Is there no longer a window of time clients have to be living in a facility prior to doing the assessment?
Can you clarify if there are any positions covered by the grant which can bill any services to Medicaid Rule 132?
Are you able to help us get informed consents that were previously summitted by the prior agency? We are having trouble getting them from the old agencies.
Can we use UIC as a resource for missing evaluations and service plans?
Will subsidy providers be using Entrust to receive documents (inspection requests/housing forms)?
MCOs have been sending records for class members that were not assigned to us on the master list sent by the state for post-transition members. Were Illinicare and Aetna sent the same lists that were sent to the Primes?
Outreach Outcome form: do we need to submit all 3 pages when either page 2 or page 3 will always be not applicable?
Informed Consent form: There is no place for a guardian to decline if they do not want the class member to be assessed.
For Aetna and IlliniCare members, when will the geographical location change in these assignments take place?
Can Prime agencies use flex funds if a class member transitioned by another agency needs something in the community?
Several questions were asked about Critical Alert Incidents and the roles of the DHS Quality Monitors.
Are Primes allowed to conduct assessments over the phone with the intent to later follow-up/verify with the class member physically once nursing facility restrictions are lifted?
If a Class Member's post-transition case was closed at the 12-month mark (under the former program), but the Class Member is still within the 18-month monitoring timeframe, should the Prime reopen the closed case and continue to monitor the Class Member until the 18 month mark?
We have heard that all neuropsych evaluations and OT assessments have been postponed until further notice. Should we continue to send the referrals over for a waiting list? Or should we discontinue sending them at all?
In a quality review of the Comprehensive Service Plan, what is being reviewed and how will it be rated?
For Class Members who have transitioned, which agency is responsible for monitoring the Class Member during the 18-month post-transition period?
Does the Informed Consent allow sunsetting providers and Prime agencies legal permission to exchange class member information without violating HIPAA?
Should Primes be instructed to have the Informed Consent signed by all class members that are assigned to them prior to their provider-to-provider meeting and the exchange of records?
Can a class member request to be assigned to a specific Prime of their choice, rather than being assigned to a Prime based on their nursing facility/SMHRF? What is the process for this?
For class members who are recommended for CAST by the sunsetting agency, should the new Prime move forward with closing the class member's case?
For class members who were recommended for transition and moved from a nursing facility/SMHRF to a SLF, does that count as a transition?
Our understanding was that Comprehensive Service Plans could be completed by a minimum bachelor's level staff, as long as a credentialed care manager reviewed and signed off on them. Is this accurate?
Can we "count" class members transitioning from nursing facility to residential, and then again when they move from residential to an apartment? Or just when they move from the facility to residential?
We have previously moved some class members from the nursing facility into RSSI. Is RSSI still a contracted provider, or should we interface with them as we would any non-contracted housing provider?
You previously confirmed that class members who have already moved, had a lease signed, or application approved, would stay with their sunsetting agency, but all other referrals would be the Prime's responsibility. If we run into scenarios where the sunsetting agency is pushing back, to whom should we refer them?
Will class members with exclusionary diagnoses need to be outreached again? Will the exclusionary diagnosis need to be re-confirmed by an MD independent from the LTC facility if it hasn't been already?
Will DMH be forwarding the Decatur Resident Reviews from January to Heritage, or would they like us to send and ROI to CMS at Decatur Manor so we can forward the Resident Reviews directly?
Can Williams Class Members be approached for outreach at any time?
If a class member is not recommended for transition, do they need to be re-approached by outreach for another evaluation, or by the assessor?
Is there an exact time frame that a Prime has to respond to a Critical Alert Incident once they are notified by the OMSU Compliance Auditor? What is the time frame for reporting the outcome of the investigation to the OMSU Compliance Auditor?
What does the Quality Monitor look for during a class member home visit that would trigger a Critical Alert Incident?
How frequently will Class Members be visited in the community by a state Quality Monitor under the Comprehensive Program?
Will there be a formal Critical Alert Incident training for the Primes and information about the Role of the State Quality Monitor?
Can a new Prime agency who "inherited" a member currently in the community use flex funds if that member needs something?
Do DON score requests still go through the member's Medicaid MCO?
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