Response to DHS HCBS Audit 5 15 08 – 5 16 08

Viwyung - Scmoen

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Response to DHS HCBS Audit 5/15/08 – 5/16/08 Clearwater County Department of Human Services Corrective Actions Required 1. Beginning immediately, case managers must conduct face‐to‐face visits with participants as required in the federally approved waiver plan. Agency Response: The Waiver Team made up of wavier case managers, case aide and social service supervisor will meet to review the face‐to‐face visits requirements specified in statute and documentation expectations. Case managers will conduct face‐to‐face visits as required by statute. Case managers will document all face‐to‐face contacts with clients. 2. Within the next 30 days, ensure that case managers develop a care plan for all participants that do not have one. Agency Response: Within the next 30 days, the waiver case managers and social service supervisor will review case files to ensure a care plan is present. For the files that a care plan in not present, the case manager will develop the care plan. 3. Beginning immediately, ensures that all full‐team DD screening documents have the two required signatures. It is required that the DD screening document is signed and dated by the case manager and either a participants with their own guardianship or a participant’s legal representative. Agency Response: DD case managers and social service supervisor will review all DD screening documents ...

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Publié par	Viwyung
Nombre de lectures	23
Langue	English

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ResponsetoDHSHCBSAudit5/15/08–5/16/08ClearwaterCountyDepartmentofHumanServicesCorrectiveActionsRequired1.Beginningimmediately,casemanagersmustconductface‐to‐facevisitswithparticipantsasrequiredinthefederallyapprovedwaiverplan.AgencyResponse:TheWaiverTeammadeupofwaviercasemanagers,caseaideandsocialservicesupervisorwillmeettoreviewtheface‐to‐facevisitsrequirementsspecifiedinstatuteanddocumentationexpectations.Casemanagerswillconductface‐to‐facevisitsasrequiredbystatute.Casemanagerswilldocumentallface‐to‐facecontactswithclients.2. Withinthenext30days,ensurethatcasemanagersdevelopacareplanforallparticipantsthatdonothaveone.AgencyResponse:Withinthenext30days,thewaivercasemanagersandsocialservicesupervisorwillreviewcasefilestoensureacareplanispresent.Forthefilesthatacareplaninnotpresent,thecasemanagerwilldevelopthecareplan.3.Beginningimmediately,ensuresthatallfull‐teamDDscreeningdocumentshavethetworequiredsignatures.ItisrequiredthattheDDscreeningdocumentissignedanddatedbythecasemanagerandeitheraparticipantswiththeirownguardianshiporaparticipant’slegalrepresentative.AgencyResponse:DDcasemanagersandsocialservicesupervisorwillreviewallDDscreeningdocuments.Casemanagerwillobtainrequiredsignatures.4. Beginningimmediately,designatesseparatecasemanagementandguardianshiprolesforallparticipantswithpublicguardianship.AgencyResponse:ClearwaterCountyDHSwillensurethatparticipantswithpublicguardianshipshaveaseparatecasemanagerandaseparatestaffassignedtotheguardianshiprole.

5. Updateallcareplansinthenextsixmonths.EnsurethatcareplansincludeallrequireddocumentationforHCBSparticipantsinallprogramsincludingidentifyingparticipantneeds,healthandsafetyissuesandparticipantgoalsandoutcomes.AgencyResponse:Waivercasemanagersandthesocialservicesupervisorhavereviewedcareplanrequirements.ClearwaterCountyhasstartedutilizingtheDHSapprovedLTCCCommunitySupportPlan,anupdatedISPandtheMSC+/MSHOCasePlanrequiredbyourmanagedcareagency.Allcareplanswillbeupdatedwithinthenextsixmonths.6. Beginningimmediately,ensuresthatchoicequestionsareincludedinthecareplansandareansweredandsignedbytheparticipant(ortheirlegalrepresentative).AgencyResponse:ClearwaterCountyisutilizingtheLTCCCommunitySupportPlanandtheMSC+/MSHOCasePlanswhichincludedchoicequestions.TheupdatedISPalsoincludeschoicequestions.ClearwaterCountyisalsousingDHSform2727InformationandSignatureSheetforPAS/EW/AC/CADI/CAC/TBIforallwavierfiles.7.IncludeabackupplanandemergencycontactinformationinthecareplanofallCADIandTBIParticipants.Allcareplansmustbeupdatedwiththisinformationwithinsixmonths.AgencyResponse:AllCADIandTBIfileswillincludedabackupplanandemergencycontactinformationinthecareplanwithinsixmonths.TheformatissimilartotheemergencybackupplanincludedintheDSPMbriefcasedocuments.8.Beginningimmediately,ensuresthatthecompletionofcareplansforCCTcasesoccurswithin10daysofassessment.Statelegislationrequiresthatcareplansbecompletedwithin14days(10businessdays)ofthecompletionoftheassessment.AgencyResponse:Thesocialservicesupervisorreviewedthisrequirementwithcasemanagementstaff.Thesupervisorwillmonitorbyongoingcasereviews.9. CompleteICF/MRlevelofcaredocumentationforallparticipantsintheDDprogramthatdonothavethisdocumentationinthenext30days.Maintainacopyofthefindingsintheparticipant’scasefile.AgencyResponse:TheICF/MRLevelofCareform(DHS4147A)hasbeenprovidedtostaffandreviewedwithstaff.TheDDprogramcasemanagerswillcompletethisformforallexistingfileswithinthenext30days.Theformwillbeaddedtotheinitialassessmentandreassessmentpaperworkpackets.

10. CompleteanOBRALevelOneforallLTCparticipantsthatdonothaveoneinthenext30days.Maintainacopyofthiscompletedformintheparticipant’scasefile.AgencyResponse:TheOBRALevelOneform(DHS–3426)hasbeenprovidedtostaffandreviewedwithstaff.TheformwillbecompletedforallLTCparticipantswithinthenext30days.Theformwillbeaddedtotheassessmentandreassessmentpaperworkpackets.Supervisorwillmonitorthroughcasereviewsforcompliance.11. CompleteaTBIWaiverAssessmentandEligibilityDeterminationFormforallparticipantsintheTBIprogramthatdonothavethisformwithinthenext30days.Maintainthisforminthecasefileandupdateitannually.AgencyResponse:DHSform3471TBIWaiverAssessmentandEligibilityDeterminationFormhasbeenprovidedtostaffandreviewedwithstaff.TheTBIworkerwillensurethattheformiscompletedforallTBIparticipantswithinthenext30days.Supervisorwillmonitorthroughcasereviewsforcompliance.12.Beginningimmediately,ensurethatthereisdocumentationthateachparticipanthasbeeninformedofandprovidedconsentabouttheirrightsanddataprivacypractices.Documentationofinformedconsentmustbecompletedforallparticipantswithinsixmonths.AgencyResponse:Casemanagementstaffandsocialservicesupervisorhavereviewedthisrequirement.CasemanagementstaffwillutilizeDHSform3979MNDHSNoticeofPrivacyPracticesandDHSform2727InformationandSignatureSheetforPAS/EW/AC/CADI/CAC/TBItoinformparticipantsoftheirrightsanddataprivacypractices.Staffwillensurethatinformedconsenthasbeencompletedforallparticipantswithinthenextsixmonths.13.Beginningimmediately,securetheevidencethatacurrentservicecontractexistswhenparticipantsuseservicesinanothercounty.MaintaincopiesofallhostcountycontractsandcurrentsignaturepagestoensureacurrenthostcountycontractexistsandisvalidfortheservicespurchasedbyClearwaterCounty.AgencyResponse:Beginningimmediately,waiverteamstaffwillreviewfilesofclientsreceivingoutofcountyservices.Ifacurrentcontactisnotsecured,staffwillcontactthehostcountyandrequestacopyofthevalidcontract.

14. Within90days,assessstaffingcapacitiesandresourceneedstomaintainbasicwaiveroperationsandmeetallprogramrequirementsincludingcasemanagementvisits,developingtimelycareplanswithfallrequiredelementsandmaintainingcasefiledocumentationrequirementsforHCBSprograms.AgencyResponse:ClearwaterCountyDepartmentofHumanServicehasrecentlyjoinedtheCountyBasedPurchasingHealthCarePlanofPrimeWest.AswefamiliarizeourselveswiththerequirementsofPrimeWestHealthSystems,inadditiontoourexistingduties,wewillbeassessingtheneedtohavestaffandtoolsinplacetosupportthepresentandfuturecaseload.Thesocialservicesupervisorandwaviercasemanagerswillreviewcurrentwaviercaseloadsandothernon‐wavierresponsibilitieswavierstaffcurrentlyhas.Basedonthereview,non‐ wavierresponsibilitiesmaybeshiftedordelegatedtoothersocialserviceunitstaff.

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Response to DHS HCBS Audit 5 15 08 – 5 16 08

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