State Plan Personal Care Changes
Aging Services Division recently implemented internal processing changes to State Plan Personal Care. The focus of these changes is to align the SPPC application processing as closely to the ADvantage processing as possible. This means the SPPC cases will now come to you already certified. The service authorization phase will continue to be processed by the OKDHS Nurse. These changes have minimal impact for the agencies however, some forms now returned/sent to your agency by the OKDHS nurse, are reflective of electronic copies rather than the current hardcopy document forms of the AG-4 Care Plan, AG-6 Service Plan, and AG-7 Provider Communication. No change in processing by the agency is required on SPPC cases, as the agency will continue to use the hardcopy documents.
As part of the new processing for the OKDHS nurse on newly opened SPPC cases, the case is now certified for services before the case is sent to the agency for plan development. Additionally, a new zero unit service plan authorizing plan development is sent along with the UCAT I, UCAT III, and AG-7 Provider Communication. Your agency is to continue conducting the plan development visit, billing for that visit, and returning the required documents. Once these documents are received by the OKDHS nurse, the requested units, tasks and plan will be reviewed and authorized for in-home services by the PCA with a second service plan detailing the authorized units per month. The authorized plan returned to your agency by the OKDHS nurse is now in an electronic format.
Below are the highlighted changes:
- New SPPC cases are certified for services prior to being sent to the selected provider agency. This now begins the service plan year for the agency. The service plan year remains at 364 days.
(Previously, certification did not occur until after the plan development phase was completed.)
- A new zero unit service plan authorizing the plan development is included in the initial packet for new cases. This plan is approved for 30 days only. The requirement for plan development by the agency with return to the OKDHS nurse remains at 10 days.
(Previously, this plan did not exist and capture of the timeframe for plan development did not occur.)
- The authorized service plan for PCA visits is faxed to the agency in electronic copy form. the authorized start date for this service plan is the day the OKDHS authorizes (approves) the plan. The end date will be 364 days from the certification date.
- Authorized updates to existing service plans for increases, decreases, etc. will be faxed to the agency in electronic copy form as well.
A review is currently underway by Aging Services to update the existing hardcopy forms used by your agency. Once these forms are finalized, the agency will be notified and the new forms will be made available.
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