part 8

[Virtual Presenter] During this portion of the presentation, we will cover the necessary documentation and data elements required for the DDRS HCBS Waivers Section 10, specifically for the F-S-W and C-I-H Waivers. These details are crucial for service authorizations and quarterly reports to accurately represent the services provided to individuals. The service authorization will include important information such as the name of the waiver-funded service, the chosen provider, cost and duration of each service, and start and end dates. This ensures clear and documented services. Additionally, progress towards outcomes and any changes in the P-C-I-S-P must be documented for tracking and potential adjustments. Furthermore, in compliance with 460 I-A-C 6-18-4, specific data elements must be included for each service, such as the individual's name, I-H-C-P Member ID, provider's name, date and duration of service, summary of behavioral support activities, progress towards outcomes, and the provider's signature. Electronic signatures are acceptable under the Uniform Electronic Transactions Act. A quarterly report must also be submitted by the service provider and shared with the individual, guardian (if applicable), and the ISt The report should summarize the level of support provided based on the P-C-I-S-P and service authorization. The service provider is responsible for uploading the report to the individual's document library. These elements are crucial for accurately reflecting services under the F-S-W and C-I-H Waivers. Thank you for your attention and we will continue discussing the remaining elements of this section in the upcoming slides..

[Audio] This slide will cover the DDRS HCBS Waivers Section 10, specifically discussing the required documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. The key information that must be included in these reports will be outlined, including details about the individual receiving services, the provider, services provided, progress towards outcomes, and any challenges hindering progress. It is important to note that there are limitations to these services, such as not allowing restrictive techniques that are not approved by the I-S-T and the human rights committee, therapy services provided in an educational/school setting, and services provided by immediate family members. Providers of Behavioral Support Services must also meet certain qualifications, such as being an active Medicaid provider and complying with Indiana Administrative Code 460 I-A-C 6, which includes documenting criminal histories, insurance, financial status, and qualifications for Behavioral Support Services. Compliance with FSSA/BDS service standards, guidelines, policies, and manuals is crucial for providers, including FSSA/DDRS BDS policies. This presentation will cover all the necessary information to ensure these standards are met. Thank you for your attention to this important information. The next section of the presentation will now be discussed..

[Audio] Welcome to slide number 3 out of 14, where we will be discussing the DDRS HCBS Waivers Section 10. This section outlines the necessary documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. It includes vital information about the individual receiving services, the provider, the services provided, progress made towards outcomes, and any challenges that may be hindering progress. Moving on to the service definition, we have Career Exploration and Planning. This targeted service is designed to assist individuals in making informed decisions about their career paths. It can be used to explore options for competitive integrated employment, self-employment, and gather information for referrals to Indiana Vocational Rehabilitation, American Jobs Center, or other employment support services. This service is particularly beneficial for individuals transitioning from school-based services who may be uncertain about their path towards competitive integrated employment. It is also useful for employed individuals seeking advancement opportunities or alternative career objectives. Now, let's take a closer look at the reimbursable activities for Career Exploration and Planning. These activities include identifying an individual's specific interests and aptitudes for competitive integrated employment, as well as exploring opportunities in their local area. This may involve business tours, informational interviews, job shadows, or work experiences. Additionally, this service covers the setup, preparation, and debriefing for each exploration opportunity to ensure individuals have the necessary support and information to make meaningful progress towards their career goals. Finally, it is important to note that Career Exploration and Planning Services are available under both the F-S-W and C-I-H Waivers. This means that individuals have access to this valuable service regardless of which waiver they are enrolled in. Stay tuned for more information on the other services covered in Section 10 of the DDRS HCBS Waivers. Thank you for listening..

[Audio] In Slide 4, we will discuss the DDRS HCBS Waivers Section 10, which covers the Service Definitions and Requirements for F-S-W and C-I-H Waivers. This section outlines the necessary documentation and data elements for Service Authorizations and quarterly reports. These reports include important information about the individual receiving services, the provider, the services provided, progress towards outcomes, and any challenges hindering progress. When it comes to career exploration and planning, it is crucial to have a thorough understanding of one's talents, skills, and knowledge. Learning styles, positive personality traits, and values also play a significant role in this process. It is essential to consider personal workplace and environmental preferences, dislikes, and any situations or careers to avoid. Previous work experiences should also be taken into account. Moreover, an individual's support system and access to community resources must also be considered when identifying specific challenges they may face and finding solutions. This may include looking into potential benefits and accommodation needs. When exploring career opportunities, it is important to consider preferred career paths and how one can contribute to the community and potential employers. It should be noted that Career Exploration and Planning are time-limited services and should not exceed 20 hours a month for six months in any 12-month period. There are certain activities that are not allowed under this service, as they are already covered under the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act (I-D-E-A-). Documentation must be maintained to show that the service is not available or funded under these acts. Lastly, in terms of provider qualifications, they must be enrolled as an active Medicaid provider and approved by FSSA/DDRS. They must also comply with Indiana Administrative Code 460 I-A-C 6, which includes criteria such as documentation of criminal histories, insurance, and financial status. Additionally, providers must adhere to any applicable FS regulations..

[Audio] The following section, slide number 5, focuses on the DDRS HCBS Waivers Section 10 for F-S-W and C-I-H Waivers. This section provides an overview of the required documentation and data elements for Service Authorizations and quarterly reports. It covers important information such as the individual being served, the provider, services provided, progress made towards outcomes, and any challenges encountered. Moving on to section 10.6, we will now discuss the specific information and requirements for Case Management services for the F-S-W and C-I-H Waivers. Case Management is a critical aspect of helping individuals access needed waiver and other Indiana Medicaid State Plan services, as well as other important resources such as medical, social, educational, and community supports. Case managers work closely with individuals to advocate for their access and participation in paid and unpaid services, programs, and settings. This ultimately promotes social capital, skill development, and personal fulfillment. It is essential to note that Case Management services include both annual planning and assessment, as well as ongoing support. These services are mandatory for all individuals under both the F-S-W and C-I-H Waivers. Furthermore, these services are only provided by DDRS-approved case management organizations/entities that have been awarded contracts through the selected contracting process of the §1915(b)(4) waiver. This process also operates concurrently with the §1915(c) waivers. It is important to mention that there is a similar but distinct service called Care Management available under the H&W and T-B-I Waivers. For further details on this service, please refer to Section 12.12: Care Management for H&W and T-B-I Waivers. Now, let's discuss the activities that are eligible for reimbursement under Case Management services. These include annual planning and assessment, which covers initial and annual activities outlined by B-D-S to support the individual's needs and goals. Thank you for taking the time to listen to the information on Case Management services for the F-S-W and C-I-H Waivers. Stay tuned for more details on the DDRS HCBS Waivers Section 10. Thank you..

[Audio] Slide 6 out of 14 covers the DDRS HCBS Waivers Section 10. This section discusses the necessary documentation and data elements for Service Authorizations and quarterly reports for the F-S-W and C-I-H Waivers. This information is crucial as it ensures that individuals receive the appropriate services and support for their unique needs. It is essential that face-to-face visits are intentional interactions and cannot be drop-in visits at a day program. This allows for dedicated time for the individual and their provider to discuss progress, challenges, and any necessary changes to their service plan. It is also required that I-S-T meetings and face-to-face contacts occur at least every 90 days, ensuring regular review and updates to the Personal Centered Individual Support Plan (P-C-I-S-P) when needed. This is necessary for addressing changes in the individual's needs or services. Risks must also be identified, assessed, and addressed initially and as needed. This includes updating service plans and submitting budget requests in a timely manner, monitoring service delivery and utilization to align with the PCISP, and monitoring the individual's health, safety, satisfaction, and service outcomes. As case managers, we have the responsibility to complete and process the Monitoring Checklist within the established timeline and submit and follow up on incident reports as required. It is crucial that case notes and necessary P-C-I-S-P revisions are completed within seven calendar days for every encounter with or on behalf of the individual. To support billing, case managers must have at least one documented meaningful encounter with the individual every month. It is also our responsibility to disseminate information, including the PCISP, all Notices of Action, and forms, to the individual, their guardian (if applicable), and the ISt In conclusion, maintaining accurate and timely documentation, regular communication, and ensuring the safety and well-being of individuals are essential elements of the DDRS HCBS Waivers..

[Audio] Our presentation on DDRS HCBS Waivers Section 10 is now on slide number 7. This section provides information on the necessary documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. It includes important details about the individuals receiving services, the providers involved, the services provided, progress towards outcomes, and any obstacles hindering progress. One crucial point to remember is that the case management entity is not allowed to subcontract with another agency or case manager for direct case management services. This means that case managers cannot be hired as contractors for the case management entity. This ensures that the case management entity maintains direct oversight and accountability for the services provided. In addition, there are limitations on the number of cases that each case manager can handle. The average caseload cannot exceed 45 active, full-time cases per case management entity. This ensures that case managers are able to effectively manage their workload and provide quality services to their clients. It is also important to note that the case management entity cannot bill for activities or tasks that are not related to case management, such as mailing greeting cards or sending holiday text messages. These types of activities will not be reimbursed through Case Management services. Furthermore, there are specific restrictions on the types of services that can be delivered through Case Management. These include services for individuals who do not meet eligibility requirements established by DDRS/BDS, counseling services related to legal issues (which should be directed to the designated Protection and Advocacy agency), and case management conducted by a person who is related by blood or marriage to the waiver individual. In terms of service standards, case managers are expected to perform all activities listed in the Reimbursable Activities section. They must also have a thorough understanding of Medicaid's role as the payer of last resort. This involves care planning, service monitoring, and working to strengthen informal and natural supports for the individual. We appreciate your attention and kindly continue to follow along as we explore the requirements and standards for F-S-W and C-I-H waivers..

[Audio] Slide 8 presents the documentation and data elements required for Service Authorizations and quarterly reports for F-S-W and C-I-H waivers in the DDRS HCBS program. It is essential for case managers to have a thorough understanding of these standards. As stated in this section, case managers must perform and document one meaningful activity with or on behalf of the individual every month. The documentation should be recorded in the case notes and support billing for the services provided. This documentation must include important details, such as who the contact or activity was with, the purpose of the contact or activity, what was discussed, what decisions were made, and the date of the contact or activity. To clarify these standards, let's look at a couple of examples. In the first example, CM Smith contacted Sam and his mother to schedule their annual planning meeting for September. During the call, they discussed the meeting's agenda and decided to hold it in Sam's backyard. Sam's mother will invite his aunt, and CM Smith will inform the team about the meeting's details. In the second example, CM Smith tried to arrange a meeting with Mary, but after several attempts, it was noted that Mary had not returned any calls, texts, or emails. CM Smith will now reach out to Supervisor Jones to discuss the possibility of sending a certified letter. As case managers, it is essential to adhere to these documentation standards and ensure that all relevant information is included in the case notes. This will not only support billing for the services but also provide a clear record of all activities and decisions made. Thank you for your attention, and let's proceed to the next slide..

[Audio] This is slide number 9 of our presentation on the DDRS HCBS Waivers Section 10. In this section, we will discuss the necessary documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. These requirements are crucial for ensuring the quality and effectiveness of the services provided to individuals with disabilities. It is important to note that the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance, and the ISO-9001 human services quality assurance system are all recognized bodies for accreditation. Any independent national accreditation organization approved by the F-S-S-A Secretary must also adhere to the guidelines and standards set by these organizations. One of the key responsibilities of these organizations is to develop and enforce a code of ethics that aligns with 460 I-A-C 6-14-7 and B-D-S policy, practices, and guidance. This ensures that all providers uphold ethical standards in their service delivery. Furthermore, case management organizations must have enough staff to provide statewide coverage while managing a caseload of no more than 45 cases per full-time case manager. This caseload limit will be monitored quarterly to ensure compliance. It is important to note that five of the six selected contracting case management organizations were already operating statewide at the time of the state's request for services. The remaining organization was given six months to become statewide to ensure the smooth operation of the §1915(c) and §1915(b)(4) waivers. Additionally, ongoing criminal background checks must be conducted for all employees hired or associated with the approved case management entity, in accordance with Indiana Administrative Code, Indiana Code, and B-D-S policy. This is necessary to ensure the safety and well-being of the individuals receiving waiver services. In order to maintain compliance and a high level of quality, it is required that at least one full-time employee actively monitor and oversee all areas of compliance. However, these employees may not carry a caseload of more than 10 cases to avoid any conflicts of interest. We hope this information has provided a better understanding of the requirements and expectations for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers..

[Audio] Slide 10 emphasizes the crucial documentation and data elements that are necessary for Service Authorizations and quarterly reports for the F-S-W and C-I-H Waivers, under the DDRS HCBS Waivers Section 10. These elements consist of information regarding the individual receiving services, the provider, the services provided, progress towards outcomes, and any obstacles affecting progress. It is of utmost importance for case managers to receive training in the person-centered planning process, aligned with the mission, vision, and values of B-D-S--. This includes participating in any B-D-S person-centered trainings. Additionally, case managers must possess effective communication skills, utilizing the individual's preferred means of communication. To meet these requirements, case managers must have specific qualifications. These qualifications include holding a bachelor's degree in social work, psychology, sociology, counseling, gerontology, nursing, special education, rehabilitation, or a related field approved by FSSA DDRS or O-M-P-P-. Alternatively, they can be a registered nurse with at least one year of experience in human services, have a bachelor's degree in any field with at least one year of full-time, direct experience working with individuals with intellectual/developmental disabilities, or hold a master's degree in a related field. It is also essential for case managers to meet the criteria for a qualified intellectual disability professional as outlined in 42 CFR 483.430(a). Additionally, technology case management entities must maintain a 24/7 emergency response system that is not connected to the local 911 system and is available to assist all waiver individuals. This includes having 24/7 staff on-hand to address immediate needs and reach out to the individual's case manager to make appropriate arrangements. Ensuring that case managers are well-trained and qualified is crucial in providing optimal care for individuals with intellectual/developmental disabilities. We appreciate your attention to these important details..

[Audio] During this presentation, we have reached slide number 11 out of 14, which covers the DDRS HCBS Waivers Section 10. This section is focused on the necessary documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. Specifically, we will be discussing Section 10.7, which pertains to the Community Transition services for the C-I-H Waiver. The purpose of these services is to aid individuals in transitioning from an institution to their own home in the community. These services include one-time setup expenses, such as security deposits for the individual's new home. It should be noted that these services are only available for a one-time transition and will not be reimbursed for subsequent moves. When we use the term "own home" we are referring to any dwelling that is owned, leased, or rented by the individual and/or their guardian or family. This can include a house, apartment, condominium, trailer, or other types of lodging. It can also include a home owned and/or operated by the agency providing supports. It is important to understand that any items purchased through Community Transition services are the property of the individual receiving the service. This means that if the individual moves to another residence, they should take those items with them, even if the previous residence was owned by a provider agency. Additionally, nursing facilities are not reimbursed for these services as they are already included in their per diem fees. It should be noted that these services are only available for the C-I-H Waiver and not the F-S-W--. For more information on Community Transition services under the H&W and T-B-I Waivers, please see Section 12.14 of this presentation. Lastly, it is important to remember that reimbursable activities for Community Transition services include security deposits required for securing an individual's new home. Thank you for your attention to this important information and we will now continue with the next section of our presentation..

[Audio] Section 10 of the DDRS HCBS Waivers pertains to the necessary documentation and data elements for Service Authorizations and quarterly reports for the F-S-W and C-I-H Waivers. In order to ensure compliance, we must first address the specific service standards for Community Transition services. These standards must be reflected in the Person-Centered Individualized Support Plan (P-C-I-S-P) and must address the individual's identified needs as outlined in the planning process. Furthermore, proper documentation standards for Community Transition services include keeping receipts for all expenditures and clearly stating the amount and nature of the expense or deposit. It should be noted that there are limitations for these services, as they are limited to one-time setup expenses and cannot exceed $2500. Additionally, there are certain activities that are not covered under Community Transition services, such as apartment or housing rental expenses, food, appliances, and recreational items like hobby supplies, television, cable TV access, V-C-Rs or D-V-D players, and streaming services like Netflix and Hulu. It is also important to be aware that services provided by a parent of a minor child participant or the spouse of a participant, known as L-R-I-s-, are not permitted. Moving on, providers must meet certain qualifications in order to be eligible to provide services under the DDRS HCBS Waivers. This includes being enrolled as an active Medicaid provider and being approved by FSSA DDRS. Additionally, they must comply with the Indiana Administrative Code, specifically 460 I-A-C 6, which includes documentation of criminal histories, insurance, financial status, and qualifications for community transition supports providers. They must also adhere to any applicable B-D-S service standards, guidelines, policies, and trainings. Thank you for your attention to these important details regarding Section 10 of the DDRS HCBS Waivers. It is crucial that all providers adhere to these requirements when delivering services under these waivers..

[Audio] Slide number thirteen of our presentation on the DDRS HCBS Waivers Section 10 is dedicated to discussing Service Definitions and Requirements for F-S-W and C-I-H Waivers, with a specific focus on Day Habilitation services. Day Habilitation services are a vital component of the Person-Centered Individual Support Plan (P-C-I-S-P). These services are designed to assist individuals in areas such as self-care, sensory and motor development, socialization, daily living skills, communication, community living, and social skills. The primary goal of Day Habilitation is to facilitate learning and provide support in these areas, while also fostering relationships and natural supports. Day Habilitation services can be offered in various settings, including the community or a facility owned or operated by an FSSA DDRS-approved provider. It is important to note that these settings are non-residential and separate from an individual's private residence or other living arrangements. Now, let's take a closer look at the reimbursable activities for Day Habilitation services. These activities include person-centered monitoring, training, education, and support to help individuals acquire and maintain skills. These skills may include leisure activities, community and public events, educational activities, hobbies, unpaid work experiences, and maintaining contact with family and friends. Furthermore, Day Habilitation services offer training and education in self-direction. This is aimed at empowering individuals to achieve outcomes such as self-advocacy skills, exercising civil rights, developing self-control and responsibility for services and support, and promoting independence and integration. To summarize, Section 10.8 of the DDRS HCBS Waivers outlines the necessary information and requirements for Day Habilitation services under F-S-W and C-I-H Waivers. These services play a critical role in supporting individuals in various areas and promoting their independence and integration. Thank you for your attention..

[Audio] As we come to the end of our presentation, we would like to bring your attention to the final section of the DDRS HCBS Waivers. This section, Section 10, outlines the essential documentation and data elements for Service Authorizations and quarterly reports for F-S-W and C-I-H Waivers. These elements include information about the individual receiving services, the provider, the services provided, progress towards goals, and any obstacles that may be impeding progress. It is crucial that all of these details are accurately documented in order to ensure high-quality care and compliance with regulations. We want to emphasize a significant aspect of the documentation requirements the involvement of a relative in providing supports. A relative of the individual may serve as a direct support professional for Day Habilitation services, as long as they are employed by a BDS-approved waiver provider. It is important to note that the decision to involve a relative in providing supports must be made as part of the person-centered planning process and clearly documented in the PCISP. Additionally, an annual review by the I-S-T is necessary to determine if the relative should continue providing these services. Moreover, our services may be provided in a group setting, but again, this decision must be made as part of the person-centered planning process and documented in the PCISP. The P-C-I-S-P must also reflect the appropriate ratio for the individual during service delivery, and providers must be able to provide proof of this upon request. In addition to adhering to the documentation standards outlined in 460 I-A-C 6, there are specific data elements that must be included for each service provided. These include the name and I-H-C-P Member ID of the individual, the name of the provider, the service provided, the date and time frame of the service, and the primary type and location of service delivery. It is vital to pay attention to these documentation standards and data elements to ensure the overall quality and effectiveness of the services offered through the F-S-W and C-I-H Waivers. Thank you for your attention during this presentation, and we hope that you now have a better understanding of the important considerations and requirements outlined in Section 10 of the DDRS HCBS Waivers..