Action Request Developmental Disabilities Services Transmittal Lilia Teninty Number: APD-AR-16-017 Authorized signature Issue date: 02/26/2016 Topic: Disability Determination Due date: 60 days (April 26, 2016) Subject: Review of Employment Services and Non-Residential Day Services. Applies to (check all that apply): All DHS employees County Mental Health Directors Area Agencies on Aging Health Services Aging and People with Disabilities Office of Developmental Self Sufficiency Programs Disabilities Services(ODDS) County DD Program Managers ODDS Children’s Intensive ODDS Children’s In Home Services Residential Services Stabilization and Crisis Unit (SACU) Child Welfare Programs Other (please specify): Brokerage Directors; Service Coordinators & Personal Agents; Employment and non- residential day service providers. Action required: The Office of Developmental Disabilities Services (ODDS) has finalized results from the initial employment and day service provider assessments. The assessments were completed as required under policy transmittal 15-006 to: 1. Verify accuracy of ODDS employment and day service authorization, billing, and service delivery, and 2. Measure initial compliance with new state and federal regulations regarding ODDS and Medicaid-funded Home and Community-Based Services (HCBS). Final service determination results are attached to this transmittal, and will also be posted to the ODDS staff tools page. Service coordinators and personal agents must work with providers of employment and day services to correct service authorizations in Plan of Care, and ensure that all authorizations are consistent with the assessment results. Any necessary corrections must be made to Plan of Care within 60 days but NO LATER THAN April 26, 2016. DHS 0078 (8/15) Date of Action Required Who to Date Action Request Complete Required Week of Correct service CDDPs, 60 days from Feb. 26, authorizations in Plan of Brokerages, notification, and no 2016 Care. and Providers later than April 26, of Employment 2016. (Final service determination and Non- results are attached and will residential day be posted on the staff tool services (DSA). page). If a service change is required, the Service Coordinator or Personal Agent will need to take the following steps: 1. Plan of Care The service coordinator or personal agent must end both the individual’s incorrect Service Plan Line(s) and provider Service Prior Authorization(s) in the Plan of Care billing system. This must be done on or before April 26, 2016. 2. ISP/CDP A change in service must be documented using the “ISP Change Form” (see attached example). Also, the actual service change and authorization would be documented in the “Chosen Services” pages of the ISP. 3. Notification to the person The change may be made with the documented verbal approval of the individual, their guardian, or a designated representative, so long as the nature of the service delivered to the individual does not change. Verbal notification must explain that the previous service categorization was incorrect. If the correct service categorization does not meet the individual’s needs or interests, the individual must be given an opportunity to review all Employment Service options in order to ensure his or her service needs continue to be met. During the individual’s annual planning process, the individual must be given an opportunity to review all Employment Service options in order to ensure his or her service needs continue to be met. The individual must also be given an opportunity to review all Employment Service options upon request. DHS 0078 (8/15) If service hours are reduced as a result of this, the Provider and the Service Coordinator or Personal Agent will need to take the following steps: Requirements for an involuntary service reduction must be followed. The Service Coordinator or Personal Agent must reconvene a meeting with the individual and his or her ISP team. The individual must be given an opportunity to review all service options in order to ensure his or her service needs continue to be met. Field/stakeholder review: Yes No If yes, reviewed by: CDDPs, Brokerages, ORA. If you have any questions about this action request, contact: Contact(s): Allison Enriquez Phone: 503-569-1710 Fax: Email: [email protected] DHS 0078 (8/15) ODDS Provider Assessment Employment services Non-residential day services Provider Name Response Provider Address Brief Description of Setting Final Service Determination ID Abililtree 1345 2525 Twin Knolls Abilitree Life Enrichment. DSA Facility Dr., Bend Abililtree 1346 2525 Twin Knolls Document destruction Employment Path Facility (in a Dr., Bend sheltered workshop setting); No new entry to Shetlered Workshop setting after July 1, 2015. Abililtree 1347 2525 Twin Knolls Laundry service at community hotel Employment Path Community Dr., Bend Abililtree 1348 2525 Twin Knolls restaurants, Juniper swimming pool and DSA Community / DSA Facility when Dr., Bend exercise facility, Sun Mountain Fun Center at provider site bowling Abililtree 1386 2525 Twin Knolls One individual hired to do scanning work Employment Path Community Dr., Bend at Abilitree office. Abililtree 1388 2525 Twin Knolls A sheltered workshop. Abilitree work Employment Path Facility (in a Dr., Bend center, employment from Hydroflask, sheltered workshop setting); No new Window Alert, Sagebrush Printing, entry to Shetlered Workshop setting Ballokai, Pelican Bay, Kialoa after July 1, 2015. Abililtree 1389 2525 Twin Knolls The individual works at our front office Employment Path Community Dr., Bend answering phones and directing customers. Abililtree 1390 2525 Twin Knolls Life Skills Classroom at Abilitree. This is Employment Path Facility (not Dr., Bend classroom to learn job-related skills for sheltered work) disabled people, so there is little interaction with non-disabled people. Abilities at Work 570 15320 NW Cornell Gas Station IES - Job Coaching Rd., Beaverton Abilities at Work 575 17971 SW Mcewan Fast Food Restaurant IES - Job Coaching Rd., Tigard Abilities at Work 580 1545 SE 23rd Ave, Assisted Living Facility IES - Job Coaching Gresham ODDS Provider Assessment Employment services Non-residential day services Abilities at Work 581 1545 SE 23rd Ave, Assisted Living Facility IES - Job Coaching Gresham Abilities at Work 582 4287 International Day services provider (not our IES - Job Coaching Way Ste. A, organization) - Edwards Center Milwaukie Abilities at Work 595 2460 NW Sundial International courier service IES - Job Coaching Road, Troutdale Abilities at Work 597 3030 NE Weidler, Retail store IES - Job Coaching Portland Abilities at Work 600 17815 65th Ave., Restaurant IES - Job Coaching Lake Oswego Abilities at Work 601 3505 Pacific Ave., Restaurant/Hotel IES - Job Coaching Forest Grove Abilities at Work 602 142 SW Baseline Vet clinic IES - Job Coaching St., Hillsboro Abilities at Work 604 22855 NE Retail store IES - Job Coaching Parkland, Troutdale Abilities at Work 605 9900 SE Sunnyside Medical center IES - Job Coaching Road, Clackamas Abilities at Work 627 22557 NE Park Retail store IES - Job Coaching Lane, Wood Vilalge Abilities at Work 628 3716 E Portland Vet Hospital IES - Job Coaching Rd. Abilities at Work 629 3485 SW Knowlton, Employee Store IES - Job Coaching Beaverton Abilities at Work 630 2650 NE Martin Outlet Store IES - Job Coaching Luther King Blvd., Portland Abilities at Work 631 319 SW Pine St., Restaurant IES - Job Coaching Portland ODDS Provider Assessment Employment services Non-residential day services Abilities at Work 632 4001 SE 182nd Assisted Living Facility IES - Job Coaching Ave. Abilities at Work 634 1800 SE MLK Jr. Auto repair IES - Job Coaching Blvd. Abilities at Work 635 2929 SW 234th Movie theatre IES - Job Coaching Ave. Abilities at Work 636 2247 SE TV Hwy Restaurant Sign Waiver IES - Job Coaching Abilities at Work 638 6855 NE 82nd Ave. Donation center IES - Job Coaching Abilities at Work 640 10223 SE Barber Sign Waiving IES - Job Coaching Sunnyside Rd. Abilities at Work 641 14845 SW Murray Barber Sign Waiving IES - Job Coaching Scholls Dr. Abilities at Work 642 8635 SW Tualatin Retail Receiving IES - Job Coaching Sherwood Rd. Abilities at Work 643 220 N Adair St. Retail Courtesy Clerk IES - Job Coaching Abilities at Work 696 1020 SW Natio Kerr Bike Shop IES - Job Coaching Pkwy Abilities at Work 741 14176 SW Cat adoption Employment Path Community Gallbreath Dr. Abilities at Work 744 17800 SE Main Church Employment Path Community Abilities at Work 754 2850 SE Library Employment Path Community Brookwood Parkway Abilities at Work 759 750 SE 8th Ave. Senior Center Employment Path Community Abilities at Work 760 10660 SE 21st Ave. Library Employment Path Community Abilities at Work 762 134 SE 5th Ave. Zoo Employment Path Community Abilities at Work 766 447 SE 3rd Church 1:1 Attendant Care Abilities at Work 767 134 SE 5th Ave. Animal Rescue Employment Path Community Abilities at Work 899 1355 N. Barlow st. Public Library Employment Path Community Abilities at Work 907 4240 SW 185th Animal Rescue Employment Path Community ODDS Provider Assessment Employment services Non-residential day services Abilities at Work 914 3131 N. Vancouver Perform packaging task at the Red Cross Employment Path Community in the Warehouse Abilities at Work 925 3131 N. Vancouver Blood Lab at Red Cross Employment Path Community Abilities at Work 1028 3131 N. Vancouver CPR Manikin room Employment Path Community Abilities at Work 1031 953 SE Maple Community Rec center Employment Path Community Street Abilities at Work 1033 7201 North Medical Admin office IES - Job Coaching Interstate Avenue Abilities at Work 1036 5717 NE 138th Kaiser Pharmacy Warehouse IES - Job Coaching Ave. Abilities at Work 1038 10200 SE Kaiser Sunnyside Warehouse IES - Job Coaching Sunnyside Rd. Abilities at Work 1040 3500 N. Interstate Kaiser Medical facility IES - Job Coaching Ave. Abilities at Work 1046 500 NE Multnomah Kaiser Enclve Services (clerical) Small Group Suite LL 105 Abilities at Work 1048 14321 NE Whitaker Uniform Laundry Company Small Group Abilities at Work 1053 AAW Hillsboro This assessment pertains to 3 individuals Employment Path Community office.