People First Care CoordinationMSC Information Session

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Info Session Updates• Sessions 1-15

– Posted on the OPWDD Website

• June 20, 2018 – In place of a Medicaid Service Coordination (MSC) session, the quarterly MSC Supervisors Conference will be held from 9:30-12:30. All Medicaid Service Coordinators are welcome to join

• To Register: http://www.opwdd.ny.gov/opwdd_careers_training/training_opportunities/slms

For viewing of or registration to the MSC Info Sessions, visit: https://opwdd.ny.gov/opwdd_services_supports/care_coordination_organizations

**Information sessions count toward current annual MSC professional development hours

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Amanda Harper and Angie FrancisDivision of Person Centered Supports

OPWDD

MSC Information Session 16

Support for MSCs: A Resource Guide on

Enrollment and Consent

Resources for MSCs• Training - “Transitioning to Care Coordination Organizations (CCOs) - What

MSCs Need to Know and Do” – on the Statewide Learning Management System (SLMS)

• MediSked Coordinate Modules - SLMS• MSC Toolkit – OPWDD website now includes the MSC Resource Guide• Brochure• CCO Coverage Chart• Example Script and Guidance• FAQs for Individuals and Families• FAQs for MSCs• Health Home Services Care Manager Checklist• MSC Resource Guide• Sample Letter• Video: Care Coordination Sample Information Session

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Care CoordinationOrganizations (CCOs)A Guide on Enrollment and Consent

MSC Resource Guide

• Intended to be a quick guide for MSCs while completing the enrollment process

• Provides easy access to all of the resources necessary to complete the entire enrollment process, from education to finalizing consent forms

• MSCs should print this resource tool to have available as they complete the enrollment process with individuals and families

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Resource Guide Information• Care Coordination Organizations (CCOs)• Completing the forms for Health Home Care Management• DOH-5200 and 5201 Health Home Patient Information

Sharing Consent: For Use with Children Under 18 Years of Age

• CCO Basic Home and Community Based Services (HCBS) Plan Support

• Decision-Making Process • How to Complete the Health Home Checklist• Share the documentation of Choice/Consent and Care Plan

with the CCO• Appendices (1-7)

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Care Coordination Organizations The Role of Medicaid Service Coordinators• Medicaid Service Coordinators have a critical role in informing

individuals and families about CCOs and must: – Educate individuals and families on care management options and

benefits– Enroll individuals and obtain consent for their chosen care management

program– Manage the decision-making process for individuals who are not able to

provide consent independently– If the Medicaid Service Coordinator is transitioning to a Care Manager

he/she must complete the checklist for individuals who choose Health Home Care Management, and

– Share the documentation of choice/consent and care plan with the appropriate CCO

• This section includes the sample individualized information letter and the CCO service comparison chart

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Completing the Forms for Health Home Care Management

• DOH-5055 Health Home Patient Information Sharing Consent: Adults 18 Years of Age and Older– The appropriate Regional Health Information Organization

(RHIO) must be indicated on this form and there is a matrix available in Appendix 6 of the Resource Guide

• DOH-5200 and 5201 Health Home Patient Information Sharing Consent: For Use with Children Under 18 Years of Age – For children and adolescents under 18 years of age, these

two consent forms are required to • Enroll a child into Health Home program; and• Identify who can share information

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Completing the Forms for Basic HCBS Plan Support

• Individuals must consent to enroll in the Basic HCBS Plan Support service program if they choose not to enroll in Health Home Care Management in order to receive OPWDD services

• Medicaid Service Coordinators must obtain a signed Basic HCBS Plan Consent form and complete the CHOICES CCO selection screen for participation in Basic HCBS Plan Support

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Completing the CHOICES CCO Selection Form

• If you try to submit the CHOICES CCO Selection Form and receive an error, directions can be found on Page 8 of the Resource Guide

• Per Page 9 of this guide, the most recent CCO Selection Form entered into CHOICES will dictate July 1, 2018 enrollment

Please note– When completing the CHOICES CCO Selection Form, MSCs can

choose “yes” when answering if the consent forms have been sent to the CCO, if the Medicaid Service Coordinator knows that they will be sending the consent form to the CCO, or if they have given the form to their supervisor or another point person for submission to the CCO

– The CCO selection form will not be available in CHOICES after June 30, 2018 and must be entered prior to that date

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Managing the Decision-Making Process for Individuals Who Are Not Able to

Provide Consent• Through the person-centered planning process, MSCs

should work with the individual, as they do today, to support and recognize each individual’s ability to make decisions

• The guide outlines the three situations to consider when an individual is unable to give consent independently for a choice of service coordination and the proper process to follow in each situation to identify the appropriate enrollment decision-maker

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How to Complete the Health Home Checklist

• In the implementation of CCOs, MSCs who are transitioning into the role of CCO Care Manager, will need to assist individuals as they transition to Health Home Care Management and educate them about the six Health Home Core Services – If the Medicaid Service Coordinator will not transition to the CCO

selected by the individual, a CCO Care Manager will need to complete the Health Home Checklist

• The checklist, found in the MSC Toolkit (and Appendix 5 of the document) is designed to– Assist in ensuring the necessary actions are completed to initiate

the individual’s smooth transition into Health Home Services– Educate individuals and their families on Health Home services,

and – Understand the current service needs of individuals and their

families

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Share Documentation of Choice/Consent and Care Plan with

the CCO• As part of the checklist, MSCs are required to

provide the following documentation to the CCO designee– Completed and signed original consent forms,

Individualize Service Plan (ISP), Coordinated Assessment System (CAS) or Developmental Disability Profile (DDP2), and

– Current and initial Level of Care Eligibility Determination (LCED) and supporting evaluations (for Waiver enrollees only), as available

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Handling of Documents• The CCO is responsible for maintaining

the original signed consent form • If the individual is selecting a CCO that is

affiliated with his/her MSC agency, the enrollment forms can be retained by the MSC Agency and the CCO will provide direction

• As referenced in the guide on Page 17, when an individual chooses a CCO that is not affiliated with his/her MSC agency, the documents must be mailed to the appropriate CCO

• Appendix 1 provides CCO contact information to mail enrollment documents

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Section 6: Appendix (1-7)

• Appendix 1: CCO Contact Information• Appendix 2: MSC Informational Session

Topics and Links• Appendix 3: Informational Brochure• Appendix 4: CCO Coverage Chart• Appendix 5: Care Manager Checklist

Appendix 6: RHIO Integration Consent Matrix Appendix 7: CCO Regional Coverage Map

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Thank you – Questions?Care.coordination@opwdd.ny.gov

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