Home and Community Based Services Waiver
Guidance Document
Division of Children and Families

Policy

The philosophy of the HCBS Waiver necessitates that the development of a HCBS Waiver site complement the existing county service system in a manner that fits local culture, including recruitment policies that help meet the cultural and linguistic needs of the program population. This requires a strong collaborative relationship between the LGU and ICC Agency.

ICC Agency Responsibilities

The ICC Agency is the lead agency for the HCBS Waiver. Responsibilities include:

• establishment and maintenance of the service provider network by negotiating written contracts for HCBS Waiver services with existing service providers in the community or with new service providers developed specifically for HCBS Waiver service provision. Subcontractor performance must be continually monitored. If the need to terminate a subcontractor arises, the ICC Agency requests decertification, with justification for such action, by writing to the LGU. The LGU forwards their recommendation to OMH for final determination.
• review, approval and documentation of qualifications of ICC Agency Waiver workers, as well as Crisis Response, Intensive In-Home, Family Support, Respite Care and Skill Building Services workers, including State Central Registry and fingerprinting clearance. No worker can begin delivering HCBS Waiver services without verification that the individual meets all required qualifications for the respective service;
• provision of umbrella liability insurance, or documentation that the individual has their own liability insurance for independent contractors (individuals);
• overseeing the use of individual service dollar expenditures in excess of $250 (ICC Program Director or Agency equivalent responsibility); approval must be noted in the case record and must relate to goals/objectives in the service plan; rules governing the uses of flexible service dollars are found in each ICC Agency’s contract with OMH and in Section 400 of this manual;
• completing Service Plans and Budgets initially, at the first 30 day interval and at every 90 day interval thereafter;
• overall monitoring of a child’s service plan budget at entry into the HCBS Waiver, at every service plan review, when the individual enters inpatient care for stabilization and when fiscal monitoring reports are received;
• monitoring inpatient stays to ensure that the child continues to meet the level of care of the HCBS Waiver and that status has not changed to warrant termination/discharge;
• hiring (including clearance through State Central Registry and fingerprinting clearance), supervising and training of Waiver workers;
• coordinating all the services the child and family receive under the HCBS Waiver, as well as monitoring the care and costs of other Medicaid reimbursed services for the child;
• functioning as the primary biller of Medicaid HCBS Waiver services as the Organized Health Care Delivery System (OHCDS);
• participating in contract negotiations with the Local DSS and LGU for the foster care population enrolled in HCBS Waiver;
• Incident Reporting and investigating for waiver services and assuring that subcontractors are aware of Incident Reporting policy and procedures*; (see below)
• informing children (as appropriate) and families of procedures for notifying authorities when abuse, neglect or exploitation is suspected, educating them regarding what constitutes abuse, neglect and exploitation;
• informing families of the agency's complaint/grievance process and assuring that they have the contact numbers for their regional OMH Parent Advisor and OMH Regional Office;
• completing all program and fiscal reporting requirements;
• overseeing completion of all necessary documentation including the CANS, at prescribed intervals;
• assuring timely, accurate data input of all necessary information into the OMH CAIRS system;
• retaining all required original documents including:1) family request for services, 2) Level of Care and annual recertifications, 3) Freedom of Choice application, 4) Provider Choice forms, 5) CANS, 6) Service Plan, Service Plan Reviews, and Budget, 7) Releases of Information, 8) Progress Notes (including subcontractors’ originals)* and 9) Discharge Summary and After-Care Plan; 10) Result of Screening Letter sent by LGU to family, 11) acceptance letter issued by OSU, 12) termination letter issued by OSU, 13) Safety Alerts Plans and any other significant documentation;
  (*The originals of progress notes are retained by the Community or Crisis Residence when the Respite Services are delivered byan OMH-certified Community or Crisis Residence.)
• developing and maintaining written agency HCBS Waiver Program policies and procedures to include Worker Safety Protocols (see Section 300.1B for guidelines), Incident Reporting, Complaint and Grievance Procedures, Client Satisfaction Surveys and overnight respite;
• attending regional and statewide HCBS Meetings;
• participating in site visit surveys and audits; submitting and completing Corrective Action Plans within prescribed timeframes;
• utilizing Field Coordinators and OMH Central Office for technical assistance;
• assuring compliance with all aspects of the OMH HCBS Waiver Program’s policy and procedures and
• assuring that HIPAA requirements are consistently met.

*Incident Reporting: Each ICC agency must follow the Incident Reporting Policy for HCBS Waiver Programs and the Definitions for Incident Types and Severity Ratings that correlate with OMH guidelines.  These must be maintained by each ICC agency in their Waiver Policy Manual.

Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.