Common use of Self-Directed Personal Care Clause in Contracts

Self-Directed Personal Care. The Department contracts with an agency for IRIS self-directed personal care (SDPC) oversight and nurse consultation services. Contractors are responsible for adhering to the IRIS Policy and Work Instructions dedicated to IRIS SDPC, as well as the following specific expectations. ICAs are responsible for: Training all new personnel initially and again annually on the IRIS SDPC option using the curriculum developed by the SDPC Oversight. Adding SDPC Prior Authorization to the Individual Support and Service Plan (ISSP) and stop any authorizations within 48 hours of disenrollment from IRIS SDPC services. Utilize the IRIS Self-Directed Personal Care Guide, provided by the oversight agency, to ensure participants qualify for IRIS SDPC prior to making a referral. A registered nurse at the oversight agency will complete the Personal Care Screening Tool to determine a participant’s personal care hours if they are deemed eligible. Ensuring that the hours ordered by the physician and authorized by IRIS SDPC agency match the amount indicated on the plan. Informing the nurse consultant when a long-term care functional screen is completed and identifies skilled nursing care. Making collateral contact with the IRIS SDPC registered nurse when completing the long-term care functional screen (LTCFS) for participants with IRIS SDPC (or MAPC) to verify changes to ADLS. This also ensures that the LTCFS is tied to the PCST if a change in personal care hours and cares may be impacted. Informing the SDPC Registered Nurse (RN) when any of the following occur: Health-related critical incident report is completed; Participant relocates; A health-related risk agreement is identified or completed; Health-related program integrity issues; Skilled services in the home; Institutionalization (e.g., hospital, nursing home, prison, etc.); Participant is traveling out of state; Participant dies; Participant has experienced a change in guardian or legal representative; Participant has been issued a Notice of Action for disenrollment; Participant has no workers; Adult Protective Services has been engaged/contacted; Participant has disenrolled from the program; or Any other health and safety issues that would impact services or care. Completing the IRIS Self-Directed Personal Care Disclosure Statement (F-01258), when applicable per IRIS Policy. FEAs are responsible for: Ensuring that all personal care services being paid to workers are only for those participants enrolled in IRIS SDPC. FEAs should look at the certification period and any holds in place to ensure that IRIS SDPC remains current and authorized. Paying only for those hours that are authorized. Crosschecking to ensure there is a valid authorization prior to payment. Ensuring that no IRIS SDPC RNs or representatives are paid for providing IRIS SDPC services.

Self-Directed Personal Care. ‌ The Department contracts with an agency for IRIS self-directed personal care (SDPC) oversight and nurse consultation services. Contractors are responsible for adhering to the IRIS Policy and Work Instructions dedicated to IRIS SDPC, as well as the following specific expectations. ICAs are responsible for: Training all new personnel initially and again annually on the IRIS SDPC option using the curriculum developed by the SDPC Oversight. Adding SDPC Prior Authorization to the Individual Support and Service Plan (ISSP) and stop any authorizations within 48 hours of disenrollment from IRIS SDPC services. Utilize the IRIS Self-Directed Personal Care Guide, provided by the oversight agency, to ensure participants qualify for IRIS SDPC prior to making a referral. A registered nurse at the oversight agency will complete the Personal Care Screening Tool to determine a participant’s personal care hours if they are deemed eligible. Ensuring that the hours ordered by the physician and authorized by IRIS SDPC agency match the amount indicated on the plan. Informing the nurse consultant when a long-term care functional screen is completed and identifies skilled nursing care. Making collateral contact with the IRIS SDPC registered nurse when completing the long-term care functional screen (LTCFS) for participants with IRIS SDPC (or MAPC) to verify changes to ADLS. This also ensures that the LTCFS is tied to the PCST if a change in personal care hours and cares may be impacted. Informing the SDPC Registered Nurse (RN) when any of the following occur: Health-related critical incident report is completed; Participant relocates; A health-related risk agreement is identified or completed; Health-related program integrity issues; Skilled services in the home; Institutionalization (e.g., hospital, nursing home, prison, etc.); Participant is traveling out of state; Participant dies; Participant has experienced a change in guardian or legal representative; Participant has been issued a Notice of Action for disenrollment; Participant has no workers; Adult Protective Services has been engaged/contacted; Participant has disenrolled from the program; or Any other health and safety issues that would impact services or care. Completing the IRIS Self-Directed Personal Care Disclosure Statement (F-01258), when applicable per IRIS Policy. FEAs are responsible for: Ensuring that all personal care services being paid to workers are only for those participants enrolled in IRIS SDPC. FEAs should look at the certification period and any holds in place to ensure that IRIS SDPC remains current and authorized. Paying only for those hours that are authorized. Crosschecking to ensure there is a valid authorization prior to payment. Ensuring that no IRIS SDPC RNs or representatives are paid for providing IRIS SDPC services.

Self-Directed Personal Care. The Department contracts with an agency for IRIS self-directed personal care (SDPC) oversight and nurse consultation services. Contractors are responsible for adhering to the IRIS Policy and Work Instructions dedicated to IRIS SDPC, as well as the following specific expectations. ICAs are responsible for: Training all new personnel initially and again annually on the IRIS SDPC option using the curriculum developed by the SDPC Oversight. Adding SDPC Prior Authorization to the Individual Support and Service Plan (ISSP) and stop any authorizations within 48 hours of disenrollment from IRIS SDPC services. Utilize the IRIS Self-Directed Personal Care Guide, provided by the oversight agency, to ensure participants qualify for IRIS SDPC prior to making a referral. A registered nurse at the oversight agency will complete the Personal Care Screening Tool to determine a participant’s personal care hours if they are deemed eligible. Ensuring that the hours ordered by the physician and authorized by IRIS XXXX SDPC agency match the amount indicated on the plan. Informing the nurse consultant when a long-term care functional screen is completed and identifies skilled nursing care. Making collateral contact with the IRIS SDPC registered nurse when completing the long-term care functional screen (LTCFS) for participants with IRIS SDPC (or MAPC) to verify changes to ADLS. This also ensures that the LTCFS is tied to the PCST if a change in personal care hours and cares may be impacted. Informing the SDPC Registered Nurse (RN) when any of the following occur: Health-related critical incident report is completed; Participant relocates; A health-related risk agreement is identified or completed; Health-related program integrity issues; Skilled services in the home; Institutionalization (e.g., hospital, nursing home, prison, etc.); Participant is traveling out of state; Participant dies; Participant has experienced a change in guardian or legal representative; Participant has been issued a Notice of Action for disenrollment; Participant has no workers; Adult Protective Services has been engaged/contacted; Participant has disenrolled from the program; or Any other health and safety issues that would impact services or care. Completing the IRIS Self-Directed Personal Care Disclosure Statement (F-01258), when applicable per IRIS Policy. FEAs are responsible for: Ensuring that all personal care services being paid to workers are only for those participants enrolled in IRIS SDPC. FEAs should look at the certification period and any holds in place to ensure that IRIS SDPC remains current and authorized. Paying only for those hours that are authorized. Crosschecking to ensure there is a valid authorization prior to payment. Ensuring that no IRIS SDPC RNs or representatives are paid for providing IRIS SDPC services.