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Welcome to Pre‐Registration Module 2 of the Office of Developmental Programs’ Provider Applicant Orientation. This module is the second in a series of modules to ensure that Applicants seeking to provide services to people with an Intellectual Disability [ID] and/or Autism Spectrum Disorder (ASD) obtain a basic understanding of how the Office of Developmental Programs (ODP) system works. The information in this module is a basic overview of person‐centered planning and the provider role in ISP development. It does not substitute for additional research using the resource materials available in this course. This material is presented so that you may learn as much about how the system works as possible to prepare for attending an in‐person Provider Applicant Orientation session. 1 PA Dept. of Human Services, Office of Developmental Programs Provider Applicant Orientation Pre-Registration Module 2 12-26-18

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Page 1: PA Dept. of Human Services, Office of Developmental Programs … · 2019. 2. 4. · Developmental Programs (ODP) system works. The information in this module is a basic overview of

Welcome to  Pre‐Registration Module 2 of the Office of Developmental Programs’ Provider Applicant Orientation.

This  module is the second in a series of  modules to ensure  that Applicants seeking to provide services to people with an Intellectual Disability [ID] and/or Autism Spectrum Disorder (ASD) obtain a basic understanding of how the Office of Developmental Programs (ODP) system works. The information in this module is a basic overview of person‐centered planning and the provider role in ISP development. It does not substitute for additional research using the  resource materials available  in this course. 

This material is presented so that you may learn as much about how the system works as possible to prepare for attending an in‐person Provider Applicant Orientation session. 

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PA Dept. of Human Services, Office of Developmental Programs Provider Applicant Orientation Pre-Registration Module 2

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This module is part of Step 1 shown on the slide. This is the second of six modules that must be completed before an Applicant can register for an in‐person session. 

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Remember that only the CEO/Executive Director should take the test that follows each module. 

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We suggest you keep written notes and questions as you review the information so that you can get the most out of the presentation and be prepared for the in‐person session. 

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An Everyday Life for most individuals requires collaboration and support from others. A team of committed friends and professionals explore individuals preferences and needs and document them in a plan. The Individual Support Plan [ISP] is a major tool of the service system. Its development process is person centered; an opportunity to really learn about an individual. The ISP is a roadmap of what services are to be delivered, by whom, when and how. Services to meet people’s needs are documented in the ISP which then becomes the source document for determining progress. It is also a source for payment based on approved and authorized services.  

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Person Centered Planning helps those who support the individual to understand what he or she needs and wants. It changes the dynamic present in most planning processes to stress the positives and the abilities of the individual and focuses the planning to assist the person in obtaining what is important TO the person, while balancing this with what is important FOR the person. 

The team relies on what the individual identifies as their personal preferences, needs and wants and what is important to them to write the ISP. Desired Outcomes are to be based on these factors. 

A good person‐centered plan should result in people working with an individual knowing and understanding the individual and why they are receiving the services being provided.  

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In 2000, ODP established one standardized plan to be used statewide – a plan that would facilitate person‐centered planning, and meet federal and state regulations. This plan is the Individual Support Plan (ISP). 

The ISP is developed when an individual is entering the waiver. Thereafter, the ISP is updated annually during the Annual Review ISP meeting or as needed in response to changing needs of the individual. Anyone who has been found eligible for ODP services and is receiving at least one service must have an ISP completed and entered into HCSIS. [HCSIS will be addressed in a later section]

The ISP is a comprehensive, integrated document that reflects what is important and meaningful to an individual to achieve or maintain in his/her life. It includes personal preferences, health and welfare needs, medical and functional information. The ISP incorporates assessment of needs,  and authorized services when services are necessary to address those needs.

Ultimately, the ISP must be meaningful in the context of a person’s life. 

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The joined circles above represent the parts of a standard ISP. The role of the team is to use this information to customize an individualized plan. 

For example, an individual who likes to sleep later in the morning but also has a personal desire to work. The team must design meaningful solutions, that recognize what’s important to the individual but also any health and safety risks that may need to be considered. The team needs to explore why does the individual sleep late?  Is s/he bored?  Could there be medications that may impact on the individual’s ability to work at an earlier hour?  Or,  in the absence of obstacles, why can’t s/he work 2nd or 3rd shift?   

The services and supports, once authorized, are required to be fully implemented by the provider[s] and be consistent with the plan. Providers must document the delivery of services and the progress being made. 

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The ISP team is a group of people that bring different perspectives and play different roles. Some are considered “content experts” – those who know the person best. These include the person him or herself, family, friends, neighbors, and many times, direct support professionals care staff. Others are considered experts on the process, such as Supports Coordinators who are responsible for facilitating ISP meetings and entering the ISP information into HCSIS, or provider staff who contribute valuable assessment data or information on progress. Together, this team shares a commitment to take action on what is important to a person, while maintaining health and welfare needs. The AE then reviews and approves/disapproves the ISP and authorizes approved services.

The planning team that shall participate in the development of the ISP typically includes the individual, the required provider staff, direct support professionals for a licensed provider and other people the individual chooses to invite. For unlicensed services, the individual, the supports coordinator and others invited by the individual are present.

There are specific ISP team requirements included in  55 Pa. Code Chapters 2380, 2390, 6400, 6500 licensing regulations. We will provide more information regarding licensing regulations on a later slide. For licensed services, at least three team members must be present for the ISP meeting. The program specialist is the only team member that is required at the team meeting from the provider, and must have knowledge of the individual and be prepared with information from others to contribute to the development of the plan. 

The individual receiving services has the choice to attend the meeting. 

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Providers are responsible for completing assessments and evaluations related to the individual as well as monthly progress notes that ensure service delivery is occurring with the quality, amount, type, frequency, and duration stated in the ISP outcomes, per service authorizations, and applicable regulations and policies. 

The waiver requires all providers to train their staff on the ISPs of the individuals you are supporting prior to providing these service. Additionally, staff must be trained annually and/or whenever there are changes to the ISP that affect implementation of the plan. Also see 55 PA Code Chapter  6100 §6100.14, relating to ISP training requirements. This is essential to assure staff know and recognize individual’s preferences as well as precautions when working with them. 

Providers are not required to develop their own separate ISP if the individual has an SC. However, if you do have an internal plan, it must be consistent with the individual’s annual ISP approved and authorized by the AE.

For licensed services, the ISP will be the first source of review to determine compliance with planning and assessment standards. Providers of service must participate in the assessment and planning process, including participation in ISP team meetings, and provide necessary information to the SC for incorporation into the ISP. Providers should maintain documentation of the submission of ISP information to the SC.  

The SC incorporates all of the information into the ISP then submits the plan to the AE, who authorizes the services. Note that, as a provider, you are responsible to ensure that all services and supports in the ISP are authorized prior to service delivery. Claims cannot be submitted or paid for services that have not been authorized on an ISP. 

Authorized Waiver services should begin within forty‐five (45) calendar days after the effective date of the Waiver enrollment date, unless otherwise indicated in the ISP (e.g. individual’s choice of provider delays service start, individual’s medical or personal situation impedes planned start date). 

Authorized services must also be implemented as written per the current approved ISP, including the type, amount, frequency, and duration listed in the ISP. Those responsible for service implementation are accountable for documentation to support the provision of services as per Department standards referenced in regulation 6100.226. Failure to document services that support claims for services rendered may lead to a return of payment, audit, sanctions, etc. [See Financial Management for more information on documentation requirements]

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Relate Shawn’s scenario on this slide and the next. 

Tell the story in as natural a way as you can without seeming to just read from the slide. Let participants read this portion of Shawn’s story as you tell it in a conversation manner. 

Advance the slide to the next in time with how you are telling the story.

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Continue relaying Shawn’s story. 

After you have finished reading Shawn’s story, reflect on the following questions: 

• What is important TO Shawn?• What is important FOR Shawn?• What information should a provider use when considering a referral?

• The individual’s preferences. • The individual’s needs. 

• Shawn has multiple needs. It is not necessary that Shawn choose only one provider for addressing her needs. A waiver individual can receive services from multiple providers. 

• Do these solutions reflect the values of Everyday Lives?

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Providers are obligated to render services according to the approved and authorized ISP. Providers are to ensure that the services the provider is authorized to provide is delivered in the amount, frequency, and duration as referenced in the individual’s ISP, even in the absence of the designated support person, when that absence would place the individual at a health and safety risk. According to Chapter 6100.223, “A back‐up plan to identify a needed support as identified by the PSP team if the absence of the designated support person would place the individual at a health and safety risk.”

Such plans are developed with the unique needs and risk factors of the participant in mind and discussed and shared with the individual and team. 

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In this section, we introduced ODP’s planning process. 

Reflect on what you learned about person‐centered planning and the ISP that is important to you as a prospective provider. Think about the specific services you intend to provide in the context of the following questions:

• All services and supports in the ISP must be authorized by the AE prior to delivering services. Services must be delivered as specified in the ISP and staff need to know the plan to be able to implement correctly. How will you ensure you and others in your organization are up to date on the most current ISP and ensuring you are delivering services according to the frequency, duration, and intended outcomes in the ISP?

• Shawn’s scenario highlights choice and control valued by individuals. How will your organization’s practices ensure you are aware of an individual’s choices and acting on them? How will your services ensure the person is in control? 

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Thank you for reviewing Module 2. 

Return to the Provider Applicant Orientation Course:• Complete the training confirmation.• If you affirmed that you have reviewed the information and are ready to take the test, you will see a link for Module 

2: Test. • Click the link to open the test. Answer all questions, then click the “submit” button and then “submit all and finish”.

After you submit your test responses, you will receive a score and feedback on next steps. If you passed the test, you will be able to proceed to the next Module. 

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