Guidelines Support Planning - Louisiana

1 Page 1 Guidelines for Support Planning Applicable to the New Opportunities Waiver Office for Citizens with Developmental Disabilities Louisiana Department of Health and Hospitals Issued: September 25, 2012 Version 7 Effective September 25, 2012 Original Issue date: January 24, 2009 Guidelines for Support Planning Page 2 Table of Contents Section Subject Click to go to section Introduction: Acronyms, Terms, and Definitions 1 OCDD S Support Planning Process Overview Planning Values Planning Assumptions Support Planning and the Louisiana Resource Allocation System Use of the Guidelines 2 New Opportunities Waiver Offer Activities Letters to Participants on the Request for Services Registry or those Receiving an Emergency Option or Transition from Supports and Services Center Completion of the 90-L Request for Medical Eligibility Determination Follow-Up of NOW Offer Letter Mailings Selection of a Support Coordination Agency Linkage to Support Coordination Scheduling the Supports Intensity Scale (SIS)

2 And the Louisiana Plus (LA PLUS) Establishing the Person s Acuity Level Attachments New Opportunities Waiver Offer - Request for Information Waiver Acceptance/Inactive/Declination Status Form Request for Medical Eligibility Determination BHSF Form 90-L Support Coordination Choice and Release of Information Form BHSF Form 90-L: Physicians Letter and Instructions Request for Removal from Inactive Status Key: Supports Intensity Scale (SIS) Rating Guide Guidelines for Support Planning Page 3 3 Completing Discovery Activities for the Support Plan Beginning Discovery Using the SIS/LA PLUS for Planning Completing Discovery (Using the Personal Outcomes Interview/Mapping/ Discovery Meeting)

3 Developing a Personal Vision and Goals Establishing the Support Team Meeting Preparation Attachments Personal Outcomes Worksheets - Support Plan Format 4 Developing the Participant s Support Plan Facilitating the Planning Meeting Developing Plan Strategies and Actions Using Natural and Community Supports Attachments Support Plan Format 5 Planning for the Use of Recommended IFS Hours Working within the Recommended Hours Using the Conversion Table to Establish a Typical Weekly Schedule Planning for Known and Predictable Deviations from the Typical Schedule Planning for Unpredictable Deviations from the Typical Schedule: Flexible Hours Using the IFS Flex Conversion Table with Flexible Hours Management Planning Examples When Additional IFS Hours are Needed Justifying the Need for Additional IFS Hours Requests for Additional IFS Hours.

4 Expectations of Support Coordinators and/or Support Teams Guidelines for Support Planning Page 4 Attachments Recommended of IFS and Day Program Hours by Level - Lives with Family Recommended of IFS and Day Program Hours by Level - Lives Independently Conversion Table Weekly Schedule and Budget Pages with Instructions IFS Flex Conversion Table 6 Using Shared Supports Benefits of Sharing Supports General Requirements for Sharing Supports Requirements when Sharing Supports in Casual/Everyday Situations (Non-Roommate) Requirements for Sharing Supports Among Roommates NOW Protocol for Support Coordination and Sharing IFS Supports Roles and Responsibilities of the IFS Provider with Service Delivery of Shared Supports Roles and Responsibilities of the Participant when Sharing Supports When Not to Share Supports Using Intermittent Supports Attachments Shared Supports Brochure HIPAA 404P Documentation for Authorization of Shared Staff and Release of Information for New Opportunities Waiver (NOW)

5 7 Support Plan Approval Process Supervisory Review OCDD Regional Waiver Office Review Guidelines for Support Planning Page 5 OCDD Guidelines for Planning Regional Office Review Committee OCDD Guidelines for Planning State Office Review Committee Attachments Individual Supports Review (ISR) Individual Support Plan Approval Guidelines form 8 Implementing the Participant s Support Plan Support Plan Approval: Activities for Implementation Providing Training to Family and Staff Identifying and Securing Needed Resources Documentation of Implementation and Collecting Data/Information Family Members as Staff Attachments Support Plan Revision Request Form Provider Guidelines Instruction Sheets Skills Training Data Sheet Seizure Report Weight Log Meal/Fluid Log Bowel Log Medication Side Effects Assessment

6 Psychiatric Symptoms Assessment Menstrual Chart Sleep Log Challenging Behavior Chart Behavioral Incident Report (ABC) Guidelines for Support Planning Page 6 Graphic Schedule 9 Review and Modification of the Participant s Support Plan Purpose of Monthly Calls in the Plan Review Process Preparing for the Quarterly Review Completing the Quarterly Review Using the Quarterly Quality Review to Document Progress Using the Quarterly Review for Annual Planning Urgent Meetings to Address Crisis Issues

7 Attachments Quarterly Quality Review 10 Appealing Denials of Services Disenrollment, Decertification, and Discharge Procedures Denial of IFS Hours Attachments BHSF Form 142 Notice of Medical Certification 11 Training and Certification Processes Training for the SIS/LA PLUS Assessors Certification in the use of the SIS/LA PLUS Certification Step 1: Classroom Training for the Guidelines for Support Planning Certification Step 2: Support Plan Completion Consistent with the Guidelines for Support Planning Designation and Requirements of Master Trainers Attachments 12 OCDD Quality Monitoring Process Relevant Policies and Requirements Guidelines for Support Planning Page 7 Support Planning Quality Monitoring Process Establishing and Monitoring Performance Indicators Responsibilities for Assuring the Quality of Support Plans and Delivery of Services Attachments 13 Frequently Asked Questions Assessments

8 Planning Shared Supports Resource Allocation General Questions APPENDICES 14 APPENDIX: Development of Louisiana s Resource Allocation System Selection and Testing of the Needs Assessment Linking the Needs Assessment to Resource Use Validation of the Model Framework for Louisiana s Allocation of IFS Hours Programmatic Assumptions for Each of Seven Levels IFS Hours Allocated to Each Level Resource Allocation for Participants Under 16 Years of Age Attachments Recommended IFS and Day Program Hours by Level - Lives with Family Recommended IFS and Day Program Hours by Level - Lives Independently Guidelines for Support Planning Page 8

9 Conversion Table 15 APPENDIX: Emergency Protocol for Tracking Location Before, During, and After Hurricanes 16 APPENDIX: NOW Resource Allocation Phase-In Plan Beginning July 1, 2009 Guidelines for Support Planning Page 9 ACRONYMS, TERMS, AND DEFINITIONS CPOC Comprehensive Plan of Care is the Support plan format currently used in the NOW. The CPOC format is included as an attachment in Section 4. Day Hab Day Habilitation Day Program Day Habilitation services provide participants, age 18 years or older, with assistance in developing social and adaptive skills necessary to enable them to participate as independently as possible in the community.

10 It allows for peer interaction, meaningful and age-appropriate activities, community and social integration, which provide enrichment and promote wellness. It includes the assistance and/or training in the performance of tasks related to acquiring, maintaining, or improving skills including but not limited to: personal grooming; housekeeping; laundry; cooking; shopping; and money management. Day Habilitation services are provided in a community-based setting focused on enabling the participant to attain or maintain his or her maximum functional level. Day Habilitation services shall be coordinated with any physical, occupational, or speech therapies or employment listed in the participant s approved Plan of Care.