Chimes Residential Case Management Responsibilities



Chimes Residential Case Management Responsibilities

● Review and update the Individual Data Form (IDF) at least two weeks prior to the ELP meeting. This can be found on Therap. The information for this form can be found from nursing and from the house manager. Print out 3 color copies for the COR’s. One copy is for residential, one for vocational and one for your records.

The Individual Data Form (IDF) has been designed to help users maintain essential information regarding the individuals they support. The form contains information about an individual's identification, contacts, medical data, and insurance. The system also builds a list of Medical and other contacts so that each contact only needs to be entered once. The form allows for two photographs to be attached. Photos are to be taken once every 3 years. You are responsible for taking these photo’s and attaching them to the IDF.

● Ensure that all annual or monthly assessments and/or documents are updated by the assigned disciplines. These are found in the person supported COR. Some of these assessments include:

1) Unsupervised time checklist (database section)

2) Behavior Support plan (located in the HRC packet)

3) Vocational Monthly Note

4) IDF

5) Monthly progress note (behavioral data)

6) Consents (database section)

` 7) ISP tracking sheets

8) Team meetings (found on Therap)

9) ELP

s 10) IPOP’s (found on Therap)

11) Monthly Case Manager Note (found on Therap)

● Schedule and Attend the Annual ELP meetings.

Send a letter out 3 months in advance. Call the guardians to confirm that they will be attending one week before the meeting.

Update the consent packets and have the team sign the unsupervised time assessment. If the consent packets have not expired yet but are close to expiring you can have them signed at the ELP meeting. Also bring a blank water temperature assessment, skills assessment and money skills assessment form for the manager to fill out and file in the house COR.

The consent packet is done yearly on or before the ELP. It contains consents that the consumer (if able), the guardian (if there is one), you, the DDDS case manager and the COO must sign.

The ELP or Essential Lifestyle Plan is a document that is done annually at the ELP meeting. The meeting is held by the DDDS case manager. This is used to help a person decide what the person wants for the year, ways to coordinate support for learning and activities for the person, and the person’s personality and preferences. You can learn a lot of about the person supported by this document.

● The ISP module can be used to design and document teaching programs, track goals or objectives for an individual. Users can write the programs based on how they want to train the individual, according to the requirements of the particular goal or objective that is to be achieved. Users can then collect data on the particular ISP Programs.

For each program that is designed, one can specify detailed information such as the long term objective, frequency of documentation, the criteria for completion and the goal to be achieved upon completion of the ISP. Once the ISP has been approved, users can start collecting data.

● The ISP is to be completed after the ELP meeting and is to be based on the current ELP. The goal or objective must be taken from the ELP outcomes.

-Train the residential manager on how to track the goals in the ISP and on how to enter the data from the tracking sheets monthly into Therap. They will in turn train their staff. Check these sheets whenever you visit the houses.

● Make all referrals for support services, therapies, assistive tech/adaptive equipment, transportation, camp programs, special events, leisure activities, etc., complete applications and assist with visits. Special Olympics is a very common program. You need to fill out the application and sign the person supported up for different sports. You also need to research adaptive equipment and order new supplies when needed, schedule repairs for wheel chairs, walkers and hospital beds. You need to research leisure activities and keep a list of addresses and phone numbers for places they can go to in the community such as amusement parks.

● Monitor and follow up on all activities contained in the ISP at the quarterly meeting or periodically throughout the ELP year.

● Make visits to the residences and vocational programs at least once a month. Make sure their individual needs are being cared for and they are in a safe environment free from danger and abuse. Document these visits in Therap. You do not need to visit supported employment sites but do check with their job coach to check on their progress. Follow up on all issues and make sure they are resolved.

● Quarterly team meetings are to be chaired by the case manager. Invite members of the team including: the residential manager, the DDDS case manager, the vocational case manager, the behavior analyst, the coordinator, the RN, a representative from their program, the guardians (only if they request to attend), and anyone who is closely involved with their care. A team meeting signature page should be signed at the meeting and a team meeting note should be written on each person supported in Therap. You need to scan in the sign-in sheet and attach it to the note in Therap for each person discussed. It is helpful to schedule the next meeting at the end of the meeting. Set a date for the next quarterly meeting before adjourning the meeting. Send out a reminder e-mail a week before the meeting.

● Maintain a quarterly contact with the parent or guardian of the person supported. Some parents request a copy of the T-logs for the month if they don’t have access to Therap.

● Monthly case management notes are to be written in Therap. These are due by the 10th of every month. Write a note on every person supported on your case load. Include any issues or progress residentially, vocationally, behaviorally, and anything involving their health and well being. Include a report on what they have been doing in the community as well. Include ISP progress.

● IPOP’s are to be updated before the ELP meetings. This is a Therap application.

The Individual Plan of Protective Oversight and Safeguards (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. It clearly enlists the key activities that affect the health and welfare of an individual. The main idea is to document the procedures and guidelines for providing support to the individuals along with their protection and safety requirements for different programs. The plan is often linked to an individual’s ISP.

● Case managers are responsible for archiving old documents except for nursing documents. Follow instruction sheet for archiving procedures.

● In-House Quality Assurance are done throughout the year. The residential department plus some from the clinical department will conduct a complete inspection of one of the residential facilities. The COR is reviewed cover to cover. The consumer’s ELP is also reviewed. After review, you will attend an exit meeting and the report will be reviewed with the team. It is your responsibility to make the necessary corrections on any documents you are responsible for.

● You are to have your people supported fill out a consumer satisfaction survey once a year and record it on the appropriate place on the Chimes web site.

Therap Services, LLC. is a web-based service organization that provides an integrated solution for documentation, reporting and communication needs of agencies providing support to people with disabilities, especially developmental disabilities. It offers an easy and efficient alternative to the immense amount of paper work that is done manually by the care providers.

Helpful Directions

● Don’t touch any of the nursing documents

● Keep track of dates and person’s supported with lists and forms.

● Keep track of all phone conversations regarding your people supported in Therap. It may be helpful to keep a paper record of these as well.

● Keep a copy of every form you are responsible for filling out or use often and keep it in a binder for quick reference and in case something gets misplaced. It is helpful to keep them sorted by house and person supported. (every house will have it’s own binder, every person gets their own section).

● Read T-logs daily and keep notes so you will know what is going on and these will help you when writing monthly notes. Just jot down significant things like med appointments, behavioral outbursts, outings they went on, when you visit them etc…. no need to keep track of what they eat everyday or if they watch TV or not.

● Send reminder emails out for team meetings one week before the meeting. Always ask the team member who can’t make it to give you information to share with the team. Let them know you can do teleconference. It is helpful when scheduling team meetings or emergency meetings to propose 3 possible days for everyone to pick from. You want to have as many team members as you can attend these meetings.

● Keep an expense report voucher and record when you make house visits to be reimbursed for mileage. These are due at the end of every month. The reimbursement rate is .44 a mile. This rate changes so don’t forget.

● Pay check cards start on a Friday and end on a Thursday. They are collected on a Wednesday or Thursday.

● Communicate with your team. Everyone should be on the same page. Don’t hesitate to call the person supported BA or nurse to discuss things that happen.

● The people supported on your case load usually begin to arrive home at 4:00 p.m. Most houses have the same key for the main entrance. Learn where the COR’s are located and take note which ones require a different key to access. Remember to knock first, show your name badge to the staff and introduce yourself. Make note of the houses with alarms and learn how to shut them off.

● When you have completed new documents, make 3 copies. One copy goes in the vocational COR, one copy goes in the residential COR and the last copy you will keep for your records in the binders that were discussed above.

● Visit your people supported at the workshop area often, even though it is not required. Rapport building is very important and the people supported appreciate having visitors. You get to know them much better one on one. Even if it is only for a minute or two per person it is still worth it. Our people supported are not always quick to trust and it may take them months before they warm up to you.

● Getting the Consent packet signed at the ELP meeting is easier because often when you mail them they get sent back late, pages are missing, signatures are not in the right spot or you don’t get them back at all. Sending pages back to be redone takes more time. This way, if they have any questions you can answer them right then and there.

● Always contact Q.A. right away if you read a t-log that says staff found suspicious bruises, marks or injury on a person supported, especially if the person supported says they got the marks from a staff or parent. Follow up even if it was a GER. The house managers should remind staff to write GER’s for any kind of event that is out of the ordinary or involves injury, illness or difficult behaviors. Sometimes this is not caught by the managers and you need to report it.

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