oltl new consumer tip sheet - hcsis.state.pa.us · effective 11/13/2016, only independent...

OLTL New Consumer Tip Sheet

In the OLTL New Consumer registration process, Service coordination users might enter demographics and determine

eligibility for consumers. The clearance process, which is conducted only by Independent Enrollment Brokers, is used to

verify that a consumer’s information does not already exist in HCSIS and/or MCI (Master Client Index). Once clearance

is complete, the Service Coordinator enters the consumer demographic information. Finally, the OLTL enrolling agency

determines the consumer’s eligibility for waiver services.

1

Open Internet Explorer and type https://www.hcsis.state.pa.us into your

address bar

Login to HCSIS by clicking HCSIS Login and entering your username and

password

Effective 11/13/2016, only Independent Enrollment Brokers (IEBs) are to clear new consumers into HCSIS.

If you are an IEB, please follow the instructions given in IEB Clearance by Linking or Case Transfer - CHC Phase 1A, which is available in the HCSIS Learning Management System.

If you are an SC, you should not perform clearance. Your work with a new

participant might begin with entering demographic information – see Step 3, if

this is the case. Or, your work might start with setting up the participant’s plan

– see Step 13 if this is the case.

1

Clearance 2

HCSIS Login 1

https://www.hcsis.state.pa.us/


3

New Consumer

(ALT ID)

Navigate to Individual>Demographics> Alt ID

Click the [Add] button

Select MA as Identifier Type from the drop-down list

Enter the following information for the consumer:

MA Number

Effective Begin Date

Click [Save]

Repeat these steps for SSN, if it was not entered during clearance using

the same effective begin date as the MA Number

Click [Save and Continue]

2

If the consumer does not have an MA Number, skip this step and return to this step

when the consumer receives an MA Number.


4

New Consumer

(Demographics)

Navigate to Individual>Demographics> Demo


Current Living Situation

County of Residence

Home Phone

Enter any additional information as appropriate (optional)


3

The fields circled above are conditionally mandatory:

•If yes, Interpreter is needed for should only be entered if “Is Interpreter Needed”

is Yes

•If Other, please specify should be entered if Other is selected from If, yes,

Interpreter is needed for field

•If the user chooses Primary Language at Home from the “If yes, Interpreter is

needed for field, the Primary Language at Home field is conditionally mandatory


5

New Consumer

(Address)

Navigate to Individual>Demographics> Address

Enter the mandatory fields marked by (*)

Address Line 1

City

State

Zip

Click [Save]

Address Type (Select

Residential by typing the

letter R)


HCSIS uses DPW’s Geographical Information System (GIS) software to

validate and standardize an individual’s address in HCSIS. After clicking [Save],

an Address Verification pop-up window will appear, indicating that a similar

address was found

When users enter an address into an Address Line 1 field in this screen, the first 26 characters of the address are entered into the field. When the user saves the record, a GIS Address Verification window (see example above) may open to allow the user to use the GIS address. If the user accepts the GIS address, any remaining characters in the address beyond the first 26 are automatically entered into the Address Line 2 field, overwriting any entry that may already be there. Any characters that may be in the Address Line 3 field are deleted. If the user clicks the [Cancel] button in the GIS Address Verification window to not accept the GIS-validated address, the address persists in the field(s) as it was entered. Users who enter an address that must use Address Lines 2 or 3 should click [Cancel] in the GIS Address Verification window to keep those address lines.

4


6

Eligibility

Determination

Navigate to Individual>Eligibility> Elig. Determination to reach the Level of

Care screen

Enter the following information:

Level of Care Eligible

OBRA = ICF/ORC

Independence and Attendant Care/Act 150 = NF

COMMCARE = NF/ Special Rehab


Name of Determining Worker


If a consumer is also served by ODP, both ODP and OLTL can capture

eligibility information unique to their program office in HCSIS. OLTL will have

read-only access to a consumer’s ODP eligibility determination information,

via a new hyperlink, on the Level of Care, Service Preference, and

Waiver/Program Enrollment screens in HCSIS

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The Level of Care screen is not required for consumers in the Act

150 Program but should be recorded if available.


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Eligibility Service

Preference

Navigate to Individual>Eligibility> Elig. Determination – Service

Preference to reach the Level of Care screen


Service Preference Choice (Set to “Home and Community Based

Services”)



The Level of Care and the Service Preference screens must be completed

in one of the following scenarios:

6

Set Service Preference Choice to

“Home and Community Based

Services”


8

Eligibility

Determination

Navigate to Individual>Eligibility> Elig. Determination – Eligibility

Documentation

Click [Add] to clear the fields on the screen. Select a required form in the Form

Type field

Select the status of the eligibility document/form from the Status dropdown box

Completed – The document/form has been completed. Ultimately, all

required forms must have the completed status to continue with the eligibility

process.

Submitted - Only used when documents/forms need to be submitted to a

third party for review.

Received – This status is for internal use only and is used to indicate a form

has been received back from a third party



Click [Save]

Repeat these steps for each required form

When all the appropriate forms are completed, click [Save and Continue]

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9

Waiver Enrollment

Navigate to Individual>Eligibility> Elig. Determination – Waiver/Program

Enrollment


Waiver/Program Type

Waiver/Program Status (Select Pending from the drop-down list)

Point of Origin/Entry Process


Click [Save]

10

Waiver Enrollment

Navigate to Individual>Eligibility> Elig. Determination – Waiver/Program

Enrollment

Select Waiver/Program Enrollment from the “Go To” drop-down list, and click

[Go]. Note: If applicable, search for the consumer using the consumer’s first

and last name. The screen will appear with the consumer’s name in the blue

header at the top of the screen.

Select Submit to State in the Waiver/Program Status field

Click [Save]

8

Note: If a consumer is also served by ODP, both ODP and OLTL can

capture eligibility information unique to their program office in HCSIS.

OLTL will have read-only access to a consumer’s ODP eligibility

determination information, via a new hyperlink, on the Level of Care,

Service Preference, and Waiver/Program Enrollment screens in HCSIS.

SC Supervisor


11 Navigate to Tools> Alerts> Pending Alerts

Enrollment Follow the HCSIS menu path above or click on the alerts link on the HCSIS home

page

Under “Alert Search Criteria” select “Eligibility Reviewer Action” as the

“Subject”

Click [Search]

Find the Alert for the consumer

Click on the hyperlink labeled “An Individual's Waiver/Program enrollment records

is pending for enrollment decision”

The Eligibility Determination page will now be displayed for this consumer. The

menu path for this screen is “Individual > Eligibility > Elig. Determination >

Waiver/Program Enrollment”

Review the consumer’s Eligibility and Plan information as needed. (This will

involve navigating to additional screens.)

Select Enrolled in the Waiver/Program Status field

Click [Save]

12

Review Enrollment

Alert

Navigate to Tools> Alerts> Pending Alerts

Under “Alert Search Criteria” select “Eligibility Reviewer Action” as the

“Subject”

Click [Search]


Review the alert message “Eligibility Reviewer has made a decision on

Waiver/Program enrollment record”

Navigate to Individual > Eligibility > Eligibility Determination

Select Waiver/Program Enrollment from the “Go To” drop-down land click [Go]

Review the waiver/program status

9


13

Plan: Create Draft

Navigate to Plan> Plan Admin> Create Draft

Select the Waiver/Program Type from the drop-down list

Note: If this field is collapsed, and you cannot select a waiver, then the consumer

does not have a waiver/program enrollment record with a status of Pending,

Submit to State, or Enrolled


Proposed Start Date (Set this to the date the consumer is expected to

begin receiving services)

Proposed End Date (Set this to 6/30/20XX)

Category of Plan Changes (Select Plan Creation)

Click [Create Draft]

Optional: Continue to enter any additional plan details that are not required

by your organization

Note: If a consumer is also served by ODP, both ODP and OLTL can

capture a consumer’s Plan information unique to their program office in

HCSIS. In addition, OLTL can view a consumer’s plan created by ODP via

the Print Plan screen in HCSIS.

Verify the draft plan was created by checking to see if an Operation Successful

message appears at the top of the screen. If you do not receive an Operation

Successful message, an error has occurred and the draft plan was not created.

Read the error message at the top of the screen, address the error, and click

[Create Draft] again

10

Select Plan Creation

from drop-down

Do not attempt to create two draft plans with different waivers at the same time in separate tabbed Internet Explorer windows. Doing so could wrongly assign the waiver of one plan to the other plan. If you receive the error “Either waiver/program status is invalid or plan dates are out of waiver/program date

range” upon saving, double-check the waivers in both draft plans


14

Strengths

Navigate to Plan> Individual Preferences> Strengths

Select one of the following form the category drop-down:

Able to Access Supports

Able to Coordinate Services Independently

Good Communicator

Good Informal Supports

Other

Enter a description of the consumer’s strength as it relates to the drop-down

selection

Click [Save]

11

The mandatory fields on the Strength screen must be completed in

order to submit a draft for review


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15 Plan:

Employment/Volunteer

Information Navigate to Plan> Functional Information> Functional Level –

Employment/Volunteer Information

Select Employed, Volunteer or None from the Work Status drop-down list.

Note: If you enter None, skip the steps below and continue Plan Outcome

Enter the following information

Frequency (Select Fulltime or Part-time from drop-down list)

Position

Employer/Organization

Address

City

State

Zip Code

Phone

Answer Does Consumer have employment/volunteer goals?

If Yes is selected, enter goal information in the List

employment/volunteer goals text box

Click [Save]

12

Select Employment/Volunteer

Information from the Go to

drop-down

A consumer must have employment information in HCSIS in order to submit a draft plan. If the

consumer does not have employment information recorded in HCSIS, you will receive an error

message when submitting the plan


16

Household

Composition

Navigate to Plan> Functional Information> Household Composition -

Household Composition

Select age of other household members for the Age (in Years) drop-down

Select from the Relationship to Individual drop-down box

Click [Save]

Repeat steps for each additional member of the household


13

The mandatory fields on the Household Composition screen must be

completed in order to submit a draft for review


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Non-Waiver Services Navigate to Plan> Service & Support> Non-Wavier Services

Answer Yes or No to Are Non-Waiver/Program Services being received?

If yes, complete the following mandatory fields

Service Name

Start Date

Location

Responsible

Party

Agency Name

Related

Outcome Phrase

What are Current

Needs?

What Actions are

Needed?

Frequency and Duration

of actions needed

Click [Save]


14

Answer yes to see additional

fields on this screen

The mandatory fields on the Non-Waiver Services screen must be completed in

order to submit a draft for review


18

Plan Outcome

Navigate to Plan> Serv & Supp> Outcome Summary

Although not indicated as required entry with an asterisk, the following information

is required: Outcome Phrase, Outcome Start Date, Outcome End Date, and

Outcome Statement

Attendant Care Users:

Enter Independent Living in the Outcome Phrase field.

Click [Save].

Skip to Plan SSD

CSPPPD Users:

Enter an outcome in the Outcome Phrase field. Outcome phrases are

based on a consumer’s desires and represent the service goals of the

consumer, his/her family, and the support team.

Click [Save].

Continue on to Plan Outcome Action

15

Examples of Outcome

Phrases include Supports

Coordination and Daily

Living Services


19

Plan SSD

Navigate to Plan> Serv & Supp> SSD

Enter the following information into the Provider Service Search fields:

Provider (If known – this is not a required field)

County (SSD section)

Click [Search]

Select the services to add to the plan by clicking the checkbox to the left of the

service name(s). Be sure to reference the Contract Start Date on the SSD to

ensure you are selecting a service that fits within the plan dates.

Click [Add to Selected]

Repeat these steps for each provider

To add Vendor Services to the plan, continue on to Plan Vendor Services.

If vendor services will not be added to the consumer’s plan, click on Service

Details in the blue menu bar at the top of the screen to go to the Service

Details screen and skip to Plan Service Details

16

Note: When searching for services in the SSD screen,

use the Go To box to view “All” results or narrow

search criteria to show fewer services on the screen


20

Plan Vendor

Services

Navigate to Plan> Serv & Supp> SSD – Vendor Services

If you just finished adding provider services to the plan, use the “Go To” drop-

down list located in the upper right corner of the HCSIS window to select Vendor

Services.

Click [Go].


Provider (This is a required field)

County of Service

Click [Search].

17

Click on the vendor service that you

would like to add. Note: See tip

sheet 6.0 Vendor Services for

additional information on Vendor

Services.

Narrowing your search criteria by entering the full provider

name will show fewer services on the screen.


21 Navigate to Plan> Serv & Supp> Serv Dtls Click the Select circle for a service in the table at the top of the screen.

Plan Service Details Click [Edit] and the service will appear in the fields on the screen below the table

Highlight the appropriate outcome in the Related Outcome Phrase field


Total Annual Units

For any CSPPPD Waivers. Enter the number of annual units,

which previously would have been entered on the CSPPPD

update form.

For Attendant Care and ACT 150 the following formulas should

be used.

Units of Supports Coordination = Number of months left

in fiscal year including month of the start

Units of Attendant Care Service = (Number of weeks left

in year from consumer’s start date * Total permanent

hours * 4)

Expected Start Date (Set this to the date the consumer is expected to

begin receiving the service)

Expected Stop Date (Set this to the last day of the fiscal year 6/30/20XX)

Click [Save]

Repeat these steps for each service

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Note: Before continuing on to the next step, review the table at the top of the

Service Details screen. Be sure the table is complete and all details

(outcome, units, and service start and end dates) have been captured for

each service on the plan. If the table is incomplete, HCSIS will not allow you

to submit the plan for review and approval.


22

Plan Outcome Action

Navigate to Plan> Serv & Supp> Outcome Action

Note: If applicable, search for the consumer using the consumer’s first and

last name. The screen will appear with the consumer’s name in the blue

header at the top of the screen.

Complete the following fields:

Related Outcome Phrase

What are Current Needs

What Actions are Needed

Who’s Responsible

Frequency and Duration

Click [Save]

19

This step represents a CSPPPD process only and does not apply to Attendant

Care/ ACT150.


23

Submit Plan

Navigate to Plan> Plan Admin> Draft Plans

Search for the consumer’s plan by Last Name

Enter any comments/details by clicking View/Add Comments. A separate

window opens and allows multiple comment entries. Please see the Comment

Box Requirements Tip Sheet for more information about what details should be

provided here

Click [Submit Comments] to save comments

Click [Close] to return to the Draft Plans screen

Click [Submit] to submit the plan for review

Verify the draft plan was submitted by checking to see if an Operation Successful

message appears at the top of the screen. If you do not receive an Operation

Successful message, an error has occurred and the plan was not submitted.

Read the error message at the top of the screen, address the error, and click

[Submit] again

20

Note: Comments are viewable to all users who have access to view the

plan in HCSIS. Comments entered on this screen cannot be deleted or

modified. If necessary, a new comment should be added to clarify or

correct errors.


24

Review Plan

Navigate to Plan> Plan Admin> Pending Review/Approval

Enter any comments/details by clicking View/Add Comments. A separate

window opens and allows multiple comment entries. Please see the

Comment Box Requirements Tip Sheet for more information about what

details should be provided here.

Note: Comments are viewable to all users who have access to view the plan

in HCSIS. Comments entered on this screen cannot be deleted or modified.

If necessary, a new comment should be added to clarify or correct errors

Click [Submit Comments] to save comments

Click [Close] to return to the Pending Review/Approval screen

25

Approve Plan


Follow the HCSIS menu path above or click on the alerts link on the HCSIS

home page.

Under “Alert Search Criteria” select “ISP status set to pending review” as

the “Subject”

Click [Search]


Click on the hyperlink labeled “Individual plan is ready for final approval

from the state”

The Pending Approval / Review page will now be displayed for this consumer.

The menu path for this screen is Plan > Plan Admin > Pending

Approval/Review

Review the consumer’s Plan information as needed. (This will involve

navigating additional Plan screens.)

Click View/Add Comments to review the comments associated with the plan

Click [Approved]

21

Click [Save] to save the plan without submitting the plan, click [Reviewed]

to send the plan on for approval, or click [Pending Revision] to send the

plan back to the Service Coordinator for revision

Note: If you send the plan back to the Service Coordinator for revision, be

sure to explain why the plan needs to be revised in the comments.

SC Supervisor


26

Review Plan

Approval Alert


Follow the HCSIS menu path above or click on the alerts link on the HCSIS home

page.

Under “Alert Search Criteria” select “ISP Status Set to Approved” as the

“Subject”.

Click [Search]

Find the Alert for the consumer. The consumer plan has been approved and no

additional action is required

If no Alert can be found for the consumer.

Under “Alert Search Criteria” select “ISP status set to pending revision”

as the “Subject”

Click [Search]

Find the Alert for the consumer.

Click on “Individual plan requires revisions.”

Proceed to ISP Status Set To Pending Revision

If no Alert can be found

under either “ISP Status

Set to Approved” or “ISP

status set to pending

revision” no decision has

yet been made regarding

this consumers plan.

27

Plan Set To Pending

Revision

Navigate to Plan> Plan Admin> Pending Revision

Click View/Add Comments to review the comments regarding why the plan was

not approved.

Click [Revise]

Make the needed changes to the plan and resubmit

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oltl new consumer tip sheet - hcsis.state.pa.us · effective 11/13/2016, only independent...

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