Resource Allocation Guidelines for Support Planning

337 Pages·2012·4.83 MB·English

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
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Guidelines for Support Planning
Table of Contents
Section Subject Click to go to section
Introduction: Acronyms, Terms, and Definitions
1 OCDD’S Support Planning Process Overview
1.1 Planning Values
1.2 Planning Assumptions
1.3 Support Planning and the Louisiana Resource Allocation System
1.4 Use of the Guidelines
2 New Opportunities Waiver Offer Activities
2.1 Letters to Participants on the Request for Services Registry or those Receiving an
Emergency Option or Transition from Supports and Services Center
2.2 Completion of the 90-L Request for Medical Eligibility Determination
2.3 Follow-Up of NOW Offer Letter Mailings
2.4 Selection of a Support Coordination Agency
2.5 Linkage to Support Coordination
2.6 Scheduling the Supports Intensity Scale (SIS) and the Louisiana Plus (LA PLUS)
2.7 Establishing the Person’s Acuity Level
2.8 Attachments
2.8.1 New Opportunities Waiver Offer - Request for Information
2.8.2 Waiver Acceptance/Inactive/Declination Status Form
2.8.3 Request for Medical Eligibility Determination BHSF Form 90-L
2.8.4 Support Coordination Choice and Release of Information Form
2.8.5 BHSF Form 90-L: Physicians Letter and Instructions
2.8.6 Request for Removal from Inactive Status
2.8.7 Key: Supports Intensity Scale (SIS) Rating Guide

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Guidelines for Support Planning
3 Completing Discovery Activities for the Support Plan
3.1 Beginning Discovery Using the SIS/LA PLUS for Planning
3.2 Completing Discovery (Using the Personal Outcomes Interview/Mapping/
Discovery Meeting)
3.3 Developing a Personal Vision and Goals
3.4 Establishing the Support Team
3.5 Meeting Preparation
3.6 Attachments
3.6.1 Personal Outcomes Worksheets - Support Plan Format
4 Developing the Participant’s Support Plan
4.1 Facilitating the Planning Meeting
4.2 Developing Plan Strategies and Actions
4.3 Using Natural and Community Supports
4.4 Attachments
4.4.1 Support Plan Format
5 Planning for the Use of Recommended IFS Hours
5.1 Working within the Recommended Hours
5.2 Using the Conversion Table to Establish a Typical Weekly Schedule
5.3 Planning for Known and Predictable Deviations from the Typical Schedule
5.4 Planning for Unpredictable Deviations from the Typical Schedule: Flexible
Hours
5.5 Using the IFS Flex Conversion Table with Flexible Hours Management
5.6 Planning Examples
5.7 When Additional IFS Hours are Needed
5.8 Justifying the Need for Additional IFS Hours
5.9 Requests for Additional IFS Hours: Expectations of Support Coordinators
and/or Support Teams
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Guidelines for Support Planning
5.10 Attachments
5.10.1 Recommended of IFS and Day Program Hours by Level - Lives with
Family
5.10.2 Recommended of IFS and Day Program Hours by Level - Lives
Independently
5.10.3 Conversion Table
5.10.4 Weekly Schedule and Budget Pages with Instructions
5.10.5 IFS Flex Conversion Table
6 Using Shared Supports
6.1 Benefits of Sharing Supports
6.2 General Requirements for Sharing Supports
6.3 Requirements when Sharing Supports in Casual/Everyday Situations (Non-
Roommate)
6.4 Requirements for Sharing Supports Among Roommates
6.5 NOW Protocol for Support Coordination and Sharing IFS Supports
6.6 Roles and Responsibilities of the IFS Provider with Service Delivery of Shared
Supports
6.7 Roles and Responsibilities of the Participant when Sharing Supports
6.8 When Not to Share Supports
6.9 Using Intermittent Supports
6.10 Attachments
6.10.1 Shared Supports Brochure
6.10.2 HIPAA 404P
6.10.3 Documentation for Authorization of Shared Staff and Release of
Information for New Opportunities Waiver (NOW)
7 Support Plan Approval Process
7.1 Supervisory Review
7.2 OCDD Regional Waiver Office Review
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Guidelines for Support Planning
7.3 OCDD Guidelines for Planning Regional Office Review Committee
7.4 OCDD Guidelines for Planning State Office Review Committee
7.5 Attachments
7.5.1 Individual Supports Review (ISR)
7.5.2 Individual Support Plan Approval Guidelines form
8 Implementing the Participant’s Support Plan
8.1 Support Plan Approval: Activities for Implementation
8.2 Providing Training to Family and Staff
8.3 Identifying and Securing Needed Resources
8.4 Documentation of Implementation and Collecting Data/Information
8.5 Family Members as Staff
8.6 Attachments
8.6.1 Support Plan Revision Request Form
8.6.2 Provider Guidelines
8.6.3 Instruction Sheets
8.6.4 Skills Training Data Sheet
8.6.5 Seizure Report
8.6.6 Weight Log
8.6.7 Meal/Fluid Log
8.6.8 Bowel Log
8.6.9 Medication Side Effects Assessment
8.6.10 Psychiatric Symptoms Assessment
8.6.11 Menstrual Chart
8.6.12 Sleep Log
8.6.13 Challenging Behavior Chart
8.6.14 Behavioral Incident Report (ABC)
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Guidelines for Support Planning
8.6.15 Graphic Schedule
9 Review and Modification of the Participant’s Support Plan
9.1 Purpose of Monthly Calls in the Plan Review Process
9.2 Preparing for the Quarterly Review
9.3 Completing the Quarterly Review
9.4 Using the Quarterly Quality Review to Document Progress
9.5 Using the Quarterly Review for Annual Planning
9.6 Urgent Meetings to Address Crisis Issues
9.7 Attachments
9.7.1 Quarterly Quality Review
10 Appealing Denials of Services
10.1 Disenrollment, Decertification, and Discharge Procedures
10.2 Denial of IFS Hours
10.3 Attachments
10.3.1 BHSF Form 142 Notice of Medical Certification
11 Training and Certification Processes
11.1 Training for the SIS/LA PLUS Assessors
11.2 Certification in the use of the SIS/LA PLUS
11.3 Certification Step 1: Classroom Training for the “Guidelines for Support
Planning”
11.4 Certification Step 2: Support Plan Completion Consistent with the
“Guidelines for Support Planning”
11.5 Designation and Requirements of Master Trainers
11.6 Attachments
12 OCDD Quality Monitoring Process
12.1 Relevant Policies and Requirements
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Guidelines for Support Planning
12.2 Support Planning Quality Monitoring Process
12.3 Establishing and Monitoring Performance Indicators
12.4 Responsibilities for Assuring the Quality of Support Plans and Delivery of
Services
12.5 Attachments
13 Frequently Asked Questions
13.1 Assessments
13.2 Planning
13.3 Shared Supports
13.4 Resource Allocation
13.5 General Questions

APPENDICES
14 APPENDIX: Development of Louisiana’s Resource Allocation
System
14.1 Selection and Testing of the Needs Assessment
14.2 Linking the Needs Assessment to Resource Use
14.3 Validation of the Model
14.4 Framework for Louisiana’s Allocation of IFS Hours
14.5 Programmatic Assumptions for Each of Seven Levels
14.6 IFS Hours Allocated to Each Level
14.7 Resource Allocation for Participants Under 16 Years of Age
14.8 Attachments
14.8.1 Recommended IFS and Day Program Hours by Level - Lives with
Family
14.8.2 Recommended IFS and Day Program Hours by Level - Lives
Independently
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Guidelines for Support Planning
14.8.3 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

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Guidelines for Support Planning

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 services provide participants, age 18 years or older, with
assistance in developing social and adaptive skills necessary to enable them to
Day Habilitation
participate as independently as possible in the community. It allows for peer
interaction, meaningful and age-appropriate activities, community and social
Day Program
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.
In addition, Day Habilitation services may serve to reinforce skills or lessons
taught in school, therapy, or other settings.

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Guidelines for Support Planning
ERT Employment Related Training services consists of paid employment for
participants, 18 years of age old or older, for whom competitive employment at or
above the minimum wage is unlikely and who because of their disabilities need
intensive ongoing support to perform in a work setting.
Employment Related Training services also include training designed to improve
and/or maintain the participant’s capacity to perform productive work and
function adaptively in the work environment.
Description of Services
Employment Related Training Services include, but are not limited to:
A participant receives assistance and prompting in the development of
employment-related skills. This may include assistance with personal hygiene,
dressing, grooming, eating, toileting, ambulation or transfers, and behavioral
support needs and any medical task, which can be delegated.
 A participant is employed at a commensurate wage at a provider facility
for a set or variable number of hours.
 A participant observes an employee of an area business to obtain
information to make an informed choice regarding vocational interest.
 A participant is taught to use work related equipment.
 A participant is taught to observe work-related personal safety skills.
 A participant is assisted in planning appropriate meals for lunch while at
work.
 A participant learns basic personal finance skills.
 A participant and his/her family, as appropriate, receive information and
counseling on benefits planning and assistance in the process.

GPSORC Guidelines for Planning State Office Review Committee
OCDD developed the Guidelines for Planning State Office Review Committee
and process to perform oversight functions required for implementation of the
“Guidelines for Support Planning.” Details of the committee function and makeup
are covered in Section 7.3.

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