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Current Status: Active PolicyStat ID: 2582564

Operating Principles for Support Coordination & Intensive Support Coordination Providers, 02-430

IMPLEMENTATION - JULY 1, 2016

APPLICABILITY

Support Coordination and Intensive Support Coordination (SC/ISC) Providers

POLICY

The DBHDD Division of Developmental Disabilities contracts with provider agencies across the state to deliver Support Coordination services to NOW and COMP waiver participants and Intensive Support Coordination services to COMP waiver participants. This policy explains the legal basis for the service, the requirements for service provision and is the index for the series of policies that contain specific detailed information for providers necessary to maintain compliance of the requirements for service delivery.

This policy and the associated series of policies listed below, apply to all Support Coordination and Intensive Support Coordination provider agencies and their personnel, who work with waiver participants using the Individualized Service Plan (ISP). Until all DBHDD policies are accessible via the index contained below, the standards set forth in the current Department of Community Health (DCH) NOW/COMP Manual, Support Coordination and Intensive Support Services Manual, and the Support Coordination Letter of Agreement remain the source for governing practices.

DBHDD policies and associated attachments may be used as templates by SC/ISC providers in the development of their own such tools. However, DBHDD makes no representation or warranty that compliance with the provisions of these policies validates a provider's compliance with all applicable laws and regulations. Support Coordination and Intensive Support Coordination provider agencies are advised to seek their own legal counsel regarding compliance with laws and regulations as appropriate.

PURPOSE

Support Coordination services identify, coordinate, and oversee the delivery of services to enhance the health, safety, and general well-being of waiver participants within the context of the person's goals toward maximum independence.

Individuals who meet eligibility requirements outlined in NOW/COMP Part III - Chapter 700, which include a high acuity of medical need or behavioral risk factor(s), may be authorized to receive Intensive Support Coordination services in lieu of traditional Support Coordination services.

In agreement with the 2014 HBCS rule, Support Coordination and Intensive Support Coordination provider agencies must comply with the "Conflict-Free Case Management" model as stated in the Federal Register at https://www.federalregister.gov/articles/2014/01/16/2014-00487/medicaid-program-state-plan-home-and-community-based-services-5-year-period-for-waivers-provider, which has the following characteristics:

  1. Separation of case management from direct services provision;
  2. Separation of eligibility determination from direct services provision;
  3. Case Managers do not establish the levels of funding for individuals; and
  4. Family members, persons related by marriage to the individual, or any of their paid caregivers are not permitted to act as staff who conduct evaluations, assessments, and write Individual Service Plans.

POLICY INDEX

DBHDD manages all operational aspects of SC/ISC delivery via a series of Support Coordination and Intensive Support Coordination polices. Polices listed below without an active hyperlink are in development. Hyperlinks are added and activated as the policies become available.

GENERAL

Philosophy and Values

Standards of Conduct and Ethics for Support Coordinator Providers, 02-431

Participant Selection of Support Coordination/Intensive Support Coordination Provider, 02-441

Support Coordination and Intensive Support Coordination Eligibility Determination and Conditions for Transfer Between Services, 02-442

AGENCY ROLE AND RESPONSIBILITIES

Role and Responsibilities of SC Leadership Members (Agency Director, Supervisor, Quality Assurance Manager)

Role and Responsibilities of ISC Leadership Members (Agency Director, Clinical/Medical Director, Clinical Supervisor)

Staff Training Requirements

Assignment of SC/ISC's from SC/ISC Agencies

Process for Changing SC/ISC or SC/ISC Provider

Support Coordination Caseloads, Participant Admission and Discharge Standards, 02-432

Internal Quality Assurance Requirements

External Quality Assurance Process

Reporting Requirements for Support Coordination, 02-437

SC/ISC STAFF ROLE AND RESPONSIBILITIES

The Service Planning Process and Individual Service Plan Development, 02-438

Coordination of Waiver Services

Community Engagement and Resource Development

Addressing Changes in Need, Requests for Additional Services, and the ISP Addendum Process

Support Coordination Contact Frequency Requirements,02-433

Outcome Evaluation: "Recognize, Refer and Act" Model, 02-435

Support Coordination Documentation, 02-434

Support Coordinator Responsibility for Assessments, Evaluations, and Healthcare or Behavioral Plans, 02-436

SC/ISC's Role in Participant Directed Services

Enhanced/Intensive Support Coordination for Hospital Transition Individuals

Support Coordination and the Critical Incident Process, 02-440

Intensive Support Coordination for Participants in Crisis Respite Homes, 02-439

LEGAL REFERENCES

42 C.F.R. 440.169 

42 C.F.R. 441.18 

42 C.F.R. 435.911 

42 C.F.R. 441.730 

42 C.F.R. 441.301

PROFESSIONAL STANDARDS

Department of Community Health (DCH) NOW/COMP Manual

Department of Community Health (DCH) Support Coordination and Intensive Support Coordination Services Manual

RELATED POLICIES

Transition Process for Individuals with Intellectual and/or Developmental Disabilities moving from State Hospitals to their Family Home or Community Residences, 04-120

Reporting and Investigating Deaths and Critical Incidents in Community Services, 04-106

Provider Manuals for Community Developmental Disabilities Providers, 02-1201

REFERENCES

Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Home and Community-Based Setting Requirements for Community First Choice and Home and Community-Based Services (HCBS) Waivers (2014, January 16). Retrieved from https://www.federalregister.gov/articles/2014/01/16/2014-00487/medicaid-program-state-plan-home-and-community-based-services-5-year-period-for-waivers-provider.

Attachments:

Approval Signatures

Approver Date
Anne Akili, Psy.D.: Policy Director 7/5/2016
Dan Howell: Director Division of Developmental Disabilities 7/5/2016
Frank Kirkland: Assistant Division Director for DD 7/3/2016
Ron Wakefield: Director, Office of Field Operations for DD 7/2/2016
Robert Bell: Director of Community Supports 7/1/2016
Anne Akili, Psy.D.: Policy Director 7/1/2016
Approver Date
Anne Akili, Psy.D.: Policy Director 7/5/2016
Dan Howell: Director Division of Developmental Disabilities 7/5/2016
Frank Kirkland: Assistant Division Director for DD 7/3/2016
Ron Wakefield: Director, Office of Field Operations for DD 7/2/2016
Robert Bell: Director of Community Supports 7/1/2016
Anne Akili, Psy.D.: Policy Director 7/1/2016
Older Version Approval Signatures