 4. L06: Transferring MRA

56 HCS Transfer Example In this transfer example, the individual will transfer from the current Program Provider to a new Program Provider and initiate the CDS option (adding a CDSA). In this transfer example, the individual will transfer from the current Program Provider to a new Program Provider and initiate the CDS option (adding a CDSA).

57 C06: TRANSFER: CONTRACT/SERVICES: A/C/D VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 1234_______ CLIENT ID: 1234_______ COMPONENT CODE/LOCAL CASE NUMBER: 8XX / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8XX / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: CONTRACT NUMBER: CONTRACT NUMBER: TRANSFER EFFECTIVE DATE: (MMDDYYYY) TRANSFER EFFECTIVE DATE: (MMDDYYYY) FOR ADD ONLY: FOR ADD ONLY: 1. CHANGING PrgP OR CDS AGENCY? Y (Y/N) 2. ADDING A PrgP OR CDS AGENCY? Y (Y/N) 3. CHANGING SERVICE DELIVERY OPTIONS? Y (Y/N) TYPE OF ENTRY:A (A/ADD,C/CHANGE,D/DELETE) TYPE OF ENTRY:A (A/ADD,C/CHANGE,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC)

58 Matrix for CARE Screen C06 Questions Answer Combinations Valid Valid Valid Valid Valid Valid Valid InValid Valid Valid Valid Valid Valid Valid Valid InValid 1. ARE YOU CHANGING YOUR Y N N Y Y N Y N PROGRAM PROVIDER OR CDS AGENCY? 2. ARE YOU ADDING A PROGRAM N N Y Y N Y Y N PROVIDER OR CDS AGENCY? 3. ARE YOU CHANGING SERVICE N Y N N Y Y Y N DELIVERY OPTIONS?

59 Service Delivery Option (SDO) means having waiver services delivered by a PrgP and/or by the Individual self-directing the services (with support from the CDSA). Explanations of the questions on CARE Header Screen C06/L06 1. Changing a PrgP or CDSA occurs when the SDO currently exists. 2. Adding a PrgP or CDSA occurs when a SDO will be added where it does not exist. 3. Changing SDO occurs when an existing service (s) is moved from one SDO to the other SDO (contract/vendor numbers do not change).

60 C06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : TYE,BEAU CLIENT ID: 1234 EFFECTIVE DATE: (MMDDYYYY) SERVICESDO CLAIM - PD/UNPD = REMAIN TO USE UNITS ADAPTIVE AIDSPRGP _____ CASE MANAGEMENT PRGP _____ DAY HABILITATION PRGP _____ MINOR HOME MODS PRGP _____ NURSING PRGP _____ RESPITE HOURLYPRGP _____ SUPPORTED HOME LIVING PRGP _____ READY TO ADD? Y (Y/N)

61 C06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : TYE,BEAU CLIENT ID: 1234 TRANSFER EFFECTIVE DATE: TRANSFERRING: SERVICE COUNTY: 006 LOCATION CODE: OHFH PRGP: COMP/LCN: 8XX / CONTRACT NUMBER: CDSA: COMP/LCN: ___ / __________ CONTRACT NUMBER: ________ RECEIVING: Enter only if changing/adding provider(s) SERVICE COUNTY: ____ LOCATION CODE: ____ RESDENTIAL TYPE: ___ PRGP: COMP/LCN: 8YY / __________ CONTRACT NUMBER: CDSA: COMP/LCN: 8ZZ / __________ CONTRACT NUMBER: DOLLAR AMTS: AA MHM DENTAL OTHER SVCS TO BE PROV NOW TO TRANS DT: TRANSFER ACCEPTED? _ (Y/N) BY: _________________________ DATE: ________ (MMDDYYYY) C.O. AUTHORIZE TRANSFER? _ (Y/N) BY: __________________ DATE: ________ (MMDDYYYY) READY TO ADD? Y (Y/N) ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC

62 C09:REGISTER CLIENT UPDATE VC PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: CLIENT ID: 1234__________ CLIENT ID: 1234__________ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

63 C09:REGISTER CLIENT UPDATE VC CLIENT LAST NAME/SUF: TYE CLIENT ID : 1234 CLIENT LAST NAME/SUF: TYE CLIENT ID : 1234 CLIENT FIRST NAME : BEAU COMPONENT : 8YY CLIENT FIRST NAME : BEAU COMPONENT : 8YY CLIENT MIDDLE NAME : CLIENT MIDDLE NAME : LOCAL CASE NUMBER : Y420__________ LOCAL CASE NUMBER : Y420__________ SEX : M_ SEX : M_ ETHNICITY : W_ ETHNICITY : W_ CLIENT BIRTHDATE (MMDDYYYY): CLIENT BIRTHDATE (MMDDYYYY): SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) MEDICAID NUMBER : MEDICARE NUMBER: ____________ MEDICAID NUMBER : MEDICARE NUMBER: ____________ PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): _____ REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): _____ LEGAL GUARDIANSHIP : 1 LEGAL GUARDIANSHIP : 1 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7258 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7258 FAMILY SIZE : 1 FAMILY SIZE : 1 SERVICE PARTICIPANT GROUP : TS (CB, SB, PD, HC, TS, EC, UC) SERVICE PARTICIPANT GROUP : TS (CB, SB, PD, HC, TS, EC, UC) READY TO UPDATE? Y (Y/N) READY TO UPDATE? Y (Y/N) ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

64 C09:REGISTER CLIENT UPDATE VC PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: CLIENT ID: 1234__________ CLIENT ID: 1234__________ COMPONENT CODE/LOCAL CASE NUMBER: 8ZZ / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8ZZ / __________ NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

65 C09:REGISTER CLIENT UPDATE VC CLIENT LAST NAME/SUF: TYE CLIENT ID : 1234 CLIENT LAST NAME/SUF: TYE CLIENT ID : 1234 CLIENT FIRST NAME : BEAU COMPONENT : 8ZZ CLIENT FIRST NAME : BEAU COMPONENT : 8ZZ CLIENT MIDDLE NAME : CLIENT MIDDLE NAME : LOCAL CASE NUMBER : Z420__________ LOCAL CASE NUMBER : Z420__________ SEX : M_ SEX : M_ ETHNICITY : W_ ETHNICITY : W_ CLIENT BIRTHDATE (MMDDYYYY): CLIENT BIRTHDATE (MMDDYYYY): SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) MEDICAID NUMBER : MEDICARE NUMBER: ____________ MEDICAID NUMBER : MEDICARE NUMBER: ____________ PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): _____ REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): _____ LEGAL GUARDIANSHIP : 1 LEGAL GUARDIANSHIP : 1 MARITAL STATUS: 2ESTIMATED ANNUAL GROSS FAMILY INCOME: 7258 MARITAL STATUS: 2ESTIMATED ANNUAL GROSS FAMILY INCOME: 7258 FAMILY SIZE : 1 FAMILY SIZE : 1 SERVICE PARTICIPANT GROUP : TS (CB, SB, PD, HC, TS, EC, UC) SERVICE PARTICIPANT GROUP : TS (CB, SB, PD, HC, TS, EC, UC) READY TO UPDATE? Y (Y/N) READY TO UPDATE? Y (Y/N) ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/PROV DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

66 C06: TRANSFER: CONTRACT/SERVICES: A/C/D VC C06: TRANSFER: CONTRACT/SERVICES: A/C/D VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 1234_____ CLIENT ID: 1234_____ OMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ OMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: CONTRACT NUMBER: CONTRACT NUMBER: TRANSFER EFFECTIVE DATE: FOR ADD ONLY: CHANGING PrgP OR CDS AGENCY? _ (Y/N) ADDING A PrgP OR CDS AGENCY? _ (Y/N) CHANGING SERVICE DELIVERY OPTIONS? _ (Y/N) TYPE OF ENTRY: C (A/ADD,C/CHANGE,D/DELETE) TYPE OF ENTRY: C (A/ADD,C/CHANGE,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC)

67 C06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : TYE,BEAU CLIENT ID: 1234 EFFECTIVE DATE: (MMDDYYYY) SERVICE SDOCLAIM - PD/UNPD - TO USE = REMAIN NEW UNITS SDO ADAPTIVE AIDS PRGP P____ CASE MANAGEMENT PRGP P____ DAY HABILITATION PRGP P____ MINOR HOME MODS PRGP P____ NURSING PRGP P____ RESPITE HOURLY PRGP C____ SUPPORTED HOME LIVING PRGP C____ READY TO CHANGE? Y (Y/N)

68 C06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : TYE,BEAU CLIENT ID: 1234 EFFECTIVE DATE: (MMDDYYYY) SERVICE SDO CLAIM -PD/UNPD - TO USE REMAIN NEW UNITS SDO ADAPTIVE AIDS PRGP P____ CASE MANAGEMENT PRGP P____ DAY HABILITATION PRGP P____ MINOR HOME MODS PRGP P____ NURSING PRGP P____ RESPITE HR CDSA C____ SUPPORTED HOME LIVING CDSA C____ CONFIRM NEW SDO? Y (Y/N)

69 C06: CONSUMER TRANSFER CONTRACT/SERVICES: CHANGE VC NAME : TYE,BEAU CLIENT ID: 1234 TRANSFER EFFECTIVE DATE: TRANSFERRING: SERVICE COUNTY: 006 LOCATION CODE: OHFH PRGP: COMP/LCN: 8XX / CONTRACT NUMBER: CDSA: COMP/LCN: ___ / __________ CONTRACT NUMBER: _________ RECEIVING: Enter only if changing/adding provider(s) SERVICE COUNTY: 006 LOCATION CODE: OHFH RESIDENTIAL TYPE: 3 SERVICE COUNTY: 006 LOCATION CODE: OHFH RESIDENTIAL TYPE: 3 PRGP: COMP/LCN: 8YY / Y444_____ CONTRACT NUMBER: PRGP: COMP/LCN: 8YY / Y444_____ CONTRACT NUMBER: CDSA: COMP/LCN: 8ZZ/ Z420 _____ CONTRACT NUMBER: CDSA: COMP/LCN: 8ZZ/ Z420 _____ CONTRACT NUMBER: DOLLAR AMTS: AA MHM DENTAL OTHER SVCS DOLLAR AMTS: AA MHM DENTAL OTHER SVCS TO BE PROV NOW TO TRANS DT: TRANSFER ACCEPTED? _ (Y/N) BY: _________________________ DATE:____________ C.O. AUTHORIZE TRANSFER? _ (Y/N) BY: _______ DATE: ________ (MMDDYYYY) READY TO CHANGE? Y (Y/N) ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC

70 C02:INDIVIDUAL PLAN OF CARE VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 1234__________ CLIENT ID: 1234__________ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: T I=INITIAL N=RENEWAL TYPE OF ENTRY: T I=INITIAL N=RENEWAL E=ERROR CORRECTION T=TRANSFER E=ERROR CORRECTION T=TRANSFER R=REVISION D=DELETE R=REVISION D=DELETE PLEASE ENTER FOR INITIAL PLANS ONLY: PLEASE ENTER FOR INITIAL PLANS ONLY: BEGIN DATE: ________ (MMDDYYYY) BEGIN DATE: ________ (MMDDYYYY) PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL _ 365 DAYS _ 270 DAYS _ 180 DAYS _ 365 DAYS _ 270 DAYS _ 180 DAYS *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

71 C02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060232A NAME: TYE,BEAU CLCN: 8YY Y420 CLIENT ID: 1234 BEG DT: REV DT: (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CMM CASE MANAGEMENT 12___ MONS SHLV SUPPORTED HOME LIVING 900 HRS CMM CASE MANAGEMENT 12___ MONS SHLV SUPPORTED HOME LIVING 900 HRS SP SPEECH/LANGUAGE _____ HRS FC HCS FOSTER CARE __ DAYS SP SPEECH/LANGUAGE _____ HRS FC HCS FOSTER CARE __ DAYS OT OCCUPATIONAL THERA _____ HRS SL SUPERVISED LIVING __ DAYS OT OCCUPATIONAL THERA _____ HRS SL SUPERVISED LIVING __ DAYS PT PHYSICAL THERAPY _____ HRS RSS RES SUPPORT SVC __ DAYS PT PHYSICAL THERAPY _____ HRS RSS RES SUPPORT SVC __ DAYS DI DIETARY _____ HRS NU NURSING 20 HRS DI DIETARY _____ HRS NU NURSING 20 HRS PS PSYCHOLOGY _____ HRS REHV RESPITE HR 30 HRS PS PSYCHOLOGY _____ HRS REHV RESPITE HR 30 HRS AU AUDIOLOGY _____ HRS RE RESPITE __ DAYS AU AUDIOLOGY _____ HRS RE RESPITE __ DAYS SW SOCIAL WORK _____ HRS DH DAY HAB 240 DAYS SW SOCIAL WORK _____ HRS DH DAY HAB 240 DAYS SE SUPPORTED EMP _____ HRS FMSV FMS MONTHLY FEE 6 MONS SE SUPPORTED EMP _____ HRS FMSV FMS MONTHLY FEE 6 MONS SCV SUPPORT CONSULTAT _____ HRS DE DENTAL __ DOL SCV SUPPORT CONSULTAT _____ HRS DE DENTAL __ DOL AA ADAPTIVE AIDS 100__ DOL MHM MINOR HOME MODS 1009 DOL AA ADAPTIVE AIDS 100__ DOL MHM MINOR HOME MODS 1009 DOL RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OHFH) READY TO CONTINUE? Y (Y/N) ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1

72 C02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060233A NAME: TYE,BEAU CLCN: 8ZZ Z444 CLIENT ID: 1234 IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS REHVRESPITE HR HRS SHLV SUPPORTED HOME LIVING 470 HRS FMSV FMS MONTHLY FEE 6.00 MONS CDS ESTIMATED ANNUAL TOTAL: $9, CDS ESTIMATED ANNUAL TOTAL: $9, READY TO COMTINUE? Y (Y/N) ANNUAL COST: $36, COST CEILING: 78, ACT: ____ (F/FWD,B/BK,L00MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC) ACT: ____ (F/FWD,B/BK,L00MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

73 C02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060237A NAME: TYE,BEAU CLCN: 8YY Y420 CLIENT ID: 1234 IPC BEGIN DATE: REVISE DATE: END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CMMB CASE MGMT SELF DIR MONS NU NURSING HRS DHDAY HABILITATION 240 DAYS REH RESPITE HR HRS SHL SUPPORTED HOME LVG 460 HRS AA ADAPTIVE AIDS DOL MHM MINOR HOME MODS DOL PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: $27, PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: $27, READY TO CONTINUE? Y (Y/N) ANNUAL COST: $36, COST CEILING: $78, ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

74 C02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060238A NAME: TYE,BEAU CLCN: CLIENT ID: 1234 PRGP: CONTRACT: COMPONENT: 8YY LOCAL CASE NUMBER : Y420 CDSA: CONTRACT: COMPONENT: 8ZZ LOCAL CASE NUMBER : Z444 IPC BEGIN DATE: REVISE DATE: END DATE: TOTAL ANNUAL COST: $36, COST CEILING: $78, ARE ANY DIRECT SERVICES PROVIDED BY A RELATIVE/GUARDIAN? Y (Y/N) CONTRACTED PROVIDER NAME: APRIL MAY____________________ DATE (MMDDYYYY): DATE (MMDDYYYY): IDT CERTIFICATION STATEMENT IDT CERTIFICATION STATEMENT DATE DATE NAME (MMDDYYYY) NAME (MMDDYYYY) CASE MANAGER : MAC TRUCK _____________________ NURSE : N. RATCHET RN__________________ CONSUMER/LEGAL REPRESENTATIVE : TYE,BEAU READY TO ADD? Y (Y/N) ACT: ____ (C00/PROV ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/PROV ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

75 C06:TRANSFER: CONTRACT/SERVICES: A/C/D VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 1234_____ CLIENT ID: 1234_____ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8YY / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: CONTRACT NUMBER: CONTRACT NUMBER: TRANSFER EFFECTIVE DATE: FOR ADD ONLY: FOR ADD ONLY: CHANGING PrgP OR CDS AGENCY? _ (Y/N) ADDING A PrgP OR CDS AGENCY? _ (Y/N) CHANGING SERVICE DELIVERY OPTIONS? _ (Y/N) TYPE OF ENTRY: C (A/ADD,C/CHANGE,D/DELETE) TYPE OF ENTRY: C (A/ADD,C/CHANGE,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC)

76 C06: TRANSFER CONTRACT/SERVICES: CHANGE VC NAME : TYE,BEAU CLIENT ID: 1234 TRANSFER EFFECTIVE DATE: TRANSFERRING: SERVICE COUNTY: 006 LOCATION CODE: OHFH PRGP: COMP/LCN: 8XX / CONTRACT NUMBER: CDSA: COMP/LCN: ___ / ________ CONTRACT NUMBER: _________ RECEIVING: Enter only if changing/adding provider(s) SERVICE COUNTY: 8YY LOCATION CODE: OHFH_ RESIDENTIAL TYPE: 3 PRGP: COMP/LCN: 8YY / Y420 ____ CONTRACT NUMBER: CDSA: COMP/LCN: 8ZZ / Z444_____ CONTRACT NUMBER: DOLLAR AMTS: AA MHM DENTAL OTHER SVCS DOLLAR AMTS: AA MHM DENTAL OTHER SVCS TO BE PROV NOW TO TRANS DT: TRANSFER ACCEPTED? Y (Y/N) BY: ART WORK_______________ DATE: C.O. AUTHORIZE TRANSFER? _ (Y/N) BY: _______ DATE: ________ (MMDDYYYY) READY TO TRANSFER? Y (Y/N) ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC ACT: ____ (C00/HCS DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC

77 TxHmL Transfer Example In this transfer example, the individual will transfer from the current Program Provider to a new Program Provider and initiate the CDS option (adding a CDSA).

78 L09:REGISTER CLIENT UPDATE VC PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: CLIENT ID: 9876______ COMPONENT CODE/LOCAL CASE NUMBER: 8SS / __________ NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. *** PRESS ENTER *** ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) L09:REGISTER CLIENT UPDATE VC PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: CLIENT ID: 9876______ COMPONENT CODE/LOCAL CASE NUMBER: 8SS / __________ NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. *** PRESS ENTER *** ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

79 L09:REGISTER CLIENT UPDATE VC CLIENT LAST NAME/SUF: ABSENT CLIENT ID : 9876 CLIENT LAST NAME/SUF: ABSENT CLIENT ID : 9876 CLIENT FIRST NAME : MARCUS COMPONENT : 8SS CLIENT FIRST NAME : MARCUS COMPONENT : 8SS CLIENT MIDDLE NAME : CLIENT MIDDLE NAME : LOCAL CASE NUMBER : S777 LOCAL CASE NUMBER : S777 SEX : M SEX : M ETHNICITY : W ETHNICITY : W CLIENT BIRTHDATE (MMDDYYYY): CLIENT BIRTHDATE (MMDDYYYY): SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) MEDICAID NUMBER : MEDICARE NUMBER: ____________ MEDICAID NUMBER : MEDICARE NUMBER: ____________ PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): 10:05A REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): 10:05A LEGAL GUARDIANSHIP : 2 LEGAL GUARDIANSHIP : 2 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7252 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7252 FAMILY SIZE : 1 FAMILY SIZE : 1 SERVICE PARTICIPANT GROUP : __ (CB, SB, PD, HC, TS, EC, UC) SERVICE PARTICIPANT GROUP : __ (CB, SB, PD, HC, TS, EC, UC) READY TO UPDATE? Y (Y/N) READY TO UPDATE? Y (Y/N) ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

80 L09:REGISTER CLIENT UPDATE VC PLEASE ENTER AT LEAST ONE OF THE FOLLOWING: CLIENT ID: 9876______ COMPONENT CODE/LOCAL CASE NUMBER: 8TT / __________ NOTE: TO ASSIGN A PROVIDER'S LOCAL CASE NUMBER FOR NEW ENROLLMENTS USE THE PROVIDERS COMPONENT CODE IN THE ABOVE FIELD. *** PRESS ENTER *** ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

81 L09:REGISTER CLIENT UPDATE VC CLIENT LAST NAME/SUF: ABSENT CLIENT ID : 9876 CLIENT LAST NAME/SUF: ABSENT CLIENT ID : 9876 CLIENT FIRST NAME : MARCUS COMPONENT : 8TT CLIENT FIRST NAME : MARCUS COMPONENT : 8TT CLIENT MIDDLE NAME : CLIENT MIDDLE NAME : LOCAL CASE NUMBER : T10 LOCAL CASE NUMBER : T10 SEX : M SEX : M ETHNICITY : W ETHNICITY : W CLIENT BIRTHDATE (MMDDYYYY): CLIENT BIRTHDATE (MMDDYYYY): SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) SOCIAL SECURITY NUMBER : (N=NONE, U=UNKNOWN) MEDICAID NUMBER : MEDICARE NUMBER: ____________ MEDICAID NUMBER : MEDICARE NUMBER: ____________ PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) PRESENTING PROBLEM : 2 (1=MH, 2=MR, 3=ECI/DD, 4=SA, 5=RC) REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): 10:07A REGISTRATION EFFECTIVE DATE: (MMDDYY) TIME (HHMM A/P): 10:07A LEGAL GUARDIANSHIP : 2 LEGAL GUARDIANSHIP : 2 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7252 MARITAL STATUS: 2 ESTIMATED ANNUAL GROSS FAMILY INCOME: 7252 FAMILY SIZE : 1 FAMILY SIZE : 1 SERVICE PARTICIPANT GROUP : __ (CB, SB, PD, HC, TS, EC, UC) SERVICE PARTICIPANT GROUP : __ (CB, SB, PD, HC, TS, EC, UC) READY TO UPDATE? Y (Y/N) READY TO UPDATE? Y (Y/N) ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/MRA DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

82 L06: CONSUMER TRANSFER: CONTRACT/SERVICES: A/C/D VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 9876 CLIENT ID: 9876 COMPONENT CODE/LOCAL CASE NUMBER: 8WW / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8WW / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: CONTRACT NUMBER: TRANSFER EFFECTIVE DATE: (MMDDYYYY) TRANSFER EFFECTIVE DATE: (MMDDYYYY) FOR ADD ONLY: FOR ADD ONLY: 1. CHANGING PROGRAM PROVIDER OR CDS AGENCY? Y (Y/N) 2. ADDING A PROGRAM PROVIDER OR CDS AGENCY? Y (Y/N) 1. CHANGING PROGRAM PROVIDER OR CDS AGENCY? Y (Y/N) 2. ADDING A PROGRAM PROVIDER OR CDS AGENCY? Y (Y/N) 3. CHANGING SERVICE DELIVERY OPTIONS? Y (Y/N) TYPE OF ENTRY: A (A/ADD,C/CHANGE,D/DELETE) TYPE OF ENTRY: A (A/ADD,C/CHANGE,D/DELETE) *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/TXHML DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/TXHML DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC)

83 L06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : ABSENT, MARCUS CLIENT ID: 9876 EFFECTIVE DATE: (MMDDYYYY) SERVICE SDO CLAIM - PD/UNPD = REMAIN TO USE NEW SDO UNITS ADAPTIVE AIDS PRGP _____ P DAY HABILITATION PRGP _____ P MINOR HOME MODS PRGP _____ P NURSING PRGP _____ P RESPITE HOURLY PRGP _____ C COMMUNITY SUPPORT PRGP _____ C READY TO ADD? Y (Y/N) SERVICE SDO CLAIM - PD/UNPD = REMAIN TO USE NEW SDO UNITS ADAPTIVE AIDS PRGP _____ P DAY HABILITATION PRGP _____ P MINOR HOME MODS PRGP _____ P NURSING PRGP _____ P RESPITE HOURLY PRGP _____ C COMMUNITY SUPPORT PRGP _____ C READY TO ADD? Y (Y/N)

84 L06: TRANSFER CONTRACT/SERVICES: ADD VC NAME : ABSENT, MARCUS CLIENT ID: 9876 EFFECTIVE DATE: (MMDDYYYY) SERVICE SDO CLAIM - PD/UNPD TO USE = REMAIN NEW SDO UNITS ADAPTIVE AIDS PRGP _____ P DAY HABILITATION PRGP _____ P MINOR HOME MODS PRGP _____ P NURSING PRGP _____ P RESPITE HOURLY PRGP _____ C COMMUNITY SUPPORT PRGP _____ C READY TO CONFIRM? Y (Y/N) SERVICE SDO CLAIM - PD/UNPD TO USE = REMAIN NEW SDO UNITS ADAPTIVE AIDS PRGP _____ P DAY HABILITATION PRGP _____ P MINOR HOME MODS PRGP _____ P NURSING PRGP _____ P RESPITE HOURLY PRGP _____ C COMMUNITY SUPPORT PRGP _____ C READY TO CONFIRM? Y (Y/N)

85 L06:CONSUMER TRANSFER CONTRACT/SERVICES: ADD VC NAME : ABSENT,MARCUS CLIENT ID: 9876 TRANSFER EFFECTIVE DATE: TRANSFERRING: SERVICE COUNTY: 006 LOCATION CODE: OHFH PRGP: COMP/LCN: 8WW / CONTRACT NUMBER: CDSA: COMP/LCN: ___ / __________ CONTRACT NUMBER: _________ RECEIVING: Enter only if changing/adding provider (s) SERVICE COUNTY: 006 LOCATION CODE: OHFH RESIDENTIAL TYPE: 3 PRGP: COMP/LCN: 8SS / S777______ CONTRACT NUMBER: CDSA: COMP/LCN: 8TT / T10______ CONTRACT NUMBER: DOLLAR AMTS: AA MHM DENTAL OTHER SVCS DOLLAR AMTS: AA MHM DENTAL OTHER SVCS TO BE PROV NOW TO TRANS DT: TRANSFER ACCEPTED?_ (Y/N) BY: ___________________ DATE:_________ READY TO ADD? Y (Y/N) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC

86 L02:INDIVIDUAL PLAN OF CARE VC PLEASE ENTER ONE OF THE FOLLOWING: PLEASE ENTER ONE OF THE FOLLOWING: CLIENT ID: 9876______ CLIENT ID: 9876______ COMPONENT CODE/LOCAL CASE NUMBER: 8SS / __________ COMPONENT CODE/LOCAL CASE NUMBER: 8SS / __________ MEDICAID NUMBER: _________ MEDICAID NUMBER: _________ PLEASE ENTER THE FOLLOWING: PLEASE ENTER THE FOLLOWING: TYPE OF ENTRY: T I=INITIAL N=RENEWAL TYPE OF ENTRY: T I=INITIAL N=RENEWAL E=ERROR CORRECTION T=TRANSFER E=ERROR CORRECTION T=TRANSFER R=REVISION D=DELETE R=REVISION D=DELETE PLEASE ENTER FOR INITIAL PLANS ONLY: PLEASE ENTER FOR INITIAL PLANS ONLY: BEGIN DATE: ________ (MMDDYYYY) BEGIN DATE: ________ (MMDDYYYY) PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: PLEASE SELECT FOR INITIAL PLANS WITH THE FOLLOWING SLOT TYPES: 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL 16=LA/REF, 17=TXHML/REF, 18=TXHML/WL _ 365 DAYS _ 270 DAYS _ 180 DAYS _ 365 DAYS _ 270 DAYS _ 180 DAYS *** PRESS ENTER *** *** PRESS ENTER *** ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

87 L02:INDIVIDUAL PLAN OF CARE ENTRY:TRANSFER VC060233A NAME: ABSENT,MARCUS CLCN: 8SS CLIENT ID: 9876 NAME: ABSENT,MARCUS CLCN: 8SS CLIENT ID: 9876 BEG DT: REV DT: (MMDDYYYY) END DT: BEG DT: REV DT: (MMDDYYYY) END DT: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS AU AUDIOLOGY 0 DOL OT OCCUPATIONAL THERAPY 0.00 DOL BES BEHAVIOR SUPPORT 0 HRS PT PHYSICAL THERAPY 0 HRS CSV COMMUNITY SUPPORT 175 HRS RE RESPITE 0 DAYS DH DAY HABILITATION 150 DAYS REHV RESPITE HR 30 HRS DI DIETARY 0 HRS SP SPEECH/LANGUAGE 0 HRS EA EMP ASSISTANCE 0 HRS SE SUPPORTED EMP 0 HRS NU NURSING 20 HRS DE DENTAL 0 DOL MHM MINOR HOME MOD 750 DOL AA ADAPTIVE AIDS 275 DOL MHMRMINOR HOME MOD RE 81 DOL AAR ADAPTIVE AIDS REQ. 28 DOL SCV SUPPORT CONSULTATION 1 HRS FMSV FMS MONTHLY FEE 6 MONS RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) RESIDENTIAL TYPE: 3 (2-5) LOCATION: OHFH (OFH) READY TO CONTINUE?: Y (Y/N) READY TO CONTINUE?: Y (Y/N) ACT: ___ F/FWD,B/BK,(L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

88 L02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060232B NAME: ABSENT,MARCUS CLCN: 8SS S777 CLIENT ID: 9876 BEG DT: REVISE DT: (MMDDYYYY) END DATE: SERVICE CATEGORY UNITS CSVCOMMUNITY SUPPORT 90 HRS FMSVFMS 6 MOS REHVRESPITE HR 17 HRS SCVSUPPORT CONSULTATION 1 HRS CALCULATE?: Y (Y/N) CDS ESTIMATED ANNUAL TOTAL: $3, READY TO CONTINUE? Y (Y/N) ANNUAL COST: $11, COST CEILING: $13, ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

89 L02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060232C NAME: ABSENT,MARCUSCLCN: 8SS S777 CLIENT ID: 9876 BEG DT: REVISE DT: (MMDDYYYY) END DATE: SERVICE CATEGORY UNITS SERVICE CATEGORY UNITS CSCOMMUNITY SUPPORT 85HRS DHDAY HABILITATION 150 DAYS NUNURSING 20 HRS REHRESPITE HR 13 HRS AAADAPTIVE AIDS 275 DOL AARADAPTIVE AIDS RE 28 DOL MHMMINOR HOME MODS750 DOL MHMRMINOR HOME MODS RE 81 DOL PROGRAM PROVIDER ESTIMATED ANNUAL TOTAL: $8, READY TO CONTINUE? Y (Y/N) ANNUAL COST: $ 11, COST CEILING: $13, ACT: ____ (F/FWD,B/BK,L00/AUTH ENTRY MENU,A/MA MAIN MENU,HLP(PF1)/SCRNDOC)

90 L02:INDIVIDUAL PLAN OF CARE ENTRY: TRANSFER VC060238A NAME: ABSENT,MARCUS CLCN: 8SS S777 CLIENT ID: 9876 PRGP:CONTRACT: COMPONENT: 8SS LOCAL CASE NUMBER: S777 CDSA:CONTRACT: COMPONENT: 8TT LOCAL CASE NUMBER: T10 IPC BEGIN DATE: REVISE DATE: END DATE: TOTAL ANNUAL COST : 3, COST CEILING: 13, TOTAL ANNUAL COST : 3, COST CEILING: 13, ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) ARE ANY DIRECT SERVICES STAFFED BY A RELATIVE/GUARDIAN? N (Y/N) CONTRACTED PROVIDER NAME: GENE POOLE CONTRACTED PROVIDER NAME: GENE POOLE DATE (MMDDYYYY): DATE (MMDDYYYY): IDT CERTIFICATION STATEMENT NAME DATE(MMDDYYYY) NAME DATE(MMDDYYYY) CASE MANAGER: JUNE MAY _______________________________ CASE MANAGER: JUNE MAY _______________________________ NURSE: NA________________________________________________ NURSE: NA________________________________________________ CONSUMER/LEGAL REPRESENTATIVE: ABSENT,MARCUS_____ CONSUMER/LEGAL REPRESENTATIVE: ABSENT,MARCUS_____ READY TO ADD? : Y (Y/N) READY TO ADD? : Y (Y/N) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/MA MAIN MENU, HLP(PF1)/SCRN DOC)

91 L06:CONSUMER TRANSFER CONTRACT/SERVICES: ADD VC NAME : ABSENT,MARCUS CLIENT ID: 9876 TRANSFER EFFECTIVE DATE: TRANSFERRING: SERVICE COUNTY: 006 LOCATION CODE: OHFH PRGP: COMP/LCN: 8WW / CONTRACT NUMBER: CDSA: COMP/LCN: ___ / __________ CONTRACT NUMBER: _________ RECEIVING: Enter only if changing/adding provider (s) SERVICE COUNTY: 006 LOCATION CODE: OHFH RESIDENTIAL TYPE:___ PRGP: COMP/LCN: 8SS / S777______ CONTRACT NUMBER: CDSA: COMP/LCN: 8TT / T10______ CONTRACT NUMBER: DOLLAR AMTS: AA MHM DENTAL OTHER SVCS DOLLAR AMTS: AA MHM DENTAL OTHER SVCS TO BE PROV NOW TO TRANS DT: TRANSFER ACCEPTED? Y (Y/N) BY: PERCY VEER________ DATE: READY TO TRANSFER? Y (Y/N) ACT: ____ (L00/AUTH DATA ENTRY MENU, A/HCS MAIN MENU, HLP(PF1)/SCRN DOC

92 BREAK

93 Questions and Answers

94 Abuse, Neglect and Exploitation (ANE)-- What will change with the implementation of CDS and what will stay the same?

95 Organization of The Texas Department of Family and Protective Services (DFPS) Two branches: Adult Protective Services (APS) Adult Protective Services (APS) Child Protective Services (CPS) Child Protective Services (CPS)

96 Organization of DFPS, cont. APS breaks down into 2 divisions: APS breaks down into 2 divisions: In-Home Investigations In-Home Investigations Facility Investigations Facility Investigations CPS is divided along lines of service delivery CPS is divided along lines of service delivery

97 Organization of DFPS, cont. APS only conducts investigations into ANE allegations involving: individuals over the age of 65, and individuals over the age of 65, and Individuals between the ages of 18 and 64 who have a disability. Individuals between the ages of 18 and 64 who have a disability.

98 Organization of DFPS, cont. One exception in APS is with regard to facility investigations. If an minor individual with a disability is receiving services in a facility, or by a person employed by an HCS or TxHmL provider agency, allegations of ANE perpetrated by the facility, or the provider agencys employee will be investigated by APS. One exception in APS is with regard to facility investigations. If an minor individual with a disability is receiving services in a facility, or by a person employed by an HCS or TxHmL provider agency, allegations of ANE perpetrated by the facility, or the provider agencys employee will be investigated by APS. CPS works on the supposition that for an individual under the age of 18, the parent is ultimately responsible. CPS works on the supposition that for an individual under the age of 18, the parent is ultimately responsible.

99 How it Works Now Providers are still required to inform all individuals or their LARs, regardless of the service delivery option they choose, how to report allegations of ANE to DFPS Providers are still required to inform all individuals or their LARs, regardless of the service delivery option they choose, how to report allegations of ANE to DFPS Providers are still required to provide all individuals or their LARs with the toll-free number for reporting ANE, regardless of the service delivery option they choose Providers are still required to provide all individuals or their LARs with the toll-free number for reporting ANE, regardless of the service delivery option they choose

100 How it Works Now, cont. DFPS Facility Investigations Division of APS investigates all allegations of ANE involving individuals who receive services in the HCS or TxHmL programs who are being served through a provider agency. DFPS Facility Investigations Division of APS investigates all allegations of ANE involving individuals who receive services in the HCS or TxHmL programs who are being served through a provider agency. Providers are required to follow all program rules regarding DFPS facility investigations. Providers are required to follow all program rules regarding DFPS facility investigations.

101 What will change? When an individual or his LAR chooses to self-direct his services and hires employees directly, allegations of ANE involving employees of the individual or the LAR (employer) will be conducted by DFPS In-Home Adult Protective Services division.

102 What will change, Cont. The In-Home division of APS does not conduct ANE investigations involving individuals under the age of 18. The In-Home division of APS does not conduct ANE investigations involving individuals under the age of 18.

103 What will change, Cont. In the event a minor individual receiving HCS services under the CDS option is an alleged victim of ANE by an employee of the CDS employer: Law enforcement should be notified, and Law enforcement should be notified, and CPS may become involved only if there is suspicion the parent or legal guardian or the minor is being negligent in the care or supervision of the child. CPS may become involved only if there is suspicion the parent or legal guardian or the minor is being negligent in the care or supervision of the child.

104 What will change, Cont. When DFPS In-Home division conducts an ANE investigation involving a direct employee or contractor of the individual or LAR, the provider or MRA is not responsible to follow program rules related to APS facility investigations involving the providers employees or contractors. When DFPS In-Home division conducts an ANE investigation involving a direct employee or contractor of the individual or LAR, the provider or MRA is not responsible to follow program rules related to APS facility investigations involving the providers employees or contractors.

105 What will change, Cont. The individual or LAR who chooses CDS and hires employees or contractors is responsible to train his employees and contractors regarding the required time frame for reporting ANE, and is responsible to provide his employees and contractors with the toll-free number for reporting. The individual or LAR who chooses CDS and hires employees or contractors is responsible to train his employees and contractors regarding the required time frame for reporting ANE, and is responsible to provide his employees and contractors with the toll-free number for reporting.

106 LUNCH

107 The Role of the Case Manager or Service Coordinator when Serving Individuals using the Consumer- Directed Services Option Winter, 2007

108 Case Management and Service Coordination Includes: Monitoring Facilitating Choice Identifying Additional Supports Coordinating Safeguards

109 Monitoring

110 Monitoring Activities Home visits to talk with individual Review of progress on service plan outcomes Review of documentation maintained by employer Review of CDSA reports Review of the effectiveness of service back-up plans, as necessary Review of any corrective action required

111 CDSA Reports The CDSA is required to provide a report quarterly, or monthly, if requested, to the CM/SC that addresses each service delivered through the CDS option, including the actual number of hours or units of service delivered The employer (individual or LAR) also receives this report

112 Communication with CDSA The CDSA is required to provide information about an individuals participation in the CDS option w/in 3 working days of request by a CM/SC The CDSA must document and notify a CM/SC of issues or concerns related to an individuals participation in CDS

113 Budget Revisions and Approval The employer or DR is required to make budget revisions when required by the CDSA, the CM/SC, the individuals service team or a DADS representative

114 Choice

115 Enrollment in the CDS Option SC is required to present CDS option at time of enrollment CM or SC is required to present CDS option annually to individual or LAR If individual or LAR requests additional information or requests enrollment into CDS option, CM or SC must comply within 5 working days CM or SC must assist an individual or LAR to complete enrollment forms

116 Transfer to Another CDSA Transferring CDSA is required to notify employer and individuals CM or SC in writing of units and dollars remaining in each budget as of scheduled transfer date Transferring CDSA is required to provide a final report to CM or SC within 5 days after transfer CM or SC has 5 working days to complete activities necessary for transfer to a different CDSA

117 Additional Supports

118 Service planning team may recommend the employer appoint a Designated Representative (DR) to assist or perform employer responsibilities based on documentation provided by the CDSA. Designated Representative

119 Support Consultation Service planning team must operate within existing budget to add support consultation funds Individual or DR must justify support consultation services, verify with CM or SC non-program resources are not available Support consultation must be approved by Service Planning Team

120 Support Consultation cont. Support Consultation services may be approved if: (1) the individual receiving CDS will become employer within 6 months; (2) the employer or DR demonstrates need for Support Consultation; (3) the individuals health and welfare may regress without additional supports for managing service providers: (4) the service planning team has justified need for the service for other reasons.

121 Support Consultation cont. If service planning team approves Support Consultation, the service planning team is required to: (1) approve the funds, the duration and frequency of service; (2) assist with development of plan (3) approve the outcomes for Support Consultation; and (4) terminate Support Consultation when outcomes are met.

122 Support Advisor Responsibilities Support Advisor is required to notify CM or SC: (1) when Support Consultation outcomes have been met; (2) if person receiving support consultation is unable or unwilling to cooperate with service delivery; (3) of progress and status of the Support Consultation service.

123 Safeguards

124 Service Back-up Plans The service planning team must describe: (1) which CDS services are critical; and (2) the length of time that constitutes a service interruption or an emergency for the individual. The service planning team must approve all service back-up plans prior to implementation (CDS form 1740)

125 Corrective Action Plans A CM or SC or service planning team may request a corrective action plan (CAP) from an employer or DR. CAP to be provided in 10 days. A CAP can be requested if employer or DR: (1) hires ineligible service provider; (2) submits incomplete, inaccurate or late documentation of service delivery; (3) does not follow budget; (4) does not comply with program requirements re: CDS option; or (5) does not meet other employer responsibilities.

126 Corrective Action Plans cont. The employer or DR may request assistance from the CM or SC or others if the CAP is related to program rules or requirements A CAP (CDS form 1741) must include: (1) the reason CAP is required; (2) the action to be taken; (3) the person responsible for each action; (4) the date the action must be completed.

127 Termination of Participation in the CDS Option CM or SC is required to convene service planning team to address issues that may warrant immediate termination of participation in CDS Service planning team may recommend termination of CDS option if attempted interventions have not resulted in: (1) elimination of immediate jeopardy; (2) successful delivery of services; (3) employer responsibilities being met; (4) successful implementation of CAPs; or (5) accessing other supports to assist employer in meeting employer responsibilities.

128 Termination of Participation in the CDS Option cont. CM or SC is required to complete following upon receipt of recommendation for involuntary termination from CDSA or other party: (1) assist in development and implementation of CAP; (2) document attempted interventions; and (3) convene service planning team to: (A) consider recommendation(s) made by CDSA or other party; (B) recommend additional interventions; (C) make revisions to service plan.

129 Termination of Participation in the CDS Option cont. When an individuals participation in CDS option is terminated, CM or SC is required to: (1) ensure continuity of those services that were being delivered through CDS option; and (2) document arrangements made to ensure continuity of services for services previously delivered through CDS option.

130 Termination of Participation in the CDS Option cont. When service planning team recommends termination of CDS option, CM or SC is required to document: (1) reason(s) for recommendation; (2) conditions and timeframes established by service planning team for re-enrollment into CDS option; (3) justification for termination timeframes that exceed 90 days; and (4) conditions and timeframes established by hearing officer, if applicable.

131 Termination of Participation in the CDS Option cont. For HCS and TxHmL, recommendations for termination must be submitted to DADS Access and Intake, Program Enrollments for review and processing.

132 Re-enrollment for Participation in the CDS Option Individual or LAR is required to notify CM or SC to request re-enrollment into CDS option

133 Re-enrollment for Participation in the CDS Option cont. Prior to re-enrollment into CDS option, CM or SC must: (1) review reason for suspension or termination; (2) verify minimum 90-day period and any other conditions have been met; (3) verify resolution of each issue that contributed to suspension or termination; and (4) refer request for re-enrollment to service planning team to: (A) revise service plan and re-enroll into CDS; OR (B) recommend denial to DADS Access and Intake, Program Enrollment for review and processing

134 CDSA is required to notify CM or SC in writing within 2 working days of any repeat of prior noncompliance or additional noncompliance with requirements of individuals program or CDS option Re-enrollment for Participation in the CDS Option cont.

135 Due Process CM or SC provides an oral explanation of an adverse action recommended by a service planning team. Any recommendations for denial, reduction, suspension or termination of current or proposed CDS services must be submitted to DADS, Access and Intake, Program Enrollment for review. DADS will generate written notification of the right to a fair hearing as appropriate.

136 BREAK

137 Questions and Answers

138 Monitoring and Oversight of HCS and TxHmL Providers who Serve Individuals using the CDS Option Winter, 2007

139 HCS Provider Certification Reviews Reviews will include individuals who receive CDS in review sample CDS responsibilities will be reviewed in conjunction with other program principles Review sequence will remain unchanged

140 TxHmL Provider Certification Reviews Reviews will monitor only provider services of individuals who receive CDS Compliance to §9.580(a)(21) will be reviewed in conjunction with other program principles Review sequence will remain unchanged

141 HCS Review Sample Individuals with CDS will be identified on pre- review report used by Waiver Survey and Certification (WS&C) One individual with CDS will always be included in the comprehensive review sample Additional individuals with CDS may be included in review sample depending on *# of individuals with CDS, *# of individuals served by contract, *findings re: CDS in comprehensive review.

142 CDS-Related Principles in HCS § 9.175(b) - IDT may include CDSA representative § 9.175(j)(1) - requires IDT to inform individual or LAR of right to transfer at least annually § 9.175(j)(2) - requires IDT to document § 9.175(j)(1)

143 CDS-Related Principles in HCS § 9.175(k) - for individuals receiving SHL or Respite, requires IDT to at least annually: (1) inform individual or LAR of right to participate or discontinue CDS at any time (2) provide individual or LAR Forms 1581, 1582 and 1583 which contain information re: CDS (3) provide oral explanation of information re: CDS (4) provide individual or LAR opportunity to choose CDS and document choice on Form 1584

144 CDS-Related Principles in HCS § 9.175(l) - If individual or LAR chooses CDS, requires IDT to: (1) provide names and contact info of all CDSAs in local service area (2) document individuals or LARs choice of CDSA on Form 1584 (3) document description of service component to be provided through CDS in ISP (4) document individuals service back-up plan in ISP

145 CDS-Related Principles in HCS § 9.175(m) - requires IDT to document: - that individual/LAR was informed of right to participate or discontinue CDS at any time and - that list of CDSAs was given to individual or LAR who chose to participate in CDS in ISP

146 CDS-Related Principles in HCS § 9.175(n) - requires IDT to recommend to DADS termination of FMS and support consultation for individuals in CDS if: (1) continued participation in CDS poses significant risk to individuals health, safety, or welfare; (2) individual or LAR has not met Responsibilities of Employers and Designated Representatives section in Chapter 41, Subchapter B

147 CDS-Related Principles in HCS § 9.175(o) - if IDT recommends termination of FMS and Support Consultation, IDT must: (1) submit IPC to DADS electronically (2) submit following documentation to DADS Access & Intake: (A) description of service recommended for termination; (B) reasons termination is recommended; (C) descriptions of attempts to resolve issues; (D) any other supporting documentation

148 CDS-Related Principles in HCS §9.177(b) - requires HCS providers adhere to each applicable rule or regulation

149 CDS Provider-Related Principles in TxHmL §9.580(a)(21) - requires program provider to notify and document notification of individuals Service Coordinator of individuals or LARs expressed interest in CDS option

150 HCS and TxHmL Provider Review Sequence Will Remain Unchanged Generally Prior Notification of Review Entrance Conference Home Visits Review of Documentation Periodic De-briefings Final De-briefing Exit Conference

151 CDS Implementation Training TxHmL Authority Principles DADS Contract Accountability and Oversight (CAO) Monitoring and Oversight of Mental Retardation Authorities

152 Overview Identification of TxHmL Authority Principles Related to CDS Identification of MRA and SC Responsibilities Key changes to CAO Oversight Process and identification of acceptable evidence for annual TxHmL Authority review 583 (r) 583 (u) 583 (s) 583 (v) 583 (b) 583 (t)

153 Oversight and Monitoring Effective March 1, 2007, 40 TAC Chapter 9 includes new TxHmL authority principles specific to CDS Contract Accountability and Oversight Unit will continue to monitor MRA compliance with TxHmL Authority Principles through annual reviews. Review Process will include new principles beginning with implementation of CDS in Review sample will include, if applicable, CDS consumers.

154 Authority Principle Related to CDS 40 TAC §9.583 (b) Oversight Process Changes Process for Enrollment The Service Coordinator (SC) must include the following in the PDP : §9.567 (a) (6) – (8) The MRA must : §9.567 (b) (1) – (5) 583 (b)

155 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes The SC must include in the PDP: §9.567 (a) (6) (6)a statement that the applicant was provided information regarding CDS as required by subsection (b) of this section. Acceptable Evidence : PDP documents the applicant or LAR was provided the required information regarding the CDS option.

156 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes The SC must include in the PDP: §9.567 (a) (7) (7)if the applicant chooses to participate in CDS, a description of the service components provided through CDS, as required by subsection (e) of this section. Acceptable Evidence : All self-directed services must be included in the PDP.

157 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes The SC must include in the PDP: §9.567 (a) (8) (8)if the applicant chooses to participate in CDS, a description of the applicants service back- up plan, as required by subsection (e) of this section. Acceptable Evidence : The SC documents in the PDP a description of the applicants service back-up plan with required elements identified in subsection § (a) – (d).

158 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes The MRA must: §9.567 (b) (1) (1)inform the applicant or LAR of the applicants right to participate in CDS and discontinue participation in CDS at any time, except as provided in 40 TAC § (a) of this title relating to Suspension of Participation in CDS; Acceptable Evidence : Documentation that the applicant or LAR was provided the required information of the applicants right to participate or discontinue participation in CDS. (Form 1584)

159 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes §9.567 (b) (2) (A) (2)inform the applicant or LAR that: A.except as provided in subparagraph (B) of this paragraph, the applicant or LAR may choose to have one or more service components provided through CDS, the other service component must also be provided through CDS; Acceptable Evidence : Documentation that the applicant or LAR was informed of the service components provided through CDS and exceptions to the service components.

160 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes §9.567 (b) (2) (B) (2)inform the applicant or LAR that: (B)if the applicant is receiving community support and respite and chooses to have one of these service components provided through CDS, the other service component must also be provided through CDS; Acceptable Evidence : Documentation that the applicant or LAR was informed of requirements related to choosing community support and respite service components provided through CDS.

161 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes §9.567 (b) (3) (3)provide the applicant or LAR a copy of Forms 1581, 1582, and 1583 which are available at books/form/default/asp?HB- CDS and which contain information about CDS, including a description of financial management services and support consultation; Acceptable Evidence : Documentation that the applicant or LAR was given a copy of Forms 1581 (CDS Option overview), 1582 (CDS Responsibilities & Self Assessment), and 1583 (Employee Qualification Requirements).

162 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes §9.567 (b) (4) (4) provide an oral explanation of the information contained in Forms 1581, 1582, and 1583 to the applicant or LAR; and Acceptable Evidence : Documentation from the individuals record that the applicant or LAR was given an oral explanation of the information contained in Forms 1581, 1582, 1583 and 1584.

163 Process for Enrollment Related to 40 TAC §9.583 (b) Oversight Process Changes §9.567 (b) (5) (5) provide the applicant or LAR the opportunity to choose to participate in CDS and document the applicants or LARs choice on Form 1584, which is available at ault/asp?HB-CDS. Acceptable Evidence : Individual or LAR choice documented on Form 1584

164 Authority Principle Related to CDS Oversight Process Changes §9.583 (h) (1) An MRA must maintain for each individual: (1) a current IPC Acceptable Evidence : New IPC (Form 8582) for all individuals

165 Authority Principle Related to CDS Oversight Process Changes §9.583 (k) (1) An MRA must ensure that a service coordinator: (1) Initiates, coordinates and facilitates the PDP Planning process to meet the desires and needs as identified by an individual and LAR in the individuals PDP. Acceptable Evidence : PDP should address the individuals desires and needs including evidence as to whether CDS option was desired or chosen.

166 Authority Principle Related to CDS Oversight Process Changes §9.583 (k) (4) An MRA must ensure that a service coordinator: (4) Coordinates and develops an individuals IPC based on the individuals PDP Acceptable Evidence : New IPC (Form 8582)

167 Authority Principle Related to CDS Oversight Process Changes §9.583 (k) (5) An MRA must ensure that a service coordinator: (5) coordinates and monitors the delivery of TxHmL and non-TxHmL Program services. Acceptable Evidence : If applicable, documentation concerning SC requesting either employer CAP per § (a)-(d) or CDSA transfer per requirements outlined in § (c) (1) – (4).

168 Authority Principle Related to CDS Oversight Process Changes The Service Coordinator must: §9.583 (m) (6) (6) ensure that the individual or LAR is informed of decisions regarding denial or termination of services and the individuals or LARs right to request a fair hearing as described in §9.571 of this subchapter (relating to Fair Hearings); Acceptable Evidence : Documentation that the SC orally explained the requirements identified in § (b) and (c) concerning denials or terminations.

169 Authority Principle Related to CDS Oversight Process Changes The Service Coordinator must, at least annually §9.583 (r) (1) – (4) (1)inform the individual or LAR of the individuals right to participate in CDS and discontinue participation in CDS at any time, except as provided in 40 TAC § (a) of this title (relating to Suspension of Participation in CDS); Acceptable Evidence : Documentation that the SC reviewed CDS participation rights at least annually. 583 (r)

170 Authority Principle Related to CDS Oversight Process Changes §9.583 (r) (2) (2)provide the individual or LAR a copy of Forms 1581, 1582, and 1583 which are available at ndbooks/form/default/asp?HB- CDS and which contain information about CDS, including a description of financial management services and support consultation Acceptable Evidence : Documentation that a copy of Forms 1581, 1582, and 1583 were provided to individual or LAR.

171 Authority Principle Related to CDS Oversight Process Changes §9.583 (r) (3) (3)provide an oral explanation of the information contained in Forms 1581, 1582, and 1583 to the individual or LAR; and Acceptable Evidence : Documentation that Forms 1581, 1582 and 1583 were explained orally.

172 Authority Principle Related to CDS Oversight Process Changes §9.583(r) (4) (4)provide the individual or LAR the opportunity to choose to participate in CDS and document the individuals choice on Form 1584, which is available at ault/asp?HB-CDS. Acceptable Evidence : Documentation of individual or LAR choice on Form 1584.

173 Authority Principle Related to CDS Oversight Process Changes The Service Coordinator must (if individual or LAR chooses CDS): §9.583 (s) (1) – (4) (1)provide names and contact information to the individual or LAR regarding all CDSAs providing services in the MRAs local service area; Acceptable Evidence : Documentation that the SC provided names and contact information to the individual or LAR regarding all CDSAs providing services in the MRAs local service area. 583 (s)

174 Authority Principle Related to CDS Oversight Process Changes §9.583 (s) (2) (2)document the individuals or LARs choice of CDSA on Form 1584; Acceptable Evidence : Form 1584

175 Authority Principle Related to CDS Oversight Process Changes §9.583 (s) (3) (3)document, in the individuals PDP, a description of the service components provided through CDS; and Acceptable Evidence : Documentation in the Annual/Revised PDP describing the service components that will be provided through CDS.

176 Authority Principle Related to CDS Oversight Process Changes §9.583 (s) (4) (4) document, in the individuals PDP, a description of the individuals service back-up plan. Acceptable Evidence : Documentation in the Annual/Revised PDP that describe the individuals service back-up plan (Form 1740). Elements of a service back- up plan are defined in the CDS rule: 40 TAC § (27) and § (a)-(d).

177 Authority Principle Related to CDS Oversight Process Changes §9.583 (t) (t) document in the individuals PDP that the information described in subsections (r) and (s) (1) of this section was provided to the individual or LAR. Acceptable Evidence : Documentation in the annual PDP that the SC shared CDS information detailed in (r) and (s)(1) with the individual or LAR. 583 (t)

178 Authority Principle Related to CDS Oversight Process Changes §9.583 (u) (1) (2) For an individual participating in CDS, the MRA must recommend to DADS that financial management services and support consultation, if applicable, be terminated if the service coordinator determines that: (1)the individuals continued participation in CDS poses a significant risk to the individuals health, safety or welfare; or Acceptable Evidence : If applicable, documentation must demonstrate that the MRA recommended to DADS termination of these services if, SC determined that (u)(1) and/or (u)(2). 583 (u)

179 Authority Principle Related to CDS Oversight Process Changes §9.583 (u) (2) (2)the individual or LAR has not complied with Chapter 41, Subchapter B of this title (relating to Responsibilities of Employers and Designated Representatives). Acceptable Evidence : If the MRA recommends termination of CDS services based on (u) (1) or (2), acceptable documentation may include the SC, DADS, or CDSA requesting a Corrective Action Plan per § (a)-(d).

180 Authority Principle Related to CDS Oversight Process Changes §9.583 (v) (1) (2) If an MRA makes a recommendation under subsection (u) of this section, the MRA must: (1) submit the individuals IPC to DADS electronically ; and Acceptable Evidence : Documentation reflecting electronic submission of individuals revised IPC to DADS 583 (v)

181 Authority Principle Related to CDS Oversight Process Changes §9.583 (v) (2) (A)-(D) (2)submit the following, in writing, to the Department of Aging and Disability Services, Access and Intake, Program Enrollment, Utilization Review, P..O. Box , Mail Code W-354, Austin, Texas Acceptable Evidence : Documentation describing (v) (2) (A)-(D) was submitted in writing to DADS

182 Authority Principle Related to CDS Oversight Process Changes §9.583 (v) (2) (A)-(D) A.a description of the service recommendation for termination; B.the reasons why termination is recommended; C.a description of the attempts to resolve the issues before recommending termination; and D.Other supporting documentation, as appropriate. Acceptable Evidence : Documentation describing (v) (2) (A)-(D) was submitted in writing to DADS

183 Summary Identification of TxHmL Authority Principles Related to CDS Identification of MRA and SC Responsibilities Key changes to the CAO Process and identification of acceptable evidence for annual TxHmL Authority review 583 (r) 583 (u) 583 (s) 583 (v) 583 (b) 583 (t)

184 Questions and Answers, Wrap-up


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