Waiver Service Providers

1
Provider Endorsement
2
Provider Endorsement

• Community FASD Waiver providers
• Must be enrolled in the Medicaid program
• Must be a Community Mental Health Center or a
  Home and Community Based Waiver Services Provider
• Must receive required training
• Must be enrolled with First Health as a FASD
  Waiver provider
• Must be accredited by The Joint Commission, the
  Council on Accreditation (COA), or Commission on
  Accreditation of Rehabilitation Facilities
  (CARF), or attest to meeting federal requirements
  regarding participant safeguards

3
Provider Endorsement
UAA Center for Human DevelopmentContractor for
Required Training Evaluation
4
Provider Endorsement
Required Training
5
Provider Endorsement

• UAA/CHD Training
• FASD Medicaid Waiver Training Evaluation ?
  Childrens Behavioral Health Advocacy Programs
• Goals
• Create a system to efficiently train providers
  and document satisfaction of training
  requirements for project.
• Support State of Alaska (SOA) in compliance with
  national project evaluation.

6
Provider Endorsement
UAA/CHD Training
7
Provider Endorsement

• UAA/CHD training required for provider
  endorsement
• Completion of FASD 101 (web based) and FASD 201
• Semi annual conference
• Core training for DSP
• 1.5 days available at each conference
• Asynchronous web version
• Webinarscontent specific training
• Monthly clinical consultationproblem solving and
  project fidelity
• CAFAS training and practice
• Support inter rater reliability

8
Provider Endorsement
Participant Safeguards
9
Provider Endorsement

• What are safeguards?
• Safeguards are policies or procedures that are
  designed to prevent harm to an individual or to
  ensure that the application of a policy takes
  into account potentially adverse effects on a
  person. Safeguards apply to
• Restraint and Seclusion
• Restrictive Interventions
• Medication Administration

10
Provider Endorsement

• Providers must submit Letters of Attestation to
  address safeguard requirements
• Accredited providers already have policies
  regarding safeguards
• Non-accredited providers can attest that they
  have policies that comport with CMS guidelines

11
Provider Endorsement

• Plan of Care template addresses safeguard
  requirements
• Medication Management- Description of how
  medication is managed and administered
• Restrictive Interventions- Description of any
  allowable restrictive interventions, the
  conditions under which restrictive interventions
  may be allowed, and safeguards in place to
  prevent injury or abuse
• Seclusion and Restraint- Description of any
  allowable seclusion or restraint, efforts to be
  taken to prevent the use of seclusion or
  restraint, the conditions under which restrictive
  interventions may be allowed, and safeguards in
  place to prevent injury or abuse

12
Provider Endorsement

• Incident Reports

• Enrolled providers must report to Behavioral
  Health (BH) within 72 hours
• Reports of Harm sent to Office of Childrens
  Services (OCS) or Adult Protective Services (APS)
• Critical Incidents
• Use of restraint/seclusion
• Medication errors that result in hospitalization
  or other medical treatment

13
Provider Endorsement

• Quality Assurance

14
Provider Endorsement

• Quality Assurance-Still Under Construction!!!

• What we know
• BH FASD clinician will authorize initial, semi
  and annual POCs for medical necessity and
  clinical appropriateness of proposed services
• Enrolled providers will be required to submit
  Incident Reports to BH FASD staff
• BH FASD staff will review incident reports and
  any other provider/recipient concerns on an
  ongoing basis
• QA will occur primarily through existing BH audit
  processes
• Site visits may occur in response to concerns

15
Provider Endorsement

• Quality Assurance-Still Under Construction!!!

• What we know (cont.)
• Data collected, aggregated, analyzed quarterly
• BH established a FASD Waiver Quality Assurance
  (QA) Team to meet on a quarterly or as needed
  basis
• QA Team regularly reports to FASD Waiver Project
  Implementation Committee
• Annual review of QA data and Quality Management
  Strategy (QMS) plan
• A special committee with medical expertise will
  review medication errors
• BH provide technical assistance or corrective
  action if needed