No narration. 1
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Hello and welcome to the fourth and final lesson of the ISP Review Checklist course. In this lesson we will be focusing on the details of using the ISP Review Checklist for the Six Month Review Process. We will also describe the Action Plans for individuals that need to be developed when needs have changed or service criteria are not met. My name is Shana Wimmer and I am a Program Representative in the Southeast Regional Office of the Office of Developmental Programs. I will be your narrator for this webcast. To provide examples of the Six Month Review Process, we will again be using Tammy s Story. Please refresh your memory with her story if you need to be reminded about her needs and life events. 3
Certificates of Achievement will be available to Administrative Entity and Provider staff as well as Supports Coordinators and SC Supervisors after completing all course requirements. For SCs and SC Supervisors, course requirements include successful completion of a pretest and post test. Please view and then save or print your certificate in order to receive credit for this course. 4
The overall objectives for the ISP Review Checklist course are to: 1. Understand the purpose and use of the revised ISP Review Checklist (formerly known as the AE ISP Checklist) 2. Describe the implementation process for use of the ISP Review Checklist effective April 1, 2013 3. Learn the standardized documentation process for the six month review of specific, required waiver services 5
The objectives specific to lesson 4 are to: Identify the services that are required for a six month review Learn about the timing of the six month review Describe the roles and responsibilities of Providers, SCs and AEs for the Six Month Review process and Describe the information that is needed in an Action Plan when it is determined that the individual does not meet criteria for a service 6
In previous lessons, we identified the use of the ISP Review Checklist for the Six Month Review process. As a reminder, the six month review is a regulatory or waiver requirement and required for these services: Residential Habilitation Licensed 6400 One Person Home Guidelines Pre Vocational and Supported Employment Job Finding Use of the ISP Review Checklist will help to make sure that people are living in the least restrictive environment and employment opportunities are being provided. 7
The six month review occurs using the licensed provider s second, 3 month review which is to be scheduled six months from the Annual Review Update Date of the ISP. This applies to licensed residential habilitation and pre vocational services. Please note that the 3 month review is also referred to as the quarterly review. Since job finding and unlicensed residential habilitation are not licensed services, the Provider is not required to conduct a formal 3 month review. In this case, the SC should obtain information from the Provider on current status and progress in achieving the desired outcome. The same timeframe for six month review occurring six months from the annual review update date should be applied. 8
If a person is receiving one or more of the following services, these sections of the ISP Review Checklist should be completed during the six month review: Section B: Residential Habilitation Section C: Licensed 6400 One Person Home Guidelines Section E: Pre Vocational and Section F: Supported Employment Job Finding 9
For all six month reviews, the Provider initiates and submits supporting documentation. SCs should compile the information from the specific service provider and the individual. If a service requiring a six month review is added to an ISP through a critical revision prior to the six month review, a six month review of the service will be required based on the next Annual Review Update Date not the date that the service was added to the ISP. 10
Here is a timeline that indicates the dates and activities that are important in understanding the six month review process for Tammy s ISP. We will be referring back to these dates throughout this lesson. 11
In Tammy s example, a six month review of the residential habilitation criteria (licensed and unlicensed) and licensed 6400 one person home guidelines occurs in the month of December 2013 which is six months from the Annual Review Update Date that was June 18, 2013. 12
Now, let s talk about the six month review for specific services and in certain situations. A six month review for residential habilitation should occur during the time of a scheduled SC individual monitoring visit. The SC is responsible for scheduling and coordinating the team discussion or meeting for the six month review. 13
Providers, SCOs, and AEs will need to develop procedures to track ISP Review Checklists in order to meet ODP s identified timelines. The Provider will participate in discussions and planning for services described in this Checklist. If the individual does not continue to meet criteria for the service, the Provider participates in developing an action plan. Information on action plans will be discussed later in this webcast. Residential Habilitation, Licensed 6400 One person homes, Pre vocational and/or Employment Job finding providers complete and submit the designated portion of the ISP Review Checklist along with supporting documentation to the SC for six month reviews. 14
For Tammy, the residential habilitation provider will initiate the Checklist for her six month review and submit with supporting documentation to her SC no later than December 15, 2013. This submission date is based on the Annual Review Update date of June 18, 2013. 15
To support the Six Month Review process, the SC should combine Providers information into one Checklist for the individual if the individual has multiple providers rendering the services identified in the Checklist. For example, at the time of the six month review, if an individual receives pre vocational and residential habilitation services, each provider needs to separately submit information to the SC. The SC will then combine all the information into one Checklist for the individual. NOTE: In those instances when the Provider does not submit supporting documentation to the SC, the SC should proceed and document how the information was obtained. 16
The Checklist identifies specifically where this information should be documented. If there are no changes identified during the six month review, the Biannual ISP must be completed to confirm that no changes were identified. The date the six month review occurred and a summary of the results of the discussion should be recorded in the individual s Biannual ISP in the Outcome Action section under How will you know that progress is being made toward this outcome? If there are changes to the services, the SC should utilize the critical revision ISP and record the information as indicated. The Biannual ISP should be completed in HCSIS by the end of the month in which the sixmonth review occurred. The Biannual ISP is used as a mechanism to assist with tracking the completion of the six month review. As a reminder, documentation of the six month review discussion should be included in service notes as for any other planning activity. 17
As an example of the documentation needed for the six month review, let s think again about Tammy. Tammy s SC documents information from Sections B and C of the ISP Review Checklist into the Biannual ISP in HCSIS since she receives licensed residential habilitation and resides in a licensed 6400 one person home. In addition, the SC would indicate the date of the six month review and the results of the discussion in Tammy s Biannual ISP under Outcome Action section, How will you know that progress is being made toward this outcome? Tammy s Annual Review Update date is June 18, 2013. Therefore, documentation of the six month review should be done by December 31, 2013. 18
SCs check off on the ISP Review Checklist the areas of the individual's ISP in which the Items to Discuss/Document were documented. If the Checklist was completed for sixmonth review services, the Checklist is only sent to the AE if the person does not meet criteria and/or does not have a continuing need for the service. 19
Since Tammy is receiving Residential Habilitation in a Licensed 6400 One person home, her SC will update the Biannual ISP with information from Sections B and C and complete Sections B and C of the Checklist during the six month review. This is to ensure that the ISP includes a summary of the information needed to determine the continued need for services. The completed Checklist is maintained in the SCO files since Tammy continues to need the service. A copy of the Checklist does not need to be sent to the AE because there is no change in the need for the service. 20
During the annual or six month review of service, it may be determined that the individual does not currently meet the criteria for continuation of the service, or the services are not assisting the individual to meet the outcomes in the ISP, or the individual s needs have changed. In any of these situations, the team will then develop and implement an action plan to: Identify changes to achieve the outcome and Explore other service options or providers to meet the individual s needs 21
When it is determined that the individual does not meet criteria for any service, the team should: Review strategies within outcome actions to identify how Providers can revise the nature of their support Assist in locating and selecting a new Provider if the individual chooses to explore an alternate willing and qualified provider based on lack of progress in achieving outcomes with their current Provider and/or Make changes to authorized services as needed 22
The action plan must address the actions that have been implemented or need to be taken to secure alternative supports within a defined period. Planning for the alternative supports is not to exceed 12 months which takes into account the potential complexity in the change of the residential service. The action plan is documented in Outcome Actions: What Actions Are Needed. 23
If licensed or unlicensed residential criteria are not met, the team must transition the person to a more appropriate service or service location. It may also happen that an individual may continue to meet the residential habilitation criteria but no longer meet the licensed 6400 one person home guidelines. In this instance, the Provider can request revising the program capacity of the home. The Provider can also transition the person to a more appropriate residential service or residential service location with the agreement of the ISP team. As a reminder, in the Six Month Review process, Licensed 6400 One Person Home guidelines are to be used to assist the team in arriving at the least restrictive environment for the individual. 24
If the individual does not have a continued need for the existing service, the AE should review the Action Plan to assure that the plan contains: Strategies within outcome actions to identify how Providers can revise the nature of their support or Information on the process for locating and selecting a new Provider or Changes to authorized services as needed The AE needs to assure that the plan is responsive to the individual s needs and circumstances. 25
This four part series on the ISP Review Checklist provided information on history, purpose, implementation, and roles and responsibilities at the time of an Annual ISP, Critical Revision ISP, and Biannual ISP for six month review services. Please take a moment to review the supporting document, ISP Review Checklist Roles and Responsibilities. This handout provides a summary of activities and related roles and responsibilities that we have discussed throughout the four lessons of the ISP Review Checklist training. This handout will be useful to you as you begin to implement the ISP Review Checklist into your daily business practice. 26
Please be reminded that Certificates of Achievement will be available to Administrative Entity and Provider staff as well as Supports Coordinators and SC Supervisors after completing all course requirements. For SCs and SC Supervisors, course requirements include successful completion of a pretest and post test and viewing then saving or printing your certificate. Please return to where you initiated this webcast to complete the course requirements and access the Certificate. 27
Thank you for participating in the ISP Review Checklist training. 28