Agenda 08/26/2003 - Laserfiche WebLink

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FY 2004 Community Services Performance Contract this contract, that are provided or contracted by the Board. Services and certain terms used in this contract are defined in the current Core Services Taxonomy, which, by agreement of the parties, is hereby incorporated into and made a part of this contract by reference. Some services also are defined in the Medicaid State Plan Option and Mental Retardation Home and Community-Based Waiver regulations promulgated by the Department of Medical Assistance Services, Expenses for Services: The Board shall provide those services that are funded within the revenues and expenses set forth in Exhibit A and documented in the Board's financial management system. The Board shall distribute its administrative and management expenses across some or all of the three program areas on a basis that is in accordance with Uniform Cost Report principles, is auditable, and satisfies Generally Accepted Accounting Principles. Continuity of Care: In order to partially fulfill its responsibility in § 37.1-197.1 of the Code of Virginia to function as tl-ie single point of entry into the publicly-funded services system in its service area, the Board shall follow the Continuity of Care Procedures that are included in the current General Requirements Document. 1) Coordination of Mental Retardation Waiver Services: The Board shall provide case management services to consumers who are receiving services under the Medicaid Mental Retardation Home and Community-Based Waiver (MR Waiver). In this capacity and in order to receive payment for services from the Department of Medical Assistance Services (DMAS), the Board shall develop the individualized services plan (ISP) and submit it to the Department for preauthorization, pursuant to section 3.2.7 of the DMAS/DMHMRSAS Interagency Agreement (10-17-2000), under which the Department preauthorizes ISPs as a delegated function from DMAS. As part of its specific case management responsibilities for individuals receiving MR Waiver services, the Board shall coordinate and monitor the delivery of all services to its consumers, including monitoring the receipt of services in a consumer's ISP that are provided by independent vendors, who are reimbursed directly by DMAS, to the extent that the Board is not prohibited from doing so by such vendors (reference the DMAS Mental Retardation Community Services Manual, Chapters Il and IV). The Board may raise issues regarding its efforts to coordinate and monitor services provided by independent vendors to the applicable funding or licensing authority (e.g., the Department, DMAS, and the Virginia Department of Social Services). In fulfilling this service coordination responsibility, the Board shall not restrict or seek to influence the consumer's choice among qualified service providers. This prohibition is not intended to restrict the ability of Board case managers to make recommendations, based on their professional judgment, to consumers regarding those available service options that best meet the terms of the consumers' ISPs and allow for the most effective coordination of services. This section does not, nor shall it be construed to, make the Board legally liable for the actions of independent vendors of MR Waiver services who are reimbursed directly by DMAS. 2) Linkages with Primary Care: When it arranges for the care and treatment of its consumers in hospitals, the Board shall assure its staff's coordination with such hospitals, especially emergency rooms and emergency room physicians, in order to promote continuity of care for those consumers. 3) Coordination with Local Psychiatric Hospitals: In the case of voluntary admissions, the Board, with the consumer's consent, shall coordinate an enrolled consumer's admission to and discharge from local psychiatric units and hospitals to assure apprepfiate use of these services in the least restrictive setting and to prevent inappropriate use of those hospitals. 2, 05-02-03