Transition Information for HCS Providers

Heart of Texas Region MHMR CenterNovember 18, 2009

MRA Service Coordination for Home and Community-Based Services

Introductions

Meeting Agenda Introductions

Purpose of the Transition

Timelines & Activities 1. DADS 2. MRAs

Clarifying Roles 1. HCS Provider, MRA SC, & DADS Responsibilities2. Comparison of MRLA & MRA SC for HCS3. DADS Frequently Asked Questions (FAQs)

MRA Transition Summary

Meeting Evaluation & Next Steps

Purpose of Transition to MRA SCSB 1, Section 48 (81st Session)

Provides $207 million General Revenue for home and community-based programs for people with intellectual and developmental disabilities and for reshaping the system of services.

7,832 people on waiting lists will receive waiver related community services by August 2011.

Additionally, HCS services will be provided to people leaving large & medium ICFs, children aging out of foster care, and children & adults at risk of institutionalization.

The funding for increased community services is contingent, in part, on the transfer of case management from the HCS Provider to the MRA.

DADS Transition TimelineSeptember 2009 DADS stakeholder meeting on draft HCS and Service Coordination rules held 9/14/09.

January 2010 Proposed HCS and SC rules > MCAC & DADS Council for approval to publish in TX Register.

February 2010 Proposed rules published in Texas Register for 30 days.

March 2010 Public comments on proposed rules received and reviewed.

April 2010 Proposed rules revised as needed, response to public comment. Training for HCS Providers and MRAs begins.

May 2010 Training for HCS Providers and MRAs continues.

June 2010 Implementation of HCS & SC rule changes – HCS Case Management becomes MRA Service Coordination.

DADS Transition Activities

DADS preparation priorities prior to transfer of HCS case management:

Develop Program Handbook, forms & templates – includes PDP & Implementation Plan (IP)

Make changes to CARE information system

Communicate changes to individuals receiving HCS services & their families

Develop training for MRAs and HCS Providers

Support flexibility of HCS Provider transitional case management requirements (TBD)

DADS 2010 Spring Training Locations

Region 20 ESC, 1314 Hines AvenueSan Antonio April 5 & 6

United Way of Greater Houston, 50 Waugh DriveHouston April 13 & 14

The Resource Connection, 1400 Circle DriveFort Worth April 19 & 20

Lubbock Memorial Civic Center, 1501 Mac Davis LaneLubbock April 29 & 30

The Power Center, 12401 Post Oak RoadHouston May 11 & 12

The Resource ConnectionFort Worth May 18 & 19

MRA Transition TimelineNovember 2009 Begin HCS CM transition meetings between Providers and MRAs – completed

November 18, 2009 Develop local case numbers for HCS consumers identified in DADS report –

completed December 28, 2009 Obtain access to Electronic Data Transfer System (EDTS) – completed

December 2009 Develop MRA dedicated webpage to post information and updates on local

transition planning – dedicated page up December 7, 2009

January 2010 Educate local Advisory Boards, PNAC and Center Board of Trustees – PNAC

presentation made November 2009 Determine staff requirements – HCS service coordinators, supervisors & support Create Provider/MRA contact lists Select MRA HCS SC Supervisor – selection completed December 29, 2009

MRA Transition Timeline (con’t)

January, continued Create Job Descriptions for HCS-MRA Service Coordinators Revise Policies & Procedures as needed Develop HCS-MRA Service Coordination Training Plan, Curriculum, and Manual

February 2010 Encourage provider sponsored consumer/family relation meetings with the MRA

March 2010 Post positions, interview and prepare for hire MRA HCS SCs

MRA Transition Timeline, (con’t)

April 2010 Begin training HCS SCs, including training provided by DADS With DADS and Providers, develop a process to manage May and June PDPs and

IPCs Create Provider/MRA contact lists Assign SCs to HCS participant caseloads Begin establishing MRA consumer records

May 2010 Consumer Relations—HCS-MRA SC to begin building relationships with providers

and consumers

Clarifying MRA, Provider & DADS Roles

3 approaches to explain fundamental roles & responsibilitiesafter the transfer to MRA SC effective June 1, 2010:

Draft HCS rule amendments (subject to change before final

adoption)

Comparison of MRLA & draft HCS rule requirements

DADS Frequently Asked Questions (FAQs) about the HCS Case Management Transition

Draft HCS Rule: MRA Service Coordinator

SC, person/LAR form Services Planning Team (SPT) with other participants selected by person/LAR including provider.

Continue enrollment of people into HCS program.

Conduct person-directed planning and completes PDP specifying needed services to achieve desired outcomes identified by person/LAR.

Update PDP annually or as needed.

Coordinate IPC completion with HCS provider, person/LAR.

SC, person/LAR or provider may request revision to IPC and/or PDP. SC agrees or disagrees with IPC renewals & revisions.

Monitor provision of individual’s program services.

Draft HCS Rule: MRA Service Coordinator

MRA SC monitoring must:

Document person’s progress towards achieving outcomes in PDP.

Ensure concerns with implementation of PDP are communicated to Provider & attempts are made to resolve.

Notify Provider if SC becomes aware emergency necessitates an HCS service to ensure health & safety and service is not on IPC/exceeds IPC amount.

Assist with transfers and approving discharges.

NOTE: SC monitoring frequency will vary based on the needs of the person. Minimum frequency of contact is quarterly; monthly contact may benecessary for some people. The Discovery process for PDP development or renewal includes determination of frequency.

Draft HCS Rule: HCS Provider

Complete assessments & submit LON requests to DADS.

Coordinate completion of the IPC with MRA SC, person/LAR & submit to DADS for approval.

Develop Implementation Plan (IP) for delivery of person’s HCS program services, with the person/LAR, based on the PDP.

Deliver services according to IPC authorized by DADS.

Monitor the delivery of services on IPC in accordance with HCS Program Certification Principles.

Monitor progress related to program services in accordance with IP.

Draft HCS Rule: DADS

Conduct residential & certification reviews of HCS Providers to evaluate compliance with HCS Principles (WS & C) .

Continue to approve IPCs & LONs (Utilization Review – UR) .

Expand current role to oversee Service Coordination for individuals in the HCS Program (MRA Contract Accountability and Oversight unit).

Comparison: MRLA & MRA Service Coordination

MRLA Draft HCS Rule

MRA conducted survey/certification

Service Coordination provided by the MRA

Service Coordinator facilitated PDP and documented the outcomes

Provider submitted strategies to theMRA for approval

MRA responsible for initial IPC & entered IPC into CARE.

DADS conducts survey/certification

Service Coordination provided by the MRA

Service Coordinator facilitated PDP and documented the outcomes

Provider develops Implementation Plan based on PDP

MRA responsible for initial IPC & enters IPC into CARE.

Comparison: MRLA & MRA Service Coordination

MRLA

Draft HCS Rule

MRA responsible to complete IPC renewals & revisions & enter in CARE.

MRA completed initial ICAP & renewed every 3 years.

MRA completed initial MRRC & entered MRRC in CARE.

Provider responsible to complete IPC renewals & revision in coordination with MRA & enter in CARE. MRA agrees or disagrees and signs in CARE.

MRA completes initial ICAP; Provider completes renewed ICAP every 3 years. MRA agrees or disagrees and signs in CARE.

MRA completes initial MRRC & enters MRRC in CARE.

Comparison: MRLA & MRA Service Coordination

MRLA Draft HCS Rule

MRA completed annual MRRCs & entered in CARE.

DADS assigned LON.

MRA submitted UR for DADS approval.

Provider completes annual MRRC & enters in CARE. MRA agrees or disagrees and signs in CARE.

DADS assigns LON.

Provider submits UR for DADS approval.

DADS Frequently Asked Questions (FAQs)

DADS published & updates FAQs to explain the transfer of HCS case management to the MRA:www.dads.state.tx.us/providers/HCS/faqs/casemanagementtransitionfaq.html

FAQ topics include:

PDP, IPC & IP – relationships between planning tasks, participants, processes & timeframes

Monitoring responsibilities of MRA SC & HCS Provider

Coordination & communications between MRA SC & HCS Provider

Various topics including emergency response, CARE system, program handbook,funding changes, etc.

For FAQ updates, sign up for “Email Updates” through GovDelivery at DADS website.

MRA Service Coordination for HCSTransition Summary

Primary MRA goals prior to June 1, 2010 implementation: Clear delineation and common understanding of fundamental functions of

the MRA Service Coordinator & HCS Provider

Staffing, training & equipping MRA operations to provide qualified and consistent Service Coordination for HCS participants

Productive communications with the HCS Provider network to ensure effective long-term working relationships

Support for HCS participants & families to minimize service disruption and promote progress towards each person’s desired outcomes

Meeting Evaluation & Next Steps

What worked this meeting?

What should change in the next meeting?

What do we know now that will needto be discussed at next meeting

(Agenda Items)?