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HomeMy WebLinkAboutMHIDD-301 Suspension and Termination1 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: Suspension and Termination PROCEDURE NUMBER: MHIDD-301 Effective Date: January 1, 2006 Date Revised: October 12, 2023 INTRODUCTION: This procedure statement discusses guidelines to be followed prior to suspending or terminating an individual funded by MH/IDD/EI from services. This policy and the related procedures are based on the Department of Human Services Regulations, Chapter §6100 and related Bulletins from the Office of Mental Health and Substance Abuse Services (OMHSAS) and Office of Developmental Programs (ODP). DISCUSSION: Agencies are responsible for making efforts to structure the environment in order to create and maintain optimum individual interest, satisfaction, development, and choice in all aspects of their program. Agencies will strive to make their programs appropriate to individuals, not make individuals appropriate to their programs. Agency policies for suspension and termination are in need of close review to assure that the right to services for each individual is protected. Agencies that suspend or terminate MH/IDD/EI Base funded individuals for reasons that are not considered by the MH/IDD/EI office to coincide with the policies and procedures for suspension or termination will not receive authorization to fill the vacancy, nor will the agencies be reimbursed for that vacancy. Additionally, if an individual is terminated from services through an MH/IDD/EI contracted provider and MH/IDD/EI does not agree with this termination, funding may be moved from said provider to serve the terminated individual elsewhere. Providers are expected to have their applicable agency policy available for MH/IDD/EI staff to review at their annual provider monitoring and/or at any point during the year when it may be requested. 2 PROCEDURE: 1. All individuals and/or responsible parties must be given a copy of the service program's suspension and termination policies and procedures at the time of the individual’s entry to the program. It is the expectation of MH/IDD/EI that time limited suspension precedes a recommendation for termination. The exception to this would be a serious policy violation(s) which would warrant immediate termination from the program. The policies and procedures must address the following areas: A. Clearly outlined actions that could result in suspension and/or termination B. Delineation of steps leading to suspension and/or termination recommendation(s), such as: a. Written notice that clearly outlines a Plan of Correction (POC) to avoid suspension of the individual. b. Meetings with the involvement of all team members i.e. the individual’s team members: Case Manager/Supports Coordinator, the individual's advocate, providers of service, and specific program staff recommending time limited suspension. c. Recommend termination due to unsuccessful remediation of behaviors leading up to suspension or flagrant policy violations resulting in immediate/direct termination. 2. In considering the suspension and/or termination of an individual, the following steps must be adhered to: A. Suspension. Agencies are responsible for providing the individual and/or the individual’s advocate, the individual’s Case Manager/Supports Coordinator, and MH/IDD/EI with a written notice of intent to suspend which will outline the rationale behind the intent to suspend and the proposed length of the potential suspension. This notice must be given thirty (30) calendar days prior to the proposed start of the suspension time period in order to allow adequate time to implement the POC. If there is noticeable improvement within thirty (30) calendar days, the status of the potential suspension will be reassessed. Additionally, agency staff must schedule a meeting with all involved parties to be held within seven (7) calendar days of intent to suspend notice preparation. The purpose of the meeting will be to: (1) discuss the factors which prompted the preparation of the intent to suspend notice; (2) make sure that all involved parties clearly understand what the expected outcome(s) of the suspension time period are; (3) communicate what type of evaluative process will be utilized at the conclusion of the period of suspension to determine potential next steps—reinstatement into the program or termination; and, (4) develop a written POC which will address the three (3) preceding items and include input from all involved parties. a. During the period of suspension, the individual’s position/status in the program will be maintained. b. Individuals have the right to file a Grievance/Appeal directly with the provider that made the determination to deny, suspend, reduce, or terminate 3 the Based funded services as outlined in Procedure Statement MHIDD-305 Grievance Procedure – Individual’s Right to Appeal. B. Termination. Agencies are responsible for providing the individual and/or their emergency contact, if deemed appropriate, the individual's Case Manager/Supports Coordinator and team members, MH/IDD/EI, and, if applicable, the Office of Developmental Programs (ODP) with a written termination notice, outlining the reason(s) for termination and the agency appeal process. The written notice must be given at least 45 calendar days prior to the termination date to allow adequate time to appeal the decision and, if appeal is unsuccessful, transition to other programming. Additionally, agency staff must schedule a meeting with all involved parties to be held within thirty (30) calendar days of intent to terminate notice preparation. The purpose of the meeting will be to: (1) discuss the factors which prompted the preparation of the intent to terminate notice; (2) create a POC which would clearly outline potential strategies to avoid termination from this service, the means through which the POC will be evaluated and to identify potential alternative support services if termination is the final outcome. a. Upon notice of termination, the appeal procedure must be explained in detail by agency staff to the individual, individual's advocate, Case Manager/Supports Coordinator, and team. b. Appeal procedures must be acted upon within the prescribed agency time frames, and documentation leading to a decision must be made available to the individual and/or emergency contact if deemed appropriate, and their Case Manager/Supports Coordinator. c. Individuals have the right to file a Grievance/Appeal directly with the provider that made the determination to deny, suspend, reduce, or terminate the Based funded services as outlined in Procedure Statement MHIDD-305 Grievance Procedure – Individual’s Right to Appeal. d. The provider shall continue to provide the authorized service during the transition period to ensure continuity of service until a new provider is approved and a new service is in place, unless otherwise directed by the managing entity or ODP. 3. Upon discharge: A. Providers who terminate an individual from service are responsible for completing an individual discharge plan. This should include at a minimum: a. Specific programmatic reason(s) for termination (including supportive documentation of discharge criteria) b. Specific individual program plan analysis supporting the individual's progression/regression c. Summary of actions taken to avoid termination, including copies of individual - provider behavioral and/or contingency agreements d. Recommendation for needed services e. Action necessary for the individual to be reinstated into the program (in quantifiable and measurable short-term individual goals) 4 B. The provider is responsible for submitting a Discharge Summary to the appropriate Program Specialist for all individual service terminations for individuals authorized for MH/IDD/EI funding, planned and unplanned, to the MH/IDD/EI Office within ten (10) business days of discharge. a. In Mental Health, the Program Specialist will close the authorization and then notify the respective Case Manager that the authorization has been closed effective as of the discharge date. Additionally, it is incumbent for the provider to formally notify all other agencies that are currently providing services to this individual of the planned discharge. b. In Intellectual & Developmental Disabilities (IDD), if the provider is no longer able or willing to provide a service for an individual in accordance with § 6100.303 (relating to involuntary transfer or change of provider), the provider shall provide written notice to the following at least 60 days prior to the date of the proposed change of provider or transfer: 1. The individual. 2. Persons designated by the individual. 3. The individual plan team members. 4. The designated managing entity. 5. The Supports Coordinator, Base-funding Supports Coordinator or Targeted Support Manager. 6. The Department. c. The Department or designated managing entity may authorize a transfer or change date earlier than the date specified to protect the health and safety of the individual or others. d. The provider’s written notice must include the following: 1. The individual’s name and master client index number. 2. The current provider’s name, address and master provider index number. 3. The service that the provider is unable or unwilling to provide. 4. The location where the service is currently provided. 5. The reason the provider is no longer able or willing to provide the service as specified in §6100.303. 6. A description of the efforts made to address or resolve the issue that has led to the provider becoming unable or unwilling to provide the service. 7. Suggested time frames for transitioning the delivery of the service to the new provider. C. Even upon termination from services, individuals are permitted to reapply for the service. Each request will be considered on a case-by-case basis and will be initiated by the individual’s Case Manager/Supports Coordinator.