Bridges to Health (B2H) Frequently Asked Questions
- Upon receiving a referral from LDSS, a representative from the HCIA meets the potential family, at which time the HCIA representative presents the list of potential HCIs and asks the family to complete the Understanding the Bridges to Health Medicaid Waiver Program (OCFS 8002). If the HCIA can not meet with the family until day 14, is it accurate that the HCI needs to be assigned and complete all the information as indicated on pg. 2-5 under the preliminary IHP in 11 days?
Answer: Yes. Per Chap. 6-4 of the Bridges to Health Program Manual, once a child has been referred to an HCIA by the LDSS for assessment and completion of an Application for Enrollment Packet, the HCIA directs the preparation of the packet. The process begins by meeting with the child/medical consenter and other caregivers to discuss B2H. Within 60 days of referral from the LDSS, the HCIA is responsible for the accurate and appropriate completion of the Application for Enrollment Packet. Completed packets must be submitted to the HCIA supervisor and quality management staff for review and submittal to the LDSS for approval. The Application for Enrollment Packet includes:
- Understanding the Bridges to Health Medicaid Waiver Program Form (OCFS-8002)
- Level of Care (OCFS-8005 A, C, or OMRDD 02-02-97)
- Freedom of Choice Form (OCFS-8003)
- Health Care Integrator Selection Form (OCFS-8007)
- Waiver Participants’ Rights Form (OCFS-8008)
- Individualized Health Plan (Preliminary IHP OCFS-8017)
Answer: These services can be provided to youth with an SED and MedF. The youth does not have to enroll in B2H through the DD waiver to receive these services.
Answer: If the approved IHP includes respite, and it lists this particular home (agency) as a B2H provider and the provider meets the qualifications outlined in the B2H Program Manual to provide out of home respite, then B2H will cover the cost of the respite as long as it falls within the approved billable units in the IHP.
Answer: The WSP must complete a new Schedule A form and send it to the HCIA, who in turn verifies that the WSP is qualified to perform a new service. The HCIA must send a copy of the Schedule A to the Regional QMS and OCFS Bureau of Waiver Management.
Answer: The Detailed Service Plan provides space for the WSP and the individual providing the service.
Answer: A child may receive B2H services outside the B2H designated region, but cannot reside outside the Region. Service providers must be within a reasonable proximity to the child’s home.
Answer: WSP cannot refuse to serve a child.
Answer: For every B2H Waiver service delivered to an enrolled child or family member, the worker must complete a Service Summary. Medicaid requires that service documentation be contemporaneous with service provision. The summaries must be complete and timely and must accurately relate to and identify the child’s service plan goals and objectives. Original Service Summaries must be submitted to the HCIA within five business days of the service contact.
Answer: The Progress Note (OCFS 8019) is documentation that captures all contacts beyond the Service Summary that HCIs or WSPs have on behalf of or with the child/medical consenter or family/caregiver. It summarizes all relevant information outside the billing information. At this time, it does not interface with CONNECTIONS.
The HCIA will be assigned a role in CONNECTIONS by the LDSS. The HCI will document significant information relevant to the Case Planner/Manager via the CONNECTIONS Progress Notes. These notes should be printed and made part of the B2H case record.
Answer: Not at this time.
Answer: Agencies should continue to use procedures already in place for entering progress notes into CONNECTIONS. HCIs will document the information on a hard copy B2H Progress Notes Form (OCFS 8019) and a B2H Serious Reportable Incident Form (OCFS 8021).
Answer: Staff training is part of professional development. It is not directly compensated, but training is figured into the rates reimbursed for services once a child is receiving the B2H Waiver.
Answer: Trainers must complete the CANS B2H Train the Trainer (TOT) to teach others to administer the CANS B2H. OCFS anticipates a training for Train the Trainers (TOT) next year. Those trained in other versions of CANS (eg: CANS-MH) must attend the CANS Basic as the CANS B2H is somewhat different than other versions. As for other training opportunities, there will be a CANS B2H training website available early in 2008.
- First Aid/ CPR
- Mandated Reporting on Suspected Child Abuse and Neglect
- Basic Crisis Intervention and De-escalation Techniques
- Overview of B2H Waiver Program Documentation Requirements"
Then, according to page 14-2, the Program Manual reads: "All WSPs are required to attend the following trainings within the first six months of engagement as a B2H provider:
- B2H Documentation: 4 hours
- Working in a Family's Home: 4 hours"
Answer: All HCIs and WSPs require B2H Documentation Training. Page 14-3 of the B2H Program Manual explains that ALL HCI supervisors MUST attend and satisfactorily complete the OCFS sponsored 3 day training (Training #4) PRIOR to providing ANY supervision to HCI staff. It is preferred that HCIs also attend the 3 day training (Training #4) prior to providing services to B2H children, but it is understood that staffing lags may occur within the initial rollout of the B2H program. The HCI MUST attend the 3 day training within their first 6 months of B2H employment.
Answer: See Question #14
Answer: If any potential HCI hires have previously and satisfactorily attended one or more of the (HCIA sponsored) required trainings, attendance must be formally documented and the training must be current and preferably within the last six months, then such previous trainings would suffice. If any of these trainings require refreshers or annual updates, then those staff would need to attend the refreshers/updates.
Answer: Documentation of satisfactory attendance and completion of required B2H training must be formally tracked by the HCIA and WSP, as well as documentation of satisfactory attendance and completion in each staff members personnel file. Staff members that have already received Crisis Intervention through an already established and OCFS approved model may continue to use this model.
Answer: Chapter 8 of the B2H Program Manual, pages 8-12, 13 and 8-17, 18, Training Requirements, specify that respite providers, within six months of engagement as a B2H provider, are expected to attend these trainings.
Answer: No services can begin before the child is officially enrolled in the B2H Waiver Program. However, once enrolled in B2H, the HCI manages the child’s B2H services on a monthly basis. To account for the additional work preformed by the HCI during the child’s enrollment, a bill using the First Month Transition rate code may be submitted for the enrollment month in addition to the bill for the normal Health Care Integration services (see pg. 13-4 of the B2H Program Manual).
Answer: Chapter 5, pg 5-10 of the B2H Program Manual speaks to the Quality Management functions of the HCIA. The HCIA is responsible for reviewing all the documentation bulleted for appropriate and efficient use of services. Three of the documents listed will be used for billing reconciliation: IHP (OCFS-8017), Detailed Service Plan (OCFS-8020) and Service Summary Form (OCFS- 8018). The HCIA, per the Provider Agreement with OCFS and per the Model Subcontract with any WSP, is responsible to reconcile that the services that are billed for are done so appropriately and accurately. The information on page 5-12, is the information that the HCIA is required to report to OCFS. Although this report does not include individualized budget information, it does not remove the responsibility of reconciling billing and approved services from the HCIA.
Answer: CONNECTIONS will provide this functionality in March 2008.
Answer: According to the Department of Health (DOH), once submitted, payment can be expected in about 4-6 weeks.
Answer: Medicaid Adjudicated Claim Reports will be provided to the HCIAs for all B2H children served by the HCIA.
Answer: HCIAs are expected to track revenues and expenditures related to the B2H program and to report them as part of the Standards of Payment (SOP) submission in a separate non Maximum State Aid Rate (MSAR) cost center.
Answer: B2H rates are fee-based rates. They are not determined based on program-specific costs.
Answer: Per the Model Subcontract for the B2H Waiver, under Section II, Scope of Services, number five states: “The agency warrants that it and its staff have all the necessary licenses, approvals and certifications currently required by the laws of any applicable municipality of local, state or federal government. The agency further agrees to keep such required licenses, approvals and certificates in full force and effect during the term of this Agreement or any extension time frames. The Agency shall promptly notify the HCIA of any enforcement action taken with respect of such license, approval or certificate and any action the Agency is taking with respect thereto….” This references the fact that the WSP is responsible for the paper verification of checks, and it is sufficient to have the contract on file that the HCIA has verified through the contract as such.
Answer: If a current employee of the HCIA is transferred to work in that same agency as an HCI, that employee is not required to have an updated background check done by the SCR.
Answer: HCIA originates and completes each of these forms.
Answer: There is no form. Chapter 11 in the B2H Program Manual, page 11-1, refers to HCI responsibilities regarding what information must be provided to the child/medical consenter.
Answer: Yes, a new number and locater code will be issued by DOH.
Answer: Yes, the child can qualify for the waiver, but must spend down first.
Answer: Medication Administration Record (MAR) is the standard for documenting medication administration. Administering medications is a function of the foster care provider. A progress note is not a sufficient means of documenting a medication error. Medication errors must be documented on the Medication Error Report (OCFS 8036.)
Answer: OCFS will undertake a review of the HCIA to devise a plan to improve the achievement rate.
Answer: B2H criteria states that as long as they are still in the custody of the LDSS or OCFS, they are eligible to receive B2H services.
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- B2H Home
- Approved B2H Agencies
- CONNECTIONS (CONX)/Welfare Management System (WMS) Instructions
- CONNECTIONS B2H Job Aid
- Request for Applications (RFA)
- B2H Program Manual (Updated 01/2012)
- B2H Forms (Updated 01/2011 & 01/2012)
- B2H Waitlist
- Approved Rates for B2H Waiver Program (PDF)
- General Information System (GIS)
- Training Reference Guide (PDF)
- Bridges to Health (B2H) Informational Video for Caseworkers
- Frequently Asked Questions
- Overview of B2H Waiver Program Documentation Requirements
- Current Bridges to Health Home and Community Based 1915(c) Waivers