ACQUIRED BRAIN INJURY WAIVER CLOSURE PROCESS FLOW

How a Participant IBA is prorated – An Example

The current ABI plan started on 09/01/17 and the new Waiver[Comprehensive or Supports Waiver] is to start on 02/01/18.

The CM needs to submit a modification for the ABI plan to reflect ending the plan. Each modification must have a signed and dated signature page. Under Reason for Modification, CM needs to state:“Moving from the ABI Waiver to (Comprehensive or Support) Waiver. Please end the current plan of care on 01/31/18 and start the new case on 02/01/18.”

The PSS willprorate the IBA to ensureservice units align to match the plan end date. In this example, there will be 5 months that the participant is on the ABI waiver, so their current ABI budget will be divided by 12. The result will bemultiplied by 5 to determine the budget that should be applied to the ABI plan. The CM will need to adjust/decrease the units to stay within the IBA. We round up to the nearest dollar.

To change the IBA in EMWS, the PSS will complete the following steps:

  • Click on Individual Budget Amount in Waiver Links box.
  • Click Add
  • Select Plan Enrollment
  • Select the 09/01/17 date
  • Enter the amount that has been prorated
  • Select Temporary in Type box
  • Under Change Reason select Waiver transfer partial IBA
  • In Comment Box, type “Based on plan date of 9/1/2017 – 1/31/2018, 5 months of service.”

The PSS will also need to prorate the new Comprehensive or Supports Waiver plan. Following the same logic, the PSS will divide the new IBA by 12 and multiply that number by 7 since there will be 7 plan months on the new waiver. The CM will need to adjust the units to stay within the 7 month IBA. We round up to the nearest dollar. The PSS will need to follow the steps outlined above, but the notation in the Comment Box will read “Based on plan date of 02/01/18-08/31/18, 7 months of service.”

PSS will then approve the Initial Closure Review.

Before closing the plan, the PSSshould make sure that the modification has gone through MMIS and has been acknowledged in EMWS by the CM. If the PSS acknowledges the final closure prior to the modification completing through MMIS, the modification will disappear.

Behavioral Health Division, Developmental Disabilities Section1 | Page

ABI Waiver Closure Process Flow 11-1-2017 LT