1. Documentation Guidelines: PARENT SUPPORT AND PEER SUPPORT July 22, 2009 Carol Neeley, MSW, LSCSW, KHS Clinical Director Anne Werring, KHS Corporate Compliance Officer

2. Brief Courtesy Items  In order to cut down on background noise, your phone was automatically muted when you joined the conference. When it is time for questions, you will be un-muted in order to ask questions.  Please do NOT place your phone on hold.  Should you experience sound quality issues, hang up and dial back in. If this persists, press *0. This will connect you with an operator.  If you have call waiting, please turn this function off for the duration of the call.

3. Today’s Webex Process  This WebEx will be limited to one hour in length.  When we get to the Q&A portion of the WebEx… ◦Type questions/comments into the box in the upper right corner of the screen called “Chat or Q&A.” You may need to press the arrow in order to drop this section. ◦We will call on you specifically. ◦When you are called on, we will un-mute your phone and you may ask your question. ◦After asking the question, we will re-mute your phone.

4. Introductions Carol Neeley, MSW, LSCSW ◦KHS Clinical Director Anne Werring ◦KHS Corporate Compliance Officer

5. Welcome!  This presentation is for the purpose of reviewing minimum expected documentation guidelines for: ◦Parent Support and Training (HCBS SED Waiver/PRTF Grant) ◦Peer Support  A Question and Answer Session will follow

6. HCBS SED Waiver / PRTF Grant Parent Support Purpose of service: Train, Support, Engage, Reinforce, Assist Provides the training and support necessary to ensure engagement and active participation of the family in the treatment planning process, and to empower the family to increase their ability to provide a safe and supportive environment in the home and community for the Member. Intervention: Develop & Enhance ◦Specific Problem-solving Skills ◦Coping Mechanisms ◦Strategies for symptom/behavior management ◦Problem Solving Training ◦Skills ◦assisting caregivers with obtaining information about medications ◦Diagnosis Interpreting ◦Choices ◦Policies, Procedures & Regulations

7. HCBS SED Waiver / PRTF Grant Parent Support Date of service* Member Name* Start Time and Duration* Location of the service (Community or CMHC) * Goal of service, which must coincide with a current treatment plan* Summary of the intervention/service * Plan for the next meeting*** Progress and/or response to intervention * Signature of the person providing the service / Credentials if licensed. Electronic Signature & Title is acceptable. * Key: * Medicaid Requirement - KMAP General Benefits 4/11/2008; KMAP non-PAHP Manual 12/17/2007; KMAP SED 5/23/2007 ** KHS Requirement - Provider Manual 1/2008 ***KHS Suggestion - Provider Manual 1/2008 ‡ KHS suggestion for children only

8. HCBS SED Waiver / PRTF Grant Parent Support Key Words AdvocatingMotivating AssistingPrioritizing CollaboratingProblem-Solving CommunicatingSupporting DevelopingTraining Educating Empowering Engaging Facilitating

9. HCBS SED Waiver / PRTF Grant Parent Support Sample Note Date: July 22, 2009 Name: Jane Doe Start Time and Duration: 1:00 PM; 30 minutes Location of Service: Community Goal of service, which must coincide with a current treatment plan: Assist Consumer's mother with interventions to help reduce Consumer’s anger outbursts Summary of the intervention/service: Reviewed behavior chart mother had developed. Worked on coming up with rewards for good behavior for Consumer for when at home and at school. Plan for the next meeting: Will review Consumer’s progress with mother and start to address any new issues or concerns. Progress and/or response to intervention: Mother actively participated and has been implementing recommendations between meetings. Sally Smith, Parent Support Worker

10. Peer Support Designed to promote skills for coping with and managing psychiatric symptoms Special focus on utilizing natural supports and resources, emphasizing the opportunity for Members to support one another in recovery and enhancement of skills Emphasis on structured, scheduled activities Assist in development of information and support network Empower Members to take proactive role in treatment, and to understand their treatment process Assisting Members with developing skills to identify precursors or triggers, and to develop skills to manage symptoms

11. Peer Support Date of service* Member Name* Start Time and Duration* Location of the service (Community or CMHC) * Goal of service, which must coincide with a current treatment plan* Summary of the intervention/service * Plan for the next meeting*** Progress and/or response to intervention * Signature of the person providing the service / Credentials if licensed. Electronic Signature & Title is acceptable. * Key: * Medicaid Requirement - KMAP General Benefits 4/11/2008; KMAP non-PAHP Manual 12/17/2007; KMAP SED 5/23/2007 ** KHS Requirement - Provider Manual 1/2008 ***KHS Suggestion - Provider Manual 1/2008 ‡ KHS suggestion for children only

12. Peer Support Key Words AdvocatingMotivating AssistingPrioritizing CoachingProblem-Solving CommunicatingSharing DevelopingSupporting Discussing Developing Empowering Engaging Facilitating

13. Peer Support Sample Note Date of service: June 5, 2009 Member Name: John Doe Start Time & Duration: 2:00 PM 45 minutes Location of the service (Community or CMHC): CMHC Goal of service, which must coincide with a current treatment plan: Reduce depressive symptoms Summary of the intervention/service: Worked with Consumer on how he tends to avoid going places because his mood is so low. Discussed what has helped others such as sticking to a daily routine, taking medications on time, exercising and eating healthy. Plan for the next meeting: To meet in the community and review how he is doing with following his routine. Progress and/or response to intervention: Consumer was tearful, but fully participated. Paul Smith, Peer Support Worker

14. Special Notes Inclusion of one of the key words previously listed does not necessarily make it a strong progress note. Key words are provided as suggestions, and must be included with additional information and detail within the progress note to fully justify the level of care provided.

15. Questions and Answers Type questions/comments into the box in the upper right corner of the screen called “Chat or Q&A.” You may need to press the arrow in order to drop this section. We will call on you specifically. When you are called on, we will un-mute your phone and you may ask your question. After asking the question, we will re-mute your phone.

16. Thank You! Power Point will be posted on KHS website As always, call Carol Neeley or Anne Werring at 1-866-547-0222 if you have questions…