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HCBS Waiver and Alternative Care Provider Training 101
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My Syllabus
Module 1: Introduction and the road to Home and Community Based Services
Introduction
Instructions for navigating this course
Training requirement for waiver providers
Definitions
Minnesota Health Care Program information
The Road to Home and Community Based Services
History of institutions
Social Security Act and the creation of Medicare and Medicaid
The Beginning of home and community-based waiver services
The Disability Rights Movement
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Module 2: Supporting People with Home and Community-based Services
Introduction
Objectives
DHS vision
Explore CHOICES domains
Service-centered vs. person-centered
Waiver provider’s role
HCBS Waivers
MHCP manual – eligibility requirements
Federal requirements for service development
Services by waiver
MHCP manual – services by waiver
Waiver service descriptions
HCBS waiver services standards
The Division of Licensing
Licensing actions
Appeals
MHCP manual – provider standards and qualifications
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Module 3: Roles and Responsibilities
Introduction
Objectives
Working together
Federal Government
CMS responsibilities
State government
State responsibilities
Counties and tribal agencies
Managed Care Organizations (MCOs)
Assesment and case management / care coordination
Provider responsibilities
Service participants and legal representatives
Choice
Self-determination proponents
Informed consent
Role of guardians and power of attorney
Commissioner appointed guardians
Delegate responsibilities
Public guardian responsibilities
Representative payee responsibilities
Power of Attorney responsibilities
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Module 4: Becoming an HCBS Waiver Provider
Introduction
Objectives
How To Become an HCBS Waiver Provider
Office of the Inspector General (OIG) Exclusions
Provider enrollment
Processing enrollment applications
MHCP Manual and New Enrollment
Selecting a waiver provider
Service authorizations
Service payment
Provider Payment Rates
Fee for service
Provider Billing
Provider Compliance
Provider Monitoring
Monthly eligibility and claims
Provider abilities
Provider call center
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Module 5: Participant Safeguards
Introduction
Objectives
Design of waiver programs
Protective processes
Adult protection
Maltreatment
Child protection
Reporting
What is a mandated reporter?
Mandated Reporter training
Civil rights
Fair hearing
Department of Health licensed provider
Department of Human Services licensed provider
Data privacy
HIPPA
Protecting Information Privacy course
Ombudsman's office
DHS or MDH license
DHS licensing
MDH licensing
County and tribes
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Module 6: Business Operations and the Provision of Medicaid Services
Introduction
Objectives
What it takes
Business focus
Resources for getting started
SBA
SCORE
DEED
MHCP Provider Compliance
Noncompliance risk/Provider violations
DHS SIRS
Examples of provider abuse
Inspector General
LEIE
PERM
PERM video
Consider this scenario
The audit
Business failure
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Module 7: Home and Community Based Services (HCBS) Settings Requirements
HCBS Settings Requirements
Requirements that apply to all HCBS settings
Requirements for All Settings
Dignity and Respect
No coercion/restraint
Independent choices
Choice of services and supports
Community life
Control of money
Employment
Residential Settings
Lockable Doors
Roommates
Decorations
Daily schedule
Visitors
Accessibility
Modifications
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