What's Up?

New Handbook as of July 1, 1010

Ellen Rothermel — Fri, 24 Sep 2010 15:32:27 +0000

I've been so busy making changes to the system so that it is in compliance with the new handbook I have not had time to update this page. If you do not know by now, you need to download the new handbook and look at the new requirements. The good - no make that great - news is that they reduced the paperwork requirements for many of the services, especially residential habilitation. You no longer are required to make monthly summaries and send these to the support coordinator. You are now to be making quarterly summaries instead and put those in the central file and send a copy to the support coordinator. Each consumer's quarterly will be on a different schedule since month one will be the effective date for the support plan. The third quarter will actually be the Annual Report!

Despite the fact that the Waiver Provider system has been updated to reflect these changes I still encourage you to continue to collect data monthly so this information can be used on the quarterly summaries. Data can be entered each month or you can wait until the 3rd month and enter the information on a progress note. Or you can do a little of both - entering trips consusmers went on each month and doctor appointments as well. They will show up on the quarterly report based on the dates.

Lots of other changes are in the handbook. All of the changes are highlighted in yellow, allowing you to browse through the book in sections relevant to your service and look for the changes. Remember to update your policies and procedures or management plan to reflect the changes.

On the Move

Ellen Rothermel — Sun, 02 May 2010 17:18:05 +0000

Well Delmarva is on the move again, scheduling and completing the new audits. Remember to look at and download the tools from their website from the section Discovery Tools.
The reviewers do not use the old "honor system" when it comes to documentation. They need to see it and if you are supposed to send it out to others they need to have a date on the documentation that shows when you sent it out. If they do not see that - well - you know the old saying... if it is not written down it never happened.
Have everything together and ready when they come and be sure to be able to answer the questions, show examples of your answers, and show them the system that you are using to generate the documentation. This part is easy if you are using the Medicaid Waiver Provider Information System. If you have not already looked in to this go to the contact us page and submit your email so we can contact you and tell your all about it!

Hip Hip Hooray!

Ellen Rothermel — Mon, 26 Apr 2010 14:20:37 +0000

As reported in the Tampa Tribune today the legislature has dropped their attempts to privitize Medicaid and Medicare at least for the time being. While I am not completely against this idea because I believe in smaller government (any thing the government does the private sector can do better!), I am not in favor of rushed, last minute attempts that are not well thought out. Let's all keep an eye out on this just in case and in the meantime have a good Summer!

New Delmarva Tools

Ellen Rothermel — Thu, 25 Feb 2010 14:59:37 +0000

I went to the training in District 14 for the new Delmarva oversight. I am really pleased - they are dropping all the touchy feely stuff and using objective date. The depth of the review will not be there - it will be very shallow. The only thing they really emphasized that may change drastically is that the notes must be done before billing or that will be a major recoup done by AHCA. I know many SCs that are months and months behind and of course a few providers so they may get hurt.

No more POMs! Hooray. They will use the projected outcomes more. Of course the tools are still in the making but will be up on Delmarva's sight within 3 weeks according to Bob Foley. While they acknowledged that the rebasing will have a major impact on outcomes they admitted this is not something they are involved in or can do anything about. There will be no more desk reviews but 12 services will be reviewed including PCA, Respite which have always been desk reviews.

They will be completing 1,428 reviews per year which comes to 2 consumers per SC/CDC Consultant. That number seems almost impossible to me. Since most of the names of the Delmarva staff were familiar they are going to have to be able to make that mental switch to this new type of review. APD will be doing the Remediation. Reconsiderations will be conducted by the Quality Assurance Supervisor. The PCR, person centered review, will include all of the providers involved with the consumer and will generate the PDR Provider Discovery Review if one has not already been done in the current 12 month period. Scoring for the PDRs will be Met, Not Met, and Not Applicable derived from a numerical percentage.

I am excited about the changes and think it will make major improvements for our consumers. Instead of concentrating on things that do not impact the quality of life for consumers they will be concentrating on objective data about health, safety, behavioral services provided, are services effectively implemented to meet the consumer's unique needs and are the services being provided as described in the handbook.