STATE OF WASHINGTON



center31912900STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Divisioncenter1769800HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINPO Box 45600, Olympia, WA 98504-5600H19-035 – Policy & ProcedureJuly 1, 2019TO: Home and Community Services (HCS) Division Regional AdministrationsDevelopmental Disabilities Administrations (DDA) Regional AdministratorsArea Agency on Aging (AAA) DirectorsFROM:Bea Rector, Director, Home and Community ServicesDebbie Roberts, Deputy Assistant Secretary, Developmental Disabilities AdministrationSUBJECT: Meaningful Day Activities for ALTSA and DDA Funded Clients in Adult Family HomesPURPOSE:To provide information and direction to staff on Implementation of the AFH Collective Bargaining Agreement Article 7.11, Meaningful Day Activities in Adult Family HomesBACKGROUND:The Meaningful Home Based Activities pilot project was developed to create proactive and individualized strategies to engage eligible AFH residents in meaningful activities designed to refocus behavior, improve health, and reduce challenging behaviors.WHAT’S NEW, CHANGED, OR CLARIFIED:The State of Washington (State) and the Adult Family Home Council (AFHC) have agreed to Article 7.11 of the 2019-2021 Collective Bargaining Agreement (CBA). This change is effective July 1, 2019. Adult Family Home providers who are trained, have a contract with the State to provide meaningful day activities, and have an eligible resident with an assessed need for meaningful activities to assist with managing behaviors, will receive a Meaningful Day Activities add-on rate of thirty dollars ($30.00 ) per day. The Meaningful Day Activities add-on rate includes the following supports provided by the AFH:Collaborating with the client to develop a Meaningful Activity Plan (MAP) based on the resident’s goals, interests, and abilities;Identifying basic supplies and costs essential for planned activities within the reimbursement provided, and when not provided by the AFH provider, determining an alternative source for supplies;Implementing the Person-Centered Activities as outlined in the MAP and Negotiated Care Plan, including the provision of home-based activities and coordination of meaningful activities in the community;Using the DSHS provided tracking tool to observe and record targeted behaviors, activity engagement of each participating client, and record outcomes;Creating a client monthly calendar to document the resident’s planned activities, events, appointments, and special care; andCoordinating meaningful activities within the home or community.ACTION:When a CM/SSS assessment in CARE indicates a client has a Behavior Point Score (BPS) of 12 or more and/or has a diagnosis of dementia, and is living in or moving into an AFH: Check for a Meaningful Day contract in the AFH Locator or either in the P1 Provider Authorization screen or the ACD to see if the AFH provider has a contract sub code 1032SS to provide Meaningful Day activities. (All AFH providers currently providing Meaningful Home Based Activities will be contacted to re-contract for Meaningful Day Activities.)If the AFH provider has this contract sub-code, the AFH is qualified to provide Meaningful Day Activities.If an AFH provider does not have the Meaningful Day contract sub code and wants to contract for Meaningful Day Activities, contact the HCS or DDA contact listed on this MB to start this process. List the need for Meaningful Day Activities on the Treatments screen. This choice will be available in CARE on July 1, 2019. Authorize the AFH Meaningful Activities Add-on of $30 per day using service code T2033 U6; and At the next assessment, assess the AFH resident’s interest in and need for Meaningful Day Activities. When requested by the resident, a resident’s representative, or the AFH provider on behalf of a resident, and the resident meets the criteria, case managers may update assessments to include Meaningful Day Activities using an Interim assessment prior to the next full assessment. For the July 1 transition:For all AFH providers who have signed the new contract prior to July 1 Meaningful Day Activities will continue at the new rate.For AFH providers who have not signed the new contract prior to July 1, Meaningful Day Activities will end. To assist with this transition:Prior to the end of June, the payment systems team will change the end date of the Meaningful Day Activities service line in Provider One to June 30, 2019.The CM/SSS will need to start a new Meaningful Day Activities service line when the AFH provider has signed the new contract.The current logic in ProviderOne that causes an error when authorizing Meaningful Day Activities will remain in place during the transition. Contact the DDA or HCS contact listed on this MB. That person will verify that a new contract has been signed by the AFH and the client meets the criteria prior to addressing the error. Notes: The client’s BPS can be found on the Personal Care Results Comparison, the Personal CARE Results, and the CARE Web Summary Screen.AFH Providers must include targeted activity goals derived from the MAP in the resident’s Negotiated Care Plan (NCP) in the “Activities/Social Needs” section.Meaningful Day is not available for ECS or SBS clients.For eligible clients, an AFH resident may receive both Meaningful Day Activities and Community Integration. Providers are expected to maintain documentation of the Meaningful Day Activities MAP, the DSHS provided tracking tool, and monthly calendars. This documentation must be made available to DSHS staff upon request.If a resident’s BPS falls below 12 after they begin receiving Meaningful Day Activities, they may continue receiving Meaningful Day Activities if they remain eligible for Community First Choice and reside in an AFH that has a Meaningful Day Activities contract.RELATED REFERENCES:ATTACHMENT(S):CONTACT(S):Natalie Lehl, HCS Residential Policy and Resource Development Program ManagerLehlNR@dshs.360-725-2370Kate Gallagher, DDA Meaningful Activities Program Manager(360) 407-1554Kate.gallagher@dshs.Kelly Hampton, DDA AFH Program Manager(360) 407-1514Kelly.hampton@dshs. ................
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