Transcript Slide 1

MRA Service Coordination for
Home and Community-Based Services
Transition Information for HCS Providers
Gulf Bend Center
March 24, 2010
Meeting Agenda
 Introductions
 Purpose of the Transition

Timelines & Activities
1. DADS
2. MRAs

Clarifying Roles
1. HCS Provider, MRA SC, & DADS Responsibilities
2. Comparison of MRLA & MRA SC for HCS
3. DADS Frequently Asked Questions (FAQs)

MRA Transition Summary

Meeting Evaluation & Next Steps
Introductions
Gulf Bend Center Staff
 Don Polzin – Executive Director
 David Way – Director of Operations
 Lane Johnson – Director of Clinical Services
 Richard Wright – IDD Residential Programs Director
 Martha Resendez – Community Services, IDD
 Judith – Authority Services Manager
 Kim – Quality Assurance Specialist
Purpose of Transition to MRA SC
SB 1, Section 48 (81st Session)
 Provides $207 million General Revenue for home and community-
based programs for people with intellectual and developmental
disabilities and for reshaping the system of services.
 7,832 people on waiting lists will receive waiver related community
services by August 2011.
 Additionally, HCS services will be provided to people leaving large &
medium ICFs, children aging out of foster care, and children & adults
at risk of institutionalization.
 The funding for increased community services is contingent, in part, on
the transfer of case management from the HCS Provider to the MRA.
DADS Transition Timeline
September 2009
 DADS stakeholder meeting on draft HCS and Service Coordination rules held 9/14/09.
January 2010
 Proposed HCS and SC rules > MCAC & DADS Council for approval to publish in TX Register.
February 2010
 Proposed rules published in Texas Register for 30 days.
March 2010
 Public comments on proposed rules received and reviewed.
April 2010
 Proposed rules revised as needed, response to public comment.
 Training for HCS Providers and MRAs begins.
May 2010
 Training for HCS Providers and MRAs continues.
June 2010
 Implementation of HCS & SC rule changes – HCS Case Management becomes MRA Service Coordination.
DADS Transition Activities
DADS preparation priorities prior to transfer of HCS case management:
 Develop Program Handbook, forms & templates – includes PDP &
Implementation Plan (IP)
 Make changes to CARE information system
 Communicate changes to individuals receiving HCS services & their
families
 Develop training for MRAs and HCS Providers
 Support flexibility of HCS Provider transitional case management
requirements (TBD)
DADS 2010 Spring Training Locations
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Region 20 ESC, 1314 Hines Avenue
San Antonio
April 5 & 6
United Way of Greater Houston, 50 Waugh Drive
Houston
Gulf Bend Center staff will attend this training
April 13 & 14
The Resource Connection, 1400 Circle Drive
Fort Worth
April 19 & 20
Lubbock Memorial Civic Center, 1501 Mac Davis Lane
Lubbock
April 29 & 30
The Power Center, 12401 Post Oak Road
Houston
May 11 & 12
The Resource Connection
Fort Worth
May 18 & 19
MRA Transition Timeline
March 2010
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Plan and schedule Provider and MRA transition meetings
Request records
Hire Service Coordinators & Transition current Service Coordinators
Develop transition webpage on Center’s website
Educate PNAC and Center Board of Trustees at their monthly meeting
April 2010
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Review records
Assign caseload to Service Coordinators
Plan and schedule consumer/family information meetings
Staff to attend training event in Houston
Establish MRA consumer records
June 2010
 Provide Service Coordination for approximately 132 individuals
MRA Transition Timeline (cont.)
TBD
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Determine staff requirements – HCS service coordinators, supervisors & support Gulf
Bend Center will have 3 MRA Service Coordinators.
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Develop HCS Service Coordination job duties and job descriptions
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Develop methodology for establishing & assigning HCS SC caseloads- caseloads will be
assigned by logistics/location of individuals served.
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Revise policies & procedures as needed
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Develop HCS SC training plan & curriculum- by April 23, 2010
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Begin process of hiring HCS SCs- March position will be posted
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Begin training HCS SCs, including training provided by DADS
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Assign SCs to HCS participant caseloads
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Create Provider/MRA contact lists
Clarifying MRA, Provider & DADS Roles
3 approaches to explain fundamental roles & responsibilities
after the transfer to MRA SC effective June 1, 2010:
 Draft HCS rule amendments (subject to change before final
adoption)
 Comparison of MRLA & draft HCS rule requirements
 DADS Frequently Asked Questions (FAQs) about the HCS
Case Management Transition
Draft HCS Rule:
MRA Service Coordinator
 SC, person/LAR form Services Planning Team (SPT) with other participants
selected by person/LAR including provider.
 Continue enrollment of people into HCS program.
 Conduct person-directed planning and completes PDP specifying needed
services to achieve desired outcomes identified by person/LAR.
 Update PDP annually or as needed.
 Coordinate IPC completion with HCS provider, person/LAR.
 SC, person/LAR or provider may request revision to IPC and/or PDP. SC
agrees or disagrees with IPC renewals & revisions.
 Monitor provision of individual’s program services.
Draft HCS Rule:
MRA Service Coordinator
MRA SC monitoring must:
 Document person’s progress towards achieving outcomes in PDP.
 Ensure concerns with implementation of PDP are communicated to Provider &
attempts are made to resolve.
 Notify Provider if SC becomes aware emergency necessitates an HCS service
to ensure health & safety and service is not on IPC/exceeds IPC amount.
 Assist with transfers and approving discharges.
NOTE: SC monitoring frequency will vary based on the needs of the person.
Minimum frequency of contact is quarterly; monthly contact may be
necessary for some people. The Discovery process for PDP development or
renewal includes determination of frequency.
Draft HCS Rule:
HCS Provider
 Complete assessments & submit LON requests to DADS.
 Coordinate completion of the IPC with MRA SC, person/LAR &
submit to DADS for approval.
 Develop Implementation Plan (IP) for delivery of person’s HCS
program services, with the person/LAR, based on the PDP.
 Deliver services according to IPC authorized by DADS.
 Monitor the delivery of services on IPC in accordance with HCS
Program Certification Principles.
 Monitor progress related to program services in accordance with IP.
Draft HCS Rule:
DADS
 Conduct residential & certification reviews of HCS
Providers to evaluate compliance with HCS Principles
(WS & C) .
 Continue to approve IPCs & LONs (Utilization
Review – UR) .
 Expand current role to oversee Service Coordination
for individuals in the HCS Program (MRA Contract
Accountability and Oversight unit).
Comparison:
MRLA & MRA Service Coordination
MRLA
Draft HCS Rule
 MRA conducted survey/certification
 DADS conducts survey/certification
 Service Coordination provided by
 Service Coordination provided by
the MRA
 Service Coordinator facilitated PDP
and documented the outcomes
 Provider submitted strategies to the
MRA for approval
 MRA responsible for initial IPC &
entered IPC into CARE.
the MRA
 Service Coordinator facilitated PDP
and documented the outcomes
 Provider develops Implementation
Plan based on PDP
 MRA responsible for initial IPC &
enters IPC into CARE.
Comparison:
MRLA & MRA Service Coordination
MRLA
 MRA responsible to complete IPC
renewals & revisions & enter in
CARE.
 MRA completed initial ICAP &
renewed every 3 years.
 MRA completed initial MRRC &
entered MRRC in CARE.
Draft HCS Rule
 Provider responsible to complete
IPC renewals & revision in
coordination with MRA & enter in
CARE. MRA agrees or disagrees
and signs in CARE.
 MRA completes initial ICAP;
Provider completes renewed ICAP
every 3 years. MRA agrees or
disagrees and signs in CARE.
 MRA completes initial MRRC &
enters MRRC in CARE.
Comparison:
MRLA & MRA Service Coordination
MRLA
 MRA completed annual MRRCs &
entered in CARE.
Draft HCS Rule
 Provider completes annual MRRC
& enters in CARE. MRA agrees or
disagrees and signs in CARE.
 DADS assigned LON.
 DADS assigns LON.
 MRA submitted UR for DADS
 Provider submits UR for DADS
approval.
approval.
DADS Frequently Asked Questions
(FAQs)
DADS published & updates FAQs to explain the transfer of HCS case
management to the MRA:
www.dads.state.tx.us/providers/HCS/faqs/masemanagementtransitionfaq.html
FAQ topics include:
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PDP, IPC & IP – relationships between planning tasks, participants, processes &
timeframes
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Monitoring responsibilities of MRA SC & HCS Provider
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Coordination & communications between MRA SC & HCS Provider
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Various topics including emergency response, CARE system, program handbook,
funding changes, etc.
For FAQ updates, sign up for “Email Updates” through GovDelivery at DADS website.
MRA Service Coordination for HCS
Transition Summary
Primary MRA goals prior to June 1, 2010 implementation:
 Clear delineation and common understanding of fundamental functions
of the MRA Service Coordinator & HCS Provider
 Staffing, training & equipping MRA operations to provide qualified and
consistent Service Coordination for HCS participants
 Productive communications with the HCS Provider network to ensure
effective long-term working relationships
 Support for HCS participants & families to minimize service disruption
and promote progress towards each person’s desired outcomes
Meeting Evaluation & Next Steps
What worked this meeting?
What should change in the next meeting?
What do we know now that will need
to be discussed at next meeting
(Agenda Items)?