oltl new consumer tip sheet - hcsis.state.pa.us · effective 11/13/2016, only independent...
TRANSCRIPT
OLTL New Consumer Tip Sheet
In the OLTL New Consumer registration process, Service coordination users might enter demographics and determine
eligibility for consumers. The clearance process, which is conducted only by Independent Enrollment Brokers, is used to
verify that a consumer’s information does not already exist in HCSIS and/or MCI (Master Client Index). Once clearance
is complete, the Service Coordinator enters the consumer demographic information. Finally, the OLTL enrolling agency
determines the consumer’s eligibility for waiver services.
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Open Internet Explorer and type https://www.hcsis.state.pa.us into your
address bar
Login to HCSIS by clicking HCSIS Login and entering your username and
password
Effective 11/13/2016, only Independent Enrollment Brokers (IEBs) are to clear new consumers into HCSIS.
If you are an IEB, please follow the instructions given in IEB Clearance by Linking or Case Transfer - CHC Phase 1A, which is available in the HCSIS Learning Management System.
If you are an SC, you should not perform clearance. Your work with a new
participant might begin with entering demographic information – see Step 3, if
this is the case. Or, your work might start with setting up the participant’s plan
– see Step 13 if this is the case.
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Clearance 2
HCSIS Login 1
OLTL New Consumer Tip Sheet
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New Consumer
(ALT ID)
Navigate to Individual>Demographics> Alt ID
Click the [Add] button
Select MA as Identifier Type from the drop-down list
Enter the following information for the consumer:
MA Number
Effective Begin Date
Click [Save]
Repeat these steps for SSN, if it was not entered during clearance using
the same effective begin date as the MA Number
Click [Save and Continue]
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If the consumer does not have an MA Number, skip this step and return to this step
when the consumer receives an MA Number.
OLTL New Consumer Tip Sheet
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New Consumer
(Demographics)
Navigate to Individual>Demographics> Demo
Enter the following information for the consumer:
Current Living Situation
County of Residence
Home Phone
Enter any additional information as appropriate (optional)
Click [Save and Continue]
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The fields circled above are conditionally mandatory:
•If yes, Interpreter is needed for should only be entered if “Is Interpreter Needed”
is Yes
•If Other, please specify should be entered if Other is selected from If, yes,
Interpreter is needed for field
•If the user chooses Primary Language at Home from the “If yes, Interpreter is
needed for field, the Primary Language at Home field is conditionally mandatory
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New Consumer
(Address)
Navigate to Individual>Demographics> Address
Enter the mandatory fields marked by (*)
Address Line 1
City
State
Zip
Click [Save]
Address Type (Select
Residential by typing the
letter R)
Effective Begin Date
HCSIS uses DPW’s Geographical Information System (GIS) software to
validate and standardize an individual’s address in HCSIS. After clicking [Save],
an Address Verification pop-up window will appear, indicating that a similar
address was found
When users enter an address into an Address Line 1 field in this screen, the first 26 characters of the address are entered into the field. When the user saves the record, a GIS Address Verification window (see example above) may open to allow the user to use the GIS address. If the user accepts the GIS address, any remaining characters in the address beyond the first 26 are automatically entered into the Address Line 2 field, overwriting any entry that may already be there. Any characters that may be in the Address Line 3 field are deleted. If the user clicks the [Cancel] button in the GIS Address Verification window to not accept the GIS-validated address, the address persists in the field(s) as it was entered. Users who enter an address that must use Address Lines 2 or 3 should click [Cancel] in the GIS Address Verification window to keep those address lines.
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OLTL New Consumer Tip Sheet
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Eligibility
Determination
Navigate to Individual>Eligibility> Elig. Determination to reach the Level of
Care screen
Enter the following information:
Level of Care Eligible
OBRA = ICF/ORC
Independence and Attendant Care/Act 150 = NF
COMMCARE = NF/ Special Rehab
Effective Begin Date
Name of Determining Worker
Click [Save and Continue]
If a consumer is also served by ODP, both ODP and OLTL can capture
eligibility information unique to their program office in HCSIS. OLTL will have
read-only access to a consumer’s ODP eligibility determination information,
via a new hyperlink, on the Level of Care, Service Preference, and
Waiver/Program Enrollment screens in HCSIS
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The Level of Care screen is not required for consumers in the Act
150 Program but should be recorded if available.
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Eligibility Service
Preference
Navigate to Individual>Eligibility> Elig. Determination – Service
Preference to reach the Level of Care screen
Enter the following information:
Service Preference Choice (Set to “Home and Community Based
Services”)
Effective Begin Date
Click [Save and Continue]
The Level of Care and the Service Preference screens must be completed
in one of the following scenarios:
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Set Service Preference Choice to
“Home and Community Based
Services”
OLTL New Consumer Tip Sheet
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Eligibility
Determination
Navigate to Individual>Eligibility> Elig. Determination – Eligibility
Documentation
Click [Add] to clear the fields on the screen. Select a required form in the Form
Type field
Select the status of the eligibility document/form from the Status dropdown box
Completed – The document/form has been completed. Ultimately, all
required forms must have the completed status to continue with the eligibility
process.
Submitted - Only used when documents/forms need to be submitted to a
third party for review.
Received – This status is for internal use only and is used to indicate a form
has been received back from a third party
Enter the following information:
Effective Begin Date
Click [Save]
Repeat these steps for each required form
When all the appropriate forms are completed, click [Save and Continue]
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OLTL New Consumer Tip Sheet
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Waiver Enrollment
Navigate to Individual>Eligibility> Elig. Determination – Waiver/Program
Enrollment
Enter the following information for the consumer:
Waiver/Program Type
Waiver/Program Status (Select Pending from the drop-down list)
Point of Origin/Entry Process
Effective Begin Date
Click [Save]
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Waiver Enrollment
Navigate to Individual>Eligibility> Elig. Determination – Waiver/Program
Enrollment
Select Waiver/Program Enrollment from the “Go To” drop-down list, and click
[Go]. Note: If applicable, search for the consumer using the consumer’s first
and last name. The screen will appear with the consumer’s name in the blue
header at the top of the screen.
Select Submit to State in the Waiver/Program Status field
Click [Save]
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Note: If a consumer is also served by ODP, both ODP and OLTL can
capture eligibility information unique to their program office in HCSIS.
OLTL will have read-only access to a consumer’s ODP eligibility
determination information, via a new hyperlink, on the Level of Care,
Service Preference, and Waiver/Program Enrollment screens in HCSIS.
SC Supervisor
OLTL New Consumer Tip Sheet
11 Navigate to Tools> Alerts> Pending Alerts
Enrollment Follow the HCSIS menu path above or click on the alerts link on the HCSIS home
page
Under “Alert Search Criteria” select “Eligibility Reviewer Action” as the
“Subject”
Click [Search]
Find the Alert for the consumer
Click on the hyperlink labeled “An Individual's Waiver/Program enrollment records
is pending for enrollment decision”
The Eligibility Determination page will now be displayed for this consumer. The
menu path for this screen is “Individual > Eligibility > Elig. Determination >
Waiver/Program Enrollment”
Review the consumer’s Eligibility and Plan information as needed. (This will
involve navigating to additional screens.)
Select Enrolled in the Waiver/Program Status field
Click [Save]
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Review Enrollment
Alert
Navigate to Tools> Alerts> Pending Alerts
Under “Alert Search Criteria” select “Eligibility Reviewer Action” as the
“Subject”
Click [Search]
Find the Alert for the consumer
Review the alert message “Eligibility Reviewer has made a decision on
Waiver/Program enrollment record”
Navigate to Individual > Eligibility > Eligibility Determination
Select Waiver/Program Enrollment from the “Go To” drop-down land click [Go]
Review the waiver/program status
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OLTL New Consumer Tip Sheet
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Plan: Create Draft
Navigate to Plan> Plan Admin> Create Draft
Select the Waiver/Program Type from the drop-down list
Note: If this field is collapsed, and you cannot select a waiver, then the consumer
does not have a waiver/program enrollment record with a status of Pending,
Submit to State, or Enrolled
Enter the following information:
Proposed Start Date (Set this to the date the consumer is expected to
begin receiving services)
Proposed End Date (Set this to 6/30/20XX)
Category of Plan Changes (Select Plan Creation)
Click [Create Draft]
Optional: Continue to enter any additional plan details that are not required
by your organization
Note: If a consumer is also served by ODP, both ODP and OLTL can
capture a consumer’s Plan information unique to their program office in
HCSIS. In addition, OLTL can view a consumer’s plan created by ODP via
the Print Plan screen in HCSIS.
Verify the draft plan was created by checking to see if an Operation Successful
message appears at the top of the screen. If you do not receive an Operation
Successful message, an error has occurred and the draft plan was not created.
Read the error message at the top of the screen, address the error, and click
[Create Draft] again
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Select Plan Creation
from drop-down
Do not attempt to create two draft plans with different waivers at the same time in separate tabbed Internet Explorer windows. Doing so could wrongly assign the waiver of one plan to the other plan. If you receive the error “Either waiver/program status is invalid or plan dates are out of waiver/program date
range” upon saving, double-check the waivers in both draft plans
OLTL New Consumer Tip Sheet
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Strengths
Navigate to Plan> Individual Preferences> Strengths
Select one of the following form the category drop-down:
Able to Access Supports
Able to Coordinate Services Independently
Good Communicator
Good Informal Supports
Other
Enter a description of the consumer’s strength as it relates to the drop-down
selection
Click [Save]
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The mandatory fields on the Strength screen must be completed in
order to submit a draft for review
OLTL New Consumer Tip Sheet
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15 Plan:
Employment/Volunteer
Information Navigate to Plan> Functional Information> Functional Level –
Employment/Volunteer Information
Select Employed, Volunteer or None from the Work Status drop-down list.
Note: If you enter None, skip the steps below and continue Plan Outcome
Enter the following information
Frequency (Select Fulltime or Part-time from drop-down list)
Position
Employer/Organization
Address
City
State
Zip Code
Phone
Answer Does Consumer have employment/volunteer goals?
If Yes is selected, enter goal information in the List
employment/volunteer goals text box
Click [Save]
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Select Employment/Volunteer
Information from the Go to
drop-down
A consumer must have employment information in HCSIS in order to submit a draft plan. If the
consumer does not have employment information recorded in HCSIS, you will receive an error
message when submitting the plan
OLTL New Consumer Tip Sheet
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Household
Composition
Navigate to Plan> Functional Information> Household Composition -
Household Composition
Select age of other household members for the Age (in Years) drop-down
Select from the Relationship to Individual drop-down box
Click [Save]
Repeat steps for each additional member of the household
Click [Save and Continue]
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The mandatory fields on the Household Composition screen must be
completed in order to submit a draft for review
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Non-Waiver Services Navigate to Plan> Service & Support> Non-Wavier Services
Answer Yes or No to Are Non-Waiver/Program Services being received?
If yes, complete the following mandatory fields
Service Name
Start Date
Location
Responsible
Party
Agency Name
Related
Outcome Phrase
What are Current
Needs?
What Actions are
Needed?
Frequency and Duration
of actions needed
Click [Save]
Click [Save and Continue]
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Answer yes to see additional
fields on this screen
The mandatory fields on the Non-Waiver Services screen must be completed in
order to submit a draft for review
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Plan Outcome
Navigate to Plan> Serv & Supp> Outcome Summary
Although not indicated as required entry with an asterisk, the following information
is required: Outcome Phrase, Outcome Start Date, Outcome End Date, and
Outcome Statement
Attendant Care Users:
Enter Independent Living in the Outcome Phrase field.
Click [Save].
Skip to Plan SSD
CSPPPD Users:
Enter an outcome in the Outcome Phrase field. Outcome phrases are
based on a consumer’s desires and represent the service goals of the
consumer, his/her family, and the support team.
Click [Save].
Continue on to Plan Outcome Action
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Examples of Outcome
Phrases include Supports
Coordination and Daily
Living Services
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Plan SSD
Navigate to Plan> Serv & Supp> SSD
Enter the following information into the Provider Service Search fields:
Provider (If known – this is not a required field)
County (SSD section)
Click [Search]
Select the services to add to the plan by clicking the checkbox to the left of the
service name(s). Be sure to reference the Contract Start Date on the SSD to
ensure you are selecting a service that fits within the plan dates.
Click [Add to Selected]
Repeat these steps for each provider
To add Vendor Services to the plan, continue on to Plan Vendor Services.
If vendor services will not be added to the consumer’s plan, click on Service
Details in the blue menu bar at the top of the screen to go to the Service
Details screen and skip to Plan Service Details
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Note: When searching for services in the SSD screen,
use the Go To box to view “All” results or narrow
search criteria to show fewer services on the screen
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Plan Vendor
Services
Navigate to Plan> Serv & Supp> SSD – Vendor Services
If you just finished adding provider services to the plan, use the “Go To” drop-
down list located in the upper right corner of the HCSIS window to select Vendor
Services.
Click [Go].
Enter the following information:
Provider (This is a required field)
County of Service
Click [Search].
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Click on the vendor service that you
would like to add. Note: See tip
sheet 6.0 Vendor Services for
additional information on Vendor
Services.
Narrowing your search criteria by entering the full provider
name will show fewer services on the screen.
OLTL New Consumer Tip Sheet
21 Navigate to Plan> Serv & Supp> Serv Dtls Click the Select circle for a service in the table at the top of the screen.
Plan Service Details Click [Edit] and the service will appear in the fields on the screen below the table
Highlight the appropriate outcome in the Related Outcome Phrase field
Enter the following information:
Total Annual Units
For any CSPPPD Waivers. Enter the number of annual units,
which previously would have been entered on the CSPPPD
update form.
For Attendant Care and ACT 150 the following formulas should
be used.
Units of Supports Coordination = Number of months left
in fiscal year including month of the start
Units of Attendant Care Service = (Number of weeks left
in year from consumer’s start date * Total permanent
hours * 4)
Expected Start Date (Set this to the date the consumer is expected to
begin receiving the service)
Expected Stop Date (Set this to the last day of the fiscal year 6/30/20XX)
Click [Save]
Repeat these steps for each service
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Note: Before continuing on to the next step, review the table at the top of the
Service Details screen. Be sure the table is complete and all details
(outcome, units, and service start and end dates) have been captured for
each service on the plan. If the table is incomplete, HCSIS will not allow you
to submit the plan for review and approval.
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Plan Outcome Action
Navigate to Plan> Serv & Supp> Outcome Action
Note: If applicable, search for the consumer using the consumer’s first and
last name. The screen will appear with the consumer’s name in the blue
header at the top of the screen.
Complete the following fields:
Related Outcome Phrase
What are Current Needs
What Actions are Needed
Who’s Responsible
Frequency and Duration
Click [Save]
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This step represents a CSPPPD process only and does not apply to Attendant
Care/ ACT150.
OLTL New Consumer Tip Sheet
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Submit Plan
Navigate to Plan> Plan Admin> Draft Plans
Search for the consumer’s plan by Last Name
Enter any comments/details by clicking View/Add Comments. A separate
window opens and allows multiple comment entries. Please see the Comment
Box Requirements Tip Sheet for more information about what details should be
provided here
Click [Submit Comments] to save comments
Click [Close] to return to the Draft Plans screen
Click [Submit] to submit the plan for review
Verify the draft plan was submitted by checking to see if an Operation Successful
message appears at the top of the screen. If you do not receive an Operation
Successful message, an error has occurred and the plan was not submitted.
Read the error message at the top of the screen, address the error, and click
[Submit] again
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Note: Comments are viewable to all users who have access to view the
plan in HCSIS. Comments entered on this screen cannot be deleted or
modified. If necessary, a new comment should be added to clarify or
correct errors.
OLTL New Consumer Tip Sheet
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Review Plan
Navigate to Plan> Plan Admin> Pending Review/Approval
Enter any comments/details by clicking View/Add Comments. A separate
window opens and allows multiple comment entries. Please see the
Comment Box Requirements Tip Sheet for more information about what
details should be provided here.
Note: Comments are viewable to all users who have access to view the plan
in HCSIS. Comments entered on this screen cannot be deleted or modified.
If necessary, a new comment should be added to clarify or correct errors
Click [Submit Comments] to save comments
Click [Close] to return to the Pending Review/Approval screen
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Approve Plan
Navigate to Tools> Alerts> Pending Alerts
Follow the HCSIS menu path above or click on the alerts link on the HCSIS
home page.
Under “Alert Search Criteria” select “ISP status set to pending review” as
the “Subject”
Click [Search]
Find the Alert for the consumer
Click on the hyperlink labeled “Individual plan is ready for final approval
from the state”
The Pending Approval / Review page will now be displayed for this consumer.
The menu path for this screen is Plan > Plan Admin > Pending
Approval/Review
Review the consumer’s Plan information as needed. (This will involve
navigating additional Plan screens.)
Click View/Add Comments to review the comments associated with the plan
Click [Approved]
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Click [Save] to save the plan without submitting the plan, click [Reviewed]
to send the plan on for approval, or click [Pending Revision] to send the
plan back to the Service Coordinator for revision
Note: If you send the plan back to the Service Coordinator for revision, be
sure to explain why the plan needs to be revised in the comments.
SC Supervisor
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Review Plan
Approval Alert
Navigate to Tools> Alerts> Pending Alerts
Follow the HCSIS menu path above or click on the alerts link on the HCSIS home
page.
Under “Alert Search Criteria” select “ISP Status Set to Approved” as the
“Subject”.
Click [Search]
Find the Alert for the consumer. The consumer plan has been approved and no
additional action is required
If no Alert can be found for the consumer.
Under “Alert Search Criteria” select “ISP status set to pending revision”
as the “Subject”
Click [Search]
Find the Alert for the consumer.
Click on “Individual plan requires revisions.”
Proceed to ISP Status Set To Pending Revision
If no Alert can be found
under either “ISP Status
Set to Approved” or “ISP
status set to pending
revision” no decision has
yet been made regarding
this consumers plan.
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Plan Set To Pending
Revision
Navigate to Plan> Plan Admin> Pending Revision
Click View/Add Comments to review the comments regarding why the plan was
not approved.
Click [Revise]
Make the needed changes to the plan and resubmit
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