Mental Health Waiver Provider Meeting

1. Mental Health WaiverProvider Meeting July 18, 2019

2. Agenda • Introductions • Waiver Update • Transition to direct billing • EVV • Credentialing updates • Critical Incidents • Medical issues and emergencies • Housing budget • Chore Service • New Format for Recovery Plans • Maintaining Husky C Eligibility = Timely Provider Payment • NOA • HIPAA • Notes/Documentation • Billing/ Audits • MHW Advisory Council

3. Waiver Update (as of 7/15/19) • Active clients on the waiver: 601 • Actively planning for admission to waiver (MHW & MFP): 40 • Referrals pending disposition (MHW & MFP): 60 • Waitlisted referrals for MHW community: 74 • Community Census for Waiver Year 11: 615 • Additional Slots for MFP clients Waiver Year 11: 60

4. Average Enrolled by Month

5. Transition to direct billing through DXC • Enrollment for the new portal began at the end of May 2019. If you have not already completed the enrollment process, please do so ASAP! You will not be able to bill for services rendered after 9/1/19 until your enrollment is completed. If you need the workshop slides to help with the enrollment, please email Chastity. • The following services will continue to be billed through ABH: • Highly Skilled Chore service • Assistive Technology • Specialized Medical Equipment • Home Accessibility Adaptations

6. Electronic Visit Verification • EVV is still slated to begin in early 2020 • If you agency is not already utilizing Sandata, there will be workshops scheduled in the future to assist you. • We will keep you posted with any updates we receive.

7. Credentialing Updates • Please remember that in order to complete your online credentialing with DXC, you must obtain a follow up document from ABH. Please contact Chastity Holloway after you complete your online application to receive this letter. • When you receive your approval letter from DXC, please forward a copy to Chastity Holloway. • Please remember to update your program contact information with ABH. A new form can be submitted to Chastity Holloway at cholloway@abhct.com any time there are changes. The form can be located on the ABH website.

8. Critical Incidents (CI) • We now have an email address where Critical Incident reports for the Mental Health Waiver can be sent. If you are able to securely email reports, you may send them to mhwcriticalincident@abhct.com. • You may also fax Critical Incident reports to 860-920-4456. • If your agency was required to submit a DMHAS Critical Incident Report, please inform us and we will obtain that report instead of your agency needing to file one with us.

9. Medical Issues and Emergencies • Clients should be encouraged to use clinics instead of emergency rooms for non-urgent care • Please review with staff what to do in case of medical emergency: • Call 911 or push PERS • Contact Home Health Agency • Contact supervisor • Direct care staff should not be making medical decisions on whether client needs to seek help • Falls • Hitting head

10. Housing Budget • Housing budget is being reviewed by the state. • All clients receiving a DMHAS subsidy must place themselves on a permanent subsidy list. All clients have been requested to sign a form regarding this, and it will be a requirement in all new subsidy cases. • Requests for subsidy and housing items are not guaranteed and are being reviewed more closely. Must show efforts made in contacting other community resources, budgeting for needed items, etc. • Partial funding may be approved in some cases. • Staff should not be making promises to clients that “DMHAS will pay for it.”

11. Chore Service • Chore Service – Agency • Service is intended to provide occasional non-routine cleaning activities, and is NOT intended as regular routine cleaning. Think in terms of “spring cleaning”. • Examples: Washing windows, tacking floorboards, washing floors, etc. • Highly Skilled Chore Service • Specialized cleaning/moving services that require prior authorization • Examples: Moving to new apartment, insect remediation, handling of waste/biohazard material • Note: These services do not replace landlord’s responsibility to provide remediation

12. New Format for Recovery Plans In order to comply with the format of the new portal, recovery plans will have only one intervention per service. The intervention will contain everything that is to be worked on with the client and the full amount of time. For services provided after 9/1/19, please be aware that allowed billing will match up more closely with what is actually written. There may be less flexibility with units throughout the 6 month authorization. For instance, if a service is authorized at 2 hours per week and you only use 1 hour in a particular week, that extra hour may not carry forward.

13. Medicaid Husky C = Timely Provider Payment • Please make sure assisting clients with Medicaid coverage is a priority with staff. • ABH and DMHAS cannot guarantee payment if coverage is inactive • DMHAS and ABH are currently working on waiver clients with outstanding Medicaid issues to try and get reimbursement for unpaid claims.

14. Medicaid Coverage issues • IF staff are going to a regional DSS office with a client, please make sure to ask for the LTSS eligibility worker and let them know the client is on the Mental Health Waiver • Per DSS, re-determination paperwork is now mailed 40days in advance of expiration. Paperwork mailed in before system letter is generated will not be accepted. Recommendation is that paperwork be mailed within one week of receipt of letter to insure continued coverage. • Please make sure you include income verification, bank statements and other assets with the application.

15. Sending in Redetermination Paperwork • Please make sure clients are submitting their DSS redetermination paperwork to the Scanning Center with the cover sheet. • DSS ConneCT Scanning Center P. O Box 1320 Manchester, CT 06045-1320 Fax: 860-812-0022 • www.connect.ct.gov • Clients can create online account, print new cover sheet, get forms, etc.

16. Notice of Action forms • Clients will be send a Notice of Action Form giving them 30 days notice when they are to be discharged from the Mental Health Waiver. This includes clients who have become ineligible due to their benefits lapsing. • If clients file for an appeal within the 30 days, their spot on the waiver will be held until a hearing is held and DSS renders a final decision. If no appeal is filed, the client will be discharged from the waiver after the 30 days and will need to go to the bottom of the waitlist. • Please make staff aware of the process so they can assist clients with the appeal process if necessary

17. HIPAA – Privacy Rules • ABH’s Fax is secure (860-920-4456) • ABH sends secure (Zix Mail) email • If you receive a secure email and can not open it please contact the sender • Identifiable Client information should not be used in email subject lines • All communications that include Client Identifiable information should be sent securely • This includes: • Name (Including initials) • Social Security Number • Medicaid ID • WOS 4 Digit Client ID numbers are unique to our program and do not need to be sent securely

18. Monthly Progress Notes • Due by the 10th day of the following month • e.g., April notes due by May 10th • This means by the 10th, not the Monday following the 10th… • CSP notes include two sections, both required • Individual interventions • General summary • Monthly Note is required for any month where there is an open authorization

19. Monthly Progress Note If you are unsure of the start and end dates for a care plan, consult the Authorization tab Only write a note for the most recent care plan.

20. CSP Monthly Note Step 1 Respond to each individual intervention Step 2 Complete a general Monthly Notes Summary For additional instruction, refer to WOS user guide on ABH website: http://www.abhct.com/Customer-Content/WWW/CMS/files/Mental_Health_Waiver/ABH_WISE_Online_System_Manual-_PROVIDERS.pdf

21. Encounter Notes • Encounter notes must either be located in a client’s home or securely stored at the agency. • You must be able to supply notes for auditing purposes to ABH, DMHAS, DSS or CMS • Must have an encounter note for any billing. • Please make sure the supervisor is reviewing encounter notes for quality (both RA and CSP). Notes should contain all required elements and be using skill building language.

22. Updated Documentation Standards • Encounter note still required for each visit • Notes with missing information will be considered incomplete and will be recouped • Please make sure handwritten notes are legible! • A complete note includes the following information: • Client full name • Date of service • Staff full name • Service provided • LOA score • Goal • Comments • Time In • Time Out • Total Time • Staff signature • Client signature • Or, document if client refuses

23. Billing Reminders • Next three week cycle is August 9th • Check Run Schedule posted on ABH website • July 2019 – December 2019 • CLEAN claims will be paid within a 30 day period from the date of submission • A claim is not considered “clean” when it requires further investigation prior to processing • Eligibility issues, insurance issues or the initial activation of a client onto the waiver may delay payment beyond the expected 30 day period

24. MHW Advisory Council • Meets twice a year in April and October • Open to any MHW provider to send a representative • We encourage staff to identify MHW clients who might be interested in participating. Staff can bill for time spent with client at meeting.

25. ABH Contact Information • Ann Marie Luongo, Program Manager • (860) 704-6211 aluongo@abhct.com • Lori-Lynn French, Quality Assurance Supervisor • 860-704-6177 lfrench@abhct.com • Chastity Holloway, Program Specialist • (860) 638-5341 cholloway@abhct.com • Cathy Parente, Claims Coordinator • 860-704-6201 cparente@abhct.com • Vacant, Utilization Review Support • NEW FAX NUMBER 860-920-4456