NEW CONSULTANT TRAINING February 5 & 6, 2013

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NEW CONSULTANT TRAINING February 5 & 6, 2013 Barbara Palmer Director Rick Scott Governor

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NEW CONSULTANT TRAINING February 5 & 6, 2013. Barbara Palmer Director. Rick Scott Governor. Welcome and Introductions. Ivonne Gonzalez Training and Outreach Coordinator Submit questions throughout this presentation to: [email protected]. - PowerPoint PPT Presentation

Transcript of NEW CONSULTANT TRAINING February 5 & 6, 2013

Page 1: NEW CONSULTANT TRAINING  February 5 & 6, 2013

NEW CONSULTANT TRAINING February 5 & 6, 2013

Barbara PalmerDirector

Rick Scott Governor

Page 2: NEW CONSULTANT TRAINING  February 5 & 6, 2013

Welcome and Introductions

Ivonne Gonzalez

Training and Outreach Coordinator

Submit questions throughout this presentation to: [email protected]

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Training Objectives•Identify the Five Principles of Self Determination•Describe the roles and responsibilities of Participant, Representative, Consultant, Area and State Office•Describe different provider types•Demonstrate how to write a Purchasing Plan•Describe how to properly manage your CDC+ Budget•Demonstrate how to Reconcile the account

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• The Developmental Disabilities Medicaid Waivers Consumer-Directed Care Plus Program Coverage, Limitations and Reimbursement Handbook (CDC+ Rule Handbook)

• Participant Notebook

• Appendix to Handbook & Participant Notebook

CDC+ Tools

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•In 2000- Consumer-Directed Care(CDC)- Pilot Program•Demonstration phase January 2004 (CDC+)•Permanent Program March 2008, authorized by Medicaid through the 1915j State Plan Amendment•Expansion Fall 2009•2500 new participants•Training and enrollment

•CDC+ Rule•Adopted as of 11/12/12 -Any changes that occur will be shared

CDC+ History

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What is CDC+

•Long-term care program alternative

•Based on principles of Self-Determination and Person-Centered Planning

•Provides opportunities to improve quality of life

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Self-Determination and Person Centered Planning

Person-Centered Planning

Principles of Self-DeterminationFreedomAuthoritySupportControlResponsibility

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CDC+ Eligibility and Enrollment Requirements

•Enrolled in the DD/HCBS waiver•Able to direct own care•Live in family or own home

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• Tier Waiver to iBudget by (July 1, 2013)

• Authorized iBudget funds determine CDC+ Monthly Budget

• CDC+ participants will still manage their iBudget funds in accordance with the CDC+ Rule Handbook

More information regarding iBudget on iBudgetFlorida.org

iBudget Transition

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•Participant•CDC+ Representative•Consultant•Area Liaison•State Office

Roles and Responsibilities

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Role of Participant (when representative not selected)

•Authorized signer•Decision maker•Employer

•Develops Purchasing Plan

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Role of Participant, continued

•Maintains accurate and complete records•Spends CDC+ budget responsibly•Complies with training and monitoring requirements•Develops Emergency Backup Plan (CDC+ Rule Handbook pg 3-3)

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•Same role as Participant•Unpaid Advocate; at least 18 years of age•Readily available to Participant and Consultant•Responsible for appropriate use of public money

Role of CDC+ Representative,

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•Be a Waiver Support Coordinator in good standing•Complete CDC+ New Consultant Training•Pass Readiness Review•Enroll as a Medicaid provider for consultant services•Complete CDC+ registration forms•Sign Memorandum of Agreement

Consultant Requirements

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•Waiver Support Coordinator•Complies with training and monitoring requirements•Sign a participant/consultant agreement•Provides on-going technical assistance

Role of Consultant

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•Reviews and signs off on CDC+ documents•Responsible for appropriate use of public money

Role of Consultant, continued

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•Develops and updates support plan•Ensures cost plan is updated•Monitors and reviews participant account activity•Ensures Medicaid eligibility

Role of Consultant, continued

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Role of Consultant, continued

•Keeps active contact with ParticipantMonthly – by phone or in personAnnually – two face-to-face per year

•Completes monthly review documentation

•Communicates effectively with Area Liaison

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•Authorizes CDC+ Budget•Reviews Purchasing Plans•Facilitates employee background screening •Liaison between participant, consultant, and State office

Role of Area Liason

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•Administers CDC+ Program•Develops policies•Approves CDC+ Monthly Budget•Develops and provides training•Provides Customer service

Role of State Office

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•Provides Quality assurance•Assigns Provider ID Numbers •Pays service claims and employer taxes•Sends monthly statements•Monitors consumer spending

Role of State Office, continued

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Quality Assurance Requirement•Consultant •Participant

Person Centered ReviewProvider Discovery Review

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Steps for CDC+ Participant Enrollment

•Expresses interest•Completes training•Passes Readiness Review

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•Application Packet•2 page application document•Cost plan service authorization summaries•Budget calculation worksheet

•Enrollment Packet•8821 – IRS •2678 – IRS•Fiscal Informed Consent

Steps for CDC+ Participant Enrollment, continued

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•Area calculates monthly budget•Participant chooses supports and services•Participant interviews potential providers•Providers complete background screening requirements

Steps for CDC+ Participant Enrollment, continued

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•Participant develops and submits purchasing plan; CDC+ approves plan•Participant completes and submits employee and vendor packets; CDC+ issues provider ID’s •Participant begins self directing supports and services

Steps for CDC+ Participant Enrollment, continued

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Calculating the Monthly Budget•Budget calculation worksheet – Participant Notebook Appendix D(3)

•Current approved DD/HCBS Waiver Cost Plan•Discount rate- 8%•Administrative fee- 4% or max amount of $160.00

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Calculating the Monthly Budget, continued

•PCA for children under 21 (use different Budget Calculation Worksheet) paid through Medicaid State Plan-(procedure code S9122TJ)

•STE-Short Term Expenditure & OTE-One Time Expenditure•Consultant fee is not part of monthly budget (billed directly through FMMIS) 28

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ServiceTotal Cost Plan Amt

Number of

months Monthly Cost

Plan

PCA $ 7,200.00 12 $ 600.00 Respite $ 8,870.40 12 $ 739.20 PT $ 5,340.80 12 $ 445.07 Trans $ 8,049.60 12 $ 670.80

ST $ 3,204.98 12 $ 267.08CMS $ 372.40 12 $ 31.03

Total $ 33,038.18 $ 2,753.18 $ 2,753.18 If more than $4,000.00, use $160 for fees Take the percentages of Col D Total 0.92 0.04 If less than $4,000, use 4% calculation for fees

$ 2,532.93 $ 110.13 $ (160.00)

This is the CDC+ Monthly Budget $ 2,372.90

Consultant services or funds for either OTEs or STEs are not included in the calculation of the monthly budget

$ 2,753.18 0.92 $ 2,532.93 $ (110.13)

This is the CDC+ Monthly Budget $ 2,422.80

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What, when, who, where and how support & services will be provided that best meet their needs & goals•Setting Priorities•CDC+ Program Services (CDC+ Rule Handbook Chapter 4)

•Restricted or Unrestricted (CDC+ Rule Handbook pgs. 4-3, 4-4)

•Allowable purchases (CDC+ Rule Handbook pgs.1-5, 3-8)

•Unallowable purchases (CDC+ Rule Handbook pgs.1-19, 3-9)

Participant Controls

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•Every service contains a definition to include: Descriptions, limitations, special conditions, provider qualifications and service type. (CDC+ Rule Handbook Chapter 4)

•Service codes and abbreviations can be found in the Service Code Chart

CDC+ Program Services

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CDC+ SERVICE CODE CHARTRESTRICTED SERVICES

Service Name Abbreviation Service CodeAdult dental services DENT 03Behavior Analysis Services BT 06Behavior Analysis Assessment BTA 06ABehavioral Assistant Services BTS 08Dietitian Services DIET 12Occupational Therapy OT 29Occupational Therapy Assessment OTA 29APhysical therapy PT 38Physical Therapy Assessment PTA 38APrivate Duty Nursing/LPN PDL 49Private Duty Nursing/RN PDR 50Respiratory Therapy RT 45Respiratory Therapy Assessment RTA 45ASkilled Nurse/LPN SNL 47Skilled Nurse/RN SNR 48Specialized Mental Health Services/ Therapy and Assessment MHT 51

Speech Therapy ST 53Speech Therapy Assessment STA 53AEnvironmental Modification Assessment ENVA 14ADurable Medical Equipment and Supplies EQUIP 83Environmental Modifications ENV 14Vehicle Modification VMOD 80

UNRESTRICTED SERVICESService Name Abbreviation Service Code

Adult Day Training ADT 02Advertizing ADV 89Seasonal Camp CAMP 85Companion Services COMP 11Consumable Medical Supplies CMS 63Supported Employment EMP 55Gym Membership GYM 88In-Home Supports IHS 22Over-The-Counter Medications OTC 65Personal Care Assistance PCA 32Personal Emergency Response System (PERS) PERS 33PERS Installation PERSI 33AParts and Repairs Therapeutic or Adaptive Equipment PARTS 82Residential Habilitation Services RHAB 43Respite Care- Day RSPD 58Respite Care- Hour RSPH 46Supported Living Coaching SLC 56Specialized Training TRNG 61Transportation TRAN 60Other Therapies XTHER 39

FOR CONSUMERS PARTICIPATING IN THE FLORIDA FREEDOM INITIATIVE (FFI) ONLY

Service Name Abbreviation Service CodeMicroenterprise MICRO 75FVehicle VEH 70F

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•Directly Hired Employee (DHE)

•Agency/Vendor (A/V)

•Independent Contractor (IC)

Provider Types

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•Identify service/support being purchased•Type of provider needed

•Provider requirements•Hiring packet – (Appendix E of the Notebook)

How to Find, Hire and Manage Providers?

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Background ScreeningsLevel 2 for all providers listed on a Purchasing PlanValid for 5 years- provided there is not a break in service of 90 days or more.

How to Find, Hire and Manage Providers, continued

Employee Packets- (Appendix G Notebook)

Vendor Packets- (Appendix H Notebook)

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•The Participant decideswhat will be done and create job descriptionhow services will be performedthe hours per week/month workedhourly rate of pay (negotiable)

Companion- only service exempt from minimum wage requirements

•The Participant mustreview, approve, & submit timesheetbudget for applicable employer taxes

Directly Hired Employee Services

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•A person or business that provides services/supports•Participant controls/directs only the result of work performed, and not the means and methods of accomplishing the result•Participant pays from submitted invoice•No Taxes withheld or paid

Agency/Vendor and Independent Contractor

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Hiring an A/V, IC or DHEAgency/Vendor (A/V) or

Independent Contractor (IC)

• Vendor/Independent Contractor Information Form

• Internal Revenue Service (IRS) Form W-9

• Background Screening Letter

Directly Hired Employee

• Employee Information Form

• Internal Revenue Service (IRS) Form W-4

• Department of Homeland Security (DHS) Form I-9

• Background Screening Clearance Letter

• Optional- Direct Deposit Form (EFT)- include a copy of a pre-printed voided check38

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Purchasing Plan – Appendix E

•Describes how CDC+ monthly budget will be spent to meet needs and goals

Authorizes services/supports Authorizes providers

•Developed by Participant or RepresentativeConsultant may provide technical assistance

and guidance (CDC+ Rule Handbook Appendix E)

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Person Responsible

Activity Due Date

Participant(Representative)

Complete Purchase Plan; submit to Consultant

By the 5th of the month

Consultant Review and sign; submit to Area Liaison

By the 10th of the month

Area Liaison Review and sign; submit to State Office

By the 20th of the month

Purchasing Plan – Timelines

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Purchasing Plan Types

•New Purchasing Plan•Purchasing Plan Change•Purchasing Plan Update•Quick Update

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•One Time Expenditure- 100% of authorized amount - only 3 services:•Equipment/Devices DME•Environmental Modifications•Vehicle Modifications

•Short Term Expenditure-Services authorized in waiver cost plan that are approved for 6 months or less, or are periodic in nature – ex. Dental, Assessments

OTE/STE Expenditure

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•Restricted Services-requires a licensed provider, 92% of the units of measure that are approved in the Cost Plan must be utilized

•Unrestricted services-services and supports that a CDC+ Participant may purchase provided the service meets needs and goals as identified in the support plan.

Restricted/Unrestricted Services

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Critical Services •Critical Services- require two emergency backup providers who are ready and able to drop everything and come to work as an emergency backup, ex. PCA

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The CDC+ purchasing plan consists of:Page 1 – Section A – Basic InformationPage 2 – Section B – Needs and GoalsPage 3 – Section C.1 and C.2 – Services and SuppliesPage 4 – Section D – Cash (no longer available)Page 5 – Sections E and F – Savings Plan and

OTEs/STEsPage 6 – Budget Summary and Signatures

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Purchasing Plan Sections

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Purchasing Plan Instructions

• Open blank purchasing plan • Follow along slide by slide• Reference tools

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The CDC+ Purchasing Plan

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Extra pages in Section C.1 and C.2 are provided in the Excel file for participants who need additional

space to enter services and supports

To move from page to page on the purchasing plan, click on a page tab in the blue bar on the bottom of the Excel page

frame. Each page contains a section of the purchasing plan

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CDC+ Purchasing PlanPage 1 - TopProvide the required information

Enter the day the Purchasing Plan will be

effectiveEnter the number of the APD area in which the

participant lives

Enter the participant’s approved CDC+ Monthly

Budget amount

Participants on the Florida Freedom

Initiative (FFI) check “Yes”, otherwise

check “No”.

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Purchasing Plan - Page 1

Section A – Participant Information

Enter the participant’s legal first name, middle initial and last name as

found on birth certificate Enter the participant’s age as of the effective date of the Purchasing

Plan

Enter the participant’s ID

number

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Purchasing Plan - Page 1

Section A – Participant Information (continued)

Enter the representative’s legal

first name, middle initial and last name

Enter a valid cell phone number for the participant or representative

Enter a valid phone number for the participant or representative

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Purchasing Plan - Page 1

Section A – Reason for Submitting Purchasing Plan

Enter the page numbers that are revised

Enter the legal name for all providers appearing on the

Purchasing Plan for the first time

Enter the number of Employee or Vendor/IC

packets submitted

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Purchasing Plan - Page 1

Section A – Reason for Submitting Purchasing Plan (continued)

Enter the names of all the providers who appeared on

previous Purchasing Plans but do not appear on this

Purchasing Plan

Manually number each page of the Purchasing Plan

including the total number of pages

Enter the total number of Purchasing Plan

pages. The minimum number of pages is six

(6)

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Purchasing Plan - Page 1Section A – Reason for Submitting Purchasing Plan (continued)

This option is no longer available

This area is to be completed by the consultant and area

liaison

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Purchasing Plan - Page 2Section B – Needs

The participant’s name will automatically fill in from the

information provided on the first page The plan’s effective date will

automatically fill in from the information provided on the first

page

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Purchasing Plan - Page 2

Section B – Needs – Column 1

Enter the date of the current Waiver Support Plan

Enter all needs and goals identified on the participant’s current Waiver Support Plan

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Purchasing Plan - Page 2

Section B – Needs – Column 2

Enter all services and supports approved on the current Waiver Cost Plan

Enter the number of months for each

support or service

Enter the current Waiver Cost Plan

date

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Purchasing Plan - Page 2Section B – Needs – Column 2 (continued)

Enter the total number of units for each support or service

The average number of units per month is automatically calculated

and inserted in this box

Click on the box to open a dropdown box then select the type of unit in

Cost Plan for each service or support

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Purchasing Plan - Page 2Section B – Needs – Column 3

Enter each service or support the participant will be

purchasing to meet long term needs and goals

Enter the total number of units per month for each service or support

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Purchasing Plan - Page 2

Section B – Needs – Column 3

Click on the box to open a dropdown box and select type of

unit in Purchasing Plan

Enter note if service or support is an OTE, STE, savings item or unpaid

natural support

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Purchasing Plan - Page 3

Section C.1 – Budget Details – Services

The service code box will automatically fill in the code when the service is selected

from the dropdown box

Click on the box to open a dropdown box then select a

service

If the service listed is critical, enter Y (yes), if not critical enter N (No). If yes is entered there must be a minimum of (2)

emergency back-up providers listed. EBU providers can only be listed for

critical services

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Purchasing Plan - Page 3Section C.1 – Budget Details – Services (continued)• Direct Hire Employee (DHE) provider relationship numbers:

1 = Parent or step-parent 2 = Participant’s child or stepchild under age 21 3 = Spouse4 = Person under 18 currently in high school (not participant’s child or stepchild) 5 = All others

Click on the box to open a dropdown box then select a

provider type

Enter the legal name of all providers. If the provider is critical, list at least

two (2) back-up providers on the lines directly underneath on the same page

Enter the provider relationship number by

opening the dropdown box and selecting the number

that applies

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Purchasing Plan - Page 3

Section C.1 – Budget Details – Services (continued)

Enter the number of units for each

service

Enter the cost per unit for each service

Click on the box to open a dropdown box

then select the unit type

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Purchasing Plan - Page 3

Section C.1 – Budget Details - # of Units:• 22 weekdays in a month • Monday - Friday workweek

• 9 weekend days in a month • Saturday and Sunday workweek

• 31 calendar days in a month • Always plan for the maximum number of days in a month

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Purchasing Plan - Page 3

Section C.1 – Budget Details – Services (continued)

The sub-total automatically calculates

and the amount will appear in this box

Provider total cost automatically calculates

Employer taxes automatically calculate and the amount will appear in

this box

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Purchasing Plan - Page 3

Section C.1 – Budget Details – Services – EBU Added Cost

Click here to calculate additional emergency back-up cost

If emergency back-up cost is calculated the amount will appear in

this box

Total monthly cost will automatically calculate and

appear in this box for primary providers

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Purchasing Plan - Page 3Section C.1 – Budget Details – Services – Totals

The total amount of EBU added cost will appear here and also

appear in box for total estimated cost for EBU in

Section E

Total monthly costs for services will

automatically calculate and appear in this box

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Purchasing Plan - Page 3Section C.2 – Budget Details – Supplies• Only one (1) supply type can be listed:

CMS – Consumable Medical Supplies (63)Select the supply type from the

dropdown box. Only one (1) type can be entered - CMS

When the service is selected, the service code will automatically

populate

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Purchasing Plan - Page 3Section C.2 – Budget Details – Supplies (continued)• List all supply providers and detailed descriptions for each supply including quantity

Examples: Adult Large Diapers (96) Adult Large Diapers (96), 1 case Wipes (6), 2 boxes Bed Pads (24) = 1 unit

Enter the number of units to be purchased

Enter the legal name of the provider where

supplies will be purchased

Enter a detailed description for each supply including quantity

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Purchasing Plan - Page 3

Section C.2 – Budget Details – Supplies (continued)

The total cost will

automatically calculate

Enter the rate for each supply listed

Enter the unit type

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Purchasing Plan - Page 3Section C.2 – Budget Details – Supplies (continued)

The total will calculate and insert in the box at the bottom of the total cost

column

Check box to indicate if additional page 3A is used to complete this

section

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Purchasing Plan - Page 4

Section D – Budget Details – Cash Purchases - Discontinued

This option is no longer available

Option 1. Section E - Savings

Option 2. Section C.1 & C.2 – Services/Supplies

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Purchasing Plan - Page 4

Section D – Budget Details – Cash Purchases – Total

In this area, enter an explanation on how purchases requested in Section E will meet the needs and goals or increase

independence. Also, enter any additional information that would assist APD staff in approving the participant’s

Purchasing Plan

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Purchasing Plan - Page 5

Section E – Savings Plan – Authorizations for Use of Accumulated, Unrestricted Funds

Enter the total amount of

unrestricted funds available

Enter the ending balance on the

current statement

Enter the most current statement

date (mm/yyyy)

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Purchasing Plan - Page 5

Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)

The total estimated cost amount is

forwarded from the Budget Detail

Services section EBU Added Cost total

Unrestricted funds made available for

savings plan purchases each month

The accumulated unrestricted funds must always be

reserved and available for use by emergency back-ups

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Purchasing Plan - Page 5Section E – Savings Plan – Authorizations for use of Accumulated,

Unrestricted Funds (continued)

Click on box to open the dropdown box containing service code

numbers. Select the correct service code for the item or service listed

Enter each item or service description

Enter the legal provider name for each item or service

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Purchasing Plan - Page 5Section E – Savings Plan – Authorizations for use of Accumulated,

Unrestricted Funds (continued)

Enter the unit type for the item or service to be

purchasedClick on the box to open a dropdown box.

Select the provider type for the item or

service

If provider is a DHE, click on the box to open a dropdown box. Select the

number that describes the relationship of the participant to the DHE named

Enter the number of units to be purchased for each item or

service

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Purchasing Plan - Page 5

Section E – Savings Plan – Authorizations for use of Accumulated, Unrestricted Funds (continued)

If applicable, employer taxes will calculate. The amount will

appear in the employer taxes box

Enter the rate per unit for each item or

serviceSub-total will automatically calculate and appear in this

box

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Purchasing Plan - Page 5Section E – Savings Plan – Authorizations for use of Accumulated,

Unrestricted Funds (continued)

Enter the actual date the item was purchased.

(mm/dd/yyyy)

The total estimated cost amount for each

item or service will calculate and insert

here

Enter the estimated date the item will be

purchased. This will always be the last day of the month (mm/dd/yyyy)

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Purchasing Plan - Page 5

Section F – Budget Detail – One Time and Short Term Expenditures

When item or service is selected the assigned

service code will appear in the service code boxClick on box to open a

dropdown box. Select type of expenditure – OTE or

STE

Click on box to open a dropdown box listing items and services available for either OTE or

STE. Select the item or service to be purchased

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Purchasing Plan - Page 5

Section F – Budget Detail – OTEs and STEs (continued)

If the provider is a DHE, click on the box to open a dropdown box. Select

the number that describes the relationship of the participant to the

DHE named

Enter the legal provider name for

each item or service Click on the box to open a dropdown box. Select the

provider type for item of services

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Purchasing Plan - Page 5

Section F – Budget Detail – OTEs and STEs (continued)

Enter rate in dollar amount for item or

service to be purchasedClick on box to open dropdown box. Select the unit for each item

or service

Enter the number of units to be purchased for each item or

service

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Purchasing Plan - Page 5Section F – Budget Detail – OTEs and STEs (continued)

The total budget for each item or service will

calculate and appear here

Sub-total will automatically calculate and appear in this

box

If DHE employer tax is calculated, the amount

will appear here

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Purchasing Plan - Page 5

Section F – Budget Detail – OTEs and STEs (continued)

Enter the start date for each item or service

(mm/dd/yyyy)

Enter the end date (mm/dd/yyyy). This is the

same date as the end date of the item funding

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Purchasing Plan - Page 6

Budget Summary

The authorized budget amount is automatically populated. It is the amount that was entered as the

monthly budget on the top of Page 1

The service and supplies amount is automatically

populated. It is the sum of Sections C.1 total and C.2

total of the Purchasing Plan

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Purchasing Plan - Page 6

Budget Summary (continued)

The total monthly expenditures is the total

authorized budget amount

This section no longer applies and should not contain any numbers

The Savings Plan amount will automatically

populate. The amount is unrestricted funds made available each month in

Section E

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Purchasing Plan - Page 6Signatures – Participant or CDC+ Representative

The participant or representative must print name then sign and

enter date signed on hard copy of form

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Purchasing Plan - Page 6Signatures – Consultant

The consultant must print name then sign and enter date signed

on hard copy of form

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Purchasing Plan - Page 6Signatures – APD Staff

APD staff will review the purchasing plan. If the plan meets the participant’s needs and goals and is written correctly then APD staff will sign and date indicating

approval

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Purchasing Plan - Page 6Signatures – APD Staff (continued)

Any exceptions will be indicated in the approval exception box. Follow-up by participant or representative is

required

Page 90: NEW CONSULTANT TRAINING  February 5 & 6, 2013

Purchasing PlanSubmission Process

Participant Responsibilities:• Double-check all information• Minimum six (6) completed pages• Submit all required paperwork• Retain copies• Submit by 5th of the month

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Purchasing PlanSubmission Process

Consultant Responsibilities:• Review for accuracy• Signs the Purchasing Plan• Submit by 10th of the month

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Purchasing PlanSubmission Process

Area Office Responsibilities:• Review for accuracy and signatures• Ensures all documents enclosed• Submit by 20th of the month

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Purchasing PlanApproval Process

CDC+ Central Office:• Reviews submitted documents • Returns if revisions are needed• Approves and processes documents• Assigns provider identification (ID) numbers • Contacts new participant with ID numbers and start date• Provides approved Budget Summary copy

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Developing a Purchasing PlanGROUP ACTIVITY

• Developing a Purchasing Plan using a Training Scenario• Developing a Quick Update• Signing off on both

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Getting Claims Paid •Directly Hired Employees

•Time Sheets –(CDC+ Rule Handbook Appendix G-2)•Vendors (AV, IC)

•Invoice•Must be tracked – (Participant Notebook Appendix K (3,4)

•Rep Reimbursements (Savings, OTE/STE)•Receipt•Must be tracked – (Participant Notebook Appendix K (6)

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•Bi-weekly payroll •Pay Schedule – (CDC+ Participant Notebook Appendix O (4))

•CDC+ work week (12:00am midnight Monday - 11:59pm Sunday)

•Payroll submission•Secure Payroll System – Web based•Interactive Voice Response – IVR•Call in – Customer Service

Getting Claims Paid, continued

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Managing Monthly Budget•Spend within CDC+ Monthly Budget

Use Calendar – Participant Notebook Appendix O (2)Spend consistent with Purchasing Plan

•OvertimeNot good use of funds

•Reconcile Monthly Statements •Participant Notebook Appendix M (2)•Track current account balance between statements

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Budget Mismanagement

•Budget mismanagement will lead to eitherCorrective Action Plan (CAP) or

Not “entitled” to a CAP before other sanctions can occur

Disenrollment and return to the Waiver

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Overspending

•Purchasing supports or services greater than the amount that is authorized•Insufficient funds in a consumer’s account result in claims being held until additional funds become available.•Once held, claims will be reviewed in the following order: timesheets, invoices, reimbursements.

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•A tool to assist participants or representatives to correct problems with mismanagement of the program as required by the 1915j State Plan Amendment.

•Developed and signed by participant and consultant

•To be developed immediately when participant/representative:• Purchases inconsistently with the approved Purchasing Plan• Overspends•Does not produce receipts upon request•Puts health and safety at risk

Corrective Action Plan (CAP) Appendix N,

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Corrective Action Plan (CAP), continued

The CAP plan addressesWHAT has happened/caused the problemHOW the participant/representative plan to correct the problemWHEN the problem will be correctedWHO is responsible for each step

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•Voluntarily or involuntarily•CDC+ Participant Information Update Form – (Participant Notebook Appendix D(XV11)

•CDC+ Account Close-Out Procedure- (Participant Notebook Appendix M(3)

Disenrollment from CDC+

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Thank you

Ivonne [email protected]

850-417-8270

CDC+ Customer Service1-866-761-7043

CDC+ Website http://apdcares.org/cdcplus/ 103

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Terms to Review

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Roles and ResponsibilitiesCritical Service, Restricted Service,STE- Short Term ExpenditurePended claims,Rep ReimbursementCAP- Corrective Action Plan

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Closing Activities

Final Q and A’s

Readiness Reviewhttp://apd.myflorida.com/cdc-plus/refreshform1.php

Evaluations

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http://www.surveymonkey.com/s/2LGVKFV