Summary: Ensures the delivery of direct care services to Community and Employment Services (CES) Waiver individuals in the community. Ensures services are provided in compliance with licensing regulations and Easterseals Arkansas (ESA) policies and procedures.
Essential Duties and Responsibilities: include the following. Other duties may be assigned.
Supervises multiple Direct Support Professionals (DSPs) who provide direct care to individuals served in the statewide CES Waiver program.
Manages service delivery by DSPs to all individuals assigned to caseload.
Remains on-call for any after-hours emergency needs or crisis intervention for all Waiver individuals on caseload or per established after hours on-call schedule.
Maintains an accurate and thorough knowledge of current CES Waiver services, licensing regulations and ESA policies and procedures.
Coordinates staffing schedules for CES Waiver supports, other Medicaid services, and additional services and supports received by individuals in a timely manner.
Calculates costs of all direct care services for each individual CES Waiver treatment plan in accordance with ESA processes to align service needs within budget parameters.
Submits prior authorization request for CES Waiver services to PASSE for approval in accordance with established timelines.
Coordinates the development of the annual and comprehensive Individual Treatment Plan (ITP) that includes the following: short and long-term goals that are functional and measurable, staffing, transportation, specialized medical supplies (as needed), equipment, housing options, etc. for each individual based on the needs and preferences of the individual and/or their legal representative. Schedules and attends the annual ITP meeting with the individual and/or their representative, staff, Care Coordinator, and any others requested to be in attendance by the individual and/or their representative.
Coordinates and facilitates annual client specific training for all assigned DSPs.
Reviews daily service records submitted by DSP for each individual served to evaluate service delivery in relation to goals and objectives of individual’s plan and provides feedback to the DSPs, as needed.
Maintains monthly documentation regarding progress, regression, or maintenance of goals outlined in the individuals’ ITP.
Ensures the integrity of all direct service billing in that the service delivered must have PASSE prior authorization, meet required service definitions, is consistent with goals and objectives in ITP, and is delivered before billing can occur.
Maintains reconciliation of hours and days worked by staff compared to what is approved in the plan of care and keeps the individual and/or representative aware of any adjustments that may need to be made.
Provides written explanation to PASSE regarding under/over utilization of support hours and transportation in annual ITP and for any requested revision throughout the plan year in a timely manner and in coordination with the assigned Care Coordinator.
Assists, as needed, in the coordination of the admission of new referrals, including procuring required documentation necessary to determine eligibility and enrollment.
Reviews each ITP goal and objective, including outcomes, at least quarterly to determine the effectiveness of service delivery and progress in goals and objectives.
Keeps case file/electronic health records for persons served in compliance with all organizational, regulatory, and accreditation standards.
Assists individuals in identifying and utilizing community resources and natural supports by working cooperatively with individuals, families, PASSE, state and/or federal agencies and other services professionals.
Works with the person served and if applicable the parent/guardian to resolve crises.
Ensures that staff are trained in positive behavior intervention techniques to manage and promote improved behaviors. As applicable, ensures that staff are trained on individual behavior plans and how to monitor, document and report effectiveness and compliance with plan. Reviews Behavior Plan quarterly or more frequently, as needed.
Assists individuals in person-centered service planning and self-advocacy.
Participates in activities that promote community awareness within the Easterseals programs to include after-hour activities and events such as Special Olympics, camps, etc.
Ensures all electronic client records and other informational tracking systems remain current and accurate.
Regularly reviews records and environments of individuals served, including medication monitoring, as scheduled by department.
Conducts and documents quality checks of service delivery for all individuals served based on frequency established by the department leadership, immediately reporting any concerns to supervisor.
Compliance/HIPAA:
While performing the duties of this job, employees will comply with all federal, state, and local laws and regulations pertaining to Easterseals Arkansas.
Employee has access to all client protected health information within their cohort of individuals served. Employees will not attempt to access any other protected health information unless otherwise approved by a supervisor or Privacy Officer.
Supervisory Responsibilities:
Manages and provides overall direction, coordination, and evaluation of DSPs on their caseload. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include training; planning, assigning, and directing work; conducting performance evaluations; rewarding and disciplining employees; addressing complaints and resolving problems. Manager makes important recommendations into hiring, termination, and promotion of DSPs that are given particular weight.