Post on 31-Mar-2015
Individual Assisted Living Planning
and Rate Negotiation Tool
Testing Version
Sponsored byAging and Adult Services
MN Department of Human Services
Testing 1…. 2….. 3…. Testing 1…. 2…. 3….
2
To Access Documents
www.dhs.state.mn.us/agingint/Services/commrescdev.htm
Stored as PDF documents.
Download Acrobat Reader 5.0 to view
3
Testing Version
Looking for counties and providers– To learn how to best use this tool.– Best applications and limitations of this tool.– How to improve its performance so that it works well for the
intended users.
– If interested, email darlene.schroeder@state.mn.us
Anticipate additional video conference training in September based on input and feedback.
4
Why? Why now?
Quality Assurance - – Need to be accountable for EW/AC
expenditures.• Demonstrate link between individual need and
services provided.• Delineate services purchased and the amount
of each.• Assure AL/AL+ is as cost-effective a manner of
purchasing services as fee-for-service.
5
Individualized Plan
Assessed
Need
Service
Rate
Units X Negotiated Component Rate
6
Residential Care Expenditures EW Program
2000Total R.C. $20,000.000
% of Total 37 %
AL $ 3,400,000
AL+ $ 9,500
RC $ 7,400.000
Corp AFC $ ----
Family FC $ 9,000.000
2002Total R.C. $42,000.000
% of Total 51 %
AL $ 2,300,000
AL+ $33,000,000
RC $ 480.000
Corp AFC $ ----
Family FC $ 6,000.000
7
Technology
Designed to Link with Screening Document
Requires Acrobat READER to see form.– (Allows you to enter data, but not save it.)
Requires Full Adobe Acrobat or Acrobat Approval 5.0 to save data
8
The Tool
What it is.
Individualized care planning tool
Calculates rate based on planned services
What it isn’t.
Doesn’t “Set” rates
Doesn’t create a base set of services
9
Three Documents1. Information on Proposed AL AL+
Services
2. A Worksheet for Computing the Costs
of Supervision
3. Individual Assisted Living Planning
and Rate Negotiation Tool.http://www.dhs.state.mn.us/agingint/Services/commrescdev.htm
10
Process
Provider Completes
“Information on
Proposed AL AL+
Services”
County and
Provider
Negotiate Component Rates
Agreed Upon
Component Rates
are applied to Individual Assisted Living Plan
11
Information on Proposed AL AL+ Services
Basic Information About Provider
Proposed Component Rates
Identification of Proposed Services
Description of Socialization and Supervision Services Available
Completed by provider for each site
12
Computing a Rate for Supervision Services
This worksheet is an example of how supervision rate might be developed.
– Avoid duplication of payments for supervision and other AL services.
– Account for staff time providing needed supervision when no other AL/AL+ services are being provided
13
County and Provider Negotiate Component Rates
14
Agreed Upon Rates are Entered on Individual Assisted Living and Rate
Negotiation Tool
Page 4 - Negotiated Component Rates
Suggestion: Develop “Naming Convention” e.g.– Save Pages 2 - 4 containing provider information under
provider site name
– Save Individual client data under their PMI or name followed by date
15
Reminder….HIPAA Compliance
Work processes that are changing to electronic documents and data
streaming need to be HIPPA compliant.
Check with your HIPAA compliance person.
16
Import Client Data
Open “ABC Assisted Living”
Choose File-Import-Form Data
Double click on the Form Data file name that you wish to transfer to the Tool.
– Note: You must “tab through” the document to populate fields
Voila!
17
Magic….. Client information automatically populates
– either from the screening document
– or from the first time entered anywhere on the form
Assessment score is pulled from the Screening document (or can be entered manually)
“Standardized description of need” and “Typical level of AL/AL+ service” populates automatically once assessment score is entered.
“$ per month” automatically computes rates based on frequency and negotiated rates
18
Complete Individual Plan
Navigation Tips– Tab through fields on the page or use
mouse and click on desired field
– Click on Back or Next Arrows to change page
– Click on Home to access Page Menu
19
Case Manager Enters
Assessment item scores (if not linked to screening document).
Describes individual need and preferences.
Indicates if all or part of need is met outside of the AL package.
Indicates frequency/# of units.
Provides additional information, if needed.
Click on “next arrow” or home to navigate to other page.
20
Special Features
Laundry– Cost per load and/or time to assist
Socialization– Guides process with fields for *Outcome
*Goal *Activities *Frequency *Support Needed
21
Special Features (cont’d)
Medications– All services related to meds are on one
page– Allows for a variety of options
Dressing and Grooming– Integrated as tasks are usually done at the
same time.
22
Special Features (cont’d)
Meal Preparation– Offers option for congregate meals and/or
assistance in preparing individual meals
Communication, Hearing and Vision– Offers space to indicate needs
23
Supervision
Pulls information from related domains and indicates whether there is documentation of the need for supervision
Fields provide the basis for describing the supervision needed by the individual
24
Rate Calculation Need to enter data
– Client program code to generate case mix cap– Total for other authorized service
If Rates for proposed AL/AL+ services exceeds service limit or individual cap– Look for duplication of planned services.– Double check case mix for accuracy– Re-examine other services authorized– Re-examine number of units authorized– Re-think negotiated component rates.
25
More Magic
Summary is automatically generated.
Final Rate calculation
Documentation of supervision needs is pulled from various fields (wheeling score must be entered manually)
26
Questions/Input/Feedback
Component Rates
Technical glitches with the tool
User friendliness of tool
Potential uses
27
Forming a Work Group
Interested counties and providers
If interested, contact– darlene.schroeder@state.mn.us
28
Questions?
29
Thanks for coming!