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HomeMy WebLinkAboutMH-206 Community Residential Service Providers Vacancies1 FRANKLIN/FULTON COUNTY MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL DISABILITIES/EARLY INTERVENTION 425 Franklin Farm Lane Chambersburg, PA 17202 (717) 264-5387 MH/IDD/EI PROCEDURE STATEMENT PROCEDURE SUBJECT: Community Residential Service Providers Vacancies PROCEDURE NUMBER: MH-206 Effective Date: January 1, 2005 Date Revised: June 20, 2018 PROCEDURE: MH/IDD/EI will consider a Mental Health (MH) residential bed to be occupied only when an individual is actually receiving residential service. Providers are not to bill MH/IDD/EI for services provided after the individual has left the program or after the authorization for the service has expired. For example, if an individual leaves on July 15, the provider may only bill MH/IDD/EI for the first fifteen (15) days of July. Absence from a residential program may occur due to any of the following reasons:  Admission to community hospital for a somatic condition  Admission to community hospital for a psychiatric condition  Incarceration in the County Jail A vacancy is not automatically created when a resident is admitted into an acute care medical facility. A potential vacancy is created only after the first fifteen (15) days in an acute care medical facility and it is determined that an individual requires more extensive treatment at an extended acute care program, state hospital, or similar rehabilitative facility, or will not return to the residential program for some other reason. These first fifteen (15) days are not billable. Unusual circumstances may occasionally warrant consideration of this policy if the needs of individuals are to be adequately addressed. Therefore, MH/IDD/EI reserves the right to make the final determination concerning the status of a bed in MH/IDD/EI-funded residential programs. At the discretion of the MH Program Specialist or MH/IDD/EI Administrator, a meeting can be held to make this determination. The potential participants could include any or all of the following:  Individual  Individual’s family  Individual’s case manager  Respective supervisor 2  MH Program Specialist  Current treatment team Various factors will be considered including but not limited to:  History of the individual in that residential program  Events that resulted in the current absence and the appropriateness of them returning to that program  Current waiting list for that residential program, etc. If it is decided that the individual would be better served in another residential program, the assigned Case Manager will complete and submit the necessary referral. If this group is unable to arrive at a definitive decision, the MH/IDD/EI Administrator or their designee will be consulted and will then make the final determination. The MH Program Specialist responsible for monitoring that particular contract will communicate the decision to the residential program in writing. Interpretive questions or requests for review should be addressed through MH/IDD/EI, to the appropriate MH Program Specialist who will consult the MH/IDD/EI Administrator, if necessary. A waiver of this decision should be requested in a letter to the MH/IDD/EI Administrator or their designee, with a copy to the MH Program Specialist stating the resident's name, Base Service Unit (BSU) number, circumstances surrounding the request, and number of days authorized payment is requested. The MH/IDD/EI Administrator or their designee will respond with a decision in writing. The residential service provider may neither independently turn down a referral submitted by MH/IDD/EI (“no reject”) nor ask someone to leave the program (“no eject”) without there first being a meeting to discuss the referral or to discuss the reasons that termination is being considered. Regarding potential termination, it is essential that the Case Manager be promptly informed when issues arise involving an individual in the program. The goal would be to appropriately address these issues in order for them not to jeopardize the individual’s status in the program. Providers are asked to fully comply with Procedure Statement MHIDD-301, Termination and Discharge. Residential providers must develop an occupancy factor of 95% or greater. Technical assistance is available by contacting the MH Program Specialist. The MH Program Specialists maintain lists of individuals in need of residential services. The residential service provider is expected to continue to provide support for persons placed in acute care medical facilities until it is determined that the person is in need of long-term care (which is defined as anything beyond acute care in a community hospital setting). When that determination is made, MH/IDD/EI will assist in securing the transfer arrangements to a long-term care facility (i.e. state hospital) and will notify all appropriate persons of these arrangements. On the day of transfer to the long-term care facility:  The individual’s bed will become available to the next person triaged on the waiting list.  The name of the transferred individual will be placed in priority status at the top of the waiting list of the appropriate housing program. 3 In the event of incarceration:  The individual’s bed will be held for a period not to exceed ten (10) business days (dependent upon the nature of the charges).  If the anticipated length of the incarceration is going to be longer than ten (10) days and/or dependent upon the nature of the charges, the bed will be considered vacant and will be offered to the next person triaged on the waiting list. Residential service providers are to work with the MH/IDD/EI Office to fill vacancies when they occur. To do this effectively, the following will be accomplished:  Contracted MH providers of residential care will maintain regular contact and communication with the MH Program Specialist to discuss potential vacancies and individuals being considered for admission.  The waiting lists of all contracted residential programs will be maintained at MH/IDD/EI and be monitored by the MH Program Specialist who has the final approval of individuals placed in these programs. It is understood that some providers may need to maintain their own waiting lists due to non-MH/IDD/EI funding sources guidelines [i.e. Housing and Urban Development (HUD)]. Ongoing collaborative efforts will be made to enable the lists to be as similar as possible.