April 13, 2011
The OKDHS Quality Assurance Unit is providing you with information concerning the new Condition that will be added to the Case Management Consumer-Focused Quality Review tool that will begin July 1, 2011. The condition refers to the Member's "Personal Goals" which is a new CMS requirement.
Personal goals are just about anything that motivates and may be achievable, i.e. go to church, volunteer, go to lunch with friends or family. In short, this will be individualized per ADvantage Member. Other examples of Personal Goals:
- Would like to be able to crochet by Christmas
- Would like to be able to dress myself.
- Would like to be able to walk around the block.
- Would like to be able to plant some flowers.
- Resume attending meetings at the VFW.
- Would like to be able to attend church regularly.
- Would like to be able to go to Senior Citizens Center every Wednesday.
- Would like to take a class at a college or vocational-technical school.
Personal goals need to be clearly defined/labeled and included in the Service Plan Goals (ADv6a1). Include the Member's realistic wants and desires; what he/she may have lost and wishes to regain in life and activities the Member wants to participate in. While ADvantage service provision is limited to addressing "needs" the case manager should explore with the Member ways to meet personal goals using additional resources available.
Services provided by a personal care assistant or advanced supportive/restorative aide can not be considered a Member's personal goals. Also, the Long Term Goal written on the Service Plan Goals (ADv6a1) would not be considered the Member's personal goals.
We are providing this additional information and definition to your agency to allow time for training and compliance with the new Condition prior to July 1, 2011.
Thank you for your continued commitment for providing quality care for the ADvantage Waiver Members of Oklahoma. If you have any questions, you may contact our Quality Assurance Manager Deborah Thompson.