1. Mental Health Waiver Provider Meeting
October 26, 2018

2. Agenda Introductions Waiver Update Waiver services rate increase
Credentialing updates
EVV
RA training updates
Staff supervision requirements
Critical Incidents
Project Notify
Medicaid Coverage Issues
Notes/Documentation
Billing/ Audits
MHW Advisory Council

3. Waiver Update (as of 10/22/18)
589 Active clients on the waiver
38 Actively planning for admission to waiver (MHW & MFP)
50 Referrals pending disposition (MHW & MFP)
149 waitlisted referrals for MHW community
Community Census for Waiver Year10: 615
Additional Slots for MFP clients Waiver Year10: 60

4. Average Enrolled by Month

5. Waiver Services rate increase
Effective January 1st, all agency provided Mental Health Waiver service rates will be increased by 2%.
DSS will be releasing a new rate schedule and provider bulletin to reflect this change. We will be sending out new rate schedules for agency signatures.
ABH will be modifying the online system but please remember to enter in the increased rate after January 1st

6. Credentialing Updates
Please remember that if you receive a notice regarding re-credentialing with DXC, you must contact Monica Vaughn. Your re-credentialing application must first come to ABH. Mental Health Waiver re-credentialing with DXC cannot be completed online and must be done on the paper application.
Please remember to update your program contact information with ABH. A new form can be submitted to Monica Vaughn at any time there are changes. The form can be located on the ABH website.

7. Electronic Visit Verification
We do not have a start date yet for when MHW billing will be transferred over to DXC and EVV, but we will be starting to gather information for DSS to start the process
We will be collecting information about which of our providers are already credentialed independently with DXC and which providers are already using EVV. Please try and respond to these inquiries in a timely manner.
Providers will still need to be credentialed through ABH in order to bill for Mental Health Waiver services once the transition occurs.

8. RA Training Updates
New online training and exam to be completed in Survey Monkey
Reminder that staff must complete the RA training before starting work with a mental health waiver client.
Reminder to please call and confirm if a new hire has already taken the RA training. We no longer provide certificates.
Recovery Assistants no longer require a
Driver’s License, but must have a valid form of
identification.

9. Staff supervision requirements
The CSC is not the supervisor of the CSP or RA
CSP/TCM:
Supervisor must be a licensed (licensed eligible) social worker, professional counselor, marriage and family therapist, or nurse.
Available for supervision, consultation on cases, and in crisis situations
Review notes completed by CSP staff
RA:
Supervisor must be a LCSW, LPC, LMFT or RN
Review notes completed by RA staff

10. Critical Incidents (CI)
A Critical Incident (CI) is defined as an incident that may have a real or potential serious impact on Waiver participants, staff, facilities, funded agencies, or the public or may bring about adverse publicity.
Examples of CI include but is not limited to: death; suicide attempt; threat; abuse/neglect/exploitation of client; missing persons; involvement of emergency services; criminal activity.
When in doubt? Submit one anyway!
Please submit written report to ABH within one business day of becoming aware of incident occurring
Fax to attn: Brian Gay to

11. Critical Incidents (CI) – What to Include?
Must Include:
Date Report is completed
Person reporting
Contact information (phone & )
Agency name (should not be ABH)
Date & Time of Incident
Location of Incident
Client Info (name, DOB & SSN/Medicaid ID)
Client’s role in the incident
Incident Category (please check one)
Any substances present?
Media attention likely?
Narrative

12. Critical Incidents (CI) – Narrative
Reported to & reviewed by DMHAS on a weekly basis
Please be thorough but concise
Please include any relevant details
Please use proper spelling & grammar – write legibly!
Example of unacceptable narrative:
“Chronic medical issues”
Example of acceptable narrative:
“Client called ambulance to be transported to ED due to vomiting and diarrhea related to her Crohn’s Disease, which exacerbated her COPD. ED did medical work up and found no issues. Client was sent home.”
Reports which are incomplete, illegible or offer insufficient detail will require follow-up

13. Project Notify
ABH has started utilizing Project Notify in order to receive alerts on client hospital admissions.
Information will be updated in the hospital log and the CSC and CSP agency will be notified that there is an update.
The expectation is that CSP will follow up on these alerts with client and/or hospital staff, and complete an incident report if one has not already been completed.

14. Medicaid Coverage issues
CSP must play active role in assisting client to maintain Husky C coverage. Please notify ABH immediately if you discover any insurance issues.
Per DSS, re-determination paperwork is now mailed 40 days in advance of expiration. Paperwork mailed in before system letter is generated will not be accepted. Recommendation is that paperwork be mailed within one week of receipt of letter to insure continued coverage.
Please make sure you include income verification, bank statements and other assets with the application.

15. Sending in Redetermination Paperwork
Please make sure clients are submitting their DSS redetermination paperwork to the Scanning Center with the cover sheet.
DSS ConneCT Scanning Center
P. O Box 1320
Manchester, CT
Fax:
Clients can create online account, print new cover sheet, get forms, etc.

16. Monthly Progress Notes
Due by the 10th day of the following month
e.g., April notes due by May 10th
This means by the 10th, not the Monday following the 10th…
CSP notes include two sections, both required
Individual interventions
General summary
Monthly Note is required for any month where there is an open authorization

17. Only write a note for the most recent care plan.
Monthly Progress Note
If you are unsure of the start and end dates for a care plan, consult the Authorization tab
Only write a note for the most recent care plan.

18. CSP Monthly Note Step 1 Respond to each individual intervention Step 2
Complete a general Monthly Notes Summary
For additional instruction, refer to WOS user guide on ABH website:

19. Encounter Notes
Encounter notes must either be located in a client’s home or securely stored at the agency.
You must be able to supply notes for auditing purposes to ABH, DMHAS, DSS or CMS
Must have an encounter note for any billing.
Please make sure the supervisor is reviewing encounter notes for quality (both RA and CSP). Notes should contain all required elements and be using skill building language.

20. Updated Documentation Standards
Encounter note still required for each visit
Notes with missing information will be considered incomplete and will be recouped
Please make sure handwritten notes are legible!
A complete note includes the following information:
Client full name
Date of service
Staff full name
Service provided
LOA score
Goal
Comments
Time In
Time Out
Total Time
Staff signature
Client signature
Or, document if client refuses

21. Billing Reminders Next three week cycle is November 9th
DXC has posted a one day delay for
11/9 and 12/21 cycle
Check Run Schedule posted on ABH website
July 2018 – December 2018
CLEAN claims will be paid within a 30 day period from the date of submission
A claim is not considered “clean” when it requires further investigation prior to processing
Eligibility issues, insurance issues or the initial activation of a client onto the waiver may delay payment beyond the expected 30 day period

22. MHW Advisory Council Meets twice a year in April and October
Open to any MHW provider to send a representative
We encourage staff to identify MHW clients who might be interested in participating. Staff can bill for time spent with client at meeting.

23. ABH Contact Information
Ann Marie Luongo, Program Manager
(860)
Brian Gay, Quality Assurance Supervisor
(860)
Monica Vaughn, Program Specialist
(860)
Cathy Parente, Claims Coordinator
Lori-Lynn French, Utilization Review Support
NEW FAX NUMBER