1 department of medical assistance services dd waiver provider training department of medical...

http://dmasva.dmas.virginia.gov/ 1

Department of Medical Assistance Services

DD Waiver Provider Training

Department of Medical Assistance Services Division of Long-Term Care

and Quality Assurance2013



Family/Caregiver Training (FCT)



Family/Caregiver Training

Definition• Provision of identified training and

education to a family member or caregiver regarding: – Disabilities– Community integration– Family dynamics– Stress management– Behavior interventions– Mental health



Family/Caregiver TrainingDefinition continued• “Family” constitutes persons who live with

or provide care to a waiver consumer– Parent– Spouse– Children– Other Relatives (including in-laws)– Legal Guardian– Foster Family




Provider Qualifications• Provider must enroll with DMAS to be a

Family/Caregiver Training Provider

• Existing Medicaid providers cannot use current Identification number

• Obtain Enrollment Packet by calling the Provider Enrollment Unit (888) 829-5373



Family Caregiver Training

• Training shall be provided on an individual basis or in small groups provided by Medicaid-certified Family/Caregiver Training providers




Provider Qualifications• Who can provide this service?

– Home health agencies;– Community developmental disabilities

agencies;– Developmental disabilities residential

providers;– Community mental health centers;– Public health agencies;– Hospitals;



Family/Caregiver Training Provider Qualifications• Who can provide this service:

– Clinics; – In-home rehabilitation agencies;– Other agencies or organizations

• Individual Family/Caregiver Trainers who have necessary Virginia licensure or certification for their profession may also enroll as a provider.



Family/Caregiver TrainingProvider Qualifications

Providers must:• Have demonstrated experience or

knowledge of the training topic

• Have the appropriate licensure or certification for their field.




Providers include:– RNs, LPNs, RNAs, & Nurse Practitioners– Occupational, Physical and Speech

Therapists– Physicians– Teachers– Psychologists– Licensed Practical Counselors– Licensed Clinical Social Workers



Referral Process• During POC development, the case

manager will document with the family the need for training.

• Training must be necessary:– To improve the family or caregiver’s ability

to give care and support to the individual.– To assist the family/caregiver with

maintaining the individual at home.



Referral Process• The case manager will give the family

and/or caregivers the choice of Family/Caregiver training providers



Referral Process• The case manager documents this

information on the POC (DMAS 456) and supporting documentation (DMAS 457) and obtains authorization from DMAS for services.

• If additional hours are needed, the family/caregiver provider should contact the case manager.



Service Units• Individuals can receive up to 80 hours of

Family/Caregiver Training services per calendar year

• The training must be authorized by DMAS and billed on an hourly basis



Service Limitations

• Training cannot include services available under Medicaid State Plan services or educational courses.

• Paid caregivers are not eligible to receiving training through this service.



Documentation• The CM should provide the following

information regarding the individual:–The POC (DMAS 456, DMAS 457)–The DMAS 225–Any relevant evaluations,

therapeutic consults, MD reports



Provider Documentation • The FCT should provide the following

information to the case manager:

Supporting Documentation(DMAS 457) Brochure of training activities



Provider Documentation cont. Contact notes:• Date, location, and time of each training

contact;• Type of activities and hours of service

provided; and • Persons to whom activities were directed



Provider Documentation cont. :

Monthly notes: • Summary of training

activities for the month;

• Dates, locations, and times of service delivery;

• POC objective(s) addressed;

• Specific details as planned or modified

• Effectiveness of the strategies and individual and caregivers’ satisfaction with services



Provider Documentation cont. Semi-annual Reviews are required by the

provider if training extends three months or longer and are to be forwarded to the Case Manager and include:

• Activities related to the supporting documentation;

• Individual status and satisfaction with services

• Training outcomes and effectives of the POC



Provider Documentation cont.• If training services extend less than three

months, the provider must forward to the Case Manager:

• Contact notes

• Monthly notes

• Or a summary of such to the Case Manager for the semi-annual review



Thank You For Coming!• We look forward

to partnering with you to provide services to our DD Waiver beneficiaries

• Any Questions? Please Ask

1 department of medical assistance services dd waiver provider training department of medical...

Documents