1. Mental Health Waiver Provider Meeting
January 7, 2019

2. Agenda Introductions- New Program Specialist Waiver Update
Waiver services rate increase
Credentialing updates
Critical Incidents
Medical issues and emergencies
Housing budget
Chore Service
Staff possession of client bank cards/money
Project Notify
Medicaid Coverage Issues
HIPAA
Notes/Documentation
Billing/ Audits
MHW Advisory Council

3. Waiver Update (as of 1/2/19)
Active clients on the waiver: 592
Actively planning for admission to waiver (MHW & MFP): 55
Referrals pending disposition (MHW & MFP): 63
Waitlisted referrals for MHW community: 122
Community Census for Waiver Year 10: 615
Additional Slots for MFP clients Waiver Year 10: 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. Support/Rehab Service
Service Type
Proc Code
Unit Cost
1 Unit =
PA#
Support/Rehab Service RA
Recovery Assistant - Agency
1213M
5.82
15 min -
Recovery Assistant - Self Directed
1212M
3.43
Recovery Assistant Group 2
1214M
4.36
Recovery Assistant Group 3
1215M
3.36
Recovery Assistant Group 4
1216M
2.94
Overnight Recovery Assistant
1217M
CSP
H2015
25.41
CSP Group
H2015 HQ
6.29
ADH
ADH Full Day Non-Medical
1200z
68.17
1 day
ADH Full Day Medical
1201z
72.33
ADH Half Day
1202z
45.88
ALSA
Assisted Living- Level 1- Occasional
1430z
24.5
Assisted Living- Level 2- Limited
1431z
40.35
Assisted Living- Level 3- Moderate
1432z
56.82
Assisted Living- Level 4- Extensive
1433z
73.16
Assisted Living Core Service
1434z
4.49
DEMO Assisted Living- Level 1- Occasional
1435z
differs by site
DEMO Assisted Living- Level 2- Limited
1436z
DEMO Assisted Living- Level 3- Moderate
1437z
DEMO Assisted Living- Level 4- Extensive
1438z
DEMO Assisted Living Core Service
1439z
Other
Transitional Case Management
G9012
16.51
Supported Employment
H2023
Peer Supports
H0038
12.57
Brief Espisode Stabilization
1229z
11.04
Ancillary Service
PERS
PERS Installation
1222z
36.05
1 service
PERS Monthly Service
1223z
60.08
1 month
Chore
Chore Service - Agency
1206z
4.2
Highly Skilled Chore Service
1208z
< 10,000
1 unit Y
HDM
Home Delivered Meals - Single
1218z
4.93
Home Delivered Meals - Double
1220z
9.02
Home Delivered Meals - Kosher Double
1221z
NMT
Non-Medical Transportation- Agency
1262z
25.4
1 trip
Non-Medical Transportation- Individual
S0215
0.4386
1 mile
Specialized Medical Equipment
T2029
Home Accesibility Adaptations
1209M
Assistive Technology
1397Z
< 1,000

7. Credentialing Updates
Please remember that if you receive a notice regarding re-credentialing with DXC, you must contact Chastity Holloway. 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 Chastity Holloway at any time there are changes. The form can be located on the ABH website.

8. 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

9. 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 & WOS ID)
Client’s role in the incident
Incident Category (please check one)
Any substances present?
Media attention likely?
Narrative

10. 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

11. Medical Issues and Emergencies
Clients should be encouraged to use clinics instead of emergency rooms for non-urgent care
Please review with staff what to do in case of medical emergency:
Call 911 or push PERS
Contact Home Health Agency
Contact supervisor
Direct care staff should not be making medical decisions on whether client needs to seek help
Falls
Hitting head

12. Housing Budget Housing budget is being reviewed by the state.
All clients receiving a DMHAS subsidy must place themselves on a permanent subsidy list.
Requests for subsidy and housing items are not guaranteed and are being reviewed more closely. Must show efforts made in contacting other community resources, budgeting for needed items, etc.
Partial funding may be approved in some cases.
Staff should not be making promises to clients that “DMHAS will pay for it.”

13. Chore Service Chore Service – Agency
Service is intended to provide occasional non-routine cleaning activities, and is NOT intended as regular routine cleaning. Think in terms of “spring cleaning”.
Examples: Washing windows, tacking floorboards, washing floors, etc.
Highly Skilled Chore Service
Specialized cleaning/moving services that require prior authorization
Examples: Moving to new apartment, insect remediation, handling of waste/biohazard material
Note: These services do not replace landlord’s responsibility to provide remediation

14. Staff possession of bank cards/money
Staff should not be taking possession of client bank cards, credit cards, EBT cards or money.
Increase in incidents of accusations against staff.
If clients are having issues with handling their own money or cards, staff should alert CSC right away so that issue can be discussed and arrangements made to assist clients.

15. 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.

16. Medicaid Coverage issues
IF staff are going to a regional DSS office with a client, please make sure to ask for the LTSS eligibility worker and let them know the client is on the Mental Health Waiver
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.

17. 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.

18. HIPAA – Privacy Rules ABH’s Fax is secure (860-920-4456)
ABH sends secure (Zix Mail)
If you receive a secure and can not open it please contact the sender
Identifiable Client information should not be used in subject lines
All communications that include Client Identifiable information should be sent securely
This includes:
Name (Including initials)
Social Security Number
Medicaid ID
WOS 4 Digit Client ID numbers are unique to our program and do not need to be sent securely

19. 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

20. 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.

21. 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:

22. 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.

23. 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

24. Billing Reminders Next three week cycle is February 8th
DXC has posted a one day delay for
1/18 and 2/8 cycle
Check Run Schedule posted on ABH website
January 2019 – June 2019
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

25. 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.

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