The Gulf Coast Center IDD SERVICES HANDBOOK. The goal of this book is to provide individuals and their families with information on:

Transcription

1 The Gulf Coast Center IDD SERVICES HANDBOOK The goal of this book is to provide individuals and their families with information on: 1. The services we offer 2. The responsibilities of a. Individuals and/or families b. Service Coordinators c. Service Providers 3. Required paperwork and timeframes 4. Why services may be stopped 5. What you need to do to keep services 1

2 IDD PROVIDER SERVICES RESPITE: Respite care is offered to give you a short term break from providing 24 hours a day, seven days a week care for a family member or other individual you are responsible for taking care of on a daily basis. Respite can be used by planning some time away, such as a weekend or an evening, or just to have time to yourself at home. be used in an emergency situation such as illness. be provided in either your home or your provider s home or in another location. be used to help individuals with personal care, assist them with their daily living activities, help keep them safe as well as giving them the opportunity to participate in leisure activities. work directly with your schedule and their schedule on times and dates that best meet your needs Respite cannot. be used to provide supervision and support when you would normally not be providing care to the individual such as when you are at work, attending work conventions, meetings and/or work related trainings. Respite Provider cannot. provide transportation to anyone other than yourself borrow money from you under any circumstances. perform any other trainings or duties that are not a part of your treatment plan Note: your provider cannot live in your home. 2

3 COMMUNITY SUPPORT: A Community Support provider offers person to person assistance in areas that are important to the individual. Although service hours are allocated monthly, services are to be provided weekly in order to work on any training goals you may have. (for example 16 hours in a month can translate to 4 hours in one day 1x a week, or 2 hours a day/2x s a week). The purpose here is for you to get the most out of your trainings in order for you to be successful on your goals. A community support provider can. work with you to improve skills you already have or learn new ones that may help you to be more independent in your home and community. Work with you on such things as housekeeping skills, selfcare, budgeting and paying bills or getting involved with group activities in your community. provide transportation to appointments and/or shopping. work directly with your schedule and their schedule on times and dates that best meet your needs Note: Your Provider cannot live in your home A community support provider CANNOT. provide transportation to anyone other than yourself borrow money from you under any circumstances. perform any other trainings or duties that are not a part of your treatment plan. 3

4 DAY HABILITATION: Day Habilitation programs are usually located in community based facilities. At a day habilitation program you can participate in classes, group activities and community field trips. work on achieving your goals by increasing your skills in things like reading, writing, money management, and health and safety. have the chance to meet, spend time, socialize and have fun with other people. Notes: Day Habilitation cannot be provided in the family home. Not all day habilitation programs are able to offer transportation to and from their facilities; those that do offer transportation may charge a fee. SPECIALIZED THERAPIES: The following specialized therapies are available through contracts with licensed or certified professionals: Speech and Language Therapy; Physical Therapy; and Occupational Therapy. This includes assessment and treatment and training and consulting with family members or other providers. Note: GCC will be the payer of last resort 4

5 BEHAVIORAL SUPPORTS: Behavioral supports are specialized interventions by professionals to help increase adaptive behaviors and to replace or modify maladaptive behaviors that prevent or interfere with the individuals inclusion in home and family life or community life. Supports include assessments, development of an appropriate behavior support plan, training and consulting with family members or other providers and monitoring and evaluating the success of the behavioral support plan and modifying it as necessary. Note: GCC will be the payer of last resort Please notify your service coordinator if you feel your needs have changed and would like to revise your plan. 5

6 YOUR RESPONSIBILITIES AS A RECIPIENT OF SERVICES OR A FAMILY MEMBER RECEIVING SERVICES We are a team: you, your family and/or the important people in your life, your Service Coordinator and your provider staff. We all need to work together and each of us has an important part to play. It is important that we talk with each other, that we meet with each other, and that we keep each other informed. As a participant in services, you have the following responsibilities: Be honest and open about your dreams and goals and about the barriers that stand in your way Decide what you want to work on first; what you most want or most need Let us know when you change your mind and/or when things change in your life such as those situations in your life or family life that may affect the services or require a change in your services. Keep us informed of changes to address or phone number We would also like to know emergency contact information should situations arise and we need to get in touch with you immediately Meeting with your Service Coordinator on a regular basis is a program requirement Maintain good communication by returning phone calls, s etc to IDD staff at LOR as quickly as possible. 6

7 Keep scheduled appointments - If you have to cancel or reschedule an appointment, please give as much notice as possible we would like at least 24 hour notice Let us know right away if you are having problems with or concerns about your staff or your services You are important to us. Do not worry that someone will get mad at you or get in trouble we want to ensure that your plan is working for you and that you are satisfied with your services and we can t do that if you don t tell us what is happening We want you to have as much freedom and flexibility in the process of selecting your personal or day habilitation provider. We hope that by your active participation in interviewing and selecting your provider, you will be able to access the services you need, when you need them and by those individuals or agencies you are comfortable with in providing these services to you. Once your provider is selected, you will be responsible for notifying the Gulf Coast Center IDD Services of the personal provider(s) you have chosen, along with their address and phone number, at which point we will contact them and assist in setting them up to begin your services. To notify IDD Provider Services call: /

8 SERVICE COORDINATOR RESPONSIBILITIES 1. To meet with you on a regular basis, preferably once a month Why: To get to know you; To find out what is important to you and for you; To assist in developing your plan; To connect you with resources; To make sure that what was put in your plan is happening; To make sure that you are satisfied with your services; To find out if there are any changes in your life To help you find the services and supports you need when things change or problems occur 2. To go over all required paperwork with you and get your or your guardian s signature as needed Why: To be able to provide services To make sure that you are aware of your rights and responsibilities 8

9 To make sure that you have agreed to the plan and to the services and supports described To get your permission to talk with or share information with other people or agencies 3. To make sure that you know how to contact the Service Coordinator 4. To meet with you and the people who are important to you and develop a plan that describes who you are, what is important to you and for you, what outcomes you want to achieve and what supports you may need to achieve those outcomes 5. To try and find the resources you want or need and to help you get connected to those resources 6. REQUIRED PAPERWORK AND TIMELINES You or your family member will be responsible for meeting with staff to complete documents required for your selected services and for returning the service packets. Within 30 days of receiving your Service Packet you will be asked to return these documents back to the Gulf Coast Center. If the documents are not received within 30 days, you risk having your services terminated. If you are requesting Contract and/or Weekend Respite - You will need to return these documents: 1. IDD Recipient of Services/Family Cover Letter (a checklist of documents to be returned) 2. Individual Assessment 3. IDD Respite Plan 4. Authorization of Medication-completed by prescribing Doctor. (Weekend Respite only) 5. GCC Release & Waiver of Liability & Assumption of Risk Mgt. 9

10 6. Consent for Treatment and Use of Over-the-Counter Meds (Weekend Respite only) 7. IDD Provider Services Out of Home Respite Program Policies 8. IDD Emergency Information Sheet (rev ) (1 page) 9. All About Contract Respite (Contract Respite Only) Note: Staff will contact family members if packet is not received within 30 days to re-assess the need for services. If you are a 1 st time user for weekend respite, we will require a preservice site visit to the program so you and the individual receiving the respite can become familiar with the surroundings prior to the scheduled weekend and so that you can complete some of the required paperwork. If you have received the respite packet prior to your visit, you may bring any or all the completed documents with you at that time If you are requesting Community Support You will need to return these documents: 1. IDD Recipient of Services/Family Cover Letter (a checklist of documents to be returned) 2. Individual Assessment 3. IDD Community Support Emergency Information Form 4. All About Community Support Note: Staff will contact family members if packet is not received within 30 days to re-assess the need for services. If you are requesting Day Habilitation You will be responsible for notifying us of your choice of Day Habilitation Provider and completing and returning the: 1. Day Habilitation Selection Cover Page This must be completed and returned before you can begin attending the Day Habilitation Program of your choice 10

11 If you are requesting Any Specialized Therapies Specialized therapies, as with all services, will be prorated out for new admissions to services for the year. These services cannot be used at the same time with any other services. Changes to service options packages may be considered under special circumstances. If any specialized services have been used, these dollars will be deducted, provider services/family and service coordination will assess what options are available for the remainder of the fiscal year. Note: Staff will contact family members if packet is not received within 30 days to re-assess the need for services. 11

12 CONTRACTED PROVIDER RESPONSIBILITIES TO FAMILIES AND IDD SERVICES 1. The personal provider(s) you have chosen is/are responsible for ensuring you get the services you requested and agreed to in your plan. 2. Your providers are responsible for assisting you as you work to achieve the goals you chose and put in your plan 3. Your personal providers will be responsible for talking with you so that you can both agree on the days and times that work best for you. 4. Your personal provider will be responsible for documenting on all services delivered and for ensuring that you have had a chance to review that documentation. Your signature on the document will authorize payment to the provider for those services. 5. Contract providers, at all times, should treat you with respect, advocate for your rights and promote a healthy and safe environment for you. For Contract Respite Only 6. Your personal providers are responsible for ensuring that the services that they are providing are not provided at a time while you are at work, attending work conventions, meetings and or work related trainings etc. 12

13 REASONS YOU CAN BE TERMINATED FROM GCC SERVICES You can be terminated from services. 1. If you do not use any GCC service during one quarter or over a 90 day period: 1 st Quarter: September-November; 2 nd Quarter: December February; 3 rd Quarter: March May; or 4 th Quarter: June August without notifying the Gulf Coast Center and providing a justifiable reason why the services could not be used by you during that quarter (Examples of justifiable reasons: you were in the hospital or you were out of town) 2. If you do not call and cancel a meeting with your provider or your service coordinator when you are not able to be there; it will be considered a no-show. If you have 3 no shows within a year (September August) this will be cause for termination of services. 3. If you falsify any documentation which misleads the Gulf Coast Center into payment for services (including but not limited to falsifying address, insurance, billing data forms, billing for services not provided etc.) 4. If you fail to complete required documents by designated time frames 13

14 OTHER IMPORTANT INFORMATION 1. At NO time will it be acceptable and under NO circumstances for a Contracted Provider to live in the same household/address as the Individual who is receiving the services. 2. Services on your plan are allocated on a monthly basis (with the exception of Weekend Respite) and any services not used in a given month, do not carry over 3. If you want to make changes in your plan, please contact your Service Coordinator. Plan changes will be made effective the beginning of the following month, however if there have not been any services provided during the month in which the plan is revised, the revised services can begin in the same month. 4. If you decide to communicate by , you will need to be aware that the Gulf Coast Center has to comply with HIPAA laws that require us to protect and keep confidential each individual s information. The Gulf Coast Center does have access to an encrypted system which ensures the security of s. If you would like to use that system, let your Service Coordinator or IDD Services Staff know and they will assist you in setting that up. 14

15 DEFINITIONS Service Coordinator These staff will assist you with developing your plan and identifying what outcomes (goals) you want to work on. They will work with you to monitor how your plan is working for you and how satisfied you are with services. They will help you find community resources. Service Coordinators also are there to link you with needed services and supports to help you prevent or manage a crisis. IDD Services Staff These Staff will assist you with linking you to your Personal Provider. IDD - Intellectual and Developmental Disabilities - Public Law No: (also known as Rosa s Law) was signed into law October 5, 2010 and changed references in federal law from mental retardation to intellectual disability, and references to a mentally retarded individual to an individual with an intellectual disability) Personal Provider This is a Contract Provider or Internal Staff that will be paid to deliver you with services of your choice. 15

16 THE GULF COAST CENTER IDD PROVIDER SERVICES FAMILY COMPLAINT PROCESS The Gulf Coast Center desires a successful partnership with the Family to best serve the individuals. The Authority encourages the provider and individuals to call with concerns, problems and complaints regarding the Authorities operations and interaction with the Provider. Every effort will be made to address the issues involved. PROVIDER SERVICES To file a complaint concerning a Contract Provider or Provider Services, call/send complaint in writing to:christine Bahr/Contract Respite, Salvador Olivares/Day Habilitation, Odelia Benefield/Community Support, Deanna David/ Contract Providers or Danielle Armknecht/Weekend-Day Respite 7000 Ave B. Santa Fe, Texas (409) Mon-Fri 8:00 am 5:00 pm IDD PROVIDER SERVICES-Community Support, Day Habilitation, Respite To file a complaint concerning a Staff or Contractor, call or send complaint in writing to: Barry Kusnerik, Director of IDD Provider Services 7000 Ave B. Santa Fe, Texas (409) Mon-Fri 8:00 am 5:00 pm DIRECTOR OF IDD PROVIDER SERVICES To file a complaint concerning the Director of IDD Provider Services, call or send complaint in writing to: Mike Winburn, Executive Director 123 Rosenberg Suite 6 Galveston, Texas / Mon-Fri 8:00 am 5:00 pm THE GULF COAST CENTER To file a complaint concerning The Gulf Coast Center, call toll free number: Texas Department of Aging Gulf Coast Center- And Disability Services Rights Protection Office Monday Friday Monday Friday 8:00 am 5:00 pm 8:00 am 5:00 pm To file a complaint concerning abuse, neglect or exploitation, call toll free number within 1 hour: Texas Department of Family and Protective Services hours Received By 16 Date

17 THE GULF COAST CENTER IDD LOCAL AUTHORITY SERVICES FAMILY COMPLAINT PROCESS The Gulf Coast Center desires a successful partnership with the Family to best serve the individuals. The Authority encourages the provider and individuals to call with concerns, problems and complaints regarding the Authorities operations and interaction with the Provider. Every effort will be made to address the issues involved. SERVICE COORDINATION SERVICES To file a complaint concerning a service coordinator, please contact: Service Coordinator Team Leader Nola Graham or IDD SERVICE COORDINATOR TEAM LEADER To file a complaint concerning the IDD Service Coordinator Team Leader, please contact: Leigh Saunders or UNRESOLVED CONCERNS OR COMPLAINTS To address unresolved concerns or complaints, please contact: Rights Protection Officer Cindy Kegg THE GULF COAST CENTER To file a complaint concerning The Gulf Coast Center, call toll free number: Texas Department of Aging Gulf Coast Center- And Disability Services Rights Protection Office Monday Friday Monday Friday 8:00 am 5:00 pm 8:00 am 5:00 pm To file a complaint concerning abuse, neglect or exploitation, call toll free number within 1 hour: Texas Department of Family and Protective Services hours Received By Date 17