Newsletter June 2018

Utilization Management

Dr. Todd Lewicki, PhD, LMSW, Chief Behavioral Health Officer
Katy Hammack, M.Ed., Waiver Coordinator

  

Health and Safety in HCBS Transition

Mid-State Health Network (MSHN) has been participating in the Home and Community-Based Services (HCBS) Rule Transition planning and activities since 2014.  The intent of the HCBS Final Rule is to make sure that individuals with disabilities have the opportunity for independence in making life decisions, to fully participate in community life, and to ensure that their individual rights are respected.

In order to be considered compliant with the HCBS Final Rule, any modification must be documented in the Individual Plan of Service (IPOS). Health or safety needs are the only acceptable justification for potentially limiting an individual's rights and freedoms. Examples include, among others, being able to have visitors at home at any time, having access to food, or to do laundry at any time. The Michigan Department of Health and Human Services (MDHHS) Behavioral Health and Developmental Disabilities Administration (BHDDA) Person-Centered Planning Policy states that the following requirements must be documented in the IPOS when a specific health or safety need warrants such a restriction:

  • The specific and individualized assessed health or safety need;
  • The positive interventions and supports used prior to any modifications or additions to the Person-Centered Plan (PCP) regarding health or safety needs;
  • Documentation of less intrusive methods of meeting the needs, that have been tried, but were not successful;
  • A clear description of the condition that is directly proportionate to the specific assessed health or safety need;
  • A regular collection and review of data to measure the ongoing effectiveness of the modification;
  • Established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;
  • Informed consent of the person to the proposed modification; and
  • An assurance that the modification itself will not cause harm to the person. 

Please contact Todd with questions or concerns related to MSHN Utilization Management and/or the above information at  Todd.Lewicki@midstatehealthnetwork.org

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