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MFP WEBINARJanuary 14, 2016

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Our goals for our MFP monthly webinars are:

n To provide training on key topics

n To better the lines of communication between you and us, the MFP staff

n To seek feedback on how to better the processes of MFP/waiver services for our participants

n To provide the opportunity to share successes and challenges as RTC’s and MFP transitions

Goals of our monthly webinars

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MFP Transition NumbersAs of January 14, 2016

215 referrals have been received72 participants have transitioned to date

(15 in 2014 and 53 in 2015 and 4 so far in 2016)

* The transition benchmark for 2016 is 77 transitions.

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Transitions – Proposed vs. Actual

Year Big SkyED

Big Sky PD

ID/DD Mentally Ill Adults

SED Youth

Total

CY2012 0 0 0 0 0 0

CY2013 0 0 0 0 0 0

CY2014 2 3 3 3 12 23

2014 Actuals

2 3 6 1 3 15

CY2015 5 10 5 3 24 47

2015 Actuals

21 21 3 8 0 53

CY2016 13/4 15 7 12 30 77

CY2017 15 22 5 12 34 88

Total 35 50 20 30 100 235

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Population Re-Institutionali

zed

Passed Away

Left by choice

Total

         DSD       1 MDC 0208

1      

PRTF 0208

       

PRTF 1915(i)

       

SDMI     1 1 Elderly 4 3 1 8Physically disabled

1 3 3 

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Total per category:

6 6 5 17

Transitioned But No Longer In Service

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Population  Completed 365

DSD  8 MDC 0208 5 PRTF 0208 3 PRTF 1915(i)

 

SDMI 1Elderly  Physically disabled

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Total Complete Transitions:

10

Completed 365 Days

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Housing Placements

Category 

MDC

0208

PRTF

0208

PRTF 1915

(i)

SDMI

Elderly

Physically

Disabled

Total

Group Home (4 bed or less)

2 2      1   5

Assisted Living

      4 19 6 29

Apartment

5     6 4 12 27

Home 2 1     2 6 11Total by Category

9 3   10 26 24 72

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Please remember that MFP Demonstration Services are available to the participant in addition to the waiver services they are receiving.

MFP Regional Transition Coordinator (RTC) – H0043/UA MFP Transition Services (Goods And Services) – H2016/UA MFP Peer Support Services – T2012/UA MFP Companion Services – S5136/UA MFP Information Technology – T1014/UA MFP Overnight Supports – S5116/UJ MFP Modifying Existing Vehicle for Accessibility – T2039/UA *MFP Substance Use Disorder Treatment Services – H0026/UA

Undefined at this time.

MFP Demonstration Services

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Definition:MFP participants living alone and needing supervision can have overnight or enhanced staffing to help support the transition for a limited time. Overnight or enhanced staffing supervision will be provided based on individual needs defined in the person centered plan. Generally this support will be available up to 30 to 45 days, unless extenuating circumstances warrant a longer timeframe.

Service Requirements:MFP Overnight Supports provide monitoring and/or supervision during the participant’s normal sleeping hours in the participant’s place of residence. Overnight support does not include hands on services. Overnight support may include 6-12 consecutive, nighttime hours during a 24 hour period. The support period must be at least 6 hours in length but cannot exceed 12 hours. Only one unit is allowed within a 24-hour period of time. The support provider can sleep but must awaken as needed to provide support as identified in the participant’s person-centered plan. If technological devices as pagers or “child” monitoring systems are used, the provider must be competent in the use of the device.

Support may be provided up to 30-45 days from the day the participant moves to the community.

Support may include: Monitoring Implementing the participant’s 24/7 backup Calling 911 in case of emergency

MFP Overnight Supports

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The participant must meet the following criteria: Lives alone in a community setting; Has a cognitive impairment, physical disability, or mental illness that requires overnight supports; Has no one available as an informal support during normal sleeping hours; Understands and agrees that the service is temporary and limited.

Overnight support shall not duplicate other waiver services. Personal care, nursing, and other hands on services should be billed under the appropriate State Plan/CFC or waiver service.Participants residing in an assisted living or a group home are not eligible for this support.This support shall not be paid while the participant is hospitalized, in a nursing home, or in any other situation where the participant can receive this service.The amount of overnight support approved and provided will vary based on the needs of the participant and has a limit within the person-centered plan.MFP Overnight Support cannot be provided by the consumer’s legally responsible relatives or those family members who normally provide the care.

MFP Overnight Supports

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It is the responsibility of the provider agency to ensure that a provider is appropriately trained under agency-based services or the consumer under the self-directed and participant directed programs. It is the responsibility of the case management team to define and arrange for any specialized training. All providers must meet state and licensure requirements for the services being provided.

Fees:MFP Overnight Support services require prior authorization. Services are limited to 30-45 days unless extenuating circumstances warrant a longer time frame. The person centered plan must document the need for additional services.

Unit of Service = 1 night (a minimum of 6 hours and a maximum of 12 hours). Limited to 30-45 days.Rate: $40

Procedure Code/ModifierS5116/UJ

MFP Overnight Supports

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Successful Transition StoryKate Anderson with Spectrum –waiver case management in Kalispell served as the RTC.

Participant transitioned from Polson Health and Rehab –to an apartment at St. Joe’s Assisted Living in Polson.

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Other ItemsQOL SurveysPlease make sure that the participants name is on the QOL invoice when submitted.The date the survey was administered needs to be reflected on the back page of the survey; and if there is a contact person for the participant, please fill out that information also located on the back page.FYI – Laurie Miller has been awarded the IFB to conduct Follow-up QOL surveys (11 and 24 month) across the state

Adaptive EquipmentAdaptive equipment is not an expense that is covered through MFP Transition Services but rather through the waivers Specialized Medical Equipment.

Assisted Living Selection FormUnder the MFP participant portion to fill out: The 3rd question: In the future would you be interested in moving out of the Assisted Living into a home or apartment yes or no.If yes would you like help applying for subsidized housing yes or no.If the participant in fact marks this as yes, we want to make sure that there is follow through to apply and/or locate affordable housing. The sooner this process is started the better.

MFP Cost SheetThe MFP cost sheet should be utilized for all transitions beginning January 1, 2016.

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Other ItemsHow to Bill for Failed Transitions A transition is unsuccessful if The Regional Transition Coordinator begins transition activities based on the date of the approval letter from the MFP program and receipt of “Informed Consent” signed by the participant or guardian and the participant does not move to the community for a minimum of one day. 

Unsuccessful transitions are those that fail to make it to moving day. Reasons for failure could include withdrawal from MFP, Medicaid/waiver ineligibility, hospitalization, decline, and death. Payment through MFP for an unsuccessful transition will consider factors such as duties performed under this service definition and amount of time spent on the transition prior to move. For example, if the majority of the duties have been completed, payment could be made for an unsuccessful transition. If some of the duties have been completed and an extensive amount of time has been spent, payment could be made for an unsuccessful transition. Payment for an unsuccessful transition will be approved and paid at the discretion of the MFP Program.  

The agency will directly invoice the MFP Program for the unit amount along with a W-9 if needed. Invoices will be sent to:SLTC-MFPPO Box 4210Helena, MT 59604

Next Webinar will be Thursday February 11th at 1:30 p.m.