Vendor Advisory Committee September 8, 2020 Retainer r (absence) - - PowerPoint PPT Presentation

SLIDE 1

Alternative Nonresidential Services During COVID-19

Vendor Advisory Committee September 8, 2020

SLIDE 2

Retainer r (absence) payments to provider ers

• f
• f nonresidenti

tial service ces s ended d on Aug ugust 31, 31, 2020 2020

SLIDE 3

Tradi ditional nal servi vices c conti tinu nue i if

Services are t the same a as t those provi vided before COV OVID-19 o

• r

Services are the same, b but provi vided t through r remote o

• r alternate

locations as a authorized t through D DDS D Direct ctive

SLIDE 4

The n next slide i is f from the DDS e DDS T Town Hal all l presentation tion on

• n Alternativ

ive Deliv ivery of

• f Non
• nresid

identia ial Se l Servic ices on

• n

Augu gust 28, t 28, 2020 2020

SLIDE 5

SLIDE 6

Infor

• rmation
• n on slides

es 7 to 16, from

• m the

DDS DDS Di Direct ctive 01 01-831 83120, 0, Policies s and and Proc

• ced

edures es for Ut Utilizing g Alternative e Non Nonres esiden ential During t g the COVI VID-19 Sta tate

• f Emergency

cy o

• n

n Aug ugust 31, t 31, 2020 2020

Pl Please note t that D DDS c continues to use “ “consumer” instead

• f t

the m he more e per person-cen enter ered ed “person s n served”

SLIDE 7

Alt lternativ ive deliv livery of f nonresidentia ial s l servic ices inc nclude udes

• a. S

Supports ts related ed to to minimizing t g the e e exposure to e to or i impact of COV OVID-19 o

• n the

e consumer er

• b. C

Comp mpletion

• n of
• f an

an in indiv ivid idual l as assessment of

• f s

skills kills, preferences, an and s service need eeds f for the c consumer er c. . Completion o

• f a

an i individualized ed s service e plan to to provide n needed ed servi vice ces f for t r the he consumer er

• d. Alter

ernative s e services es deliver ered ed to to t the c consumer er v via te telep ephone, e, v video eo o

• r o
• ther

er electronic ic c com

• mmunic

ication ion

• e. D

Del eliver ery of s supplies es o

• r other

er ite tems to to t the c consumer er’s h home n e needed ed to to provide e services es or s supports ts f. . Use o e of s f sel elf-gu guided ed t training a and e educational m mater erials s supplied ed to to t the consumer er b by the v e ven endor inte tended ed to s support t t the consumer er’s s service

SLIDE 8

Alt lternativ ive deliv livery of f nonresidentia ial s l servic ices inc nclude udes ( s (continued) d)

g.

• g. Skills training to

g to i individuals w within t the consumer er’s h househ ehold who a

• are s

specif ific ically ly design gnated ed to to s support t the c e consumer er

• h. Alter

ernative e services es p provided ed i in-per erson a at the e consumer er’s home me, i in a comm mmunity y set etting, or a at a a provider er’s f facility, m modified ed to c

• com
• mply w

ly with t the mos most prote tective s sta tate te or

• r

loc local l CO COVID-19 s safety ty gu guidelines in effect a t at t the e time t the s ser ervice i is to b be e deliver ered ed – Provider er s staff m f must b t be trained on C COVI VID-19 s safety p prec ecauti tions p prior to to t the d e deliver ery

• f
• f in

in-per erson s services es

• i. S

Supports ts for t tran ansit ition ion t to t

• the S

Self lf-Deter ermination Prog

• gram

am a and

• j. O

Other er modifications to to n nonres esiden enti tial s services es t that a are a e approved ed b by t the c consumer er that f t further o

• r a

achieve h his o

• r h

her er s ser ervice need eeds

SLIDE 9

Alter ernative e deli livery ry o

• f n

nonresid idential l services ces s shall b be p permitted ed wh wher ere t e the e pr provider c r certi rtifies s in w writing t to t

• the

reg egion

• nal c

center p prior

• r t

to s

• see

eeki king reimburse sement, t, t tha hat: t:

SLIDE 10

Certification Requirement

• a. T

The e provider h has en engaged c consumers a about t thei eir n need eed f for a and i interest i t in Alternati tive Servi vice ces a as an n option ion

• b. T

The e provider er h has a advised ed consumer ers o

• f t

the specific s step teps t they c can take i e if they disagr gree w ee with the A Alter ernati tive e Services es o

• ffer

ered ed b by t the provider er

• c. T

The e provider h has o

• r wi

will prep epare a an individual s ser ervice p plan t that s t specifi fies t the Alter ternative S e Services es i identified ed t through t the c consumer er engage gement

• d. T

The e provider er h has t trained ed staff o f on C COVID VID-19 s safety p prec ecauti tions prior to t the e del elivery o

• f

in in-per erson servi vice ces e.

• e. T

The provider er w will c continue to e to c comply with t the most p protec ective s e state o

• r l

local C COVI VID- 19 safety g guidel elines es i in effec ect a at t the t e time i e in-per erson s services es a are to e to b be deliver ered ed

SLIDE 11

Certification Requirement (continued)

• f. T

The e provider wi will m maintain a a spec ecifi fied phone number a and em email a address and b be e res esponsive d during t the e time s ser ervices are b e bei eing provided ed

• g. T

The e provider er w will m maintain d documen entation of s services es provided ed a as r required ed b by Title e 17 17 se section 5432 54326(a)(3)

• h. T

The e provid ider will ill main intain s staff to p

• provid

ide servi vice ces and

• i. T

The e provider wi will i iden enti tify o

• ne o
• r more o
• f the A

e Alternative Ser ervices t to b be e offe fered

SLIDE 12

Certification must be provided to the regional center prior to submitting the first claims for each vendorization that includes provision of Alternative Services. The provider shall update the certification only if there are changes to the Alternative Services offered prior to submitting claims.

SLIDE 13

Reporting Requirement

On or

• r before t

the e fifth d day of

• f ea

each m mon

• nth the p

e provid ider shall s submit it t to

• the r

reg egio ional cen enter a a written r n report for e each h vendo ndori rization of

• f t

the A e Alternativ ive S Ser ervic ices p provid ided f for

• r t

the e prior m mon

• nth.

This req equirement appli lies to

• any p

provid ider that p provid ides A Alternativ ive S Ser ervic ices t to

• on
• ne or
• r m

mor

• re

e consumers. The e initial r report, c covering t the p period of September 1, 1, 2020 2020 through Oc October 31, 31, 2020, s shall b be s subm bmitted d by by Novembe ber 5 r 5, 2020. Each r report rt shall include ude, b but n not b be limited d to to: a. The total n numbe ber o r of c cons nsum umers w with h service a autho hori rizations. b. Th The n e number of

• f consumers w

with ser ervic ice a authoriz izatio ions f for

• r tradit

itio ional ser ervic ices.

• 1. The n

e num umber er o

• f consum

sumer ers s who r recei ceived ed t tradi ditional s services. ces.

• 2. The n

e num umber er o

• f consum

sumer ers s who d did n d not r recei ceive e tradi ditiona nal s services. ces.

c. c. The n numbe ber r of cons nsum umers w with h service a autho horizations ns f for Al Alterna rnative Services.

• 1. The n

e num umber er o

• f consum

sumer ers s who r recei ceived ed A Alternative S e Services ces.

• 2. The n

e num umber er o

• f consum

sumer ers s who d did n d not r recei ceive e Alterna native S e Services ces.

• 3. The n

e num umber er o

• f consum

sumer ers s who r recei ceived ed e each ch t type e of Alterna native Service ce.

• 4. For each

ch consum nsumer er, t the e num umber of days an Alterna native Service ce was recei eived. ed.

d. Th The e provid ider’s v ver erif ific icatio ion of

• f c

com

• mpliance with t

the m mos

• st p

prot

• tectiv

ive s state or

• r l

loc

• cal

l CO COVID- 19 19 safety g guideli elines i in e effec ect at the time i e in-per erson s servi vices es w were d e deliv iver ered ed.

SLIDE 14

Rates effective November 1, 2020

Pr Prior to

• November 1, 2020, p

provid iders will b l be n e not

• tif

ified of

• f t

the m e mon

• nthly

ly r rate f for

• r Alternative

Servi vices, a along w with the d data a and met ethodology u used ed f for t the c e calcula lation. Fo For vendo dori rizations ns prior to March ch 2020, 2020, t the monthl hly u unit rate calculated by by the De Depa partment shall ll u use e the f follo lowing m met ethodology: : a.

• a. T

Tak aking the t total a amoun unt billed o d over t the 1 12 months hs e endi ding ng Februa bruary 2 2020, d divide ded by d by t the tot

• tal

l number of

• f con
• nsumer m

mon

• nths of
• f ser

ervice durin ing the 1 e 12 mon

• nth p

per eriod.

• b. Th

The e tot

• tal

l number of

• f c

con

• nsumer m

mon

• nths of
• f ser

ervic ice i is t the e sum of

• f the n

number of

• f c

con

• nsumers

receiving ng s services each m h month d h during the 1 12 months hs endi ding ng F Februa bruary 2 2020.

• c. R

Rate ate calcul ulations ns s shall only include ude m months hs i in w which r h reimbur bursement to the provider for a a consumer is gre reat ater t than z zero.

• d. Th

The e calcul ulation n shall inc nclude ude a adjus ustments for r rate c changes t that occurr urred duri ring ng o

• r

subseque uent t to the 1 12 months hs e endi ding Februa bruary 2 2020.

SLIDE 15

Billing for September and October 2020

• a. P

Provider ers shall use t e the e current a t auth thorized r rate a and ea each consumer er’s average ge monthly atten endance e over er the p prior 1 12 month ths ending F g February 2020 f for e each consumer er w who r recei eived ed A Alter ernati tive e Services es

• b. P

Provider ers shall n not s t submit r t rei eimbursement c t claims for consumers wh who did not r t rec eceive servi vice ces

SLIDE 16

Billing for November 2020 and subsequent months

• a. T

The e month thly u unit rate wi will be u e uniform f for a all consumers s ser erved b by t the p e provider wi with thin each vendorizati tion

• b. P

Provider ers shall u use e the m e month thly u unit t rate fo for each c consumer er w who r received ed Alter ternative e Servi vices

• c. P

Provider ers shall n not t submit r t rei eimbursement c claims f for c consumers wh who d did n not r t rec eceive servi vice ces

SLIDE 17

Transportation

OC OCTA wi will n need eed advance n noti tice when en p progr grams o

• pen

en f for t traditional s services es a and n need tran ansportation ion

SLIDE 18

Ancillary Day Program Authorizations

If If Alter ernative e Servic vices d day program s servi vices are a authorized, e effective Oc October 31, 31, 2020, 2020, R RCOC OC will cancel a authorizatio ions for t thes ese s e servi vices es:

• Service C

Code de 1 110, S Suppl pplemental Da Day S Service P Program S Suppo pport rt

• Ser

ervice C Cod

• de 8

880, T Transportation A Addit itio ional l – Componen ent

• Service C

Code 882, 882, T Transportation A Assistant If If traditio ional d day p program servi vices a are p e provi vided ed (in t the s same manner as prior t to COVID-19), 9),

• This inf

nformation m must b be i inc nclud uded d in t the i indi dividua dual s service p plan

• No

No c change t to 110, 110, 880 880 and 882 882 authorizations

SLIDE 19

Temporary Solution

• Avail

ailab abili lity of feder eral f funding f g for r ret etainer er paymen ents wa was tim ime lim limit ited

• Fed

ederal funding m must c t conti tinue

• Effec

ecti tive e Novem ember er 1 1, 2 2020, r regi gional center ers w will p pay t the m e monthly u unit rate f e for e each person s served ed w who r recei eived ed A Alter ternative S e Services es; a at t this time, e, t ther ere i e is no m minimum amount o

• f s

service r e required ed to to r recei eive t e the month thly rate e

• Alternati

tive Ser ervices d do n not t rep eplace t the t traditi tional p program t that t parents ts are u e used ed t to

• Paren

ents ts may s start s shopping g for other er provider ers w who a are a e able to e to a accommodate o e on-site te servi vice ces

SLIDE 20

Non-Day Program Options for Families

• Pers

rsonal Assistance W e Worker er A Administr trati tion ( (PAWA) ) – those f e families es w who have e someo eone w e who i is willing to g to t take e the p e per erson ser erved o

• ut o

t of t f the e home for several h hours ev ever eryday m may choose P e PAWA

• Res

espite i in lieu eu o

• f d

f day program

SLIDE 21

Next Steps

DDS DDS will c continu nue w working ng w with h stakeho holde ders on next s steps, i includi uding ng but n not limited to to:

• Mo

Monthly y report rting ng r requi uirements

• Iden

entifyin ing addi ditiona nal a accoun untabi bility and o

• utcome

e measures es

• Dev

evelo elopin ing, p posting and u d upda dating Freque quently As Asked Questions ns (FAQs) o

• n

its we website

• Roll
• llin

ing ou

• ut the

e Famil ily M Mem ember a and Self elf-Advocate E e Engagemen ent G Guide

• Techni

hnical As Assistanc nce and T d Traini ning

• Ongoing evalua

uation o n of Al Alterna rnative Ser ervices