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Agenda. Summary of Revisions to 10/1/16 Rollout CRP Payment System Description Pre-Authorization (Review) Reimbursement for Services Rendered (Review) Case Flow for Employment Provider Services Forms Referral for Employment Provider Services CRP Plan for Employment Provider Services
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Agenda • Summary of Revisions to 10/1/16 Rollout • CRP Payment System Description • Pre-Authorization (Review) • Reimbursement for Services Rendered (Review) • Case Flow for Employment Provider Services • Forms Referral for Employment Provider Services CRP Plan for Employment Provider Services Progress Report for Employment Provider Services Employment Placement Report Employment 90+ Days Report
What has been revised since the 10/1/16 rollout? • Expanded grid of services and fees • Service definitions • Expanded to employment provider services (not just job development) • Added clarification on Progressive Employment and Pre-Employment Transition Services (Pre-ETS) • Job Development Plan Eliminated • Employment Detail Report replaced by two forms: • Employment Placement Report • Employment 90+ Days Report
FAQs Remote (Underserved) Areas: Definition • An area is considered remote (underserved) if there are two or less CRP agencies providing employment-related services to BRS clients in that area. Remote Area Travel Reimbursement • Reimbursement for remote travel is authorized at the rate of $30 per hour for Job Coaching Services and for Job Development Services provided in an identified remote (underserved) area. This must be added to the CRP’s contract.
FAQs • How Does One Qualify for Job Coaching and Job Development for Population Specific Certification/Competency? • Job Coaches and Job Developers may qualify for the higher hourly rate if they are competent in American Sign Language or a foreign language. This must be added to the CRP’s contract. • Contact christina.d.hardy@maine.gov for more information
FAQs Bonus Paid at Successful Closure • Bonuses paid at Successful Closure are paid to the CRP when a case is eligible for successful closure. For someone in supported employment, this means 90 days after the transition to long term supports, assuming that all other successful closure criteria has been met.
FAQs Substantial Gainful Activity (SGA) Bonus Payment (SSI/SSDI Beneficiaries) • SGA earning levels are substantiated initially by the CRP and documentation is submitted to the VRC to confirm that the SGA earning level has been met for at least three months and that the CRP expects that earnings are to continue. • The VRC will issue a confirming authorization to a CRP for $1,000.00, if the SGA earnings level ($1,170 gross per month Non Blind; $1,950 gross per month Blind in 2017) is met for clients receiving SSI/SSDI benefits.
Pre-Authorization (Review) • The requirement for pre-approval of Authorizations can disrupt the flow of services • Crucial that on-going client services, such as job coaching, not proceed longer than a one month period of time without an Authorization for Payment. • Should the CRP continue to provide services beyond a one month period of time without pre-authorization and the corresponding Authorization for Payment, the CRP will not be reimbursed for the services provided for that month and any following month.
Reimbursement for Svcs Rendered(Review) • The authorization for payment/invoice and associated reports must be received in the local BRS office as soon as possible after the service has been completed but no later than ten days after the end of the month in which the service(s) was provided. • At the discretion of the Regional Manager, payment of the authorization/invoice may be processed but no more than 60 days after the date of service has been completed/provided. • Authorization for payment/invoices received more than 60 days after the service has been provided will not be honored. • Exception: Should an error in the issuing of an Authorization for Payment be made, sufficient time will be provided to process the Authorization and submit for processing the payment.
Selection of CRP • Client selects CRP via Client Choice Meetings or CRP Fair • For Progressive Employment clients CRP selected via Jobsville meeting (with client approval)
Referral to CRP-Form Form: Referral for Employment Provider Services • CARNs (Comprehensive Assessment of Rehabilitative Needs) Info now required • Referral form lists services requested • Required Documents to be sent include signed Release, IPE, other supporting documents • Authorization for Payment not included Form Review
Referral to CRP-Meeting • VRC and CRP meet in person (preferred) or via phone or video conferencing • Review CARNS info, IPE, specific services to be authorized for the next 3 months • Schedule time for 3 month review
CRP Intake Meeting & Plan for Employment Provider Services • After Referral Meeting CRP meets in person with client to complete intake process and together write CRP Plan for Employment Provider Services • CRP provides a copy of the plan to the client and submits plan to VRC which includes request for prior authorization of services and hours for the first 1-3 months. Services requested should match those agreed to in Referral Meeting or provide explanation. • Form review
Pre-Authorization of Services • The VRC will submit a Request for Authorizations form to Support Staff to create up to 3 authorizations for payment, one for each month, as outlined in the CRP Plan for Employment Provider Services. Support staff will forward them electronically to the CRP.
Exception: Progressive Employment and Pre-ETS • The REFERRAL MEETING is required for all Employment Provider Services with the exception of Progressive Employment and Pre-Employment Transition Services. For these two services an Authorization for Payment will be included in the referral packet. • The CRP PLAN FOR EMPLOYMENT PROVIDER SERVICESis required for all Employment Provider Services with the exception of Progressive Employment and Pre-Employment Transition Services. The CRP and VRC will come to agreement on the services to be provided but the CRP Plan is not required.
Progress Report and Authorization for Payment • CRP will submit electronically at the end of the month after services have been rendered: • Progress Report for Employment Provider Services; and • Completed Authorization for Payment • VRC will review and approve these documents, if appropriate, and submit the authorization to Support Staff for payment processing. • Form Review
Mtg to Review Progress Reports for Emp. Provider Svcs (3 mos)New CRP Plan for Emp. Provider Svcs.
Progress Reports Submitted Monthly Progress Reports for Employment Provider Services will continue to be submitted monthly with applicable authorization for payment.
Mtg to Review Progress Reports for Emp. Provider Svcs(6 mos)New CRP Plan for Emp. Provider Svcs.
Employment Placement • The CRP will email (and call) the VRC in order to notify them that the client will be placed in a job (firm job offer) along with the anticipated start date and the CRP will submit the Employment Placement Report. • Form Review
Employment 90+ Days • Once the client has been successfully placed for at least 90 days, and has received Long Term Supports (if applicable) for at least 90 days, and is stable in the position the CRP will submit to the VRC the Employment 90 + Days Report • Form Review
SSI/SSDI Recipients at SGA Earnings Level • If the clients is receiving SSI/SSDI benefits and has been earning Substantial Gainful Activity (SGA) for at least 3 months, and are expected to continue, CRP is eligible for a SGA bonus. • CRP must submit documentation of SGA to the VRC. VRC will then request confirming authorization for $1000 bonus.
Point of Contact Questions related to the CRP Payment System and Case Flow for Employment Provider Services can be directed to Christine Robinson – BRS Director of Quality Assurance Christine.c.robinson@maine.gov