Case Management, Waiver Coordination (Direct Care Supervisor)/Supportive Living

Role of Case Manager Location, coordination and monitoring of: All waiver services State plan services Medical, social, educational and other public funded services Informal community supports

Intent of Case Management To enable persons to receive services/support that are Planned Coordinated Efficient Effective

Case Management Activities Arranging for services and supports Monitoring services and supports Facilitating crisis intervention Guidance and support Case planning Needs assessment Follow along to assure quality of care

Case Management Activities Assistance with eligibility paperwork – Medicaid and ICF Level of Care Assisting with appeals for service denials Arranging for access to advocacy services Assuring advance submission plans of care/revisions and eligibility paperwork Assuring integrity of case management billing

Case Manager Role in Assessment/Evaluation Process Find out individual’s needs and preferences Help identify other needs Explain options for meeting needs including formal and informal supports

Case Manager Role in Service Plan Process Translates assessed needs to a plan based on assessed needs and wants Coordinates supports needed with other entities/persons Monitors quality and appropriateness of supports and consumer satisfaction Assist in developing emergency back up plans

Levels of Support Pervasive – constant support 24 hours a day, 7 days a week – 1 visit and one other contact each month Extensive – daily or weekly supports less than 24 hours a day, 7 days a week – one visit each month Limited – intermittent support – one visit each quarter with one contact each month

Role of Direct Care Supervisor– Supportive Living Direct Care Supervisor is responsible for Assuring delivery of all supported living direct care services Coordination of all direct service workers Liaison between person, case manager and DDS Coordination of schedules for waiver and generic services

Role of Direct Care Supervisor– Supportive Living (cont) Preparing direct service provider information for plan Assuring integrity of billing Arranging for alternative living settings Assuring transportation in plan Assuring advance plans/revisions and eligibility information (ICF Level of Care and Medicaid)

Role of Direct Care Supervisor– Supportive Living (cont) Medication Management Plan Positive Behavior Plan for psychotropic's given for behavior Assure direct care staff are adequately trained