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just is now starting all attendees are in listen only mode hi good afternoon everyone today is september 11th i'm donna will professional development coordinator for the developmental disabilities administration we welcome you to the revised person center planning process detailed service authorization tool our presenters for today are patricia stokey director of programs drew smith and aaron leviton who are both consultants for dda before we begin i'd like to go over a few things about the webinar all participants are in lesson only mode there are two options for listening to the webinar and that's by computer and smartphone and we also have three handouts which you can find in the panel to your right they can also be emailed on request we are recording the webinar and any questions you have can be typed in the question box in the webinar panel and we'll try to get to those at the end so now i'd like to introduce patricia sustoke good afternoon good afternoon donna um thank you and thank all of you who are joining us it looks like we have a little over 680 plus participants in in our webcast uh this afternoon so i really want to take the opportunity to thank you all for joining us and hopefully by now you've had an opportunity to read the letter from the deputy secretary bernard simons and also the detail service authorization tool and have been able to really familiarize yourself with today so ro today we're going to talk about an overview and a background of why is it that we created this tool why is it that we're doing this and we're presenting this to you today what is the purpose of the detail service authorization tool and how it will be used we're also going to take some time to demonstrate uh how to complete the tool what is the functionality the information fields and in the tool and then the tool submission process and then we're going to open up for questions so in essence we're going to do a quick presentation and then just open it up for a dialogue between you and the dda next slide please so just to kind of give you a background the dda has been working with the coordinators of community services and providers to identify potential areas to improve a person-centered process or services and and with that we also learned that the ccs's were already coming up with some tools or cheat sheets in working when they're putting together their personal center plan and their service authorization and then the providers were having some concerns about that the information that they talked about submitted didn't really quite match or was incorrect um and so based on that we learned that there are some tools out there that are being utilized and we're like okay well let's let's get together with the people who are putting tools and they're getting creative and i have to say your providers you have come up with some really good ideas so we thought why reinvent the wheel let's see where people are let's see what what they're doing and then from there like see if we can reduce the number of times the qualification request is to come in to the regional offices and then what is the ccs needs to do and then reduce the back and forth communication between the service authorization between the ccs and the provider so that was the main goal and and we learned that there was already a lot of that happening so next slide um based on that uh we used what was being developed uh by some of the ccs's and the providers and then we decided that we were going to figure out how are we going to together put something that could be used um and then this is how we came up with the the proposed detail service authorization tool it is a tool it is not a replacement of the ltss maryland detail service authorization and so um you in the memo from our deputy secretary for north simons you see that this is a tool that the dda is asking and it will be a mandatory component of the person-centered planning process and this is mainly to effectively make sure that there is clear communication and consistency between of what's being discussed in pre-meetings and where you guys land when it comes to what services um you're proposing or being submitted for authorization by the dda so this becomes a mandatory tool it will be completed by the provider and sent to the ccs and we want to make sure that is uploaded by the ccs into ltss maryland prior to submission of the plan for um the renewal of the office so so we want to make sure that everything and i think that what this does it really makes sure it aims to improve the communication between a provider agency and the ccs and also dda so we're all on the same page of what what is being requested what is being done and so we're hoping that we're able to achieve that next slide please so the um detail service authorization tool will be used too a couple of a couple of things from load um the pcp process with information about how the person is currently being supported or how a provider will propose to support the participants moving forward so what did you did in your pre-meeting what did you do in the pcp meeting and so that way it's very clear and then what happens is then that the tool will then be able to bridge that gap of communication the tool will not be used to supplement or reduce or modify uh the intent of the process that occurs when the planet meeting uh it's more of a a way to communicate i call it like a cheat sheet what is it that you need to do to be able to make sure that everything that you gather from the team and from the members of the person's team um are properly uh uploaded or transferred into the ltss maryland um and then we just have in a big ball highlighted the the detail service authorization is a proposed authorization the planning meeting will determine the final authorization okay so next slide so i am going to turn this over to drew who is going to upload on the screen right now the actual tool we're going to walk through the tool we're going to show you all the different tabs and then we're going to open it up for questions and answers so go ahead great thanks patricia and good afternoon everyone thanks for the opportunity to walk through the detailed service authorization tool um as patricia noted um there so the the tool was sent out prior uh you know with the memo from the deputy secretary and so hopefully folks have had an opportunity to take a look at it and um become generally familiar with it uh we did make a few slight modifications to the tool primarily nothing of substance really just in some of the field inputs and so the tool that we are showing today is slightly different from that that was originally sent out but i know that it's part of the attachment so what we're showing today is the same tool that's available in the handouts for the presentation so yeah i think as patricia laid out the the intent here is to walk through the the structure of the the tool uh talk a little bit about how the information is meant to work together where fields carry over and and you know kind of what that process is and then to really just you know put in some data fields and say you know this is this is what it is intended to be able to show um and how we would hope that folks can navigate this i'll be honest i mean i think once people have gotten into the tool you know that it should hopefully be pretty self-explanatory so i think today is just to make sure that we're all talking about the same way and then really to focus the remainder of the presentation on answering questions about it um and so let's go ahead and get started so hopefully everybody can see my screen patricia uh let me know if you can't but we'll start on the instructions page okay perfect perfect so really what we wanted to do is to lay this out as clearly as possible so knowing that there are likely going to be a lot of folks who are inputting data but then also what is it that's going to be needed when the data comes through to the ccs and potentially gets then inputted into ltss and so we put a lot of time into thinking about really what are the fields that we need to include so that there is a good crossover with lcss maryland without asking everybody to input you know too much data and so as we walk through the instructions what you'll see is general overview you know this again is similar to the parameters that were identified in the memo from the deputy secretary things that are in red you'll you'll see really called out as areas of reminders and so what you'll see here in this first overview is an expectation of how service units are captured within the dsa so with the exception of service units that are billed as milestone payments um everything is going to be captured in this tool of hours of support per week um you know i we know that some services are monthly supports and um you know some like residential well there's a presumption of if you're if you're getting it you know as one day in the months you're going to be getting it for the entirety of the month but really what we're trying to do here is to the degree possible is standardized on this front end again as this tool's intent is to be for information collection and sharing uh to the extent that we can to really standardize some of that terminology and some of the ways that we're looking at this um you know the value of that i think is ltss maryland has the agility and the capacity to then make those conversions on its side so we didn't feel like the tool needed to make all of those conversions but really ltss maryland would make those conversions um so as we work our way down you know we'll spend time going through each of these sheets so i'm not going to go into uh extreme detail into you know the the instructions on each sheet here but we'll walk through it really in in our example but what you'll see in the instructions are really the fields that we're asking people to input data um and specifically what type of data would be inputted there um and so here for the cover sheet for example we see the primary components around the in the individual who's receiving services the information that's being completed there for them um the next step there around you know how do you use them the selection component so anything in blue here as a heading is an area where a data input will occur everything else as you'll see as we get into the tool is really locked because we again wanted to limit the amount of input areas that somebody had to fill those out we didn't want anybody to have to spend you know three weeks on filling out a tool that is going to be supplementary information we really wanted to look uh you know to patricia's point of how do we streamline a process um again really with the intent of helping everyone just think about this consistently to really identify a way to reduce that back and forth so again as we go down we'll see that for each of the service categories we again have the instructions and then towards the end of the form you'll see that we talk a little bit about how the form will be submitted and then again how the form will be uploaded so as patricia identified the intent of the form is to be something that is completed by the provider agency for the services that they provide to an individual so understanding that one individual might access different services from different providers the expectation here is if i'm providing residential support to somebody but not currently doing their day services or any other support services that i would just do the residential services for that person using the tool so i would complete it um i would then either print it and scan it and send it to the ccs or i would print it as a pdf and send it securely to to the ccs once the ccs gets it they would then be able to review the form uh use it as a component of the planning process and then they would take that next step of uploading the form into um into ltss maryland so what you'll see then is that upload um process for the form and really the standardization of around how file labeling will occur from the ccs perspective and that form would then get put into the system what you may have seen um from the letter or the memo released by the deputy secretary is uh you know this becomes a component now of the regional office review for finalization of plans and so part of the expectation here will be to see this form as an attachment in the pcp as the regional offices are going through and doing that process and if not to then reach back out to the to the ccs and say hey do you have this um and if so let's get it uploaded so we'll move now into the the tool itself so let's talk a little bit about the intent of the construction of the tool and kind of how these pieces work together and then we'll we'll start to work through some actual examples so you'll see here that we start on the cover sheet now the intent of the cover sheet as we were developing this was there are a lot of services that may be provided to an individual and as this information comes back to a ccs if we were to say go through all of these fields and make sure that you don't miss any that were selected that this provider is providing there's a high likelihood that something would be missed so the intent of the cover sheet is to do two things one is to you know start the process of identifying the the individual who the provider is responding to for service and the second is to be a cover sheet that goes back to the ccs that has identified what services the provider agency is is responding to so from the ccs perspective they're not again going through all of the individual service line sheets they can look at this and say okay i need to make sure that i go in and look specifically at career exploration or supported living or family and pure mentoring supports because those are the services specific for this provider following that and what we'll walk through after we test out the cover sheets is you'll see we've broken out and we've you know aligned the coloring of the service structures here around meaningful day residential and support services to the three tabs that follow the cover sheet uh within the tool uh and so you know again what we didn't want to make this was one sheet with all services because we would all go cross-eye trying to kind of follow down that that list so really how do we group these services together in a meaningful way that you know really allows the provider agency who's completing the form to go in and specifically respond to the services that they are completing and then as it's transmitted back to the ccs to reduce how much information has to go back that is not relevant to the services being provided by that agency so we'll take a look at how this form gets filled out so what you'll notice is up at the top of the cover sheet in all these gray boxes are data inputs what you'll see and what we'll be able to see when we move into a service specific sheet is this is the only time in which you will input the the individual who's receiving service uh their information into the form this information will then carry over to the three service line forms that follow so again what we wanted to do was a reduce the amount of time you spent putting in information and you know where we could to make it a single action but two for consistency to make sure that you know there wasn't a misspelling of a name on one sheet versus another sheet because there were so many inputs that that were being completed the other piece of this is as the form is being submitted back to the ccs we wanted to make sure that this information carried over to all of those other sheets so that if for some reason um when it got scanned to be sent back the sheets ended up getting mixed up or or put together with with another file that the ccs could easily reconcile that so again they're not having to go back to the provider and say hey i think in between you know sheet 1 or c2 or c3 for this individual but really it makes a lot easier to follow so as we fill it out i'm going to use myself and my colleagues as examples here so i'm going to say that the participant name is me my ltss id is going to be one one one one one my provider name is going to be dea agency one my friend aaron levington is the one completing this forum for me when we get over to plan type you'll see that we have three options to select from so we have an initial plan an annual plan and a revised plan so for my example i'm going to say that this is my annual plan my plan date is going to be 12 1 2020 and the date that i'm sending that aaron is sending this back to the ccs is going to be 11 1 20 20. and then just in case there are any con questions specific to the the form that was completed here um i'm going to go ahead and say that aaron's email is aaron test.com okay so now quickly before we select the services what you'll see is across each of the other residential tabs all of that information is pulled over you actually can't edit it here you would have to edit it on the cover sheet so now as we look at the rest of the form the intent here again is to select which forms um do you want or which services do you want to identify that you as a provider are going to select so we're just going to pick some examples at random here and i'm going to say that i am receiving employment discovery i am receiving community living group home and personal supports but i'm also getting personal supports from appendix k add-on um just because we are in the midst of the pandemic skill so the cover sheet now is complete i've done my job i've had i've identified my services i can do a quick check and see that really there's nothing left for me to do so now my job is to go through those three tasks so what i know is because i'm providing three relatively comprehensive services to an individual i need to fill out all three tabs so as i go into this again we see that the information for me as a service participant has crossed over we'll also notice that a green x or a white x and a green box has come up next to employment discovery and really what that is to do is to say we want to make sure that as you're you fill out the cover sheet for the services you remember as you go into this other field without having to go back multiple times that um you know that's the service that you need to complete so we'll see then that i'm going to fill this one out i can do a quick check no other employment or date services for me to fill out now is the part where we'll start to go through and fill out for the the specific service so a couple of notes here across all pages we put this reminder you know unless something is billed as a milestone payment or has some other set unit that wouldn't support this all units should be inputted as hours of support per week what we also then have is down the right hand side for service specific notes um around what the agency should be considering uh as they're inputting the notes into the system um or additional notes that might be needed or information about what types of units would be expected so here what i can see is for my um employment services discovery which is a milestone payment um i need to think about this of you know if i'm new to this service i would be requesting you know potentially one two and three milestones if this is a plan that is crossing over where i started the service last year and it's crossing over into a new plan there for me i may just be requesting a milestone to a milestone three so i'm going to go ahead and filled this out for myself so here i'm going to say that i am going to request milestone one two and three you'll notice that across all the data input areas by service we try to keep information quite consistent so there are really four areas of input first is the number of units that are being requested second is the medical assistance number associated with the service or the site third are the notes and then fourth are the number or the months in which the service is being requested so i'm going to say that my medic my medical id is going to be let's say four four five five and then i might put in notes of this is a new service for drew and anything else relevant to really really the intent here is to say you know what why are you over customer service especially if it's new so anything that's going to help really in the seat with the ccs's process of working with the individual to say you know the provider said this is a service that you're interested in are you really interested into it in it here's what they're requesting as far as an authorization that does that seem to make sense so i add my notes and then we go through and say well what once am i going to request the service i might have to ask for in january february march april and may so really you know hopefully what you'll find is the inputs here by service are pretty straightforward uh pretty user friendly we really tried to make this as few mouse clicks as possible and as few key clicks as possible and so again really what we're just asking for is what is the unit uh number that you're asking for what's the provider medical assistance number again either associated with the service or with the site when appropriate a few notes about how the service is going to be provided and then when you're asking for that authorization to be available you know again our intent here is to see to the extent we can um and for those of you who are very familiar with how information gets inputted into lcss maryland or how you can view material or information in ltfs maryland hopefully this seems you know a logical approach to how this will will work as you this information gets transferred over so that's day services so let's our meaningful day services so let's move into residential so again as i move into residential what i see is that all that information is pulled over i see that my exes have pulled over for what services i need to complete so i'm going to complete my information on community living group home now i'm going to say that i need this for 12 months my site number is going to be by five let's see who has lived at this site for two years and wishes to continue and then i would say you know just as a double check to make sure that everything is aligning i'm going to select all 12 months to say yep drew is planning to be here throughout the year now a quick note around community living group home so as most of you i think are aware community living group home in lcss maryland currently defaults to awake overnight staffing and so you know one option in the notes is if you're supporting somebody at a home who you know you don't currently operate overnight staffing and or a wake overnight staffing and you do not believe that you will need to you can put into the notes to say this is not a home or this individual does not need awake overnight and request that they'll awake overnight staffing uh service not be associated in ltss maryland that way the ccs could then say okay we now have justification and we can modify that and put what is the quote-unquote standard rate uh back into the number of hours that someone will receive next what i see is um dedicated hours for community living group home were selected so i'm gonna say that i need one to one hours and uh my agency aaron is going to request 25 hours a week of dedicated supports for me you know my information stays the same and i'm going to be asking for that um you know again every month that i am in my community living group home study so as we look down the residential auction again no other green x is for me to go through nothing else for me to complete so i'm going to move my way into support services support services you'll notice that we have a lot more in the area to the right around detail so you know support services gets a little bit more nuanced and how services are requested and how services are provided and so again what we really wanted to do is be as direct as possible of expectations of what type of types of information would be inputted into this and really assist to the degree possible whoever's completing the form to make it again as standard as it can be but but also ensure that when it is submitted that first time back to the ccs that all the relevant information is included so we can reduce the amount of back and forth um and really hope that this tool can assist in that so again all of my details have followed over from that initial cover sheet as i scroll down looking for my green x's i come down to my personal support hours and i see okay now it's time for me to go and put data in here i'm going to request 30 hours of personal support so i'm going to put in my false id number and then we've got to remember to include proposed skills and schedule support so i'm going to say i'm just gonna put a note about my schedule support so drew means six hours per day monday through friday okay and i'm gonna say we're going to request this just in a time limited duration um really from you know january through april now what you'll also see is we have added a separate breakouts for personal supports for the appendix k add-ons through the kobit 19. so as i'm sure all of you know um there is not a specific service code in lcss for the add-on hours for appendix k um but you know once we started to think about this and think about you know how do we make sure as this process goes forward we don't lose track of those hours then we account for them in ltss maryland but also you know at when the pandemic ends or when the appendix k is no longer relevant or valid then when you know how do we make sure that we have records to be able to pull those hours out so that you know we don't we don't over authorize so we have added this in to be able to capture those hours now a few notes about that what you'll see is as you go to select the month um we have limited the month selection options from september of 2020 to march of uh 2021 so again this is aligning with currently the the expiration date of the appendix k and so to avoid additional hours getting added into the system uh we thought if we can constrain that as much as possible so that as the ccs is reviewing this and they're putting these hours into personal supports as that main bucket um then they could go ahead and say okay well we see that you know drew needs 30 hours a week you know from january through february he's also there's a request for 15 additional hours um january february and march that as they go and put in april it should be easier to say oh well you know in april it's not 45 hours it goes back to 30. so you know this is hopefully going to help to reduce any need to do a revised plan after the appendix day um so again to the extent that we can we're trying to limit that kind of that back and forth of having to continue to make modifications to the plan and really collect as much information up front you know really to go into that planning process uh with as much information as possible to to streamline the approach so you know as we look through the entire tool again you'll see that we do have a lot more information or suggestions around types of information that will be needed in personal supports um but again you know hopefully as you've taken a look at the tool that's that's a those are helpful reminders um i mean if there are suggestions i think that you know with any tool that gets released like this i mean it's something that i think looks relatively straightforward but as you can imagine there are a lot of moving pieces behind it so you know as folks are using that uh you know we anticipate that it will continue to develop but hopefully that as we come out the gate with this and really do this initial release that it does seem to be a tool that can assist in the process that the types of information we're asking for are not administratively burdensome from the the provider agencies nor is it administratively burdensome from a ccs perspective of being able to take a look at this information and use it so the last thing i will note before patricia i can pass it back to you and donna we can we can ask for questions is to make this again as easy to use once it's done so i've completed all my service inputs for for the services that i'm being done i'm requesting i'm going to then print this to a pdf where i'm going to print this to my printer and scan it and send it back to ccs we've set up all of these pages um already for print and so you won't have to reformat you can just go ahead and say control p we can show an example of this now um let's see if i want to pull up here for us oh my printer's not going to work let's see if we can just do a print preview but all of the formatting in the structure of the page has already been set up where page breaks have been inserted um and there shouldn't be any need for additional formatting so you know as you go through and you can see the page breaks here we've got a broken in services so there shouldn't be bleed over so again from a review perspective but also from just a consistency of information perspective all that should be pre-set up for you so you know after i've completed this i've printed off my cover sheet and because i'm providing services across meaningful day residential support services for for this person i would print all four of these pages i don't need to print the instructions page and then i would send all of them with the cover page on the front back to to the ccs of record so i will pause there um yeah i hope that we've been able to walk through enough of the intent of the tool and kind of the functionality but i'm guessing there are likely questions um and want to make sure that we have adequate time for that so patricia i will pass it back to you and donna and we can open it thanks drew yeah there is lots of questions in the chat box and some are um specific tool questions and some are program questions and so i've asked aaron to help us with the questions because i want to make sure that we talk specifically about the tool and their program questions um then we try to answer them um and some of the questions in the chat are basically me having to tell people to go back to the waiver and read what that service definition is so um i've been typing some answers in the chat box um but go ahead let's open up for questions um aaron do you want to start us off and truly hi everyone drew lead the tool up because you have to go back and navigate and show um if you could do that that would be great yeah uh because i think one of them specifically can you go to the first page where it says plan uh type and people want to know what is what should they do there and what is the plan date that they should be putting on there and um so you want to um go ahead aaron yeah so first of all thank you everybody for being interactive we know it's hard to do these things um through a chat box and remotely and we just appreciate everybody dialing in and asking questions and we'll work through as many as we can i've combined as many as i can and you know what we don't get to gives us a really good start for guidance we know that there's been some some people have experienced sound problems the webinar is being recorded the sound has worked through all of it and it will be posted and so you'll have access to it that way so drew let's start with what patricia was asking which is we've gotten a number of questions about what is the plan type and then once you've selected the plan type what does that mean in terms of which months you select for a particular service yeah that's a really good question so what happens here is i selected that i have an annual plan right my plan starts on twelve one um and then you know as an example of that let's go into a day service right so maybe i'm gonna ask for my uh milestone service of employment service and discovery now if my plan starts on december then i should not be asking well this is a little confusing let me let me back up here let's use a plan to start date that starts more in the middle of the year right so let's say my plan start date is actually july one let me change it here so we're all looking at the same information uh 2020 and this is going to be 0601 2020. um so as we go back so my plan date starts in june then you know really what i need to be cognizant of is for a time limited service that let's say it's a service that can only last for three months so as we look at for example job development you know it's limited to 90 hours total um or as we look at you know the co-worker employment support that's limited to the first three months on the job then we need to be mindful of when the plan date is and then when the services are selected so if i'm saying that i'm going to do coworker employment supports my plan date is in july then i shouldn't be requesting you know more than services that cross that first three months and so really you know i think this is something that in many instances especially services that are really an annual service to thinking about those residential services that you know we would anticipate anticipate to be a full 12 months that's this is not an issue really where this becomes an issue and just something that needs to be paid attention to is in those time limited duration services um because you know if those services are requested above and beyond then we would expect that the ccs would go back and say hey you know you've requested six months of a three month service can we have some clarification which three months do you really want to have that in so you know that's part of where we're really relying on the provider to to really kind of follow some of those details keep an eye on it that's where we've tried to really flag this in red as reminders but it is a really good question of you know how do we make sure that we are connecting the information around what the date of the plan start is with what the date of the service requests are yeah thanks sure and can you talk specifically about milestone services i see your polls up there there are some notes in red about that there are three or four questions about how do you know which months to select in a milestone service yeah that that's a good question and you know patricia i would uh maybe i'll ask if you want to chime in here a little bit as well um you know i i think that part of that is really a oh go go ahead so the way that we did the milestone payments we really wanted to be considered at that any time that the person would be able to do that so you would check when that would happen so that when a the service would be completed then the provider can can bill so we don't know when that's going to happen so we wanted it to be checked throughout so that people would have the opportunity to not be locked into a specific month or date um and we were going to tweet those like upper pay limits so that you could just you could build them throughout and you would only just be billing when you actually finish the milestone because we don't know if you're going to do it september october or november or december so we wanted to provide that flexibility all right so you know they're oh i was just gonna say there's a couple of questions you know that are technical about the tool but i think there's some overall confusion that um really either of you could address around um how does this work um in terms of pcis2 like how will this relate to what what's happening through service authorization and pcis so there's a couple of things happening right now only just because this is mainly a tool that is going to be used through the ltss maryland to make sure that everything matches when we go into billing into lts maryland right now because we're using two systems you're using the cost detail sheet and you want that cost detail sheet to match everything that's in the person's plan and you submit it to build that way right so we want to make sure that and then we are going to our patricia we want to do a series of trainings about can you hear me [Music] yeah you're good yeah yeah we can hear you now you but we launched you there um kind of adds that introduction into you know moving into ltss right so so as we look as we're going into two systems we really wanted to put together a series of trainings for everybody and we started with the cause detail service authorization right now as the tool because we want to make sure we're looking at the ebv process we're looking at personal supports we wanted people to really understand how that works because that's right now we will we're going to be putting the personal supports and services we are also working in pcis too where we use the cost detail sheet so we want to also do a training on the cost detail sheet and how do you use the cost detail sheet and submit your plans for approval so those are really really good questions this tool specifically so that you have all the information so that you can complete everything that you have to in the details service authorization of ltss maryland and you use the cost detail sheets to defer the pcis to approval and services at this point and so you want to make sure that all the services that are being built under um pcis too has a cost detail sheet and anything of the services are being built under the ltss maryland you're using these tools to make sure that is reflected what you guys discuss with the team and the ccs's and it matches so that when you actually put it in the provider gets that service authorization uh signature sheet it matches what you've discussed and when you've uploaded evidence and what was what was approved joe do you want to add to that no i mean i think that's exactly right i mean i think that there are a couple of different things coming together right now um and you know i think that's part of where really that that guidance around that transitionary phase of 7-1 comes into play but you know to the extent that this is relevant to that operation both systems i think you know the patricia's point the hope here is that i think two things one we can streamline the process of really how a pcp moves through the cycle and and what the communication is and how long that takes and the amount of back and forth but second i think you know making sure that pcps that are moving into lpss maryland as personal supports moves in and goes live and then you know as other services at some point in the future come in to go live the best most reliable most accurate and really reflective data of a person's life is captured in that system and so you know that does work into that transition into then how do we get paid in pcis too um but really what we're hoping is on the ltss side that we've got really good person-centered plan data that should then translate relative i mean more directly into pcs2 based off of the other guidance so you know i do think that they are related but they are also quite separate in intent yeah thank you for that um let's jump to some pretty tactical questions so the first question is who's responsible for completing this so if a person has more than one provider who fills it out or do all providers fill it out and if a provider provides more than one service to the person do they complete one form or multiple forms yeah good questions like i'll go ahead and start that off so to the first around you know who completes this so yes so if i'm a provider and i am providing just one service to to me right so my i'm provide our record and really all i'm doing is residential services i am then going to only complete residential services for the person that i am providing those supports to now the other providers would come in and they would fill out their services for somebody for you know let's say aaron is providing me the meaningful day services and patricia is doing some support services for me so three forms would go in for me as an individual each specific to that agency who's making a request for an authorization only about the services in which that agency is providing if an agency is providing multiple services you do not need to provide multiple forms right so that's the entire point of the um cover sheet here is to identify which services you are submitting for that person so again up top we see this is specific to one individual we've got their name we've got their lpss id and what i'm going to do is say for my agency what am i providing to support group so that might be i'm doing community living group home services and i'm doing day services so i would check both of those on the cover sheets and then i would fill both of those out in this one time for for drew and send that back so i only need to fill out one per person i'm supporting for all of the services in which i'm completing for them okay and then so what if you're working with somebody and you're not currently providing a service for them but you believe they would benefit from that service and it would help them achieve their goal for the year you include services that you are not currently providing but that you expect would be good over the coming year no yeah i'll start and then patricia if you want to add just kind of i think we've gone around in this conversation but yes right i mean because this is not and getting back to the the intent of person-centered planning and what the process looks like this form is not meant to replace the finalized detailed service authorization lpss right this is meant to be a proposed detailed service optimization so me as a provider saying here's what i'm requesting understanding that that is not necessarily what has been identified yet in the planning meeting so if i'm the provider and say you know i am on record right now of providing uh let's say a day of the location but i know that drew really wants to start to get into employment services then i might you know put in the authorization request for day habilitation because that's what i'm doing now but might also then add employment services uh discovery and say in my notes you know drew and i have been talking a lot about this i think this is a service that he's really interested in it's one that we're capable of providing i think it would really help him achieve his goals and then when that form goes back to the ccs and the ccs sits down with me and with my support team and we talk through that process and we develop our plan the ccs would say you know your provider aaron said that you know you might also be in uh interested in employment services and and has requested discovery is that something that you would like to add into your your meaningful day service structure um and if if i say yes then that would then get put into the detailed service authorization into lps maryland so i think the intent here is to you know really push that information forward if you as a provider who knows somebody really well has identified that as a potential support structure that would help them in their goals then it should be added but with sufficient notes to help identify that as you know why it's being added and what the intent of it is and patricia i don't know if i've got gaps in that i know we've talked back and forth on this so anything to add always because only because this is a tool it's kind of draft for communication and dialogue and to make sure that you're looking at everything so it is a tool whatever goes into the ltss maryland it's going to be the final piece but this is like a working tool for communication to make sure you're covering all the things that the person has expressed that they that they want to achieve within that year or they want to work corner as a goal so um that's i think that's a really good question i think the way you answered is fine thank you and i i just want to stress one point that you both really um mentioned because there are a couple of questions to it which is is this going to replace sort of signing off on the pcp and signing off on the service authorization the answer is no right this is part of a planning process this is a cheat tool is something that helps facilitate communication uh make sure everybody's on the same page make sure there's an opportunity to agree to disagree make sure that this is really what the team and the person wants uh people are asking is this only for traditional services no this applies across all services uh traditional and self-direction um because the services are offered um for both and some are budget authority and some are employer authority so it applies for both um and we really want folks to think of this as a tool to think about um what is the the needs of the person uh what are the goals that they want to achieve and how do you come together with all the providers to be able to identify what that looks like patricia on that point so can you address what should a ccs do if you know either they or the person disagrees with what comes in on one of these forums so that's a great question and we're hoping that those forms prior to being submitted that really both parties all the parties from the team family providers and ccs haven't had an opportunity to really discuss and talk about what those services if there is a disagreement we really want to focus on the access need for that person and the supporting documentation for that access need and so we're going to be advocating on that on that presence of what is that assessed need for that person and hopefully you know we can able to the dda office and then renova skin assistant and facilitate the communication but we really would want this to be used at the level where providers in ccs at their communication at that table be able to agree to disagree and submit information that really represents that person's need thank you um so flipping to personal supports and i know that's on everybody's mind as we're getting ready for electronic verification true can you go back to that page please and walk folks through how personal support works given that some people are still receiving appendix k hours i know you talked through that but it was quick um there are a number of questions coming in around that the other question that's coming in um around that is sort of in the notes box and this might be better for patricia to answer so what what goes in there and how much tax do the boxes support i know that's a multi-part i can repeat it if you need it once you get started no that's okay go ahead drew and then i'll continue after you yeah perfect so i i think it's a really good question about you know how do we account for the attendance pay hours that are currently in there um so as everyone on this line is aware i mean there's a really big push right now to look at the pcps related to personal support as the transition to edv occurs and so i think this is going to be something that's very relevant over the next few months so the way that lcss maryland is set up right now there are two service options related to personal supports there's personal supports and personal supports in hand there is not a personal support appendix k add-on for kobit 19. so what's happening right now is hours are getting added into that personal supports or personal supports enhanced bucket that are really specific to the enhancements related to the appendix k and so as we were thinking about this we saw this as an opportunity to start to delineate those appendix pay hours because we know at some point hopefully malcolm would that you know we won't be dealing with uh covert pandemic and so what we'll need to be able to do is without having to do a full revision of somebody's plan because we just accounted for those hours generally and we can't then pull them back because we don't know which ones are appendix here or not we'll do a specific call out of the appendix k hours in this uh tool so that when it comes to the end of march or you know even let's say that the pandemic ends in february and we need to pull those hours out at some point we'll know exactly how many there are how that were requested per week and what months they were requested in so that as we look at this and say you know in ltss maryland using the amounts we've put in here it would say that i'm getting 45 hours a week well what we know of that is 30 of those are traditional personal support hours that i need at six hours per day monday through friday 15 of those were add-on hours due to the pandemic so you know as march comes as the appendix k you know becomes null and void unless the pandemic continues and an extension occurs then you know we can set this up so that effective in march the system will already account for that and they'll pull out those additional 15 hours so we don't have to go back and do a revised plan because we've already captured it here and so again it's the intent here is to stop a future step that would be duplicative just to go back and to kind of redo the the appendix pay hours so our goal here is to break them out have record of that be able to set it up into the system um so that you know effective march i think it's march 12th uh those hours could discontinue without somebody having to go through and do a revision okay in reference to the notes section erin um really this section is more of a way since the provider is completing this it's just any information that would support or assist the case manager in really looking at the interpreting those services and why they're being requested so then when um there is a question or has been submitted or you know they're able to really justify the that service when they're submitted to the dda um some don't need any any notes some may need a note in case you uh you wanted to just uh make sure that you are um maybe at the meeting you all kind of didn't finalize where you were in there you can say you know we really talked to susie and she really wants job development and therefore you know we're going to do milestones and our milestones are going to be throughout the year and you know so those are the kinds of things there's some specific notes to support you know your reasoning behind or you're thinking behind that service request from a technical perspective on that i i think you know this supports patricia what you just said you know we've set this up and you can see on the screen to not be you know to not show a full you know 500 characters um just because again i don't think that was the intent of this initially um all of the notes fields are set up to wrap text so you could include a lot of text here um but i don't think that was the the initial intent um on the on the tool side if we find you know this gets released that there is for some reason a need to to extend that there are a few ways that we can reformat that but as of right now it is from a technical side meant to to kind of constrain you know how much is written there and we also know life happens and so just because you say you're going to do this um we want it to be as broadly and as if you're going to do a service just like drew has on there you need six hours of support monday through friday we don't we're gonna want to know between three and five and ten and two and all that because that gets way too complex and too complicated we're not asking for that just want to make sure you guys know we're not asking for that yeah that's helpful drew here's an e let's let's do a kind of a softball there's a little bit of um confusion about the fact that you know sort of the months are set up to check off in a calendar basis right so it runs january to december but people's pcp years may start at any time and may start in the middle of a month how does that all work yeah yeah great question um and so again you know the intent of the month so what month the pcp starts on is almost irrelevant for the months that are selected in these service boxes except for the piece that we talked about earlier of you know if you're requesting a three-month service but your pcp starts in june then we shouldn't see that extend beyond that three month period or whatever that time constraint is the check boxes were never meant to be as delineated as a specific date in which the plan started so if i'm saying that i'm using 30 hours a week of support for personal supports and i'm requesting that for july my plan started july one but let's say my plans start july 15th i know that as a ccs when i'm in putting this data that i'm going to start that in week two of july right i mean what i know is this is going to be a total of 60 hours um and so that gets inputted the system knows to account for when the start date of the plan is and so it'll it'll prorate the information so really again the intent isn't to get so nuanced in this information but to use it as you know general constraints around how the information is collected and shared so the plan date is important just for thinking about when services can begin or when services could be authorized through um but the the intent of the calendar is not to be um as nuanced as to a day of service that's going to be provided i think that patricia's point of you know the intent is not to get so detailed and so complex in this process i know we are close to being out of time a couple of you have sent us some requests for changes in the forum of note a number of people have pointed out that it would be helpful to have space um on that cover sheet drew for provider contact information so um as an example if you're a provider and you provide both residential and day there might be a need for more than one person now there um there was a question about whether we'll update this after amendment three is completed we will and um there was some um confusion about how the overnight hours were listed so we really appreciate all of that feedback we'll definitely take a look at it um you know we understand that you know this is a living document and um we're committed to working with you to get it right so please let us know as you begin to use it what else you find i'll turn it over to you now for any closing remarks yeah i think one of the things that we said in the memo is that if anybody had any questions or specific recommendations to email me so please email me and then i'll work with my team to make sure that we can update or make the appropriate changes also we know there's a lot of questions on the chat box that we didn't get through so we're going to use some of those to provide guidance additional guidance because i think um you know i think do does a fantastic job but if it's something new and you haven't used it it's like greek and so we're hoping to provide additional guidance there's a questions about you know effective immediately what does that mean uh because we did the webinar today and we wanted people to get you know the hands with it and play with it and look at it we really put an effective date for september 21st and that's in the memo i know that's been asked a lot in the chat so i just want you guys to know that we we are very um concerned about making sure that we hear what you're saying we want to make sure that this tool is not another additional work or headache but really was to bridge the gap between what we see is happening within the system um as it relates to finalizing and getting authorization signed and approved by both parties of our parties so we hope that this um please send us your thoughts your emails your recommendations be glad to to look into it and to tweak it as aaron said this is a living working document is a tool for us to use to bridge the gap so i really think all of you have joined us today and i welcome your emails if you are going to send me an email specifically about the tool can you please on the subject line put exactly detailed service authorization or for sure d s a that way i'll know that it's specific for that and i can put them all into one one section so when i'm in with the team i don't miss your your email so thank you all so much and have a wonderful weekend