1. Private Duty Nursing Policy Revision Nov. 15& 29, 2016
Department of Health and Human Services Stakeholder Meeting and Listening Session

2. Home Care Initiatives (HCI)
Community Based Services, Clinical Policy Section
Private Duty Nursing (PDN) - Policy 3G (Proposed 3G1 & 3G2)
Home Health Services – Policy 3A
Hospice – Policy 3D
Home Infusion Therapy – Policy 3H1
services-clinical-coverage-policies
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

3. Home care initiatives program oversite
Linda Rascoe
Associate Director for Community Based Services
Behavior Health
Home Care Initiatives
Krystal Hilton
Home Care Initiatives and Ancillary Services Unit Manager
Private Duty Nursing
Home Health Services
Hospice
Home Infusion Therapy
Optical & Hearing Services
Outpatient Specialized Therapies
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

4. Home care initiatives program staff
Nursing Services Supervisor: Stanislavka Bratic
Home Care Nurse Consultants:
Rebecca McDowell
Sharon Lipscomb
Laura Ferguson
Home Care Administrative Assistant: Natalie Wilson
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

5. Policy Review Process and Timeline
July – Sept. 2016
HCI gathered feedback from CAP Waiver & Policy Change Stakeholder Working Group and Listening Sessions
Sept. – Nov. 2016
PDN Program Staff Began Review of the policy
HCI staff worked with several areas of DMA to determine needs of beneficiaries
Internal DMA Policy Review
Nov. – Dec 2016
Host stakeholder work groups and listening sessions
NC Physician Advisory Group policy review and approval
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

6. Policy Review Process and Timeline
Dec – Jan. 2017
Policies Posted for Public Comment
February 2017
Provider & Stakeholder Informational Sessions
Spring 2017
Implementation of Policies
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

7. Private Duty Nursing policy development
Current Needs:
Assist with CAP/C Waiver Amendment:
Support CAP/C Waiver Compliance
Remove nursing services from waiver
Prevent gaps and minimize loss of coverage for CAP/C waiver beneficiaries
Separate PDN Services Policy (3G) into two policies:
Beneficiaries ages 0-20: 3G2 Children
Beneficiaries 21 years and older: 3G1 Adult
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

8. Planned policy modifications
Certification period from 60 to 90 days
PDN Nurse experience requirement
Expansion of expertise areas for nursing supervisor
Modify the health criteria for the children’s policy
Policy 3G to 20 Years
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

9. Planned policy modifications
New initial referral authorization process
Provisional PA
30 Day Period
Requires a signed physician order with supporting status documentation
Employment attestation
Continuation PA
Day 31 – 90 of initial certification period
Employment verification letter/form
Signed 485 – Demonstrate status tenure or changes
Provider consent to treat
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

10. Questions/Additional Comments
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

11. What’s next? Finalize Draft Policy for PAG Post for Public Comment
Revise and Finalize Policies
Provider/Stakeholder Informational Sessions
Proposed Policies Effective Date: Spring 2017
Private Duty Nursing Policy Revision | Stakeholder Meeting & Listening Session |

12. Contact us Online Phone Email By U.S. Postal Service
ADD WEBSITE URL HERE (When created)
Phone
Main Line: (919)
Fax: (919)
Home Care & Hospice Fax: (919)
ADD HERE (If applicable)
By U.S. Postal Service
Private Duty Nursing
Division of Medical Assistance North Carolina Department of Health and Human Services Mail Service Center Raleigh, NC
CAP/C 1915 (c) HCBS Waiver Stakeholder Engagement