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Idaho HCBS Medicaid Provider Orientation Guide General Information: Part II Division of Medicaid An Introduction to Medicaid Programs for Home and Community.

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Presentation on theme: "Idaho HCBS Medicaid Provider Orientation Guide General Information: Part II Division of Medicaid An Introduction to Medicaid Programs for Home and Community."— Presentation transcript:

1 Idaho HCBS Medicaid Provider Orientation Guide General Information: Part II Division of Medicaid An Introduction to Medicaid Programs for Home and Community Services Waiver Providers.

2 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 13 The Medicaid Aged and Disabled Waiver, (A&D)  What is the Aged and Disabled Waiver?  Who does the A&D Waiver Serve?  What are the Eligibility Requirements?  What Services are Available?  What Provider Types Can Serve A&D Waiver Participants?

3 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 13, (Page 2) The Medicaid Aged and Disabled Waiver, (A&D)  Aged and Disabled Waiver Additional Terms Agreement  Training  Quality Assurance  Financial Stability  Policies and Procedures

4 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 13, (Page 3) The Medicaid Aged and Disabled Waiver, (A&D)  Transition of Participants  Records/Reports  Subcontractors

5 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 14 HCBS: Assistive Technology/Specialized Medical Equipment  What is Assistive Technology?  Who Does Assistive Technology Serve?  What are the Eligibility Requirements?  What are the Equipment Requirements?  What Provider Types can Provide this Service?

6 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 15 HCBS: Home Modification  What is Home Modification?  What Examples May Home Modifications Include?  What Does Home Modification Exclude?  Where May Home Modification Take Place?  What Provider Types can Perform Home Modification?

7 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 16 HCBS: Personal Emergency Response System, (PERS)  What is a Personal Emergency Response System?  Who is Eligible for a PERS?  What are the Provider Qualifications for a PERS Provider?

8 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 17 HCBS: Home Delivered Meals  What are Home Delivered Meals?  Who is Eligible for Home Delivered Meals?  What are the Provider Qualifications for Home Delivered Meals?

9 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 18 HCBS: Adult Day Care  What is Adult Day Care?  Who does Adult Day Care Serve?  What are the Eligibility Requirements?  What Services are Available?  Adult Day Care Additional Terms Agreement  Enrollment Criteria  Space and Accommodations Requirement

10 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 19 Service Coordination for Personal Care Services  What is Service Coordination?  Who is Eligible for Service Coordination for PCS?  What are the Functions of Service Coordination for PCS?  What Services are Reimbursed  What are the Provider Qualifications?

11 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 20 State Plan Personal Care Services  What is State Plan Personal Care Services  Who does the State Plan PCS Program Serve?  What are the Eligibility Requirements?  What Services are Available?  PCS Also Provides the following:

12 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 21 Traumatic Brain Injury, (TBI), HCBS Waiver  What is the TBI Waiver?  Who Does the TBI Waiver Serve?  What are the Eligibility Requirements?  What Services are Available?  What Provider Types Can Serve TBI Waiver Participants?

13 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 21, (Page 2) Traumatic Brain Injury, (TBI), HCBS Waiver  TBI Waiver Additional Terms Agreement  Training  Quality Assurance  Financial Stability  Policies and Procedures

14 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 21, (Page 3) Traumatic Brain Injury, (TBI), HCBS Waiver  Transition of Participants  Records/Reports  Subcontractors

15 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 22 Behavioral Health Care Management for Adults with Developmental Disabilities  History  Behavioral Health Care Mgt for Adults with DD  What is a Developmental Disability?  What Services are Available to Adults with D.D.  Home and Community Based Services, (HCBS)

16 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 22, (Page 2) Behavioral Health Care Management for Adults with Developmental Disabilities  What is the Developmental Disabilities Waiver?  Who Does the DD Waiver Serve?  What are the Eligibility Requirements?  What Services are Available?  Independent Assessment Providers

17 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 22, (Page 3) Behavioral Health Care Management for Adults with Developmental Disabilities  What Provider Types can Serve DD Waiver Participants?  Training for Residential Habilitation Providers  Training for DD Agency Personal  Training Targeted Service Coordinator/Plan Developer/Monitor

18 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 22, (Page 4) Behavioral Health Care Management for Adults with Developmental Disabilities  Quality Assurance  Departmental Quality Assurance  Types of Quality Assurance Reviews  Alternative Corrective Actions

19 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 22, (Page 5) Behavioral Health Care Management for Adults with Developmental Disabilities  Cause for Termination  Coordination with S/URs and Fraud and Abuse Unit  Employment Service Providers

20 Idaho HCBS Medicaid Provider Orientation Guide, Part II CHAPTER 21 Certified Family Home, (CFH), Program  What are Certified Family Homes?  What are CFH Certification Requirements?  What Services do CFH’s Provide?  CFH Application Requirements


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