1 Department of Medical Assistance Services DD Waiver Provider Training Department of Medical Assistance Services Division of Long-Term Care and Quality Assurance 2013

2 Department of Medical Assistance Services Family/Caregiver Training (FCT)

3 Department of Medical Assistance Services Family/Caregiver Training Definition Provision of identified training and education to a family member or caregiver regarding: –Disabilities –Community integration –Family dynamics –Stress management –Behavior interventions –Mental health

4 Department of Medical Assistance Services Family/Caregiver Training Definition continued “Family” constitutes persons who live with or provide care to a waiver consumer –Parent –Spouse –Children –Other Relatives (including in-laws) –Legal Guardian –Foster Family

5 Department of Medical Assistance Services Family/Caregiver Training Provider Qualifications Provider must enroll with DMAS to be a Family/Caregiver Training Provider Existing Medicaid providers cannot use current Identification number Obtain Enrollment Packet by calling the Provider Enrollment Unit (888)

6 Department of Medical Assistance Services Family Caregiver Training Training shall be provided on an individual basis or in small groups provided by Medicaid-certified Family/Caregiver Training providers

7 Department of Medical Assistance Services Family/Caregiver Training Provider Qualifications Who can provide this service? –Home health agencies; –Community developmental disabilities agencies; –Developmental disabilities residential providers; –Community mental health centers; –Public health agencies; –Hospitals;

8 Department of Medical Assistance Services Family/Caregiver Training Provider Qualifications Who can provide this service: –Clinics; –In-home rehabilitation agencies; –Other agencies or organizations Individual Family/Caregiver Trainers who have necessary Virginia licensure or certification for their profession may also enroll as a provider.

9 Department of Medical Assistance Services Family/Caregiver Training Provider Qualifications Providers must: Have demonstrated experience or knowledge of the training topic Have the appropriate licensure or certification for their field.

10 Department of Medical Assistance Services Family/Caregiver Training Providers include: –RNs, LPNs, RNAs, & Nurse Practitioners –Occupational, Physical and Speech Therapists –Physicians –Teachers –Psychologists –Licensed Practical Counselors –Licensed Clinical Social Workers

11 Department of Medical Assistance Services Referral Process During POC development, the case manager will document with the family the need for training. Training must be necessary: – To improve the family or caregiver’s ability to give care and support to the individual. –To assist the family/caregiver with maintaining the individual at home.

12 Department of Medical Assistance Services Referral Process The case manager will give the family and/or caregivers the choice of Family/Caregiver training providers

13 Department of Medical Assistance Services Referral Process The case manager documents this information on the POC (DMAS 456) and supporting documentation (DMAS 457) and obtains authorization from DMAS for services. If additional hours are needed, the family/caregiver provider should contact the case manager.

14 Department of Medical Assistance Services Service Units Individuals can receive up to 80 hours of Family/Caregiver Training services per calendar year The training must be authorized by DMAS and billed on an hourly basis

15 Department of Medical Assistance Services Service Limitations Training cannot include services available under Medicaid State Plan services or educational courses. Paid caregivers are not eligible to receiving training through this service.

16 Department of Medical Assistance Services Documentation The CM should provide the following information regarding the individual: –The POC (DMAS 456, DMAS 457) –The DMAS 225 –Any relevant evaluations, therapeutic consults, MD reports

17 Department of Medical Assistance Services Provider Documentation The FCT should provide the following information to the case manager: Supporting Documentation(DMAS 457) Brochure of training activities

18 Department of Medical Assistance Services Provider Documentation cont. Contact notes: Date, location, and time of each training contact; Type of activities and hours of service provided; and Persons to whom activities were directed

19 Department of Medical Assistance Services Provider Documentation cont. : Monthly notes: Summary of training activities for the month; Dates, locations, and times of service delivery; POC objective(s) addressed; Specific details as planned or modified Effectiveness of the strategies and individual and caregivers’ satisfaction with services

20 Department of Medical Assistance Services Provider Documentation cont. Semi-annual Reviews are required by the provider if training extends three months or longer and are to be forwarded to the Case Manager and include: Activities related to the supporting documentation; Individual status and satisfaction with services Training outcomes and effectives of the POC

21 Department of Medical Assistance Services Provider Documentation cont. If training services extend less than three months, the provider must forward to the Case Manager: Contact notes Monthly notes Or a summary of such to the Case Manager for the semi-annual review

22 Department of Medical Assistance Services Thank You For Coming! We look forward to partnering with you to provide services to our DD Waiver beneficiaries Any Questions? Please Ask