Services

Is a Medicaid-enrolled provider who is responsible for:

Supporting you (or your family member / caregiver when he or she is acting as an employer on your behalf)
Providing you with training on how to be an effective employer; and
Completing ongoing services review activities as required by you and the Department of Medical Assistance Services (DMAS).

Accurately identifies the services with the established services system that best meet the individual’s needs.
Displays effective interviewing techniques to correctly understand and assess an individual’s needs and the services planning process.
Understands and respects the individuals’ rights to make decisions about, direct the provisions of, and control his/her services.

Consistently arrives to all appointments within 10 minutes of the scheduled time.
Runs “Visits To Do” report weekly and schedules face-to-face client visits within +/- 5 business days of their target date. Attempts to schedule next visit at the current visit, but no later than by the 5th of each month.
Limits short-notice absences to rare occasions and requests time off at least two weeks prior to taking time off.
Understands the different visit types and frequency. Appropriately enters current visit type and target visit type and date.

Researches and trouble-shoots service authorization challenges, time sheet issues, aide status, EOR status, eligibility and PPL challenges.
Writes justifications when an increase in Personal Care hours is needed.
Maintains strong client relationships, remains objective and demonstrates positive regard for individuals/families.
Demonstrates patience and respect when handling difficult situations.

Enters action-oriented notes in client profiles at least weekly when visits are out of compliance with anniversary date.
Enters referrals within 2 days of receiving them that include complete contact information and details of the referral source.
Understands and updates appropriately all sections of the SF assessment in WISE and on the DMAS-99.

Displays detailed knowledge of all CD-PAS waiver services (PCA, Respite, Companion/Supervision, PERS, Assistive Technology (AT), Durable Medical Equipment (DME), and Environmental Modifications (EM)) and can identify what is available to each client served.
Understands the rules and regulations, application process, eligibility criteria, appeal process, rights, and procedures, transfer process, and services available under CCC Plus Waiver, Community Living Waiver (CL), and Family & Individual Supports Waiver (FIS) Consumer-Directed services.
Understands roles and responsibilities of all of the entities involved in administering Virginia Medicaid Waivers – Moms In Motion/SFs, Agencies, PPL, KePRO, DBHDS, DMAS, CSBs, DSSs, DOHs, and MCOs.