Developmental Disability Targeted Case Management Change required due

Developmental Disability Targeted Case Management Change required due to billing guideline changes from 1 contact with consumer per month to Encounter Based System

Process ØEstablished Expectations ØIdentified Data and designed tools (reports) for monitoring implementation ØCommunicated need for change to staff ØMonitored process to identify where challenges existed ØMet with staff on addressing challenges ØContinual feedback loop of reports and identification and addressing of challenges

Developmental Disability Targeted Case Management ØIdentified data that needed to be recorded and tracked, such as: ØFace to Face Encounters with Client ØFace to Face Encounters with Collateral Contacts ØPhone Encounters with Consumer and Collaterals

Developmental Disability Targeted Case Management ØMet with Service Coordination Staff to discuss change in billing and how the Encounter System is a Best Practice to ensure the needs of the consumer are being addressed and met

Developmental Disability Targeted Case Management ØDeveloped reports to monitor progress on moving to: ØOne Face to Face Encounter with Consumer per month ØAverage of three other Encounters per month ØReport tracks Medicaid and Non. Medicaid to monitor potential impact on revenue

Challenges Encountered ØCase Managers not use to recording all encounters ØGetting Case Managers to understand that not all contacts had to be with the consumer ØOne Supervisor was very vested in the process and made tremendous progress while another supervisor was less vested and the Case Managers showed minimal progress

Overcoming Challenges ØTraining with Supervisor to get on board with process ØAdditional training with Case Managers to ensure recording all encounters ØReviewed scenarios with Case Managers of potential encounters

Overcoming Challenges ØMet with Case Managers of less vested supervisor and: ØShowed examples of Case Managers meeting the Encounter Standards thus taking away the response of “it can’t be done” ØReviewed their encounter information and addressed barriers such as coordinating travel for visits

Where Are We Now? From September to June Increased Percentage of Current Billings from 72% to 92%

Where Are We Now? Case Managers are actually requesting additional reports to track their progress Training Case Managers to adjust service codes to meet new billing parameters, such as second face to face with consumer recorded as follow up encounter