THE LIFE PATTERN
A publication of Life Patterns, Inc. April 1, 2007
www.lifepatternsks.org
Do you have some questions about the Plan of Care? Listed below are some frequently asked questions that may help.
WHAT IS THE PLAN OF CARE (POC)?
The Plan of Care (POC) is the document that outlines services for the person receiving Medicaid services. It describes the type of services, the amount of services per month, the cost of services per month, and who will provide those services. It is written by the Case Manager, submitted to the CDDO for approval, then sent on to the state for final approval.
IS THE PLAN OF CARE GOOD FOREVER?
No. The BASIS is done every year in the person’s birth month. A new POC is then written describing the services for the year. If different or additional services are needed during the year, the POC must be changed for that month to reflect those changes. The POC must then go through all the steps of approval before it can be valid and those services paid.
WHAT IF WE NEED MORE RESPITE OR SUPPORTIVE HOME CARE (SHC)
DURING SPRING BREAK OR FOR THE SUMMER?
Remember that SHC cannot be changed. A POC for the summer months could have additional hours for school age children. Respite is based on a yearly total and can be added to or subtracted from the POC as needed. Try to plan a month or two ahead. Figure out when you will need additional hours, contact your Case Manager and tell them what you need so they can start the process.
CAN THE PLAN OF CARE BE DIFFERENT EVERY MONTH?
Yes. However, it is not advisable to change it monthly because of the process that is required to make changes.
IF WE NEED ADDITIONAL RESPITE HOURS WILL OUR DIRECT SUPPORT STAFF BE PAID ON TIME?
Life Patterns will make every effort to be sure support staff are paid for hours that they work in a timely manner. Sometimes the process of approving the POC takes longer than anticipated. When this happens, we cannot pay the additional RESPITE hours until we have an approved POC.
Why does Life Patterns need a copy of the approved POC?
We must keep a current approved POC on file in order to verify that hours worked match up with hours available on the POC. Timesheets are totaled and checked against the POC to be sure you have not exceeded the available hours.
HOW CAN I BE CERTAIN THAT LIFE PATTERNS HAS A CURRENT POC?
When you sign a new POC, whether it is the annual plan or a change to an existing plan, remind your Case Manager to send a copy to Life Patterns as soon as it is approved. Be sure that you also receive a copy for your records.
MY DAUGHTER’S POC SAYS SHE HAS 15 HOURS OF SHC PER WEEK AND 266 UNITS PER MONTH. WHAT DOES THAT MEAN?
It is important to remember that the Plan of Care is written for the month and not the week. The 266 units are 1/4 hours so 266 units divided by 4 equals 66 1/2 hours per month. That is the maximum number of hours that may be used in a month. The 15 hours per week is an easy way to budget those hours for the month. You may use more than 15 hours per week but you may not go over the 66 1/2 hours per month.
The Home and Community Based Medicaid service system can be very confusing. However, if we take each part and break it down to understand it, we will better be able to advocate for the best services possible!
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Thanks for the help!!
A Mom writes from Topeka “How do I get my family and friends to treat my daughter in an age appropriate manner? She is 27 years old and they often treat her like she’s still a child.”
Probably the most important step in helping our family member with a disability to be treated in an age appropriate way starts with the way we feel and act.
According to Tom Pomeranz, a well-known speaker on disability issues, adults with developmental disabilities are not children in adult bodies. An adult is determined by virtue of age and not intelligence. An adult is determined by the number of years you have lived.
As a person with a disability reaches adulthood, they have a right to the dignity and respect afforded to other adults. We must be certain that other family members and friends observe us interacting as an adult. We must share productive adult activities that the person does, from making his bed to volunteering at the local nursing home. For a person with a more severe disability, it may be that she holds the pillow while her support person makes the bed.
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One idea we received was to provide family and friends with a list of suggested birthday and Christmas gifts so that the gifts will be age appropriate. Then you don’t have to figure out what to do with the baby doll or the toy truck and you can help the giver of the gift see your family member in a different light.
A family from Wichita shared with us that when she finally got it and started helping her son dress like other 30-year old men instead of like his little brother, they noticed a difference in the way people treated him.
Another parent from Kansas City took the child’s puzzle that her 25-year old daughter loved to do and covered the pieces with pictures from a woman’s fashion magazine to make the puzzle more age appropriate.
With all children, relating to our sons and daughters on an adult level is different, but is very rewarding. That transition can sometimes take a little more thought when a disability is involved but the rewards can still be reaped!!
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Last month we told you about the College of Direct Support online training for people providing direct support for individuals with a disability. We thought you might like to hear some comments from one Life Patterns employee who completed one of the training courses: “This course taught me what abuse, neglect & exploitation are, how to report the issue and who to report to. It showed how to find signs of maltreatment and ways to prevent it. This was great information!”. Call Jon at Life Patterns to sign up for free online classes.
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Thoughts shared by Maya Angelou in an interview with Oprah:
“I’ve heard that you can tell a lot about a person by the way he/she handles these three things:
a rainy day, lost luggage, and tangled Christmas tree lights.”
“I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands;
you need to be able to throw some things back.”
“I’ve learned that people will forget what you said, people will forget what you did,
but people will never forget how you made them feel.”
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THE LIFE PATTERN
A publication of Life Patterns, Inc. March 1, 2007
www.lifepatternsks.org
Feeling confused? Supportive Home Care….
Temporary Respite….
Emergency Respite…….What’s the Difference?
The short answer is…..there’s not much difference. The same types of support may be provided whether a person is being paid with Supportive Home Care (SHC) dollars or Respite dollars.
SHC is allocated using two criteria. The first criteria is need and the second is tier level. A person might receive 10, 20, 30 or more hours per week. However, the monthly total of hours is the amount that should be considered. There are more than 4 weeks in a month so the total for the month is greater than the weekly total times 4. For example, if a person receives 20 hours per week in SHC, he/she would probably have around 86-90 hours per month. This can vary depending on a 30 or 31 day month. Using more than the 20 per week is perfectly acceptable as long as the total for the month does not go over the monthly total on the Plan of Care. Hours may be used any day of the week up to 8 hours per day. The absolute maximum per day is 12 hours. SHC hours should always be used first before Respite hours because SHC may not be carried over to the next month.
Respite hours (either Temporary or Emergency) are allocated by the year and budgeted by the month. This means that for Temporary Respite there are 260 hours/year divided by 12 months and available at 22 hours/month. Emergency is 120 hours per year and 10 hours/month. (Check your Plan of Care for the exact number of hours per month.) The good thing about Respite hours is that if you don’t use them in one month they may be used in another month later in the year. The only stipulation is that if you intend to use more than the allocated Respite hours in a month, you must tell the Case Manager in advance, if possible, so a new Plan of Care can be written. The new Plan of Care would include the additional Respite hours needed for that month. Remember, Respite hours may not be paid to a parent or guardian.
Respite hours can be “saved up” for spring break or Christmas break for school aged children. For adults who are not in school, Respite hours can be “saved” for when there are higher needs for support. Respite hours are based on a calendar year and may not be carried over from one year to the next.
In summary, always use SHC hours first and not Respite hours until all the SHC hours are gone for the month. SHC pays the attendant more per hour, $8.70 compared to $7.95/hour. Also, SHC may not be carried over from month to month and Respite can. So, if you don’t use SHC hours, you lose them!
It is important to know what is on the Plan of Care so keep it handy so you can refer to it. If you don’t know what is on the Plan of Care and are more confused than ever, give us a call and we will answer specific questions.
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Remember…..summer is just around the corner. Do you need to change the Plan of Care for increased hours in the summer? If so, call your Case Manager—the sooner the better!!
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Thanks for the help!!
In our last newsletter, we shared a question from a Dad in Southeast Kansas who was concerned with how his son is spending his time. His son completed his high school program last year and they didn’t want him to go to a day activity program as they felt it wasn’t the best program for him.
Suggestions from other parents included:
Volunteering at a local hospital
Volunteering at a local nursing home-reading to or playing games with residents
Shredding papers for non-profits or businesses
Sharpening pencils for local church pews
Delivering shredded paper to local animal shelters to be used in dog/cat pens
One parent reported that her son’s favorite “job” is volunteering at their local hospital. Her son absolutely loves it because he gets to wear a uniform. It is also very gratifying to be helping someone else.
Another family in the Pittsburg area reported that they started an organization called Arts Explorers. This is a coalition of local folks dedicated to the enrichment of fine art activities for people with mental disabilities. All workshops are FREE and offered through the talents of local artists and volunteers.
One Mom reported that her daughter and attendant like to go to the same café for breakfast every Tuesday morning. They have gotten to know the people who work there and the people who regularly go there for coffee. They really look forward to seeing their “café” friends.
Another young man likes to go to the local community center to watch the dancers practice “clogging”. Although he uses a wheelchair and can’t join in the dance, he loves the music and the people. Usually they stay to watch the “salsa dancing” class too.
A young man in the Topeka area likes to ride the trolley. Since the trolley has wheelchair lock-downs it is easy for him to take a ride on nice days. In fact, since this was one of his favorite activities, they rented the trolley for a holiday ride for friends and family to see the Christmas lights.
A Mom writes from Topeka “How do I get my family and friends to treat my daughter in an age appropriate manner. She is 27 years old and they often treat her like she’s still a child.” If you have faced this challenge and have suggestions please email us at
lifepatterns1@hotmail.com.
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WHAT IS THE COLLEGE OF DIRECT SUPPORT?
The College of Direct Supports provides online training for direct support staff working with people with a disability. The State of Kansas has provided the funding so the training is free of charge. There are many courses available but we recommend:
If you or any or your support people are interested in taking these courses, call Jonathan at the Life Patterns office to get started. We are offering a $25 bonus to any Life Patterns employee who completes these 5 courses.
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