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Department of Medical Assistance Services
DD Waiver Provider Training
Department of Medical Assistance Services Division of Long-Term Care
and Quality Assurance2013
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Department of Medical Assistance Services
Family/Caregiver Training (FCT)
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Department of Medical Assistance Services
Family/Caregiver Training
Definition• Provision of identified training and
education to a family member or caregiver regarding: – Disabilities– Community integration– Family dynamics– Stress management– Behavior interventions– Mental health
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Department of Medical Assistance Services
Family/Caregiver TrainingDefinition continued• “Family” constitutes persons who live with
or provide care to a waiver consumer– Parent– Spouse– Children– Other Relatives (including in-laws)– Legal Guardian– Foster Family
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Department of Medical Assistance Services
Family/Caregiver Training
Provider Qualifications• Provider must enroll with DMAS to be a
Family/Caregiver Training Provider
• Existing Medicaid providers cannot use current Identification number
• Obtain Enrollment Packet by calling the Provider Enrollment Unit (888) 829-5373
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Department of Medical Assistance Services
Family Caregiver Training
• Training shall be provided on an individual basis or in small groups provided by Medicaid-certified Family/Caregiver Training providers
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Department of Medical Assistance Services
Family/Caregiver Training
Provider Qualifications• Who can provide this service?
– Home health agencies;– Community developmental disabilities
agencies;– Developmental disabilities residential
providers;– Community mental health centers;– Public health agencies;– Hospitals;
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Department of Medical Assistance Services
Family/Caregiver Training Provider Qualifications• Who can provide this service:
– Clinics; – In-home rehabilitation agencies;– Other agencies or organizations
• Individual Family/Caregiver Trainers who have necessary Virginia licensure or certification for their profession may also enroll as a provider.
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Department of Medical Assistance Services
Family/Caregiver TrainingProvider Qualifications
Providers must:• Have demonstrated experience or
knowledge of the training topic
• Have the appropriate licensure or certification for their field.
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Department of Medical Assistance Services
Family/Caregiver Training
Providers include:– RNs, LPNs, RNAs, & Nurse Practitioners– Occupational, Physical and Speech
Therapists– Physicians– Teachers– Psychologists– Licensed Practical Counselors– Licensed Clinical Social Workers
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Department of Medical Assistance Services
Referral Process• During POC development, the case
manager will document with the family the need for training.
• Training must be necessary:– To improve the family or caregiver’s ability
to give care and support to the individual.– To assist the family/caregiver with
maintaining the individual at home.
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Department of Medical Assistance Services
Referral Process• The case manager will give the family
and/or caregivers the choice of Family/Caregiver training providers
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Department of Medical Assistance Services
Referral Process• The case manager documents this
information on the POC (DMAS 456) and supporting documentation (DMAS 457) and obtains authorization from DMAS for services.
• If additional hours are needed, the family/caregiver provider should contact the case manager.
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Department of Medical Assistance Services
Service Units• Individuals can receive up to 80 hours of
Family/Caregiver Training services per calendar year
• The training must be authorized by DMAS and billed on an hourly basis
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Department of Medical Assistance Services
Service Limitations
• Training cannot include services available under Medicaid State Plan services or educational courses.
• Paid caregivers are not eligible to receiving training through this service.
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Department of Medical Assistance Services
Documentation• The CM should provide the following
information regarding the individual:–The POC (DMAS 456, DMAS 457)–The DMAS 225–Any relevant evaluations,
therapeutic consults, MD reports
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Department of Medical Assistance Services
Provider Documentation • The FCT should provide the following
information to the case manager:
Supporting Documentation(DMAS 457) Brochure of training activities
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Department of Medical Assistance Services
Provider Documentation cont. Contact notes:• Date, location, and time of each training
contact;• Type of activities and hours of service
provided; and • Persons to whom activities were directed
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Department of Medical Assistance Services
Provider Documentation cont. :
Monthly notes: • Summary of training
activities for the month;
• Dates, locations, and times of service delivery;
• POC objective(s) addressed;
• Specific details as planned or modified
• Effectiveness of the strategies and individual and caregivers’ satisfaction with services
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Department of Medical Assistance Services
Provider Documentation cont. Semi-annual Reviews are required by the
provider if training extends three months or longer and are to be forwarded to the Case Manager and include:
• Activities related to the supporting documentation;
• Individual status and satisfaction with services
• Training outcomes and effectives of the POC
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Department of Medical Assistance Services
Provider Documentation cont.• If training services extend less than three
months, the provider must forward to the Case Manager:
• Contact notes
• Monthly notes
• Or a summary of such to the Case Manager for the semi-annual review
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Department of Medical Assistance Services
Thank You For Coming!• We look forward
to partnering with you to provide services to our DD Waiver beneficiaries
• Any Questions? Please Ask