1. Targeted Case Management Monthly Documentation Pilot
Texana Center
Sheri Talbot, Authority Services
Carin Shuford, Information Services

2. Why Monthly Documentation Summary?
Expectations of state for progress/lack of progress/satisfaction/lack of satisfaction every 90 days
Documentation burden to TCMs (turnover)
Compliance challenge – missing outcome/missing service in 90 day reviews
Expectations for transition to managed care: Maximize the use of data to drive decision making

3. Steps Taken… Researched model TCM documentation for Managed Care
Identified Tennessee Format
The Support Coordination Monthly Documentation Form is used to
summarize information gathered from the monthly face-to-face visit; interviews with the person, family members and conservators or guardians; interviews with provider staff; and other information and documentation relevant to the implementation of the ISP that is received during the month. The ISC must complete this form at least monthly to document review of ISP implementation status, including monitoring and narrative documentation of the progress made with respect to each action step and outcome. Contact with the person’s guardian/conservator or an involved family member may be required to complete the form, particularly if the person is unable to communicate responses to interview questions.

4. Steps Taken… Reviewed with the Local Authority Workgroup
Molly Hurst, Tarrant County, presented to the IDD Consortium, September 2016
Implemented Pilot at Texana Center, October 2016

5. Texana Center Pilot Implementation
Purpose
Introduce a Monthly Summary Documentation
Test and improve format prior to requirement
Promote user feedback
Implementation October 2016
Participation Voluntary for Waiver Service Coordinators (9 TCM, 6 TCM Supervisors)
Participation Mandatory for Enhanced Community Coordination (Format provided data for mandatory quarterly ECC report) (4 TCM, 1 TCM Supervisor)

6. Texana Center Pilot Implementation
Developed the Monthly Documentation Summary in Cerner (Anasazi), preceded by
Extensive Training on Outcomes July - August
August implemented revision to the PDP
Action Plans categorized by 9 life areas (not services)
Outcomes for Non Waiver services moved to the Action Plans
Desired Outcomes of the Monthly Documentation Summary
Improved time management
Improved compliance
Improved quality of Service Coordination

7. Texana Center Pilot Implementation
Challenge with Tennessee Model: Tennessee Single Monthly F/F = Billing Requirement; Texas 1 F/F and 2 Collaterals = Billing Requirement
Desired components of the Monthly Summary:
Capture Billable Face to Face Services
Capture Billable Collateral Services
Include PDP Review as a billable event that provides reportable data
Include 90 Day Review with Outcomes populating from the PDP
Allow for Quality Review (Final Approval) by the TCM Supervisor

8. Demonstration Carin Shuford, Information Services Specialist
Dedicated position to assist with IDD documentation
Focus on IDD Electronic Health Record
Focus on Staff Training
IMC Systems Policy Workgroup Liaison to Local Authority Workgroup

9. Implementation Challenges
Timeliness Benchmark – Final Approval is for the complete summary
TCM Supervisor Time Management – Final Approval at the end of the billing period
Time management for Targeted Case Managers – procrastination, end of month documentation
Narrative to include indicators of the matching billing strip
Communication of changes to pilot participants

10. Implementation Opportunities
Facilitated quick identification of issues requiring follow up for both the TCM and TCM Supervisors
Relayed the individual’s ‘story’ in a more concise, meaningful format
Facilitated improved time management by the TCM
Tracking of F/F and Collaterals for Benchmarks
Reduced time required to complete contact notes
Collateral PDP Review
90 Day Review with populated Outcomes

11. Moving Forward
CAP Review week of January 30th – Present Modification to the PDP Action Plan
Mandatory format for all Service Coordinators beginning February 1, 2017
Continued flexibility in the format for ease in use by Service Coordinators
Revision to the Final Approval process to allow for timeliness benchmarks and time management by the TCM supervisor

12. Questions, Suggestions and Discussion
Questions on the Texana Center Monthly Documentation Summary
Suggestions for improving the Monthly Documentation Summary
Discussion of statewide support for the use of a TCM Monthly Documentation Summary

13. Texana Center Contacts
Sheri Talbot, Director IDD Authority Services
Carin Shuford, Information Services Specialist
Utude Akposheri, Diversion Coordinator