Case Management, Waiver Coordination (Direct Care Supervisor)/Supportive Living

1. Case Management, Waiver Coordination(Direct Care Supervisor)/Supportive Living

2. Role of Case Manager Location, coordination and monitoring of: • All waiver services • State plan services • Medical, social, educational and other public funded services • Informal community supports

3. Intent of Case Management To enable persons to receive services/support that are • Planned • Coordinated • Efficient • Effective

4. Case Management Activities • Arranging for services and supports • Monitoring services and supports • Facilitating crisis intervention • Guidance and support • Case planning • Needs assessment • Follow along to assure quality of care

5. Case Management Activities • Assistance with eligibility paperwork – Medicaid and ICF Level of Care • Assisting with appeals for service denials • Arranging for access to advocacy services • Assuring advance submission plans of care/revisions and eligibility paperwork • Assuring integrity of case management billing

6. Case Manager Role in Assessment/Evaluation Process • Find out individual’s needs and preferences • Help identify other needs • Explain options for meeting needs including formal and informal supports

7. Case Manager Role in Service Plan Process • Translates assessed needs to a plan based on assessed needs and wants • Coordinates supports needed with other entities/persons • Monitors quality and appropriateness of supports and consumer satisfaction • Assist in developing emergency back up plans

8. Levels of Support 24/7/365 • Pervasive – constant support 24 hours a day, 7 days a week – 1 visit and one other contact each month • Extensive – daily or weekly supports less than 24 hours a day, 7 days a week – one visit each month • Limited – intermittent support – one visit each quarter with one contact each month

9. Role of Direct Care Supervisor–Supportive Living Direct Care Supervisor is responsible for • Assuring delivery of all supported living direct care services • Coordination of all direct service workers • Liaison between person, case manager and DDS • Coordination of schedules for waiver and generic services

10. Role of Direct Care Supervisor–Supportive Living (cont) • Preparing direct service provider information for plan • Assuring integrity of billing • Arranging for alternative living settings • Assuring transportation in plan • Assuring advance plans/revisions and eligibility information (ICF Level of Care and Medicaid)

11. Role of Direct Care Supervisor–Supportive Living (cont) • Medication Management Plan • Positive Behavior Plan for psychotropic's given for behavior • Assure direct care staff are adequately trained