REFERRALS Residential, Day Program, Employment Readiness, Supported Employment, RSA, Initial Waiver

Purpose of the referral Share important information about the person with potential providers. Provide an opportunity for a provider to determine if they have the ability to support the person. Control capacity Allocate funding Ensure a slot is available prior to enrolling a person into the HCBW program.

Referral Process The referral process starts with the planning process. The service coordinator schedules a meeting (e.g. ISP, case conference) to discuss services and supports in the following order: 1. Natural Support 2. Community Resources 3. State Plan Services a. Provider website: https://www.dc- medicaid.com/dcwebportal/nonsecure/searchprov# 4. Home and Community Based Services Waiver Program (HCBSW) a. Provider website: http://dds.dc.gov/book/current- waiver-providers-list 5. Adult Day Health Program: 55 or older

Referral process Cont’d A referral must be completed prior to a person receiving the following services: Enrolling in HCBW Program Residential Services: Host Home Intermediate Care Facility (ICF) Supported Living Residential Habilitation Respite (local funding only) Day Services: Individualize Day Services (IDS) Day Habilitation Employment Readiness Seniors Program Supported employment /RSA

Referral form Type of referral

Types of referral Regular referral: Emergency referral: Court order: Must be submitted by noon, Wednesday to the Planning and Allocation Specialist. Referral meetings are held on Thursday at 3:00 pm Regular referral are emailed to the provider, SC, SSC, and QA Specialist within 3 business days of the referral meeting. Providers have up to 5 business days to submit a response. Emergency referral: Submit immediately Emergency referral are emailed to the provider, SC, SSC, and QA Specialist within 1 business day of receipt by the Planning and Allocation Specialist. Provider have 1 business day to submit a response Court order: Check the court order box if a Judge ordered services for person. Check the appropriate box that applies; regular or emergency, MFP, and/or initial waiver.

Types of referral cont’d MFP: Money Follows the Person (MFP) program supports people who are transitioning from an institution to a less restrictive setting (e.g. supported living/ residential habilitation). MFP should be checked to ensure the referral is submitted to the appropriate provides with vacancies. A person who transitions through MFP must be referred to a location with 3 or less people. Indicate on the referral if the person is utilizing a voucher to secure an apartment Check the appropriate box that applies; regular or emergency, and initial waiver. MFP Point of Contact: Sakena  McWright, MSW, MSIR Project Coordinator, Money Follows the Person Demonstration Aging and Disability Resource Center District of Columbia Office on Aging sakena.mcwright2@dc.gov 500 K St. NE Washington, DC 20002 Office:  202.727.1871 Mobile:  202.341.1607 Initial Waiver: Select for initial enrollment into the HCBS waiver. Check the appropriate box that applies; regular or emergency, MFP and initial waiver

Initial Waiver The service coordinator must complete the Referral Form. Select the appropriate type box: initial and emergency or regular List the reason for the request, include the waiver services. The referral form is the only required document if the person is not requesting residential and/or day services. Additional supporting documentation is required if the person is selecting residential and/or day services as well.

Sample Initial Waiver request

Regular referral Residential program: Natural Homes: Present Personal Care Aid (PCA) State Plan service; in-home support; companion services; and/or respite prior to requesting a residential services. A referral should be submitted for people who insist that residential services are the most appropriate services. The person and his/her support team must be informed that the residential referral will be submitted to vacancies. Do not share the vacancy list and/or locations with the person/families. However, you may share the providers who are listed on the Provider Sanction List. People may not visit a location prior to submitting a referral and receiving an acceptance from the provider. The referral committee meets weekly; therefore, several referrals are submitted to locations on the vacancy list and the location may not be available after the viewing. Requesting another provider: Prior to submitting a referral, discuss the concern with the providers. Determine if the housemate(s) have the same concern. If so, the housemates should select a new provider to support the people in their home. If not, the SC will submit a referral. Referral Committee: The referral committee will select at least three appropriate providers from the vacancy list. The referral committee reviews the age, level of functioning, diagnosis, and accessibility needs of the person(s) residing in the home prior to submitting the referral. Therefore, the diagnosis and adaptive equipment needs must be updated in MCIS for everyone.

Regular referral Day Programs Initial request for day services: During the planning meeting, the team should discuss the most appropriate day services for the person. Remember, Employment First. If the person is not interested in employment, document the reason on the section marked: Reason for the referral. Encourage the person and support team to visit at least three providers prior to submitting the referral. The providers should be listed by 1st, 2nd, and 3rd choice. Changing providers: Prior to submitting the referral, a meeting should be held with the current day provider to discuss the concerns and/or reason for change. Referral Committee: The referral committee will submit the referral to the provider listed as the first choice. All referral for Employment Readiness will be submitted to RSA as well, unless the reason for the referral section indicates the person is receiving services through RSA.

Supporting documentation for referrals Residential Referrals: Referral cover form Individual Profile For Residential Referral Current Consent Form Current ISP, if available. An ISP is not required for an intake case that needs emergency placement. Current Assessments, if available: Medical Social Work Psychological BSP HCMP PCT Other

Supporting documentation for referrals cont’d Day Referrals: Referral cover form Individual Profile For Day Referral Current Consent Form Current ISP, if available Current Assessments, if available: Medical Social Work Psychological BSP HCMP PCT PPP Job Search/Community Participation Plan Other Include the SSI award letter for RSA referrals.

Referral forms Referral Cover Form

Referral forms cont’d Consent

Referral forms cont’d Residential Profile

Referral forms cont’d Day Profile

Waiver referrals Waiver referrals are processed to ensure that a waiver slot is available for the person. SC must receive a copy of the Waiver Application letter from the Planning and Allocation Specialist prior to submitting the initial waiver package to the Waiver Unit. Include a copy of the letter with the waiver application.

Waiver Application Letter

Residential referrals Residential referrals are submitted to the three providers identified by the referral committee. The providers are required to submit a response within 5 business days. Schedule an opportunity for the person to meet with the provider and visit the location. Ensure the person only visits the location listed on the referral letter. Inform the assigned QA Specialist if the provider attempts to show the person another location.

Referral letter

Residential referrals The service coordinator will initiate a sfa after the person selects a provider. Ensure the address is added to MCIS prior to initiating the sfa. Select local for the funding source for the following services: Supported Living Residential habilitation Host Home (only if the person SSI is less than $733) Select Medicaid as the funding source for the following placement: ICF Host Home The sfa must be fully approved prior to scheduling the intake/transition date.

Day Program Referral Day Program referral are emailed to the provider listed as the 1st Choice. Initiate the SFA after the person selects the provider. Select Medicaid as the funding source for all day services, unless the person is ineligible for Medicaid. Schedule the intake meeting after the sfa is fully approved. A referral is not required for active treatment providers. The ICF develop a contract with the proposed active treatment provider. RSA referral are hand delivered to RSA

Referral feedback form SC completes the referral feedback form for the following: The person declines the providers that accepted the person. No provider accepted the person The referral needs to be resubmitted

Referral feedback form

New Development The person and his/her family/guardian must explore all appropriate vacancies prior to requesting new development. The new development memo must be approved prior to submitting a referral. The person must select a provider with a Human Care Agreement (HCA). The team may not select a provider on the Provider Sanction List for new development.