OVERVIEW WITH SELECT TOPICS
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1 OVERVIEW WITH SELECT TOPICS
2 (651) (888)
3 AGENDA History and Services Who Can Qualify? How to Enroll Approval Process and Transitioning SSIS Reporting Billing and Claims Q & A
4 JOHN A. ANDERSON Program Deputy Director
5 WHAT IS MOVING HOME MINNESOTA (MHM)? A federal demonstration project known as Money Follows the Person nationally Allows states to develop, implement and evaluate demonstration and supplemental services not otherwise covered by the state s HCBS waivers
6 MISSION STATEMENT Creating choice and opportunity for Minnesotans to move from institutions to homes and communities, live more independently, and enhance the quality of their own lives.
7 WHY MHM MATTERS TO THE CLIENT Focus on Community Integration Person-Centered Planning Planning for safety (Risk Mitigation) Additional services, alternatives and choices Expanded Benefit Set to aid in transitioning and supporting the individual in the community for the first 365 days
8 WHY MHM MATTERS TO THE LEAD AGENCY It provides more tools and resources to assist in transitioning the client into the community. It can allow for an additional 180 days of Transitional Services if the client was unable to successfully transition using Relocation Service Coordination (RSC).
9 WHY MHM MATTERS TO THE LEAD AGENCY It can serve as an alternative to utilizing a waiver. It provides compliance to the Olmstead Act and the Jensen Settlement.
10 SERVICES Approximately 30 different services available
11 PATRICK ALFORD Enrollment Specialist
12 WHO IS ELIGIBLE? Resident of Minnesota Any age or disability group 90 consecutive days in a Qualifying Institution
13 WHO IS ELIGIBLE? Qualified to received Medicaid (Medical Assistance) Medical Assistance paid for at least one (1) day of institution care prior to discharge
14 WHAT IS A QUALIFYING INSTITUTION? Nursing Facilities / Hospitals Intermediate Care Facility for Developmentally Disabled (ICF/DD) Institution for Mental Disease (IMD) (under 21 or 65 years of age and older)
15 QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 41 Nursing Facility I - Medicare certified 42 Nursing Facility II - Non-Medicare certified Yes, but exclusive of Medicare days Yes 43 ICF/DD - Public or private Yes 47 RTC/ICF-DD - Not IMD Yes 48 Medical hospital >30 days Yes, but only if the stay is 90 or more days.
16 QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 50 RTC - MI psychiatric inpatient hospital - IMD Yes, but only if the person is under 21 or 65 years and older. 51 Rule 31 CD - IMD Yes, but only if the person is under 21 or 65 years and older and the person has a co-occurring MH diagnosis. CD diagnosis only is not sufficient to enroll in MHM. 52 Rule 36 MI - IMD Yes, but only if the person is under 21 or 65 years and older. 53 Private psychiatric inpatient hospital - IMD Yes, but only if the person is under 21 or 65 years and older.
17 QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 58 RTC - CD psychiatric inpatient hospital - IMD 59 Out-of-state SED residential treatment facility for children - IMD Yes, but only if the person is under 21 or 65 years and older, and has a cooccurring MH diagnosis. CD diagnosis only is not sufficient to enroll in MHM. Yes, but only if the facility is paid an allinclusive institutional rate and one day is paid by MA. 78 IMD Nursing Home Yes, but only if the person is under 21 or 65 years and older
18 INSTITUTION FOR MENTAL DISEASE Hospital, Nursing Facility, or other institution with more than 16 beds Primary focus is providing diagnosis, treatment or care of mental health disorders (42 CFR Ch IV)
19 MENTAL HEALTH IMD PROGRAMS Anoka Metro Regional Treatment Center Andrew Board and Care (Minneapolis) Prairie Saint Johns (Fargo) Richard P Stadter Psychiatric Center (Grand Forks)
20 CHEM DEP IMD PROGRAMS
21 HOW TO APPLY Intake Form can be completed by the client, a family member, social worker, case manager, care coordinator, or an other invested caregiver.
22 METHODS TO APPLY Online via edocs: (search for document #: 5032) By Mail: Moving Hove MN PO Box Saint Paul MN
23 METHODS TO APPLY By Fax: (651) By Phone: -Senior Linkage Line (800) Disability Linkage Line (866)
24 INTAKE FORM DHS-5032
25 WHO ACTS AS LEAD AGENCY? Health Care Product Enrolled in MSHO or MSC+ (65 and over) Enrolled in SNBC (under or over 65) PMAP straight MA, not enrolled in Managed Care Acting Lead Agency Managed Care Organization County or Tribe County or Tribe County or Tribe
26 APPROVAL PROCESS: INTAKE Participant Identified Completed Intake Form Submitted
27 APPROVAL PROCESS: VERIFICATION DHS determines initial eligibility DHS notifies client/lead Agency of result If eligible, Lead Agency assigns Transition Coordination agency
28 APPROVAL PROCESS: COMPLETION Transition Coordinator meets with client Informed Consent is signed/returned Client/Lead Agency informed and services can now begin and be billed
29 COMMUNICATION FORM DHS-6759H
30 TRANSITION COORDINATOR RESPONSIBILITIES Meets with client for initial face-to-face to acquire signature on and complete: -Informed Consent (DHS-6795I) -Housing Transitions Worksheet (DHS-6759G)
31 INFORMED CONSENT DHS-6759I
32 LEAD AGENCY RESPONSIBILITIES Pre-transition: Screenings (MnCHOICES/LTCC/DD) Assessments Determination/Approval of Services
33 LEAD AGENCY RESPONSIBILITIES Pre-transition: Assignment of Transition Coordinator MMIS maintenance (RLVA etc)
34 RSC VS MHM Relocation Service Coordination Not necessarily Person-Centered. If client uses 180 days of RSC first and doesn t move, client could receive MHM if eligible. Services are primarily focused on communication and coordination. Might be able to be used to relocate out of state. Some services require Waiver Transitional Services to receive. MHM Transition Coordination Person-Centered Planning utilized in all phases of transition. If client uses MHM first and 180 days were exhausted, client cannot access RSC. Payments for expenses to secure housing, for furnishings and supplies available. Client can move to another state participating in MFP. All services available with or without waiver services.
35 TRANSITIONING SERVICES Participants will be eligible for 180 days of Transition Coordination Services once the Informed Consent is signed.
36 TRANSITION PLANNING Development of a Person Centered Plan for Transition
37 TRANSITION COORDINATION Transportation to research/locate housing opportunities Funds for furnishings, deposits, moving expenses Purchase of items relating to establishing and setting up a household
38 TRANSITION COORDINATOR REPORTING RESPONSIBILITIES Estimated transition date when known Request for assistance with employment or mental health services Actual transition date including housing information and type
39 TRANSITION COORDINATOR REPORTING RESPONSIBILITIES Referral of client to a MHM Case Management Agency (if not going out on waiver) or warm hand-off to Waiver Case Manager Client status or condition changes
40 WHAT IS A QUALIFIED RESIDENCE? Home, owned or leased by the individual or individual s family Apartment with an individual lease
41 WHAT IS A QUALIFIED RESIDENCE? Community-Based residential setting in which no more than four (4) unrelated people reside Assisted Living for those aged 55+ Adult Foster Care (Corporate or Family owned)
42 WHAT IS A QUALIFIED RESIDENCE? Any residence must have lockable access and egress. Must include separate living, sleeping, bathing, and cooking areas.
43 ADULT FOSTER LICENSED FOR UP TO 5 INDIVIDUALS If the residence has a fifth crises bed, the residence is not qualified for MHM.
44 POST TRANSITION SERVICES Participants of all populations can be eligible for 365 days of post-transition services once they move to the community (with or without a waiver)
45 POST TRANSITION SERVICES Case Management (waiver or MHM Demo CM required) Case Consultation and Collaboration Comprehensive Community Support Services
46 POST TRANSITION SERVICES Customized Employment Services Overnight Assistance Environmental Modifications Durable Medical Equipment and Assistive Technology
47 LEAD AGENCY RESPONSIBILITIES Lead Agencies will assess if waivered services are appropriate at discharge. For those not being enrolled on a waiver, a referral to MHM Demonstration Case Management will be made.
48 HANDING OFF THE CASE WARM hand-off between Transition Coordinator and Case Manager
49 CASE MANAGER RESPONSIBILITIES Case Manager added to MAXIS [STAT/SWKR panel] to receive notices. Open communication with County Financial Worker for proper handling of other benefits (cash, SNAP, etc.)
50 Questions?
51 SSIS Reporting
52 SSIS ENTRY New Not Automated HCPCS/Modifiers added for MHM Use Reports to pull Time & Payments associated to MCPCS/Modifiers Payments- Not Automated Potentially Billable Time- Not Automated Potentially Billable
53 SSIS ENTRY CON T Use County sub-service for tracking Use Special Studies for tracking By Client or Workgroup Send enhancement requests to Help Desk for Reports to help pull this data
54 TIME- NOT AUTOMATED POTENTIALLY BILLABLE REPORT
55 PAYMENTS NOT AUTOMATED POTENTIALLY BILLABLE REPORT
56 COUNTY SUB-SERVICE TIME RECORD
57 COUNTY SUB-SERVICE PAYMENTS
58 Moving Home Minnesota HCPCS/Modifiers Services Reference Guide rev 07/10/14
59 HCPCS/ Modifiers Description Unit Type Services Activities The Moving Home Minnesota codes added to SSIS are in the Not Automated Claim Category. The start date for all codes is 06/01/2013. The following services were added to SSIS for staff provided time. H0040 U6 Assertive Community Treatment, MHM Day Assertive Community Treatment (ACT) Client contact Collateral contact Consultation Coordination Documentation Paraprofessional case management Service delivery Service planning Transportation Group time -.5 hours Group time - 1 hour Group time hours Group time - 2 hours Group time - 4 hours
60 MAYCHEE MUA MAI YANG Provider Training and Communications
61 PROVIDER MANUAL
62 PROVIDER ENROLLMENT
63 DEMO & SUPPLEMENTAL LINK
64 DEMO & SUPPLEMENTAL SERVICES
65 RETURN TO ENROLLED PROVIDER HOME PAGE
66 MHCP ENROLLED PROVIDERS HOME
67 SELECTING PROVIDER TYPE
68 MHCP ENROLLED PROVIDERS- MHM
69 COMMUNICATIONS Check the following for updated MHCP coverage policy and billing procedures: Provider Home Page Latest Manual revisions Provider News
70 COMMUNICATION LINKS
71 MHCP PROVIDER CALL CENTER (651) or (800) Option 1 Provider Help Desk Option 5 Provider Enrollment Option 6 MN-ITS Administration Only Option 7 EVS Eligibility Option 9 MCHP & General Information
72 PROVIDER TRAINING
73 PROVIDER TRAINING HOMEPAGE
74 MHM BILLING HOME PAGE
75 FREE MHM BILLING LABS Attend in person or via webinar Wednesday 07/29/2015 8:30am 3:00pm DHS: 444 Lafayette Rd, St Paul, Room 1235 Scheduled quarterly through July 2016
76 FREE MHM BILLING LAB Register online: MHM Billing Training Page Computer, internet access, speakers or headphones required for webinar
77 MHM PROVIDER LIST Log-in into your MN-ITS Account Left Hand Side Navigation Select Provider List
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79
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81 Questions?
82 Thank you! Don t forget to request your PDF tool kit!
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