providers. letter at time of enrollment into transition process. TC solicits participant’s choice in selecting services and providers. CMS-Appendix G: Participant Safeguards – Health & Welfare MFP-Risk Mitigation and Health & Welfare Case Review Sub-assurance a. - Documentation of backup Verify adequate ITP # and % of Aggregate Quarterly Transition The State, on an plan in ITP backup plan in Backup Health & data from H Planning ongoing basis, ITP Plan Welfare form by & W form Annual Process CC completes Health and identifies, action items. provided to qualitative Welfare Case Review Transition addresses and seeks TM reviews Health & TM on summary of form (or equivalent) at Process to prevent the Health & Welfare # and % of MFP quarterly sources of every home visit and case occurrence of Welfare Case Case participants basis. backup Post review once person in abuse, neglect and Review forms Review referred to APS support Transition community. exploitation. forms Request Form documents action # and % quarterly taken when unmet need referrals, report from or risk identified. complaints MAPSIS of all handled by MFP referrals All reportable events are LTCOP for MFP from Care logged on Reportable population Coordination Event Form. Agencies Abbreviations APS - Adult Protective Services LTCOP – Long Term Care Ombudsman Program ASA – Assessing Services Agency MDS – Minimum Data Set (nursing facility assessment tool) CC – Community Coordinator NF – Nursing Facility ITP - Individual Transition Plan OADS – Office of Aging and Disability Services LOC – Level of Care QM – Quality Management
providers. letter at time of enrollment into transition process. TC solicits participant’s choice in selecting services and providers. CMS-Appendix G: Participant Safeguards – Health & Welfare MFP-Risk Mitigation and Health & Welfare Case Review Sub-assurance a. - The State, on an ongoing basis, identifies, addresses and seeks to prevent the occurrence of abuse, neglect and exploitation. Transition Planning Process Transition Process Post Transition Documentation of backup plan in ITP CC completes Health and Welfare Case Review form (or equivalent) at every home visit and case review once person in community. Form documents action taken when unmet need or risk identified. All reportable events are logged on Reportable Event Form. Verify adequate backup plan in ITP TM reviews Health & Welfare Case Review forms ITP Backup Plan Health & Welfare Case Review forms # and % of Health & Welfare form by action items. # and % of MFP participants referred to APS # and % referrals, complaints handled by LTCOP for MFP population Aggregate data from H & W form provided to TM on quarterly basis. Request quarterly report from MAPSIS of all MFP referrals from Care Coordination Agencies Quarterly Annual qualitative summary of sources of backup support Abbreviations APS - Adult Protective Services ASA – Assessing Services Agency CC – Community Coordinator ITP - Individual Transition Plan LOC – Level of Care LTCOP – Long Term Care Ombudsman Program MDS – Minimum Data Set (nursing facility assessment tool) NF – Nursing Facility OADS – Office of Aging and Disability Services QM – Quality Management