Two forms that were previously emailed to you in draft format are now in a completed format and have been uploaded to the DHS website. They are:
- Member Negotiated Risk Agreement – 02CB024E
- Allows Members to decline services, take specific actions, or follow recommendations that are determined necessary to assure the Member’s health and safety in their home.
- Service Provider Safety Agreement – 02CB025E
- (previously known as the Behavioral Agreement) – Allows CM and Home Care RN to document barriers to care and needed actions to prevent disruption of needed services. This is intended to be a discussion with the Members to identify solutions to barriers of care.
Links to these forms can be found on the ADvantage Administration Form Directory page.
If you have any questions regarding the information provided above, please feel free to contact us via email.