Transition Information for HCS ProvidersMeeting 2

Heart of Texas Region MHMR CenterJanuary 21, 2010

MRA Service Coordination for Home and Community-Based Services

Introductions

Agenda Review Packet Information

Recap of November Meeting1. Meeting Outcome2. Review of Power Point

Revisiting Timelines & Activities 1. DADS

*Timeline*Training*Review of draft documents

2. HOTR-MRA

Review of Draft Provider Activities for April and May

Consumer/Family Communication

Transition Summary

Meeting Evaluation & Next Steps

Outcome of November Meeting

The initiation of a collaborative local

process for transition of HCS CM to MRA SC

Initial MeetingPower Point Topics

DADS Transition TimelineDADS Transition ActivitiesDADS Spring Training Locations (NEW)MRA Transition TimelineClarifying MRA, Provider and DADS Roles (from draft

rule)Differences between MRLA and MRA SCFAQs

Updated DADS Transition TimelineJanuary 2010 Proposed HCS and SC rules > MCAC & DADS Council for approval to publish in TX Registry. – was

approved by MCAC and sent to DADS Council (January 20?)

February 2010 Proposed rules published in Texas Register for 30 days.

March 2010 Public comments on proposed rules received and reviewed.

April 2010 Proposed rules revised as needed, response to public comment. Training for HCS Providers and MRAs begins.

May 2010 Training for HCS Providers and MRAs continues.

June 2010 Implementation of HCS & SC rule changes – HCS Case Management becomes MRA Service Coordination.

DADS 2010 Spring Training Locations

Region 20 ESC, 1314 Hines AvenueSan Antonio April 5 & 6

United Way of Greater Houston, 50 Waugh DriveHouston April 13 & 14

The Resource Connection, 1400 Circle DriveFort Worth April 19 & 20

Lubbock Memorial Civic Center, 1501 Mac Davis LaneLubbock April 29 & 30

The Power Center, 12401 Post Oak RoadHouston May 11 & 12

The Resource ConnectionFort Worth May 18 & 19

DADS Transition ActivitiesDADS preparation priorities prior to transfer of HCS case management:

Develop Program Handbook, forms & templates – includes PDP & Implementation Plan (IP); draft PDP and IP documents were distributed for comment at the P/P Coalition meeting in December; a number of documents, including MRA-SC Responsibilities section of the handbook, an HCS Contact information form for consumers, and a Notification of SC Disagreement form were distributed for comment at the January P/P meeting.

Make changes to CARE information system

Communicate changes to individuals receiving HCS services & their families – done through letter with consumer distribution date no later than December 7, 2009

Develop training for MRAs and HCS Providers -- scheduled

Support flexibility of HCS Provider transitional case management requirements – letter dated December 28 authorizing contracted Case Management

Short Review of Draft Documents

Person Directed Planning Template

Implementation Plan Template

MRA Service Coordination responsibilities draft

PDP Template: MRA Comments

The document requires a section that gives you a broad overview of the person, including likes and dislikes, strengths and successes.

The action plan section should also include DISCOVERY, with a summary of the process, what was learned through discovery, identification of appropriate outcomes, and barriers to outcomes.

Additional section for justification of Service Coordination.

Additional section for justification of contraindications (no day hab because of retirement/home schooling because of medical issues, etc.) and deliberations (agreements/disagreements).

IP Template: MRA Comments

Despite a desire to have a template that would promote a consistent format, the draft document is wide open. Our opinion is that it would benefit providers and the MRA equally to have a format that is not as wide open, remains individualized, and meets the needs outlined in the instructions to the draft template.

HOTRMHMR Action Plan template – review and comment.

There is a tremendous amount of work still to be done in all areas of this

transition.

MRA SC Responsibilities:Making sense of what is in the rule.

EXAMPLES:

2. II. B. Recommends that the SC be familiar with billing guidelines to facilitate “justifying supports and services”

Comment: This is a key area of confusion for delineating SC and Provider functions. The draft rule infers that the SC justify the type of service to be provided based on a desired outcome; the provider then justifies the amount of the service provided. Clarification is needed.

MRA SC Responsibilities:Making sense of what is in the rule.

(continued)EXAMPLES:

3. IV. A. bullet 4 States that the SC must monitor to determine whether an individual’s health and safety is ensured in the environments in which the individual frequents.

Comment: The SC should not be accountable for monitoring an individual in environments that are not related to HCS of non-HCS services and supports.

MRA SC Responsibilities:Making sense of what is in the rule.

(continued)EXAMPLES:

5. IV. D. 4 States that the SC is not responsible for providing the provider with a written review of their monitoring activities and documentation.

Comment: This implies that the MRA and the Provider are monitoring the same services separately, without input from each other. This is costly and inefficient duplication.

MRA SC Responsibilities:Making sense of what is in the rule.

(continued)EXAMPLES:

11. IX. B. C. States that the SC must ensure the HCS provider enters the suspension data in CARE screen C18.

Comment: This requirement, as worded here and in the draft rule, appears contradictory to the SC role to monitor the individual, not the provider.

MRA TRANSITION ACTIVITY

MRA TRANSITION TIMELINENovember 2009 Begin HCS CM transition meetings between Providers and MRAs – completed

November 18, 2009 Develop local case numbers for HCS consumers identified in DADS report –

completed December 28, 2009 Obtain access to Electronic Data Transfer System (EDTS) – completedDecember 2009 Develop MRA dedicated webpage to post information and updates on local

transition planning – dedicated page up December 7, 2009 at www.hotrmhmr.orgJanuary 2010 Educate local Advisory Boards, PNAC and Center Board of Trustees – PNAC

presentation made November 2009 Determine staff requirements – HCS service coordinators, supervisors & support Create Provider/MRA contact lists Select MRA HCS SC Supervisor – selection completed December 29, 2009

MRA Transition Timeline (con’t)

January, continued Create Job Descriptions for HCS-MRA Service Coordinators Revise Policies & Procedures as needed Develop HCS-MRA Service Coordination Training Plan, Curriculum, and Manual

February 2010Encourage provider sponsored consumer/family relation

meetings with the MRAMarch 2010 Post positions, interview and prepare for hire MRA HCS SCs

MRA Transition Timeline, (con’t)

April 2010 Begin training HCS SCs, including training provided by DAD Develop local training(s) for provider and MRA staff

With DADS and Providers, develop a process to manage May and June PDPs and IPCs

Assign SCs to HCS participant caseloads Begin establishing MRA consumer records

May 2010 Consumer Relations—HCS-MRA SC to begin building relationships with providers

and consumers

With DADS and Providers, develop a process to manage May and June PDPs and IPCs

(April, 2010)

1. No later than April 30, 2010, HCS Providers must complete annual MRRC Assessments, renewal IPCs and ISPs for all individuals who have MRRC and IPC expirations between June 1, 2010 and June 30, 2010.

2. No later than May 31,2010, HCS Providers must complete annual MRRC Assessments, renewal IPCs and ISPs for all individuals who have MRRC and IPC expirations between July 1, 2010 and July 31, 2010.

3. For ISPs beginning August 1, 2010 or later, HCS Providers and MRAs must conduct service plan renewal activities in accordance with the new process. (Beginning June 1, 2010 HCS providers must notify the MRA of individuals who have IPCs expiring in August and September to get the process started.)

4. All individuals receiving HCS services will be transitioned into the new service planning documentation process by August 31, 2011.

Encourage provider sponsored consumer/family relation meetings with the MRA

(to begin February, 2010)

Provider facilitation of consumer meetings to jointly discuss transition issues with the MRA.

Development of a “talking points” document to communicate a consistent message across the state

1. January 28, 2010 stakeholder focus group (tentative schedule).2. Brochure similar to the “Making Good Choices” brochure that explains available community services.

Where does clarity need to be provided? (Take notes)

Things to think about and remember: DADS published & updates FAQs to explain the transfer of HCS case management to the MRA:www.dads.state.tx.us/providers/HCS/faqs/casemanagementtransitionfaq.html

For FAQ updates, sign up for “Email Updates” through GovDelivery at DADS website.

Dads has developed a webpage specific to the HCS transition issue that can be accessed at:

http://www.dads.state.tx.us/hcscmtransition

Consumer lists: pulled directly from information in CARE; we used this list to create local case numbers; verify that these are ALL of your consumers; might be a good time to update info in CARE

MRA Service Coordination for HCSTransition Summary

Primary MRA goals prior to June 1, 2010 implementation: Clear delineation and common understanding of fundamental functions of the

MRA Service Coordinator & HCS Provider

Staffing, training & equipping MRA operations to provide qualified and consistent Service Coordination for HCS participants

Productive communications with the HCS Provider network to ensure effective long-term working relationships

Support for HCS participants & families to minimize service disruption and promote progress towards each person’s desired outcomes

Meeting Evaluation & Next Steps

What worked this meeting?

What should change in the next meeting?

What do we know now that will needto be discussed at next meeting

(Agenda Items)?