Intensive Support Coordination Questions and Answers
Topics
ISC Eligibility and Enrollment
ISC Staff Qualifications, Roles and Responsibilities
Waiver Participant Choice of SC-ISC Providers
ISC Eligibility and Enrollment
- Given that the HRST Scores are a driving part of determining is an individual qualifies for Intensive SC, what it the plan for competency based administration of the tool?
Based on the current policy on annual assessment updates, DBHDD Field Office I&E Clinicians are responsible for reviewing the HRST of all individuals who meet the criteria for ISC. Therefore, all of the HRST’s would have been reviewed for accuracy within the past year for individuals eligible for the service. - Given that the SIS scoring is also going to determine who is eligible for the new Intensive Support Coordination Service, will all individuals in service receive a new SIS in order to be sure needs have not changed since the last one?
At this time, DBHDD will be using the most recent SIS scores available in determining eligibility for Intensive Support Coordination. As new SIS’s are being administered by DBHDD SIS Assessors, the new SIS scores will drive eligibility for ISC. - HRST and SIS scores can fluctuate if a medical issue arrives but is not permanent. What system will be in place to monitor these scores so that a person can receive Intensive Support Coordination Services when needed and then go back to traditional Support Coordination Services when Intensive SC is no longer needed?
Should a person’s condition change such that the HRST score indicates the need for Intensive Support Coordination by virtue of the qualifying HRST or SIS scores, the expectation is that the individual’s medical or behavioral condition requires monitoring for the remainder of the ISP year (plan year). Therefore, stabilization that might warrant a return to traditional support coordination will not be considered until the next annual reassessment and ISP development. - Will an individual automatically go back to the provider of traditional Support Coordination after the Intensive SC services are no longer needed, be given choice from all SC agencies, or automatically stay with the agency providing the Intensive SC services?
If an individual is assessed as needing Intensive Support Coordination, they must receive Intensive Support Coordination. Until assessed otherwise, they must choose between Intensive Support Coordination agencies that serve their risk category (medical or behavioral). As with traditional Support Coordination, a waiver participant has the opportunity at any time to choose whether they want to continue with their current SC/ISC agency or elect to transfer to another SC/ISC agency. If an individual’s assessed needs result in a need for Intensive Support Coordination and they currently have Support Coordination, they (or their representative) can decide whether or not they would like to stay with their current agency (if they provide both services) or chose another agency that provides Intensive Support Coordination. The same choice of agency is offered in the opposite circumstance, as long as the individual is able to receive the service for which they have been assessed at the agency they choose. - Of the 1500 persons currently identified, has DBHDD further identified by numbers and locations which modality of ISC (medical or behavioral) that will be needed for these persons? Will DBHDD “tag” these and each newly-eligible person for the modality of ISC needed before referral to an ISC provider?
We do not yet have this information available, but are working to compile it. Moving forward, yes, newly eligible persons will be designated with an ISC modality upon initial assessment for services. Our current identification of those preliminarily eligible for intensive support coordination, 130 were identified through use of the behavioral section of the Supports Intensity Scale and the remainder of the 1,500 through use of the Health Risk Screening Tool. DBHDD certified assessors are in process of reevaluating high risk individuals through use of the SIS, thus additional people may be identified as a wider population is reassessed. - If a person has both intensive medical and behavioral support coordination needs identified, what will be the process or expectation for determining which type of specialized ISC should take precedent for the person?
Intensive Support Coordination services will be provided based on assessed need. The clinician conducting the most recent assessment will be responsible for determining which modality of ISC would best meet the individual’s most recent needs. It may be recommended for individuals with concurrent extensive medical and behavioral risks to be served by an agency that has clinical supervision available in both medical and behavioral, so holistic consultation can be available within the agency. - Is a transition from a state hospital in of itself a sole eligibility criterion irrespective of a person’s HRST and/or SIS score? If yes, and there is not a corresponding HRST or SIS score to indicate a need for ISC, which type of ISC (medical or behavioral) should be deployed for these persons? Will these persons also be able to “opt out” of ISC as noted in the current eligibility criteria?
All individuals transitioning from state hospitals are eligible for ISC based on the sole criteria of their transition from institutional care. ADA Hospital Transition waiver participants will be provided ISC for the remainder of the DOJ Settlement Agreement Extension, at minimum, under the modality where the greatest risk is assessed. Thereafter, if their annual assessment indicates no further need for ISC, they will be transferred to traditional support coordination for the following ISP year. - Will persons receive ISC services indefinitely (provided there is no change in the person’s HRST or SIS score, or the person does not opt out)? Does DBHDD anticipate that supports and services can be stabilized or integrated through the provision of ISC to the point of resuming traditional SC services for the person?
Individuals receiving ISC will receive clinical assessment updates on an annual basis. At the time of the annual update of the assessments, the clinician can recommend continuation of ISC or transfer to transitional SC due to risk reduction and stabilization of medical/behavioral support needs. During the plan year the individual will be served at the most-recently assessed level of support coordination unless an event or condition change warrants change to intensive support coordination.
ISC Service Implementation
- What is the effective date and projected timeline for implementation of the Intensive Support Coordination service?
July 1, 2016 was the anticipated effective date for Intensive Support Coordination. However, due to delays in the provider enrollment process, as well as ISC business start-up and staff recruitment, DBHDD anticipates that providers will begin enrolling waiver participants in August or September 2016. The timeline for enrollment of participants in Intensive Support Coordination will be determined through a process of eligibility evaluation and rolling enrollment over the course of the year. This will begin with clinical evaluations occurring on or after August 1, 2016 for inclusion in ISP’s thereafter. - Will there be specific, ongoing (monthly) monitoring tools identified or required for ISCs to use (for assessing the adequacy of supports and services, healthcare status, risk monitoring, etc.)?
Yes. There is one “monitoring tool” that will be used statewide for all waiver participants as of July 1, 2016 – the Individual Quality Outcome Measures Review. This outcome review will be used by both traditional support coordinators and intensive support coordinators statewide. Additionally, a User’s Guide for use of the review and guidelines for evaluating outcomes under the “Recognize, Refer and Act” method will be made available as part of the training on ISC. - As a result of ISC monitoring, are Waiver service providers obligated to respond to ISCs if a problem, gap or issue with the person’s care, support or services is identified? Has a reporting and feedback mechanism been identified so ISCs can report unresolved issues or barriers to DBHDD for assistance or remediation? Does the mechanism include penalties or sanctions for a provider’s failure to act or respond to issues identified by the ISC monitoring?
Yes, a reporting and feedback mechanism has been developed that includes the role of the provider, the ISC, the DBHDD field office and various levels of DBHDD’s Division of Accountability and Compliance. This information will be included in policy and presented during training on ISC. - What is the mechanism for the responsibility handoff when the ISC (intensive support coordination) team identifies an issue with consumer care and reports it to the State Recognize and Refer teams upon initiation of ISC?
In light of the clinical model of Intensive Support Coordination, it is expected that clinical needs will be managed largely by the Intensive Support Coordination team by using strategies such as: communication with primary care or other physicians and referral to non-Medicaid and State Plan Medicaid-enrolled providers for medical and behavioral follow up. Actions initiated through the Recognize, Refer and Act model will be the primary responsibility of the ISC teams, led by clinical supervision. In those instances where community resources and waiver resources are not available, the ISC Team will be expected to reach out to the Field Office for collaboration and assistance with the opportunity to request follow up by the Integrated Clinical Support Team. - What feedback will the Field Office Regional Quality Review (RQR) teams provide to the ISC team to insure issues raised have been addressed to protect consumer health and welfare?
DBHDD RQR clinicians will work with and through Intensive Support Coordination teams to assure follow up assignment. Prior to a visit or follow up activity, Intensive Support Coordinators will be expected to review all recent information available in the waiver participant record to familiarize him/herself with the most recent visit outcome of the RQR clinician and any follow up needs noted during that visit. Thus, the electronic record will provide the first line of communication regarding identified needs supplemented by follow up between clinicians when necessary for coordination. - What will be the mechanism in deciding who determines the course of an individual’s medical treatment between the various clinical teams, nurses and physicians?
Medical treatment is always determined by the individual’s treating physician or healthcare provider. ISC teams will be responsible for communication of physician orders and treatment to other team members, typically through use of the electronic record system but in some cases by direct contact or initiating case conferences. - To ensure coordination of Medicaid state plan benefits and Waiver services and access to a sufficient provider network for meeting the extensive physical and behavioral health needs for this population, is there any expectation in place or preparations being made for the CMOs (or other managed care contractors) to work closely and collaboratively with ISC providers? If not yet developed, will the providers of ISC services be expected to establish the linkages and relationships that will be necessary, and can or will DBHDD and the state Medicaid authority assist in ensuring those linkages exist with the CMOs?
Following the question above related to exclusion from participation in CMOs, it will be the role of ISC providers to initiate some of the linkages for behavioral and physical health needs though many individuals are admitted to intensive support coordination with clinical relationships already established. Additionally, DBHDD has initiated a linkage model through Intensive Clinical Support Services available statewide. ICS team members are available through referral to provide evaluation and technical assistance, including assistance with linkage to community providers in the areas of physical, occupational and speech therapy, behavioral services and nursing, and other clinically indicated services. - If systemic problems or gaps are identified within any of the physical or behavioral healthcare provider networks operated by the state’s Medicaid managed care contractors (CMOs), what will be the mechanism for ISCs to report those problems to the DBHDD or the state Medicaid authority for follow-up or correction?
DBHDD administers a statewide crisis and access service which assists in identifying available behavioral health and developmental disability services. Identified systemic problems or gaps in the healthcare provider networks should be communicated to the DBHDD Office of Health and Wellness and Integrated Clinical Support Services. - What requirements or mechanisms are in place currently for Waiver service providers to provide healthcare oversight or coordination to persons under their care who require such? Do providers routinely screen persons to assess individual healthcare status or needs? Is the HRST used to determine if a person requires nursing oversight and monitoring at and by the service provider, or at some other system level?
Both provider agencies and DBHDD staff use the HRST to identify potential healthcare needs, with additional evaluation by DBHDD clinicians who recommend the type and duration of clinical services. Nursing services are available in the COMP waiver as a reimbursed service, both on the LPN and RN levels. Professional behavioral services are also reimbursed through the waiver program.
ISC Staff Qualifications, Roles and Responsibilities
See
NOW/COMP Waiver Policy, Part III, Chapter 700
- Is an Intensive Support Coordination agency required to have both a Medical and Clinical Director or just one or the other?
If the agency plans to provide Intensive Support Coordination for individuals with exceptional medical support needs, a Medical Director (MD) is needed. If the agency plans to provide Intensive Support Coordination for individuals with exceptional behavioral support needs, a Clinical Director (Psychologist) is needed. If the agency plans to provide ISC for both, then both a Medical and a Clinical Director will be needed. However, a psychiatrist (MD) could meet the needs of both target areas served. Keep in mind that these roles can be on a contract “a la carte” basis (hourly fee-for-service). An agency does not need to hire a medical/clinical director as a permanent staff member. - Can a Licensed Nurse Practitioner be employed or under contract to act as the Medical/Clinical Director?
Since a Licensed Nurse Practitioner in Georgia must work under the supervision of an MD for their clinical practice, it would be allowable for a Licensed NP to be the Medical/Clinical Director for Intensive Support Coordination. However, they must be able to show evidence that they have a direct supervisory relationship with a MD as their consultant. - Would we need both a behavioral clinical supervisor(s) and a medical clinical supervisor(s)?
If the agency plans to provide Intensive Support Coordination for individuals with exceptional medical support needs, an ISC medical clinical supervisor will be needed. If the agency plans to provide Intensive Support Coordination for individuals with exceptional behavioral support needs, an ISC behavioral clinical supervisor will be needed. If the agency plans to provide ISC for both, then both clinical supervisors will be needed. An agency may choose to specialize in only medical or only behavioral ISC. However, they are services rendered under the same billing code. If the agency does not have a staffing pattern to support individuals with exceptional medical or exceptional behavioral needs, then individuals who would benefit from that specialty of ISC will not be referred to that agency. - This question pertains to required experience for Intensive Support Coordinators. Please elaborate on the intent of “Medical - minimum 2 years’ experience in a healthcare, habilitative/rehab, residential or similar setting.” Specifically, would current Pioneer Project SCs with greater than 2 years’ experience serving persons with complex medical needs in the capacity of SC/Case Management only fit this particular requirement?
"A minimum of two years of experience in a healthcare, habilitative/rehab, residential or similar setting” could include experience as a Support Coordinator, as long as the experience included serving persons with complex medical needs. Therefore, yes, those Support Coordinators who have had 2 years of experience with the Pioneer Project/Transition Process/Enhanced Support Coordination in the State of GA or other similar services in other states would meet this requirement for relevant experience. - May an ISC approved provider utilize staff or contractors currently working in other programs operated by the provider; however, do not work in the waiver programs, to serve as the Medical Director and/or Clinical Director for their ISC services?
There is no conflict with utilizing a staff or contractor working in another program as long as dedicated hours are sufficient to meet the needs and intent of their role within the Intensive Support Coordination service. - In the qualifications for ISC Medical and ISC Behavioral, it is stated that experience providing care management/coordination preferred. Does this mean that it is preferred for ISC Medical or ISC Behavioral staff members to have previous Support Coordination experience?
It is a preferred qualification for all ISC Clinical Supervisors to have some type of experience coordinating care plans, guiding acquisition of supports within and outside of the healthcare arena, or providing clinical case management services. Support Coordination experience is not specifically a preferred qualification, but would fall within the mentioned preferred experience. - Other than a consultation note in CIS, would a support coordination MD be required to complete any additional form of documentation?
The Medical Director role is one of consultant to the ISC team and ISC management around unmet medical needs, changes in condition, and recommendation about what issues to communicate to the primary care physician. In some cases the Medical Director may need to reach out to other treating providers to inform the medical provider of special issues or request follow up on particular concerns. In cases where consultation occurred a note will document the purpose of the consult, the recommendations, and the plan for follow up. That note need not be generated by the physician but rather may be documented by the clinical supervisor.
SC-ISC Agency Start-Up
- Is it permissible to select all 6 regions on the Application with the intent to initiate service in each region incrementally (as opposed to accepting clients in all regions all at once)? Conversely, if we only select 1 region on the application, will we be permitted to expand into other regions at a future date?
Yes to the first question. The DBHDD has an enrollment policy that requires all agencies serving NOW and COMP waiver participants to provide services for a full year and then expand with good standing status. If the agency enrolls for all six regions, phasing in service provision across regions over time is allowable. - At what point in the new provider enrollment and implementation process will providers know our initial numbers of persons to be supported?
There will not be a specific number of waiver participants assigned in either traditional Support Coordination or Intensive Support Coordination to be supported by each enrolled agency. Waiver participants in Georgia have the Freedom of Choice to select any provider that serves their area of residence and can request a change in provider at any time through completion of a form submitted to the Field Office in their region. The freedom to choose providers is a fundamental requirement of HCBS Waiver Programs. - Will providers be expected to hire any number of qualified SC-ISC personnel and/or have retained a medical director prior to knowing the number of persons to be supported?
For both services, it is expected that an agency will have adequate staffing to meet the needs of the number of participants enrolled with their agency. In order to serve even one waiver participant, an ISC agency must, at minimum, have one retained medical/clinical director as an employee or under contract, one ISC Clinical Supervisor and one Intensive SC prior to beginning service provision. For standard SC, one SC supervisor (who can provide the direct service) or a combination of one SC supervisor and one SC will be needed to begin service provision. As enrollment of ISC waiver participants exceeds 20, two Intensive SC’s will need to be employed. As enrollment of SC waiver participants exceeds 40, two SC’s will need to be employed, and so on in order to be in compliance with caseload guidelines. - What is the length of time (weeks or months) anticipated for the pre-service training, certification or credentialing of new personnel hires to provide SC-ISC services? Will the training/credentialing process need to be completed before services may be billed if delivered during that time period.
Training will be required to provide both Support Coordination and Intensive Support Coordination in Georgia. There will be training offered both in-person and web-based that will allow staff to meet the requirements to allow for the start-up of service provision. Training focused on credentialing ISC staff is anticipated to be completed within 90 days of initiation of service delivery. - Providing the ISC service is costly. A significant number of recipients of that service are necessary to make it work financially for a new provider. Has DBHDD considered or developed contingency plans if new providers have to drop out during the implementation process due to an insufficient number of persons selecting new providers?
As is the case with all Medicaid programs, provider enrollment or continued participation is voluntary. The application process for enrollment in Intensive Support Coordination requires that provider applicants submit an implementation plan. DBHDD will be working with providers in editing the implementation plan to promote sustainability. - Does DBHDD expect to have more than one provider approved in each region? What will be DBHDD’s process for how eligible persons initially choose, or are assigned to, an approved ISC provider? If an existing SC agency is approved to provide the new ISC service, will the ISC-eligible persons already supported by that agency remain with that agency by default? Or, will there be an expectation that choice will be offered to those persons, if another provider is approved and available for ISC services in that same area?
Yes, there will be enough providers in each region such that choice is an option for eligible waiver participants. At the time of enrollment in ISC, the individual and/or their representative will be presented with information on the ISC providers that offer the indicated modality of ISC and they will be able to select from those available. If an existing SC agency is approved to provide ISC, the ISC eligible individuals currently served by that agency will be offered the opportunity to either remain with their current provider, or select from other available ISC providers in their area that serve individuals with their assessed need modality. - Was a formal rate study conducted to set the ISC rate? If one has been completed, is the methodology or model used available? Will DBHDD be studying or monitoring the actual costs of ISC during its implementation to ensure the rate is adequate?
No. A formal rate study has not yet been completed for ISC. The current rate was based on provision of a similar waiver service to a similar population. A rate study is underway and DBHDD will use actual costs and audited cost reports submitted by support coordination agencies in determining adequate rates for both traditional and intensive support coordination. Adjustments to both rates will be proposed through waiver amendment following extensive public comment by both DBHDD and the State Medicaid Agency, DCH. - Are there rate studies underway or anticipated that will address the current rate for traditional SC services? Will that or any future study being looking at the ISC rate for the long run? For example, does DBHDD anticipate a point in time when ISC and traditional SC could be blended into one modality (with a single, comprehensive rate) that allows SC providers to assess and adjust the level of service coordination based on fluidity in a person’s acuity, or due to any disruptive change in a person’s situation or condition?
Yes, the current rate study will address both traditional SC and ISC. We have not yet considered a blended support coordination rate, but that has not been ruled out as a future consideration. - Will the ISC be a Medicaid billable reimbursed service? Is not, how will the funds be dispersed?
Yes, ISC is a billable reimbursed service under the COMP (Comprehensive Supports) Waiver. - How frequently may payment claims be submitted for ISC services? What is the typical timeframe between the submission of a claim to the state and when that claim is paid to the provider?
Georgia Medicaid providers may submit claims through the Medicaid Agency at any time since all claims in Georgia are submitted electronically following prior authorization. All authorization and payment history is available to providers assigned to provide services to the Medicaid member through the Agency’s billing website found at www.mmis.georgia.gov. “Clean” claims are paid weekly through electronic funds transfer. - It will take extraordinary effort, time and expense to start delivery of ISC services to any number of persons by any number of approved providers. Overall, to support 1500 persons, a minimum of 90 highly compensated professionals need to be recruited and hired across the state. Other support staff need to be hired, and Medical/Clinical directors employed or placed on paid retainer. All of these employees must be outfitted, orientated and trained before starting ISC services. Clearly, a number of months of expensive payrolls and operations will be incurred prior to being able to start delivery of the service and submit the first claims for payment. To ensure qualified providers are not financially stressed or placed at financial risk during or after start-up, what provisions are being made to assist approved agencies financially or administratively?
DBHDD is allowing providers to “roll in” participation in the COMP waiver, adding clinical and administrative staff as the member volume increases. Further individual discussions are expected to take place following receipt of completed application. DBHDD is still considering many options relative to startup of intensive support coordination providers. - During and after startup, if DBHDD determines the cost of providing ISC services exceeds and cannot be provided as defined by DBHDD within the rate set by DBHDD, will the state indemnify providers (through its contracts with providers) against that risk and make providers whole for unforeseen cost overages identified by DBHDD?
DBHDD has not considered such at this time, preferring to temporarily modify start-up requirements for new agencies. - Do Georgia’s CMOs (Medicaid managed care contractors) cover both physical and behavioral healthcare benefits for their enrollees? Or, are behavioral health benefits under the state’s Medicaid program delivered under another modality or network of providers?
In Georgia, adults and children served through any of the 1915c Medicaid Waiver Programs are exempt from CMO eligibility/coverage. There is an exception for children whose Medicaid eligibility is derived by virtue of falling into the “foster care or adoption assistance” class of assistance but that number is small. Waiver participants typically receive psychiatric or behavioral health services through State Plan, fee-for-service Medicaid or through Medicare, if eligible, as the primary payer source.
Waiver Participant Choice of SC-ISC Providers
- Will an individual be given choice among Intensive Support Coordination agencies when entering the service?
Every individual entering services who meets eligibility criteria for Intensive Support Coordination will be provided with information on all available Intensive Support Coordination agencies that serve individuals with their risk classification (medical or behavioral) and the individual and/or their representative will have the opportunity to choose from any of those options. - Will the process for persons to choose their Intensive Support Coordination providers be completed as the first, or as one of the very first steps in implementation of the new ISC service?
There will be three pathways by which waiver participants will have the opportunity to choose their Intensive Support Coordination provider agency.- Annual DBHDD Field Office Evaluation:
Current policy indicates that all waiver participants who have exceptional medical or behavioral support needs (as assessed by the SIS and HRST) are to have an annual evaluation completed by a DBHDD Field Office clinician in advance of their annual ISP. We will leverage this process already in place to determine eligibility of waiver participants for Intensive Support Coordination. These clinical evaluations are to be completed 90 days prior to the participant’s birthday, so that the information and recommendations can be available for the purpose of ISP development. As part of the clinician’s evaluation recommendations, they will recommend the new ISC service for all participants that meet eligibility criteria. The service will be added to their upcoming ISP, in alignment with their birthday. For any clinical evaluation completed on or after August 1, DBHDD Field Office Clinicians will be required to include a recommendation relating to Intensive Support Coordination eligibility for any eligible waiver participant, for service inclusion in their next ISP. - Change of Condition
If a participant’s medical or behavioral support needs reflect a change in condition whereby Intensive Support Coordination becomes imminently indicated, the current SC will submit a Request for Clinical Review to the Field Office for a clinical evaluation to be conducted as soon as possible. A Field Office clinician will conduct a clinical evaluation as soon as possible and the clinician will indicate in their recommendations that Intensive Support Coordination is needed for that participant (to begin upon implementation of the service). - Needs Not Being Met
At any time, with any service, if a participant or their legal representative does not feel as though their needs are being met by their current provider agency, they have the Freedom of Choice to select another provider agency from the options available in their area of residence. This process is facilitated by the DBHDD Field Office.
- Annual DBHDD Field Office Evaluation:
- Are only those persons in the COMP Waiver who qualify for the ISC service going to be choosing available providers, or will persons receiving standard SC services in the NOW and/or COMP waivers also be choosing among all available providers?
At annual reevaluation (ISP), waiver participants and/or their representatives are made aware of their Freedom of Choice opportunities. Thus, during every reevaluation (ISP), participants and/or their representatives may select a new provider of any service, including Support Coordination, if dissatisfied with the current service provider. Additionally, participants and/or their representatives may request options for a new Support Coordination provider agency at any time. Persons served in standard Support Coordination services in the NOW and COMP waivers will be offered choice by the DBHDD Field Office, whenever they express dissatisfaction with their current standard SC provider. - If yet identified, what does DBHDD anticipate the provider choice process will look like? How will it be communicated? Who will be presenting and verifying choice with the person? Will all persons be expected to affirmatively state their selections? If some do not exercise an affirmative choice, will those persons remain with their current SC providers, or be proportionately assigned among available providers in their regions?
Upon completion of a clinical evaluation and determination that the waiver participant meets eligibility criteria for Intensive Support Coordination, the DBHDD Field Office clinician will:
A. Educate the participant and their representative about the availability of the new ISC service.
B. Provide each eligible participant and/or their representative with information on the Intensive SC agencies available in their area of residence from which they may select.
C. Give the participant and/or their representative information on “Choice in ISC Provider Selection.”
D. Give the participant and/or their representative an ISC Provider Selection Form.
The participant and/or their representative has the following options for making their selection (or opting out of selecting a provider).
1. If they are able to make the decision on the day of the clinical evaluation, the participant or their representative can give the completed ISC Provider Selection Form back to clinician to deliver to the DBHDD Field Office.
2. If the participant and/or their representative is unable to make a decision on their ISC provider selection on the day of the assessment, they will be offered the opportunity to mail the ISC Provider Selection Form to the DBHDD Field Office within 30 days. If no selection is made within 30 days, or the participant or legal representative wishes to defer the selection, the participant will be assigned to an ISC provider in their area, based on a rotation methodology.
In circumstances where, due to limitations in cognitive capacity, a participant cannot affirmatively state their ISC provider selection, there will be a rotation methodology used to determine which ISC agency available in the region will be selected for the participant. This will take place, only after an exhaustive search for any informal representative able to assist the participant with the decision. This process will also become DBHDD policy for participants receiving standard Support Coordination services.
- If any or all of the current SC agencies are approved also as ISC providers, is it expected that the majority of persons eligible for the ISC service will want to remain with their current SC agency?
We are nearing completion of the provider enrollment process for new or current agencies to provide SC or ISC services and will soon know how many providers of either service will ultimately be enrolled. We cannot presume what eligible participants will chose when offered options of agencies that serve their area of residence. Per CMS waiver requirements, all waiver participants will be offered the opportunity to make an informed choice between current and newly enrolled providers at any point when they express interest in exploring provider options.