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This comprehensive guide outlines necessary paperwork and procedures for high-risk cases in the personal assistance program. Ensure regulatory compliance to support discharge planning or prevention of institutionalization.
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Must meet criteria • To prevent institutionalization or to facilitate discharge from institution • To resolve a hazardous home situation
Authorization of tasks must be according to policy Remember to consider: -Age Appropriateness -Living situation -Tasks available through the personal assistance program
Appropriate paperwork must be completed • For Agency Based PAS: • Temporary Authorization (SLTC 161) • Referral form (SLTC 154)-fax to MPQH • Nurse supervision form (SLTC 150)
Paperwork continued • For Self Directed PAS • Temporary Authorization (SLTC 165) • Referral form (SLTC 154) – Fax to MPQH • Consumer Agreement (SLTC 159) OR Personal Representative Agreement (SLTC 166) • Health Care Professional Authorization (SLTC 160) • Oversight Document (SLTC 164)
What, Why and How • What: A phone screen completed by MPQH • Why: MPQH nurse unable to make in person visit within 10 working days • How: MPQH completes a telephone pre-screen with the consumer PAS/SDPAS 411
MPQH • MPQH provides page 1 of the overview to the agency and a prescreen profile. • MPQH provides a complete overview and profile after completion of home visit which will occur within 30 days of referral PAS/SDPAS 411
Agency Intake Form (SLTC 163) • Required on all new admits since 7/1/09 • Document date SERVICES begin • FAX to MPQH • If admit is delayed, document reason
WHAT IF? • Agency receives referral, but services are never instituted? • Complete Discharge/Unable to Admit Form (SLTC 158) • FAX to MPQH
Provider Discharges from PAS services • Complete discharge/Unable to admit form (SLTC 158) for all discharges • Fax form to MPQH • Send to consumer (exception to this rule is death to the consumer) • Remember to discharge a consumer who has not received services for ____days PAS/SDPAS 705
READMISSIONS When: Admits within 45 days to 6 months of discharge How: Submit overview (SLTC 154) to MPQH and check “Readmit” Who: MPQH conducts telephone interview What: Previous authorization reinstated Agency completes all necessary paperwork
Readmissions continued Question? What would that paperwork be? Note: If readmit is within 45 days of last date of service, contact MPQH via fax. They will cancel the discharge and agency can just resume services. PAS/SDPAS 411
Switching Options-Agency Based PAS to Self Directed PAS Consumer/Personal Representative contacts SDPAS provider SDPAS agency sends overview referral (SLTC154) to MPQH Question? What do you fill out on the SLTC 154 to alert MPQH to the reason for this referral? PAS/SDPAS 413
Switch continued • MPQH completes review and capacity and forwards information to the SDPAS agency • SDPAS agency and consumer/PR complete all necessary paperwork • New SDPAS agency contacts current ABPAS agency to coordinate date of transition What is the final step for the SDPAS agency? What is the final step for the ABPAS agency? PAS/SDPAS 413
Switch in Option- Self Directed to Agency Based Consumer/Personal Representative contacts agency based provider (ABPAS) ABPAS agency sends overview referral (SLTC-154) to MPQH (remember to mark “CHANGE”) MPQH completes review and forwards information to ABPAS provider PAS/SDPAS 413
SDPAS to ABPAS continued Question? What changes might be made to profile assuming no change in consumer’s needs or living situation? Final step: Intake sheet (SLTC 163) completed by receiving provider. Discharge sheet (SLTC 158) completed by discharging provider PAS/SDPAS 413