Medical Assistance Site Training Process

Transcription

1 Medical Assistance Site Training Prcess E Orchard Rad, Suite 280 Greenwd Village, CO 80111

2 Cntents Organizatinal Overview... 2 General Training Apprach... 2 Accessing Training... 3 Training Center... 3 Learning Management System (LMS) Inbx... 4 Training Plan Creatin... 4 Training Requirements... 5 CBMS Users... 6 Training Curses... 7 Training Curse Availability MA Site Trainer Certificatin New Trainer Certificatin Existing Trainer Certificatin Trainer Re-Certificatin Travel Reimbursement Onging Supprt CBMS Access Required Certificates Page 1 f 25

3 Organizatinal Overview The Health Care and Ecnmic Security Staff Develpment Center (SDC) was established as a result f Huse Bill and exists t prvide a cmplete training array t staff wrking with families accessing medical and ther types f public assistance, such as the Supplemental Nutritin Assistance (SNAP), Medicaid, CHP+, Aging services, and Temprary Assistance fr Needy Families (TANF) prgrams. The SDC is the training cnnectin between the Clrad Department f Human Services (CDHS), the Clrad Department f Health Care Plicy and Financing (HCPF), and the Gvernr s Office f Infrmatin Technlgy (OIT) t the 64 cunty Departments f Scial/Human Services and Medical Assistance (MA) sites thrughut Clrad. The SDC wrks t identify essential training needs and t establish, facilitate, and maintain cmpetencybased training curricula, while cntinually evaluating results. General Training Apprach The SDC will generally prvide a blended and mdularized apprach t training. This apprach allws fr immersin in varius levels f learning tracks, with the initial level being standardized and cmpulsry. Blended learning is als mst efficient where pre-requisite wrk can be cmpleted prir t cming t any in-persn training, and time spent ut f the ffice is minimized t the extent pssible. Blended learning als allws fr web-based and virtual in-persn training t ccur withut the cst f travel fr Eligibility Sites in rural areas f the state. This particular apprach was chsen based n ur knwledge f the varying ways that medical and ther public assistance prgrams perate under a state-supervised, cunty-administered system in Clrad. Mre specifically, it is based n differences in talent-acquisitin, rural and urban staffing challenges, Eligibility Site specific training mdels, resurces and business prcesses, and supervisr/lead wrker supprt t learning transfer. Where apprpriate, curricula will include bth state plicy and hw that plicy is applied within and utside f the Clrad Benefits Management System (CBMS). Page 2 f 25

4 Accessing Training Training registratin and infrmatin can be accessed n TrainClrad.cm Training Center Abut the SDC = Missin and Visin, Lcatins, Fr Persns with Disabilities Curses = What Curses D I Need t Take (build a training plan), Review available curse listing Dcuments and Resurces = Dcument Library (includes curse materials and guides), Q & A s Trainers Territry = Link t reprt issues with the CBMS Training Envirnment, Link t request access t materials (individuals wh have cmpleted the Certified Trainer Prcess), Links t materials accessible by Certified Trainers nly Page 3 f 25

5 Cntact Us = Prject Requests, Travel Reimbursement Requests, Lcatins and Facility Infrmatin, and Phne Number t cntact the SDC Learning Management System (LMS) CO.Train.rg is the LMS used by the SDC CO.Train.rg is the registratin lcatin fr all curses (in persn r web based training) Under Curses n the SDC website TrainClrad.cm, there is a Register Nw link t the curse in CO.Train.rg (LMS) Inbx The SDC can be cntacted via [email protected] Users may cntact the SDC fr questins regarding training material Training Plan Creatin Each new user must create a Training Plan t identify the training curses that must be cmplete in rder t gain CBMS access. Page 4 f 25

6 Training Requirements The SDC will develp and deliver training n an nging basis. The SDC will ntify Eligibility Sites and the MA Site Cntract Manager when a new curse is released. The ntificatin will include curse infrmatin, such as the lcatin and mdality, estimated length f the curse and time frame fr cmpletin f the curse. If the curse is required fr new users, the curse will be added t Training Plans fr users wh have nt cmpleted all training requirements. If the user is an existing CBMS user, the MA Site Cntract Manager will determine if the curse is required and will wrk with the site t verify cmpletin. In rder t verify cmpliance with this requirement, the MA Site Cntract Manager will prvide a list t the SDC that includes existing MA Site CBMS user infrmatin. The SDC will then prvide the MA Site Cntract Manager a reprt which includes details regarding training cmpletin. The MA Site Cntract Manager will wrk with the Eligibility Site t ensure each user cmpletes required training. Training must be cmpleted in rder t remain eligible fr CBMS access. CBMS implements new builds n a regular basis. MA Sites are required t cmplete training t keep up-t-date n changes t CBMS. The training is delivered in varius mdalities. Fr example, training may be delivered during a live webinar, such as a Knwledge Transfer Call r CBMS Build Training delivered by the SDC. Dcumentatin fr each build is available n the CBMS Prtal and TrainClrad.cm and must be reviewed by Eligibility Sites. The Eligibility Site is required t keep dcumentatin f the type f training (where applicable) cmpleted fr each build and prvide the infrmatin t the MA Site Cntract Manager upn request. Fr example, if a webinar is attended, the Eligibility Site shuld have a sign in sheet with attendee s names and signatures. Page 5 f 25

7 CBMS Users CBMS users are categrized as: New Existing Returning New CBMS Users are: Individuals wh have never used CBMS Emplyees wh have nt had access t CBMS within 180 days f submitting a request fr access Existing CBMS Users are: Individuals wh currently have access t CBMS Emplyees wh have had access t the prtal and CBMS within 180 days and access is active Returning CBMS Users are: Individuals wh previusly had CBMS and are returning r changing psitins within a Medical Assistance (MA), Cunty, r a HCPF apprved Third Party Agency If a CBMS user mves t a new psitin and has nt been ut f CBMS fr mre than 180 days, such as MA Site t MA Site, Cunty t State r Medical Assistance Site, the user must meet all training requirements, unless the CBMS Training Request Waiver Frm is submitted thrugh ticket submissin r the Online Request (OLR) prcess. G t TrainClrad.cm under Dcuments and Resurces>Dcument Library>Training Prcesses t access the frm. The waiver will nly exempt the user frm attending training curses. The user must cmplete the Assessment fr the curse. Even if the user has previusly cmpleted the Assessment, a new Assessment must be passed in rder t receive CBMS access. If the MA Site has a certified trainer n bard, the individual may cmplete the Assessment at the MA Site. If n certified trainer is n bard, the user must cmplete the Assessment at the SDC. If the user must travel mre than 60 miles t cmplete the Assessment, cntact the SDC fr ptins. Page 6 f 25

8 The user must create a Training Plan in rder t identify the type f user and type f CBMS access that will be needed. Once a Training Plan is cmpleted, the user shuld cntact the SDC at [email protected] t infrm the SDC that the user is a returning CBMS user that wuld like t take the Assessment. The SDC will cmplete steps necessary within three wrking days t allw the user t take the Assessment. Training Curses Page 7 f 25

9 The fllwing curse is required t be trained by the Eligibility Site. Curse Name Curse High Level Descriptin Training Delivery Verificatin f Cmpletin HIPAA (Health Insurance Prtability and Accuntability Act) The primary gal f the law is t make it easier fr peple t keep health insurance, prtect the cnfidentiality and security f healthcare infrmatin and help the healthcare industry cntrl administrative csts. The Eligibility Site is required t prvide this training prir t any ther training the new hire receives. The Eligibility Site must maintain and prvide verificatin f training cmpletin. CMAP Certified Applicatin Assistance Site (CAAS) Training prvided fr the fllwing: - CHP+ fee administratin - Medicaid Buy-In fee administratin and case management (until this has been updated by the SDC) - Manual Enrllments fr MCO s Required fr Certified Applicatin Assistance Site (CAAS) staff wh are authrized by the Department f Health Care Plicy and Financing t verify the authenticity f citizenship and identity dcuments required f Clrad Citizens applying fr medical benefits (if verificatin cannt be btained electrnically), and/r in need f assistance cmpleting an Applicatin fr Health Cverage & Help Paying Training is prvided by the Medical Assistance Site r HCPF Subject Matter Expert. Training is prvided by HCPF Subject Matter Experts. The curse is includes in the Training Plan fr Inquiry Plus users. Trainers must verify student cmpletin in CO.Train in rder t have a certificate available fr the student. The curse is psted fr registratin in CO.Train. Trainers must verify student cmpletin in CO.Train in rder t have a certificate available fr the student. Page 8 f 25

10 Csts r an Applicatin fr Public Assistance. Inquiry Hands On Training Required fr users wh are cnsidered Inquiry Only users but will cmplete sme data entry tasks in CBMS. Training is prvided by the Medical Assistance Site Certificate f cmpletin is cmpleted by the MA Site. The certificate is nt generated frm the SDC Learning Management System. Cntact the Cntract Manager fr mre infrmatin regarding the certificate f cmpletin. The fllwing curses are trained by the SDC (web based r instructr led) r a Certified MA Site Trainer. The curses listed belw will appear in the Training Plan created by the new hire. - I USER TYPE COURSE NAME CBMS Access WBT Inquiry Only All MA Sites Inquiry Plus (ES) CMAP PE Medical Only Eligibility Enrllment Specialist (EES) Medical and Lng Term Care Eligibility Enrllment Specialist X X X X X X Building X X X X Fundatins fr MA Sites CMAP X X Client ID State ID Research WBT Expanding Fundatins Medical Assistance Expanding Fundatins Lng Term Care Presumptive Eligibility *If applicable X X X X X X X X X X X * X * * Page 9 f 25

11 Curse Name Curse High Level Descriptin Training Delivery Verificatin f Cmpletin CBMS Access Web Based Training curses required t cmplete prir t registering fr interactive training curses. Examples: Clrad Address Cnfidentiality Prgram CBMS Hme Page Tur Web Based Training At yur desk The student must pass the Assessment upn cmpletin f the required WBTs. The student will have access t print r save a Certificate f Cmpletin nce this requirement is met. Nte: The required curses may change as new curses are develped Building Fundatins Infrmatin n the prgrams and benefits available t clients Review f the applicatin fr assistance Purpse and Intrductin t Applicatin Initiatin in CBMS Enter an AI int CBMS as part f the web based training Web Based Training At yur desk The student will cmplete the assessment after cmpleting all mdules. The student must pass the Assessment with at least 85% in rder t attend the Expanding Fundatins fr Medical Assistance curse. Once the student cmpletes this requirement, the student will have access t print r save a Certificate f Cmpletin. Client ID State ID Research WBT Explains the Client ID and State ID assignment prcess. Prvides the user knwledge and skills needed t successfully search fr existing IDs in Web Based Training At yur desk The student must cmplete this curse prir t taking the Assessment. Page 10 f 25

12 rder t eliminate the creatin f duplicate IDs. Expanding Fundatins Medical Assistance Three-day curse prvides: General eligibility and rules Mdified Adjusted Grss Incme (MAGI) methdlgy Retr Medical Assistance Data entry practice in CBMS Interactive Interview Cmplete Eligibility Determinatins and Authrizatins SDC r Certified Trainer The student will be required t attend ne additinal day f training fr hands n practice and t cmplete the Assessment. If the MA Site has a Certified Trainer n bard, the Assessment can be cmpleted at the MA Site. The additinal day f hands n practice shuld ccur t prvide users the data entry practice. Presumptive Eligibility Training PE Plicy Training CBMS Hands On Training Clrad Address Cnfidentiality Prgram Webinar Client Id and State ID Research Webinar HCPF/PE Administratr HCPF/PE Administratr Web Based Training At yur desk Web Based Training At yur desk Attended Plicy Training Attended Hands On Training The student will have access t print r save a Certificate f Cmpletin nce this requirement is met. The student will have access t print r save a Certificate f Cmpletin nce this requirement is met. Presumptive Eligibility (200) Web Based Assessment Student will receive a Certificate f Cmpletin if passing scre is 80% r better. Page 11 f 25

13 Certified Applicatin Assistance Site This curse is required fr Certified Applicatin Assistance Site (CAAS) staff wh are authrized by the Department f Health Care Plicy and Financing t verify the authenticity f citizenship and identity dcuments required f Clrad Citizens applying fr medical benefits (if verificatin cannt be btained electrnically), and/r in need f assistance cmpleting an Applicatin fr Health Cverage & Help Paying Csts r an Applicatin fr Public Assistance. Web Based The student will have access t print r save a Certificate f cmpletin nce this requirement has been met. Expanding Fundatins Lng Term Care (LTC) Tw-day curse prvides: General eligibility and rules fr LTC Administratin f the LTC prgram Data entry practice in CBMS Interactive Interview Cmplete Eligibility Determinatins and Authrizatins SDC r Certified Trainer The student will be required t attend ne additinal day f training fr hands n practice and t cmplete the Assessment. If the MA Site has a Certified Trainer n bard, the Assessment can be cmpleted at the MA Site. The additinal day f hands n practice shuld ccur t prvide users the data entry practice. MA Site Practice/ Assessment This curse is t allw students an pprtunity t practice entering cases int CBMS. An SDC Trainer will be available t prvide ver SDC The Assessment cnsists f entering a case int CBMS. The case data entry and end result will be graded by a trainer within three wrking days f cmpleting the Assessment. Page 12 f 25

14 the shulder supprt and answer any questins. The student will use this time t cmplete the Assessment. The student must receive at least 85% in rder t pass. If the user des nt pass, the user must submit the request fr the Assessment again. If the user des nt pass n the secnd attempt, the SDC HCPF Training Manager will wrk with MA Site Cntract Manager t determine next steps. Once the student cmpletes this requirement, the student will have access t print r save a Certificate f Cmpletin. Training Curse Availability The SDC will ensure curses are available each mnth fr MA Site new hires t receive training in rder t gain access t CBMS. Fr example, the target training dates may be: Building Fundatins 2 nd Mnday and Tuesday f each mnth Expanding Fundatins Medical Assistance Expanding Fundatins Lng Term Care Practice/Assessment 2 nd Wednesday, Thursday and Friday f each mnth 3 rd Mnday and Tuesday f each mnth 3 rd Wednesday f each mnth **Dates subject t change due t hlidays ***Check the available registratin dates n TrainClrad.cm. Curses will be psted fur mnths in advance fr planning and hiring purpses Page 13 f 25

15 MA Site Trainer Certificatin The SDC ffers the pprtunity fr Eligibility Sites t have a Certified Trainer r Trainers t facilitate training using curse material develped by the SDC. A Certified Trainer n staff prvides the Eligibility Site the pprtunity t train staff immediately upn hire. Certified Trainers are expected t deliver the training materials cnsistently and accurately. This is accmplished thrugh cmpletin f certificatin requirements, participatin in wrkgrups t prvide feedback, attendance during regular training pprtunities and delivering the training as it was develped by the SDC. The Certified Trainer is requested t ntify the SDC using the Reprt Curse Changes link if there are ideas fr imprvement f materials r cncerns regarding existing materials. The link is als available n TrainClrad.cm under the Trainer s Territry. If the MA Site des nt have a Certified Trainer, new hires must register fr training ffered thrugh the SDC, r may als attend the curse thrugh anther MA Site r Cunty facilitated curse if scheduled trainings are pen. MA Site Certified Trainers are requested t make training available t ther MA Site new hires if space is available in the curse. New Trainer Certificatin In rder t ensure MA Site new users receive training frm an experienced CBMS user, the fllwing requirements are in place fr individuals interested in becming certified t train SDC curses: Trainer must have been a current CBMS Update User fr at least six mnths Trainer must attend all curses in the series as a student The trainer must cmplete a Training Plan n TrainClrad.cm Trainer must cmplete all curses required t becme a Certified Trainer Instructins fr this prcess are lcated n TrainClrad.cm Trainer must pass the Assessment fr the curse with at least 85% Page 14 f 25

16 Access t the Assessment is available nce all curses in the Training Plan are cmpleted Trainer must facilitate ne full day f the curse with an SDC Trainer bserving. The SDC Trainer will prvide the Observatin Frm t the MA Site Trainer prir t the bservatin. The Observatin Frm cntains expectatins that must be met in rder t be cnsidered certified. The bservatin can ccur at the SDC r the MA Site lcatin depending n the SDC Trainer availability r the need fr ther MA Site trainers t be bserved during the same mnth Fr example: If mre than ne MA Site needs t have an bservatin cmpleted fr certificatin, the SDC may request the MA Site Trainers t facilitate the ne full day at the SDC t allw ther MA Site Trainers t becme certified r recertified during the same curse. If the MA Site has multiple trainers, the bservatin can be cmpleted thrughut the entire curse if trainers rtate delivering tpics. Existing Trainer Certificatin The SDC is respnsible t ensure existing Certified MA Site Trainers have met all requirements and are training materials cnsistently statewide. An existing Certified MA Site Trainer is defined as an individual wh has received the curse materials prir t July 1, 2015 t facilitate a SDC curse. By Nvember 1, 2015, the SDC will verify that existing MA Site Certified trainers have met all requirements t be cnsidered certified. The SDC will prvide a reprt t the MA Site Cntract Manager. If there are requirements that must be met, the Certified MA Site Trainer will be ntified by the SDC. The SDC will prvide a timeline fr cmpletin f the training in rder t remain certified. Page 15 f 25

17 Trainer Re-Certificatin The SDC is respnsible t ensure existing Certified MA Site Trainers have met all requirements and are training materials cnsistently statewide. An existing Certified MA Site Trainer is defined as a Trainer wh has access t the current training materials. The SDC is respnsible t ensure MA Site Certified Trainers are cntinuing t prvide training using the apprved materials and that the infrmatin prvided is accurate. The infrmatin belw describes the prcess and due dates fr the re-certificatin prcess. Existing Certified Trainers: By Nvember 30, 2015, the MA Site Certified Trainer must cntact the SDC t schedule a date t facilitate ne day f the curse in which the certificatin exists. The recertificatin timeframe will be based n the mnth that the first bservatin was cmpleted. The MA Site Certified Trainer must cntact the SDC t set up a date fr the bservatin. This may be an existing curse already set up r anther curse can be added. The SDC Trainer will prvide the Observatin Frm t the MA Site Trainer prir t the bservatin. The Observatin Frm cntains expectatins that must be met in rder t be cnsidered certified. The bservatin can ccur at the SDC r the MA Site lcatin depending n the SDC Trainer availability r the need fr ther MA Site trainers t be bserved during the same mnth Fr example: If mre than ne MA Site needs t have an bservatin cmpleted fr certificatin, the SDC may request the MA Site Trainers t facilitate the ne full day at the SDC t allw ther MA Site Trainers t becme certified r recertified during the same curse. If the MA Site has multiple trainers, the bservatin can be cmpleted thrughut the entire curse if trainers rtate delivering tpics. Page 16 f 25

18 If the MA Site Certified Trainer des nt meet this requirement, the individual will n lnger be certified. This means the individual will lse access t the Learning Management System t pst curses and will n lnger have access t curse materials/updated materials. In additin, new hires must attend training at the SDC r anther Eligibility Site ffering the curse since the trainer will n lnger be certified. In rder t becme certified again, the individual must fllw all requirements in the New Trainer Certificatin sectin f this dcument. By Nvember 30, 2015, the MA Site Certified Trainer must cmplete the Assessment fr the curse in which the certificatin exists. The Assessment will be graded by an SDC trainer A scre f at least 85% is required The Certified Trainer will have tw attempts t pass the Assessment. If the Certified Trainer des nt pass the Assessment, the results will be prvided t the MA Site Cntract Manager t determine next steps. Cntinued Re-Certificatin: MA Site Certified Trainers must be bserved by an SDC Trainer every six mnths r meet cnditins in the Re-Certificatin Waiver in rder t remain certified. If an MA Site has mre than ne trainer, it is recmmended t stagger the recertificatin s that all trainers at the site d nt need t get re-certified during the same mnth. The MA Site Certified trainer must cntact the SDC during the 5 th mnth t schedule this bservatin t ccur during the sixth mnth f certificatin. SDC will respnd within 5 wrking days t crdinate the training dates. The Trainer Re-Certificatin Waiver may be submitted t the SDC during the 5 th mnth f the certificatin. If all requirements are met, the SDC will ntify the trainer if the Waiver is accepted, therefre an in persn bservatin wuld nt be required. Waiver Cnditins: Trainer must have facilitated at least three sessins f the curse within the 6-mnth perid Page 17 f 25

19 Trainer must have psted all sessins in the SDC LMS in rder t receive credit fr facilitating the curse Trainer must have had students cmplete the SDC evaluatin at the end f the sessin. The SDC evaluatin prcess is cvered in the SDC Tls web based training. The SDC will use the student evaluatins t determine the success f the training and identify if there are areas the SDC shuld discuss with the Certified Trainer. Trainer must attend the SDC Sessin t review updates t curse material fr each CBMS Build. The SDC will keep track f the Certificatin and Re-Certificatin mnths. If the MA Site Certified Trainer des nt meet the Re-Certificatin requirement, the individual will n lnger be certified. This means the individual will lse access t the Learning Management System t pst curses and will n lnger have access t curse materials/updated materials. In additin, new hires must attend training at the SDC r anther Eligibility Site ffering the curse since the trainer will n lnger be certified. In rder t becme certified again, the individual must fllw all requirements in the New Trainer Certificatin sectin f this dcument. Travel Reimbursement Reimbursements will be made t an rganizatin (Cunty r MA site), nt an individual. The rganizatin may seek reimbursement fr sending staff members t training wh will travel mre than 60 miles frm their pint f rigin t the Staff Develpment Center r mre than 60 miles t the lcatin f the event: Mileage Ldging Per diem The MA Site requesting reimbursement must submit a Pre-Travel reimbursement request using the frm lcated n TrainClrad.cm. If apprved, the MA Site will be ntified alng with instructins n next steps. Page 18 f 25

20 Onging Supprt The Eligibility Site is respnsible t prvide cntinued supprt fr CBMS users. With all new hires, it is highly recmmended that users are placed under Certified Trainers/Quality Assurance/CBMS Supervisrs review until a determinatin is made that the individual has the knwledge t prcess cases accurately. Use reference materials prvided during training Use On Line Help (Shift F1) in CBMS Cntact the SDC if there are data entry questins r training questins Submit a Service Desk ticket if an issue is being experienced n a case If there is nt a MA Site Certified Trainer n site, the site shuld cntact the MA Site Cntract Manager if assistance r additinal training is needed. CBMS Access MA Site users will submit Third Party Access User Request frms, CBMS Access frms, Training Certificates and any additinal required frms (waivers, cnflict f interest, r verride capability) t the designated HCPF Cntract Manager fr apprval. Apprved frms and required certificates will be submitted t HCPF Infrmatin Security via Service Desk. All access will be sent t the requesting user s designated MA Site Security pint f cntact r Security Administratr. Page 19 f 25

21 CBMS Access Frms Third Party User Access Request CBMS Override Functin Waiver Agreement (where applicable-specified persnnel) CBMS Training Waiver (where applicable) CBMS Access Frms CBMS Cnflict f Interest (where applicable) Required Certificates Certificate fr Inquiry Only Users Page 20 f 25

22 Certificate fr Inquiry Users wh receive Hands On Inquiry Training Page 21 f 25

23 Certificate fr Inquiry Plus (ES) Users Page 22 f 25

24 Certificate fr Eligibility Enrllment Specialists (EES) Medicaid Only and Medicaid and Lng Term Care Nte: This is the same certificate that Cunty Users receive upn cmpletin f training requirements. The language in the certificate it t cver bth user types (MA Site and Cunty). Page 23 f 25

25 Certificate fr Presumptive Eligibility Page 24 f 25

26 Certificate fr Certified Applicatin Assistance Sites Page 25 f 25