new consultant training february 5 & 6, 2013
DESCRIPTION
NEW CONSULTANT TRAINING February 5 & 6, 2013. Barbara Palmer Director. Rick Scott Governor. Welcome and Introductions. Ivonne Gonzalez Training and Outreach Coordinator Submit questions throughout this presentation to: [email protected]. - PowerPoint PPT PresentationTRANSCRIPT
NEW CONSULTANT TRAINING February 5 & 6, 2013
Barbara PalmerDirector
Rick Scott Governor
Welcome and Introductions
Ivonne Gonzalez
Training and Outreach Coordinator
Submit questions throughout this presentation to: [email protected]
2
Training Objectives•Identify the Five Principles of Self Determination
•Describe the roles and responsibilities of Participant, Representative, Consultant, Area and State Office
•Describe different provider types
•Demonstrate how to write a Purchasing Plan
•Describe how to properly manage your CDC+ Budget
•Demonstrate how to Reconcile the account
3
• The Developmental Disabilities Medicaid Waivers Consumer-Directed Care Plus Program Coverage, Limitations and Reimbursement Handbook (CDC+ Rule Handbook)
• Participant Notebook
• Appendix to Handbook & Participant Notebook
CDC+ Tools
4
5
•In 2000- Consumer-Directed Care(CDC)- Pilot Program•Demonstration phase January 2004 (CDC+)•Permanent Program March 2008, authorized by Medicaid through the 1915j State Plan Amendment•Expansion Fall 2009•2500 new participants•Training and enrollment
•CDC+ Rule•Adopted as of 11/12/12 -Any changes that occur will be shared
CDC+ History
5
What is CDC+
•Long-term care program alternative
•Based on principles of Self-Determination and Person-Centered Planning
•Provides opportunities to improve quality of life
6
Self-Determination and Person Centered Planning
Person-Centered Planning
Principles of Self-DeterminationFreedomAuthoritySupportControlResponsibility
7
CDC+ Eligibility and Enrollment Requirements
•Enrolled in the DD/HCBS waiver
•Able to direct own care
•Live in family or own home
8
• Tier Waiver to iBudget by (July 1, 2013)
• Authorized iBudget funds determine CDC+ Monthly Budget
• CDC+ participants will still manage their iBudget funds in accordance with the CDC+ Rule Handbook
More information regarding iBudget on iBudgetFlorida.org
iBudget Transition
9
•Participant
•CDC+ Representative
•Consultant
•Area Liaison
•State Office
Roles and Responsibilities
10
Role of Participant (when representative not selected)
•Authorized signer
•Decision maker
•Employer
•Develops Purchasing Plan
11
Role of Participant, continued
•Maintains accurate and complete records
•Spends CDC+ budget responsibly
•Complies with training and monitoring requirements
•Develops Emergency Backup Plan (CDC+ Rule Handbook pg 3-3)
12
•Same role as Participant
•Unpaid Advocate; at least 18 years of age
•Readily available to Participant and Consultant
•Responsible for appropriate use of public money
Role of CDC+ Representative,
13
•Be a Waiver Support Coordinator in good standing
•Complete CDC+ New Consultant Training
•Pass Readiness Review
•Enroll as a Medicaid provider for consultant services
•Complete CDC+ registration forms
•Sign Memorandum of Agreement
Consultant Requirements
14
•Waiver Support Coordinator
•Complies with training and monitoring requirements
•Sign a participant/consultant agreement
•Provides on-going technical assistance
Role of Consultant
15
•Reviews and signs off on CDC+ documents
•Responsible for appropriate use of public money
Role of Consultant, continued
16
•Develops and updates support plan
•Ensures cost plan is updated
•Monitors and reviews participant account activity
•Ensures Medicaid eligibility
Role of Consultant, continued
17
Role of Consultant, continued
•Keeps active contact with ParticipantMonthly – by phone or in personAnnually – two face-to-face per year
•Completes monthly review documentation
•Communicates effectively with Area Liaison
18
•Authorizes CDC+ Budget•Reviews Purchasing Plans•Facilitates employee background screening •Liaison between participant, consultant, and State office
Role of Area Liason
19
•Administers CDC+ Program•Develops policies•Approves CDC+ Monthly Budget•Develops and provides training•Provides Customer service
Role of State Office
20
•Provides Quality assurance
•Assigns Provider ID Numbers
•Pays service claims and employer taxes
•Sends monthly statements
•Monitors consumer spending
Role of State Office, continued
21
Quality Assurance Requirement•Consultant
•Participant Person Centered ReviewProvider Discovery Review
22
Steps for CDC+ Participant Enrollment
•Expresses interest
•Completes training
•Passes Readiness Review
23
•Application Packet•2 page application document•Cost plan service authorization summaries•Budget calculation worksheet
•Enrollment Packet•8821 – IRS •2678 – IRS•Fiscal Informed Consent
Steps for CDC+ Participant Enrollment, continued
24
•Area calculates monthly budget
•Participant chooses supports and services
•Participant interviews potential providers
•Providers complete background screening requirements
Steps for CDC+ Participant Enrollment, continued
25
•Participant develops and submits purchasing plan; CDC+ approves plan
•Participant completes and submits employee and vendor packets; CDC+ issues provider ID’s
•Participant begins self directing supports and services
Steps for CDC+ Participant Enrollment, continued
26
Calculating the Monthly Budget•Budget calculation worksheet – Participant Notebook Appendix D(3)
•Current approved DD/HCBS Waiver Cost Plan
•Discount rate- 8%
•Administrative fee- 4% or max amount of $160.00
27
Calculating the Monthly Budget, continued
•PCA for children under 21 (use different Budget Calculation Worksheet) paid through Medicaid State Plan-(procedure code S9122TJ)
•STE-Short Term Expenditure & OTE-One Time Expenditure
•Consultant fee is not part of monthly budget (billed directly through FMMIS) 28
ServiceTotal Cost Plan Amt
Number of
months Monthly Cost
Plan
PCA $ 7,200.00 12 $ 600.00 Respite $ 8,870.40 12 $ 739.20 PT $ 5,340.80 12 $ 445.07 Trans $ 8,049.60 12 $ 670.80
ST $ 3,204.98 12 $ 267.08CMS $ 372.40 12 $ 31.03
Total $ 33,038.18 $ 2,753.18 $ 2,753.18 If more than $4,000.00, use $160 for fees Take the percentages of Col D Total 0.92 0.04 If less than $4,000, use 4% calculation for fees
$ 2,532.93 $ 110.13 $ (160.00)
This is the CDC+ Monthly Budget $ 2,372.90
Consultant services or funds for either OTEs or STEs are not included in the calculation of the monthly budget
$ 2,753.18 0.92 $ 2,532.93 $ (110.13)
This is the CDC+ Monthly Budget $ 2,422.80
29
What, when, who, where and how support & services will be provided that best meet their needs & goals•Setting Priorities
•CDC+ Program Services (CDC+ Rule Handbook Chapter 4)
•Restricted or Unrestricted (CDC+ Rule Handbook pgs. 4-3, 4-4)
•Allowable purchases (CDC+ Rule Handbook pgs.1-5, 3-8)
•Unallowable purchases (CDC+ Rule Handbook pgs.1-19, 3-9)
Participant Controls
30
•Every service contains a definition to include: Descriptions, limitations, special conditions, provider qualifications and service type. (CDC+ Rule Handbook Chapter 4)
•Service codes and abbreviations can be found in the Service Code Chart
CDC+ Program Services
31
CDC+ SERVICE CODE CHART
RESTRICTED SERVICESService Name Abbreviation Service Code
Adult dental services DENT 03Behavior Analysis Services BT 06Behavior Analysis Assessment BTA 06ABehavioral Assistant Services BTS 08Dietitian Services DIET 12Occupational Therapy OT 29Occupational Therapy Assessment OTA 29APhysical therapy PT 38Physical Therapy Assessment PTA 38APrivate Duty Nursing/LPN PDL 49Private Duty Nursing/RN PDR 50Respiratory Therapy RT 45Respiratory Therapy Assessment RTA 45ASkilled Nurse/LPN SNL 47Skilled Nurse/RN SNR 48
Specialized Mental Health Services/ Therapy and Assessment MHT 51
Speech Therapy ST 53Speech Therapy Assessment STA 53AEnvironmental Modification Assessment ENVA 14ADurable Medical Equipment and Supplies EQUIP 83Environmental Modifications ENV 14Vehicle Modification VMOD 80
UNRESTRICTED SERVICESService Name Abbreviation Service Code
Adult Day Training ADT 02Advertizing ADV 89Seasonal Camp CAMP 85Companion Services COMP 11Consumable Medical Supplies CMS 63Supported Employment EMP 55Gym Membership GYM 88In-Home Supports IHS 22Over-The-Counter Medications OTC 65Personal Care Assistance PCA 32Personal Emergency Response System (PERS) PERS 33PERS Installation PERSI 33AParts and Repairs Therapeutic or Adaptive Equipment PARTS 82Residential Habilitation Services RHAB 43Respite Care- Day RSPD 58Respite Care- Hour RSPH 46Supported Living Coaching SLC 56Specialized Training TRNG 61Transportation TRAN 60Other Therapies XTHER 39
FOR CONSUMERS PARTICIPATING IN THE FLORIDA FREEDOM INITIATIVE (FFI) ONLY
Service Name Abbreviation Service CodeMicroenterprise MICRO 75FVehicle VEH 70F
32
•Directly Hired Employee (DHE)
•Agency/Vendor (A/V)
•Independent Contractor (IC)
Provider Types
33
•Identify service/support being purchased
•Type of provider needed•Provider requirements
•Hiring packet – (Appendix E of the Notebook)
How to Find, Hire and Manage Providers?
34
Background ScreeningsLevel 2 for all providers listed on a Purchasing PlanValid for 5 years- provided there is not a break in service of 90 days or more.
How to Find, Hire and Manage Providers, continued
Employee Packets- (Appendix G Notebook)
Vendor Packets- (Appendix H Notebook)
35
•The Participant decideswhat will be done and create job descriptionhow services will be performedthe hours per week/month workedhourly rate of pay (negotiable)
Companion- only service exempt from minimum wage requirements
•The Participant mustreview, approve, & submit timesheetbudget for applicable employer taxes
Directly Hired Employee Services
36
•A person or business that provides services/supports
•Participant controls/directs only the result of work performed, and not the means and methods of accomplishing the result
•Participant pays from submitted invoice
•No Taxes withheld or paid
Agency/Vendor and Independent Contractor
37
Hiring an A/V, IC or DHEAgency/Vendor (A/V) or
Independent Contractor (IC)
• Vendor/Independent Contractor Information Form
• Internal Revenue Service (IRS) Form W-9
• Background Screening Letter
Directly Hired Employee
• Employee Information Form
• Internal Revenue Service (IRS) Form W-4
• Department of Homeland Security (DHS) Form I-9
• Background Screening Clearance Letter
• Optional- Direct Deposit Form (EFT)- include a copy of a pre-printed voided check
38
Purchasing Plan – Appendix E
•Describes how CDC+ monthly budget will be spent to meet needs and goals
Authorizes services/supports Authorizes providers
•Developed by Participant or RepresentativeConsultant may provide technical assistance
and guidance (CDC+ Rule Handbook Appendix E)
39
Person Responsible
Activity Due Date
Participant(Representative)
Complete Purchase Plan; submit to Consultant
By the 5th of the month
Consultant Review and sign; submit to Area Liaison
By the 10th of the month
Area Liaison Review and sign; submit to State Office
By the 20th of the month
Purchasing Plan – Timelines
40
Purchasing Plan Types
•New Purchasing Plan
•Purchasing Plan Change
•Purchasing Plan Update
•Quick Update
41
•One Time Expenditure- 100% of authorized amount - only 3 services:•Equipment/Devices DME•Environmental Modifications•Vehicle Modifications
•Short Term Expenditure-Services authorized in waiver cost plan that are approved for 6 months or less, or are periodic in nature – ex. Dental, Assessments
OTE/STE Expenditure
42
•Restricted Services-requires a licensed provider, 92% of the units of measure that are approved in the Cost Plan must be utilized
•Unrestricted services-services and supports that a CDC+ Participant may purchase provided the service meets needs and goals as identified in the support plan.
Restricted/Unrestricted Services
43
Critical Services •Critical Services- require two emergency backup providers who are ready and able to drop everything and come to work as an emergency backup, ex. PCA
44
The CDC+ purchasing plan consists of:Page 1 – Section A – Basic InformationPage 2 – Section B – Needs and GoalsPage 3 – Section C.1 and C.2 – Services and SuppliesPage 4 – Section D – Cash (no longer available)Page 5 – Sections E and F – Savings Plan and
OTEs/STEsPage 6 – Budget Summary and Signatures
45
Purchasing Plan Sections
46
Purchasing Plan Instructions
• Open blank purchasing plan • Follow along slide by slide• Reference tools
The CDC+ Purchasing Plan
47
Extra pages in Section C.1 and C.2 are provided in the Excel file for participants who need additional
space to enter services and supports
To move from page to page on the purchasing plan, click on a page tab in the blue bar on the bottom of the Excel page
frame. Each page contains a section of the purchasing plan
48
CDC+ Purchasing PlanPage 1 - Top
Provide the required information
Enter the day the Purchasing Plan will be
effectiveEnter the number of the APD area in which the
participant lives
Enter the participant’s approved CDC+ Monthly
Budget amount
Participants on the Florida Freedom
Initiative (FFI) check “Yes”, otherwise
check “No”.
49
Purchasing Plan - Page 1
Section A – Participant Information
Enter the participant’s legal first name, middle initial and last name as
found on birth certificate Enter the participant’s age as of the effective date of the Purchasing
Plan
Enter the participant’s ID
number
50
Purchasing Plan - Page 1
Section A – Participant Information (continued)
Enter the representative’s legal
first name, middle initial and last name
Enter a valid cell phone number for the participant or representative
Enter a valid phone number for the participant or representative
51
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan
Enter the page numbers that are revised
Enter the legal name for all providers appearing on the
Purchasing Plan for the first time
Enter the number of Employee or Vendor/IC
packets submitted
52
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan (continued)
Enter the names of all the providers who appeared on
previous Purchasing Plans but do not appear on this
Purchasing Plan
Manually number each page of the Purchasing Plan
including the total number of pages
Enter the total number of Purchasing Plan
pages. The minimum number of pages is six
(6)
53
Purchasing Plan - Page 1
Section A – Reason for Submitting Purchasing Plan (continued)
This option is no longer available
This area is to be completed by the consultant and area
liaison
54
Purchasing Plan - Page 2
Section B – Needs
The participant’s name will automatically fill in from the
information provided on the first page
The plan’s effective date will automatically fill in from the
information provided on the first page
55
Purchasing Plan - Page 2
Section B – Needs – Column 1
Enter the date of the current Waiver Support Plan
Enter all needs and goals identified on the participant’s current Waiver Support Plan
56
Purchasing Plan - Page 2
Section B – Needs – Column 2
Enter all services and supports approved on the current Waiver Cost Plan
Enter the number of months for each
support or service
Enter the current Waiver Cost Plan
date
57
Purchasing Plan - Page 2
Section B – Needs – Column 2 (continued)
Enter the total number of units for each support or service
The average number of units per month is automatically calculated
and inserted in this box
Click on the box to open a dropdown box then select the type of unit in
Cost Plan for each service or support
58
Purchasing Plan - Page 2
Section B – Needs – Column 3
Enter each service or support the participant will be
purchasing to meet long term needs and goals
Enter the total number of units per month for each service or support
59
Purchasing Plan - Page 2
Section B – Needs – Column 3
Click on the box to open a dropdown box and select type of
unit in Purchasing Plan
Enter note if service or support is an OTE, STE, savings item or unpaid
natural support
60
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services
The service code box will automatically fill in the code when the service is selected
from the dropdown box
Click on the box to open a dropdown box then select a
service
If the service listed is critical, enter Y (yes), if not critical enter N (No). If yes is entered there must be a minimum of (2)
emergency back-up providers listed. EBU providers can only be listed for
critical services
61
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)• Direct Hire Employee (DHE) provider relationship numbers:
1 = Parent or step-parent 2 = Participant’s child or stepchild under age 21 3 = Spouse
4 = Person under 18 currently in high school (not participant’s child or stepchild) 5 = All others
Click on the box to open a dropdown box then select a
provider type
Enter the legal name of all providers. If the provider is critical, list at least
two (2) back-up providers on the lines directly underneath on the same page
Enter the provider relationship number by
opening the dropdown box and selecting the number
that applies
62
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)
Enter the number of units for each
service
Enter the cost per unit for each service
Click on the box to open a dropdown box
then select the unit type
Purchasing Plan - Page 3
Section C.1 – Budget Details - # of Units:• 22 weekdays in a month • Monday - Friday workweek
• 9 weekend days in a month • Saturday and Sunday workweek
• 31 calendar days in a month • Always plan for the maximum number of days in a month
63
64
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services (continued)
The sub-total automatically calculates
and the amount will appear in this box
Provider total cost automatically calculates
Employer taxes automatically calculate and the amount will appear in
this box
65
Purchasing Plan - Page 3
Section C.1 – Budget Details – Services – EBU Added Cost
Click here to calculate additional emergency back-up cost
If emergency back-up cost is calculated the amount will appear in
this box
Total monthly cost will automatically calculate and
appear in this box for primary providers
66
Purchasing Plan - Page 3Section C.1 – Budget Details – Services – Totals
The total amount of EBU added cost will appear here and also
appear in box for total estimated cost for EBU in
Section E
Total monthly costs for services will
automatically calculate and appear in this box
67
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies• Only one (1) supply type can be listed:
CMS – Consumable Medical Supplies (63)Select the supply type from the
dropdown box. Only one (1) type can be entered - CMS
When the service is selected, the service code will automatically
populate
68
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)• List all supply providers and detailed descriptions for each supply including quantity
Examples: Adult Large Diapers (96)
Adult Large Diapers (96), 1 case Wipes (6), 2 boxes Bed Pads (24) = 1 unit
Enter the number of units to be purchased
Enter the legal name of the provider where
supplies will be purchased
Enter a detailed description for each supply including quantity
69
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)
The total cost will
automatically calculate
Enter the rate for each supply listed
Enter the unit type
70
Purchasing Plan - Page 3
Section C.2 – Budget Details – Supplies (continued)
The total will calculate and insert in the box at the bottom of the total cost
column
Check box to indicate if additional page 3A is used to complete this
section
71
Purchasing Plan - Page 4
Section D – Budget Details – Cash Purchases - Discontinued
This option is no longer available
Option 1. Section E - Savings
Option 2. Section C.1 & C.2 – Services/Supplies
72
Purchasing Plan - Page 4
Section D – Budget Details – Cash Purchases – Total
In this area, enter an explanation on how purchases requested in Section E will meet the needs and goals or increase
independence. Also, enter any additional information that would assist APD staff in approving the participant’s
Purchasing Plan
73
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for Use of Accumulated, Unrestricted Funds
Enter the total amount of
unrestricted funds available
Enter the ending balance on the
current statement
Enter the most current statement
date (mm/yyyy)
74
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)
The total estimated cost amount is
forwarded from the Budget Detail
Services section EBU Added Cost total
Unrestricted funds made available for
savings plan purchases each month
The accumulated unrestricted funds must always be
reserved and available for use by emergency back-ups
75
Purchasing Plan - Page 5Section E – Savings Plan – Authorizations for use of Accumulated,
Unrestricted Funds (continued)
Click on box to open the dropdown box containing service code
numbers. Select the correct service code for the item or service listed
Enter each item or service description
Enter the legal provider name for each item or service
76
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)
Enter the unit type for the item or service to be
purchasedClick on the box to open a dropdown box.
Select the provider type for the item or
service
If provider is a DHE, click on the box to open a dropdown box. Select the
number that describes the relationship of the participant to the DHE named
Enter the number of units to be purchased for each item or
service
77
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)
If applicable, employer taxes will calculate. The amount will
appear in the employer taxes box
Enter the rate per unit for each item or
service
Sub-total will automatically calculate and appear in this
box
78
Purchasing Plan - Page 5
Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)
Enter the actual date the item was purchased.
(mm/dd/yyyy)
The total estimated cost amount for each
item or service will calculate and insert
here
Enter the estimated date the item will be
purchased. This will always be the last day of the month (mm/dd/yyyy)
79
Purchasing Plan - Page 5
Section F – Budget Detail – One Time and Short Term Expenditures
When item or service is selected the assigned
service code will appear in the service code box
Click on box to open a dropdown box. Select type
of expenditure – OTE or STE
Click on box to open a dropdown box listing items and services available for either OTE or
STE. Select the item or service to be purchased
80
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
If the provider is a DHE, click on the box to open a dropdown box. Select
the number that describes the relationship of the participant to the
DHE named
Enter the legal provider name for
each item or service Click on the box to open a dropdown box. Select the
provider type for item of services
81
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Enter rate in dollar amount for item or
service to be purchasedClick on box to open dropdown box. Select the unit for each item
or service
Enter the number of units to be purchased for each item or
service
82
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
The total budget for each item or service will
calculate and appear here
Sub-total will automatically calculate and appear in this
box
If DHE employer tax is calculated, the amount
will appear here
Slide 48
Purchasing Plan - Page 5
Section F – Budget Detail – OTEs and STEs (continued)
Enter the start date for each item or service
(mm/dd/yyyy)
Enter the end date (mm/dd/yyyy). This is the
same date as the end date of the item funding
84
Purchasing Plan - Page 6
Budget Summary
The authorized budget amount is automatically populated. It is the amount that was entered as the
monthly budget on the top of Page 1
The service and supplies amount is automatically
populated. It is the sum of Sections C.1 total and C.2
total of the Purchasing Plan
85
Purchasing Plan - Page 6
Budget Summary (continued)
The total monthly expenditures is the total
authorized budget amount
This section no longer applies and should not contain any numbers
The Savings Plan amount will automatically
populate. The amount is unrestricted funds made available each month in
Section E
86
Purchasing Plan - Page 6Signatures – Participant or CDC+ Representative
The participant or representative must print name then sign and
enter date signed on hard copy of form
87
Purchasing Plan - Page 6
Signatures – Consultant
The consultant must print name then sign and enter date signed
on hard copy of form
88
Purchasing Plan - Page 6Signatures – APD Staff
APD staff will review the purchasing plan. If the plan meets the participant’s needs and goals and is written correctly then APD staff will sign and date indicating
approval
89
Purchasing Plan - Page 6Signatures – APD Staff (continued)
Any exceptions will be indicated in the approval exception box. Follow-up by participant or representative is
required
Purchasing PlanSubmission Process
Participant Responsibilities:• Double-check all information• Minimum six (6) completed pages• Submit all required paperwork• Retain copies• Submit by 5th of the month
90
Purchasing PlanSubmission Process
Consultant Responsibilities:• Review for accuracy• Signs the Purchasing Plan• Submit by 10th of the month
91
Purchasing PlanSubmission Process
Area Office Responsibilities:• Review for accuracy and signatures• Ensures all documents enclosed• Submit by 20th of the month
92
Purchasing PlanApproval Process
CDC+ Central Office:• Reviews submitted documents
• Returns if revisions are needed
• Approves and processes documents
• Assigns provider identification (ID) numbers
• Contacts new participant with ID numbers and start date
• Provides approved Budget Summary copy
93
Developing a Purchasing PlanGROUP ACTIVITY
• Developing a Purchasing Plan using a Training Scenario• Developing a Quick Update• Signing off on both
94
Getting Claims Paid
•Directly Hired Employees•Time Sheets –(CDC+ Rule Handbook Appendix G-2)
•Vendors (AV, IC)•Invoice•Must be tracked – (Participant Notebook Appendix K (3,4)
•Rep Reimbursements (Savings, OTE/STE)•Receipt•Must be tracked – (Participant Notebook Appendix K (6)
95
•Bi-weekly payroll •Pay Schedule – (CDC+ Participant Notebook Appendix O (4))
•CDC+ work week (12:00am midnight Monday - 11:59pm Sunday)
•Payroll submission•Secure Payroll System – Web based•Interactive Voice Response – IVR•Call in – Customer Service
Getting Claims Paid, continued
96
Managing Monthly Budget
•Spend within CDC+ Monthly BudgetUse Calendar – Participant Notebook Appendix O (2)
Spend consistent with Purchasing Plan
•OvertimeNot good use of funds
•Reconcile Monthly Statements •Participant Notebook Appendix M (2)•Track current account balance between statements
97
Budget Mismanagement
•Budget mismanagement will lead to either
Corrective Action Plan (CAP) orNot “entitled” to a CAP before other sanctions can occur
Disenrollment and return to the Waiver
98
Overspending
•Purchasing supports or services greater than the amount that is authorized
•Insufficient funds in a consumer’s account result in claims being held until additional funds become available.
•Once held, claims will be reviewed in the following order: timesheets, invoices, reimbursements.
99
•A tool to assist participants or representatives to correct problems with mismanagement of the program as required by the 1915j State Plan Amendment.
•Developed and signed by participant and consultant
•To be developed immediately when participant/representative:• Purchases inconsistently with the approved Purchasing Plan• Overspends•Does not produce receipts upon request•Puts health and safety at risk
Corrective Action Plan (CAP) Appendix N,
100
Corrective Action Plan (CAP), continued
The CAP plan addresses
WHAT has happened/caused the problemHOW the participant/representative plan to correct the problemWHEN the problem will be correctedWHO is responsible for each step
101
•Voluntarily or involuntarily
•CDC+ Participant Information Update Form – (Participant Notebook Appendix D(XV11)
•CDC+ Account Close-Out Procedure- (Participant Notebook Appendix M(3)
Disenrollment from CDC+
102
Thank you
Ivonne [email protected]
850-417-8270
CDC+ Customer Service1-866-761-7043
CDC+ Website http://apdcares.org/cdcplus/ 103
Terms to Review
104
Roles and ResponsibilitiesCritical Service, Restricted Service,STE- Short Term ExpenditurePended claims,Rep ReimbursementCAP- Corrective Action Plan
Closing Activities
Final Q and A’s
Readiness Reviewhttp://apd.myflorida.com/cdc-plus/refreshform1.php
Evaluations
105
http://www.surveymonkey.com/s/2LGVKFV