Support Coordination Alliance
Minutes
May 12,, 2015
Attendance
Alison Goodrich, CAU
Bill England, Disability Services
Mercedes Witowksy, CAU
Neeta Das, Progressive Comprehensive Services
Michelle Barker
Staff: Donna Bouclier
I. Welcome and Introductions were made.
II. Minutes from the April 2015 were not available.
III. DDD Fee for Service Implementation Discussion
a. Audit Protections
Given the changing billing environment as we transition from contract to a fee for service system, it appears that clear policy and procedures are still lacking. An SCO was recently audited over an allegation of fraud. According to that provider, DDD contacted families to inquire if the SC made contact with the family; how long; where; were documents signed; visits made; etc. DDD wanted proof that phone calls were made. Agencies are investigating vendors who can provide a service. Over $90,000 is being withheld by DDD as a result of their investigation which is pending. The provider has appealed and has attorneys involved.
As a result of this experience, SCO’s recognize that they must ramp up their documenting procedures and quality management oversight. This is problematic for several reasons. First of all, supervisors do not have an opportunity to review the monitoring documents since they must be uploaded by the SC. Once it is uploaded, it becomes part of the formal record. If there were supervisory issues related to the monitoring, it is caught after the fact, not before. SCOs brought this to the attention of DDD who reportedly stated that they did not understand a need to change their process.
Completing the Tracking Forms presents another challenge. First of all, there is no mention of it in the 2nd draft of the Supports Program Manual. Yet, SCs are being told that the monitoring begins the next day and to continue using those forms. Which day begins day #1 toward the 30 days? The next day or the day the plan was completed? Yet, the draft version of the Supports Program Manual, 2nd revision, page 48 specifies that the monthly contact be conducted within 30 days from the date of the ISP approval and within every 30 day timeframe thereafter. Since there is no mention in the draft Manual, will SCs still be required to use the Tracking Forms?
When the ISP is renewed, does that visit count toward a monitoring visit?
SCO members are concerned that ISP revisions are not a valued/rate driven service. One member noted that according to Tom Papa, SCOs have 13 months of billing included in the completion of the monthly monitoring tools. For example, you can have 2 deliverables in one month. This is mentioned in the Tracking Form procedures, but not in the 2nd revision to the draft manual.
Currently, SCOs cannot bill at the end of any month for any service that was delivered in that month. So, if a service was completed April 15, 2015, the SCO has to wait until 5/15/15 to bill for that service. Yet, the monitoring tools must be completed every month vs. within a 30 day timeframe of service.
Actions:
1. ABCD is arranging for Molina to come to present to the trade organizations June 15, 2015.
2. Dan will present the above noted questions to DDD for a response
b. Tiering and Notification
SCOs are still questioning when they will see the scores so they can let providers know ther tier and acuity for the person.
c. HIPAA Compliance
SCO are investigating the best service/vendor to use so that emails are encrypted. Some suggested CISCO and others noted that google can also be used.
d. Supports Program Manual
The 2nd revision was distributed. According to one member whose agency did an analysis between the 1st and 2nd versions, less than 15% of the comments made were incorporated into the 2nd draft.
IV. Follow Through and Updates
1. Compensation and duties vs the contract and how it compares with other states was going to be investigated by Alex, Neeta and Julian. As of this meeting, there is no update. Mercedes will share a didactic contract so we can at least begin to look at the contract vs the actual duties. However, unless someone takes the lead, this will not be a priority.
2. Dan will present the questions within this document to either DDD and/or CMS,
Questions for CMS:
When can an SCO bill?
Can DDD exercise control over when the SCO bills in a Medicaid Fee for Service world?
Questions for DDD:
Why can the SCO not bill after delivering the service?
What does DDD not place a value on calls, travel and ISP revisions?
Who pays for interpreter services such as sign language for the family?
How is DDD going to handle indirect costs such as calls and travel?
V. ABCD Provider/Support Coordination Event Planning
Provider Wine and Cheese will happen in June. No date is set. (Since this meeting, the date is now set for June 17, 2015. Location to be determined)
Next Meeting
June 9, 2015
July 14, 2015
August 11, 2015
September 8, 2015
October 13, 2015
November 10, 2015
December 8, 2015
ABCD Office in Hamilton
Dbouclier:forums/supportcoordination/5.12.15