Ending Self-Directed Services, Grievance and Appeal Rights Sample Clauses

Ending Self-Directed Services, Grievance and Appeal Rights. An individual may voluntarily end a self-directed service arrangement at any time for any reason. The Prepaid Inpatient Health Plan (PIHP) and or the Community Mental Health Service Provider (CMHSP) must work together with the individual to transition to another service arrangement through the person-centered planning process. Discontinuation of a self-direction agreement, by itself, shall neither change the individual’s plan of service, nor eliminate the obligation of the PIHP/CMHSP to assure specialty mental health services and supports required in the IPOS are provided. Ending self-directed service arrangements may be initiated by either, the individual or the Prepaid Inpatient Health Plan (PIHP) and/or Community Mental Health Support Plan (CMHSP). Before they can end self-directed services, the PIHP and/or CMHSP must inform the individual of the issues that have led to the possibility of ending self-direction arrangements, in writing. They also must provide opportunities for problem solving and resolution have been exhausted. The individual must be involved in all problem solving attempts. Ending self- direction arrangements are only done if other mutually agreeable solutions have been exhausted. Termination of a self-direction services agreement by a PIHP/CMHSP is not a Medicaid Fair Hearings Issue. Only a suspension, reduction, or termination of Medicaid services can be appealed through the Medicaid Fair Hearings Process, not the use of self-direction arrangement to obtain those services. As it pertains to termination of self-directed service arrangements, ending the Financial Management Services (formerly Fiscal Intermediary) can be appealed through the Medicaid Fair Hearings Process. Definition of Terms Agency Supported Self-Direction (Also Known as Agency with Choice) This allows the person to direct as much or as little employer and administrative responsibilities as agreed upon in the Individual Plan of Service (IPOS) and Agency Agreement while a provider agency serves as employer of record. Choice Voucher Arrangements Choice Voucher is the name for self-directed services for people under the age of 18. This is because children cannot independently direct their services until adulthood. Direct Hire or Direct Employment The Direct Hire or Direct Employment Model is an option of self-direction where the person is considered the employer of record and has the authority to hire, fire, supervise, and manage individual, aide level workers.