Physical Disabilities Waiver – Resource Utilization Improvement

1. Physical Disabilities Waiver – Resource Utilization Improvement Mandatory Information Sessions for Targeted Case Managers: April 11, 13, 17 or 19, 2012 Kansas Department of Social & Rehabilitation Services ~ Disability & Behavioral Health Services

2. Agenda • Welcome; attendees; goals; commitment • Today’s subject matters/action items • Standardization: Estimated normative utilization • Attendant Care Worksheet (ACW) review • Action if not within estimated norms • Waiting list management • Crisis service access • Focused review – today’s subjects + FMS • Post-attendance survey

3. Standardization: Information • The Attendant Care Worksheets (ACWs) you use should be developed within the estimated normative ranges that are published. http://www.srs.ks.gov/agency/css/Documents/PD%20Waiver/Attendant%20Care%20Worksheet%20052610%20%20PM%20DRAFT.pdf • If the person’s needs cannot be met within the identified ranges, specific need must be identified and documented, and SRS program approval obtained.

4. Standardization: Action Items • Within five business days from this session, you should review the ACWs for each person you support. • If any ACW category of service utilization is outside the standardized norms, within 10 business days from this session, either • Develop a revised ACW and submit a revised POC; or • Develop and submit an ACW Exception Form with specific consumer-related details. ** Note: If you need more time to complete your review, please contact Lucy.Bloom@srs.ks.gov to discuss your circumstances.

5. Standardization: How To Request Exceptions In order to get approval for ACW time exceptions: • Develop specific consumer-related justification and time requirements, by completing the ACW Exception Form. • The TCM must directly submit the ACW Exception Form, with the ACW, as email attachments, to: Lucy.Bloom@srs.ks.gov • Response will be sent back via email.

6. Additional Reminders • Confine the creation of the POC to the identified needed hours. Temporary hours can always be added should the need arise. • Plans must reflect consumer needs without regard to staff preferred schedules and must follow the provider manual definitions/descriptions. • Sleep cycle support must be utilized, when appropriate, focusing only on demonstrated consumer nocturnal needs.

7. Waiting List Management: Information • Every person who has been determined eligible for PD waiver services and is waiting for those services must: • Be reassessed annually (this is an existing requirement and will be enforced) • Have follow up check-ins quarterly • Receive information as to how to access crisis service • TCMs must document these processes

8. Waiting List Management: Action Items • Ensure that every person you serve who is waiting for PD waiver services has written information about the waiting list process and crisis service exceptions. • Ensure that notice of action is provided at time of initial evaluation and annually thereafter. • Check in (telephone is fine) with each person waiting once per quarter, to determine whether a change of circumstances requires action. • Document each of these actions in the person’s case file.

9. Crisis Exceptions: Information These are the crisis exception criteria: • Confirmed by APS abuse, neglect or exploitation (this includes self-neglect), with documentation from the APS worker. • Risk of family dissolution - interpreted to be children at risk of state custody or consumer at risk of institutionalization or both, with documentation from social worker, physician, law enforcement or other. • End Stages of terminal illness - can be documented by physician’s order to hospice, physician’s statement or ARNP with statement as to end stages of life. • Victim of domestic violence within the recent past documented by social worker, APS worker, physician, ER or law enforcement.

10. Crisis Exceptions: Information • When one of these criteria are met, the person will be allowed immediate access to PD waiver services • Deterioration of health or safety, environmental concerns, or other negative situations should be viewed carefully for crisis exception need.

11. Crisis Exceptions: Action Items • Ensure that each person waiting for services has information about the crisis exceptions. • In each quarterly interaction with people waiting for services, evaluate whether any of these criteria are met. • Contact the SRS program manager immediately to request a crisis exception if you think a crisis exception applies.

12. Focused Review: Information • Starting in May 2012 the SRS Quality Management Staff will be conducting a focused review of the issues that have been addressed in this information session. • In addition, we will be including targeted probes on issues related to FMS practices, and direct service worker pay rates.

13. Focused Review: Action Items • Ensure that you understand the information in this session. • If you have questions, please confer with your supervisor or submit the question via email to Elizabeth.Phelps@srs.ks.gov. • Ensure that you have followed up on the action items identified in this session. • Cooperate fully when contacted for the focused review.

14. Post-Session Survey: Information • In order for you to complete the process of this mandatory information session, you should complete the survey located at: http://www.zoomerang.com/Survey/WEB22FBV6QR548 • This includes contact information for you, as well as caseload and subject matter information.

15. Post-Session Survey: Action Items • Please complete the survey within 3 business days of this session. • The survey is brief and should take only 10-15 minutes to complete. • After completion, we will send you the ACW Exception Form. • If you have additional questions, you can contact Elizabeth Phelps, SRS/DBHS Medicaid/Program Oversight; Elizabeth.Phelps@srs.ks.gov; 785.296.4552.

16. Summary/Next Steps • Remember to complete your survey within 3 days, and review all of your ACWs within 5 days. • Follow up on all “action items” in this session. • The presentation document is available online at www.selfdirect.ks.gov. • Cooperate with focused review activities in May. Thank you for participating!