The following message was emailed to Provider Organization contacts by the six Portland metro area brokerages on 02/02/2019.
IMPORTANT NOTICE TO OREGON PROVIDER ORGANIZATIONS
RE: APD-PT-19-003* Policy Transmittal: Agency Billing Activities Effective 2/1/2019
As of Friday, 2/1/19, most eXPRS submissions by provider organizations will automatically be paid by ODDS without case management review. (Service codes OR539, OR570, and OR310 are excluded from this change.) The Oregon Office of Developmental Disabilities Services (ODDS) will conduct post-payment reviews of provider organization documentation. This change may expedite payment to some provider organizations, but it does not change documentation requirements.
Oregon Administrative Rule 411-415-0090 requires Case Management Entities (both CDDPs/counties and Brokerages) to conduct extensive and specific monitoring of services including but not limited to:
- Ensuring all services provided align with those authorized in the ISP
- Confirming support and progress toward goals
- Confirming individual choice is being honored
The review of provider organization progress notes is an invaluable tool in meeting these monitoring mandates. For this reason, the six Portland metro-area brokerages will continue to expect to receive progress notes for all services delivered. Per the state’s transmittal, these notes must include:
- Customer name
- Provider of service
- Dates of service (the date range is sufficient)
- Units of service provided (total number of units for the period is sufficient)
- A progress note summarizing the service provided and progress toward goals (weekly or monthly summaries are perfectly acceptable)
As guidance, please review the following from the Indirect Case Management Monitoring Worker’s Guide:
Adequate provider agency progress notes focus on describing the supports a person received to achieve the desired outcome. These include the ADL, IADL, medical and behavioral supports identified on the ISP as being needed. The notes should focus on the specific activities (i.e. “visited a museum”) only insofar as they are important to achieving the desired outcomes as described in the ISP. Simply stating the name of the service associated with the procedure code is not sufficient (i.e. “Provided Day Support Activities” is not an adequate progress note to support a claim by the agency or for the purposes of indirect monitoring.) An adequate note will allow a SC/PA to determine if the services are consistent with those authorized in the ISP. Provider agency progress notes are also a place for the provider to convey observations about possible changes in support needs, challenging behaviors and a wide variety of topics. These reported observations should be reviewed by the SC/PA for their potential impact on risk identification, new person-centered information, and service planning. The SC/PA’s supporting progress note should reflect their assessment of the observations and the actions they will take in response, if any.
This excerpt demonstrates that progress notes are an important tool in monitoring supports and communicating changes in an individual’s needs and choices. As such, we request that providers submit progress notes for all supports no later than one month after the provision of services. For example, notes for services provided in February will be due by the end of March.
In compliance with the transmittal, we will be notifying ODDS when we do not receive progress notes within the 30-day window.
We anticipate that issues with overlapping billings will likely continue. As CDDPs/counties Brokerages are no longer part of the invoicing and payment processes, providers will need to seek resolution of these issues from ODDS.
Finally, we trust that our provider organization partners share our values with regard to continuing to offer customers the authority to review and authorize their services via signature. We will have one-on-one conversations with each of our customers regarding their options, and plan to solicit broad customer and family input on how to ensure choice continues to be offered and honored.
Thank you for your continued partnership and your service to our shared customer base as we work together through this next transition.
This week’s Provider Spotlight is Exceed Enterprises in Milwaukie. Exceed works to with adults living with disabilities to find and retain both customized and competitive employment in the Pacific Northwest area. Because they have been around for several decades, they have the experience and expertise needed to make community employment a reality for job seekers all over the Metro Area. Check out their Facebook page here.
Meet EQC Home Care! In addition to housekeeping, personal care, and meal support, they also have nursing services for end of life care, medication assistance, and 24 hour availability for respite. Nurses are available for community outings and they serve children as well. EQC is this week’s provider spotlight. Details here: http://www.eqchomecare.com
This week’s Provider Spotlight is on Empowerment Services, LLC. ES delivers individualized employment alternatives and life-skills training to teenagers and adults with developmental disabilities. Given the unique behavioral and sensory needs of everyone they serve, support plans are highly customized.
Be sure to check them out on the web at www.empowermentservicesllc.org
Edwards Center remains one of the best kept secrets in Washington County. Founded in 1972 by a group of parents, this agency puts family front and center. This week’s provider spotlight is on the Aloha Community Center where Edwards takes community inclusion to the next level. A quarterly online catalog is available full of classes and outings for people of all ages and abilities. Check them out at https://www.facebook.com/alohacommunitycenter/
This week’s provider spotlight is on Eastco Diversified Services. Eastco’s Supported Employment Program places adults with I/DD into integrated jobs, based on individual interest and work experience. Prospective employees are carefully screened to guarantee a successful match of job requirements, individual abilities, and needs. Eastco provides a Job Coach on-the-job until he or she can independently perform the job to the employer’s quality and production standards. To find out more, check out their Facebook page.
Good things come in small packages – that’s what Destination Autonomy founder Rochelle Moore believes. She started her company in 1999 to serve adults with Developmental Disabilities in Washington County. DA provides community activities both individually and in groups, in home and employment supports. Check out the photos of their awesome activities on Facebook.
This week’s provider spotlight is on Community Access Services. CAS is a private nonprofit organization that provides residential, community, and employment services to individuals with intellectual and developmental disabilities who live and work in our community. CAS has a personal commitment to those they serve and are one of the best in the business. If you’re looking for top-notch service, check them out!
Right At Home may be a national agency but that won’t prevent you from experiencing great, local customer care. Serving the Metro area, Right at Home caregivers provide services for almost any family and practically any situation. Right at Home will tailor care to your unique situation through a Custom Care Plan. They have lots of caregivers on standby so they are also a great option in a pinch.
Byron and Kim Bender
Small but mighty. That’s your take away from this week’s Provider Spotlight. Bender Rehabilitation and Consulting is a family run business that focuses on helping people with disabilities get jobs in the community.
Ask your VR Counselor or your Personal Agent about their job development, placement, and coaching services or visit them by clicking here.
Assisted Community Ties is an active provider organization focused on helping people make friends and learn social skills. Based in Washington County, ACT offers community engagement 1:1 or in groups. Check out their Facebook page to learn more!
Business partners Rex Goode and Drew Stinson didn’t realize that flexibility would be their new middle name when they founded Arise Mentors. Arise Mentors is this week’s provider spotlight because they currently have capacity to take on new customers. They focus on independent living and inclusion in the community with an aim for utmost flexibility and creativity. Learn more at their website www.arisementors.com.
This week’s Provider Spotlight features Advocates for Empowerment.
AFE provides in-home, community inclusion, and job services for both adults and children. This values-based organization makes a strong commitment to matching families with the right provider upfront. They even publish biographies of all their employees on their website. Check them out here.
Last night we held our first of three Focus Groups for our provider community and it was a great success! Huge thanks to Jessica Leitner for facilitating a lively, engaging, and community-building conversation.
Thank you to Compass Career Solutions, Advocates for Empowerment, Eastco Diversified Services, EQC Home Care, Trellis Inc., Arise Mentors, Hosanna Homes, Community Access Services , Mentor Network and Pacific Opportunities for giving us your time and energy to help make our community stronger.
News on upcoming focus group coming soon.
This week’s Provider Spotlight is Ability Training Services.
If you live in Washington County then you should check out Ability Training Services. This amazing group not only supports people with training, activities and learning based retreats, they help coordinate a central calendar with other agencies in order to help friends meet up in the community! ATS believes that everyone deserves encouragement, motivation and the tools necessary to grow.
This Week’s Provider Spotlight: Looking for quality in home care and respite? Then check out Cornerstone Inclusion Supports. Focused on highly individualized supports, staff from CIS will meet with you to help you (and your family) to determine your needs. In addition to traditional supports, CIS also supports small groups to meet up in the community, mostly just friends who want to hang out together.
For more information, check with your Personal Agent.
This week’s Provider Spotlight is Creative Goal Solutions – they’ve made a BIG SPLASH in Clackamas and Washington counties with their awesome community activity schedule. Groups from CGS attend festivals, concerts, museums and more! There are groups focused on sports, outdoors and nightlife as well as music and dance.
Sometimes there is a waitlist because groups fill up fast so be sure to sign up at their website or visit the event page on their Facebook page for more!
Albertina Kerr is pretty well known around the Portland Metro area but did you know that they currently have openings in their day program?
This week’s Provider Spotlight is on Kerr’s Activity and Recreation services, some at Port City in North Portland and elsewhere in the community. One of their groups called Open Signal recently made their own movie! At their gallery called Art from the Heart, Kerr participants have the opportunity to grow creatively through art and make money!
For more information about Kerr’s programs check out their website.
This week’s provider spotlight is on Abilities at Work who is changing the face of today’s workforce. In partnership with Portland-Metro employers they support wage-based job opportunities for people with developmental disabilities. They currently serve over 100 people through Discovery, Job Development & Placement and Job Coaching. On the west side of town they offer computer and job skill classes to help people prepare for a job in the community.
For more information call 503-641-5820. You can also see some success stories on their Facebook page!
Welcome to PROVIDER SPOTLIGHT, a new series to shine a light on the creative work of our providers in the Metro area. This week’s focus is on Bridge City Mentors.
Bridge City Mentors takes their name to heart by mentoring adults with disabilities to be independent in all activities. Whether that’s in home activities like chores and cooking, or community based activities, BCM offers lots of groups for those with diverse interests. BCM also offers respite for caregivers and is accepting new customers in the Washington County area. Check out some of their amazing pictures on their Facebook page.
Welcome to INW’s PROVIDER SPOTLIGHT, a new series to shine a light on the creative work of our providers in the Portland metro area. This week’s focus is on Amie’s Community Care.
Founded by Amie Scott, ACC proudly serves 170 people in the Portland area. In addition to in home supports and help with housing, ACC coordinates outings with 9 other agencies so that adults with disabilities can meet up in the community and make new friends. Amie believes strongly in “goodness of fit” and starts off every new referral with a personal meet and greet.
To learn more check out their facebook page or visit their website at www.amiescommunitycare.com.
Important Note to Provider Organizations: Jan 1st 4% Rate Changes in eXPRS
In the last few weeks, Personal Support Workers and brokerage customers should have received information directly from the State of Oregon and/or SEIU regarding an important change just around the corner. For a good many years, TNT Fiscal Intermediary Services has issued paychecks for PSWs serving our customers. TNT’s contract with the state ends at the end of 2016 and a new agency, PCG Public Partnerships LLC (known as PPL) will be taking over this responsibility. So in the very near future, Personal Support Workers will stop getting payment from TNT and start getting payment from PPL.
What does this mean to Personal Support Workers and Customer-Employers?
Generally speaking, it means that Personal Support Workers and employers (be they a brokerage customer or a legal designee) have some paperwork to fill out. Right now, PPL is sending out mailers to three groups of folks:
- Employers (customers or their designees) who employ PSWs (You’ll get a packet by mail on or around November 4th, 2016)
- Personal Support Workers who work for one Employer (customer or their designee) (You’ll get a packet by mail on or around November 7th, 2016)
- Personal Support Workers who work for two or more Employers (customers or their designees) (You’ll get a packet by mail on or around November 8th, 2016)
Customer-Employers and Personal Support Workers can return their packets in a variety of ways: by mail, fax, or secure email.
What Help Is Available?
If you’d like some hands-on help, consider attending one of the optional Enrollment Information and Help Sessions for Employers and PSWs. Multiple sessions will be held here at Independence Northwest and there are sessions in all three metro area counties. RSVP for a session by clicking here. If you have received your packet, you can bring it to the session in your area to receive hands-on help. If you haven’t received it by the time the session you want to attend happens, they’ll print a packet for you there and assist you in person.
You can also call PPL Customer Services for help. Their number is listed on this flyer or you can visit this website.The state’s eXPRS Facebook page has a ton of resources related to the change as well.
Transition time is very tight on this, so be sure you’re responsive and get the help you need! If packets are not completed and processed by the end of the year, payment for services may be affected. If you have questions, don’t hesitate to reach out to PPL for help.
Resources and Help
Here’s a great list of resources to help you get started:
The Office of Developmental Disability Services (ODDS) will be holding an informational phone call about the upcoming policy changes for entry into sheltered workshops for individuals and their family members/support people on Wednesday, June 17, 2015 from 9:00 – 10:00 AM.
The purpose of this call is to discuss:
- Upcoming changes to entry into sheltered workshops
- How these changes will affect you or your family members/support people
- Effects on those already working in a sheltered workshop
- Effects on those not working in sheltered workshops
- Other employment services that are available
- Answer your questions
To call in please use this conference line: 800-260-0702 and enter guest code 361647
Entry into Sheltered Workshops: Upcoming Policy Changes FAQ
Watch a Video of ODDS Director Lilia Teninty Answering FAQs About the Changes
Governor’s Executive Order
Since the State of Oregon Department of Human Services began taking on Personal Support Worker and provider payment through its eXPRS system, one of the most common questions brokerages have received from providers is “Did you get my timesheet?”
There’s a relatively easy way for providers to access this information via eXPRS. ODDS’ Julie Harrison and her team have created a How To guide entitled “How to Find/View Plan of Care Service Claims”. Check out the guide by clicking here. You’ll learn how to read the eXPRS screens and determine where your payment claim is in the process. Be sure to bookmark this guide for future reference. (Of note: eXPRS refers to hours or miles keyed into its system as SDEs – Service Delivered Entries.)
One additional note: If you are sending invoices or timesheets via email, please be sure to use the email@example.com email address. If you are faxing invoices or timesheets, please be sure you receive a return confirmation that the fax was received.
Thanks for your continued partnership through the ongoing systemic changes. Your work is very much appreciated.
By Larry Deal, Executive Director of Independence Northwest
Over the past year and a half, so much time has been spent deconstructing and reconstructing Oregon’s Intellectual and Developmental Disabilities system, there’s been little opportunity to sit back and celebrate some of the successes. Here are five things that are currently working well – and that deserve their moment in the sun.
People are getting more services. With the change from 100% Title XIX Waiver to a mix of K Plan and Waiver funding, Oregonians with intellectual and developmental disabilities are getting more services than ever before. This is a wonderful thing. Historically, people in crisis situations had limited resources and little option other than out of home placement (group homes and foster care homes) whether that was their preference or not. In the new system, many Oregonians now have the resources to continue living at home; the current design supports true individual and family choice. The importance of this change cannot be overstated. (That said, there’s still a very real fiscal sustainability discussion that must be had to support these efforts long-term.)
Providers are beginning to expand capacity. This one’s a slower burner, but it’s beginning. Customers, families, and professionals have all been highly concerned about the increase in funding since it came without an ounce of provider capacity expansion planning or incentives. Oregon put the funding before the resources. In recent weeks and months, many agencies have begun reaching out to brokerages and are expanding their services to our community in everything from in-home to employment supports; in 2015, I believe we will see a tangible increase in options for our customer base.
There’s a recent willingness for course correction when things aren’t working. If you haven’t heard of DSA (Day Support Activities,) consider yourself lucky. In short, DSA was an exercise in rushed change implementation. Ultimately, it changed rates, it changed processes, and it changed the definition of certain services. The process upended Brokerage, CDDP (Community Developmental Disabilities Program) and provider organization operations and damaged the integrity of reporting systems statewide. However, collaborative efforts (led by ODDS) amongst brokerages, CDDPs (counties), providers, and state has made a real difference. Recent changes in leadership have assured a common sense, customer-first approach to problem solving. In other words, there’s strong collaboration happening again in Oregon. This is a very good thing – let’s do more of it.
We’re sticking with our current needs assessment tool. One of the major concerns brokerages have been facing while implementing the still-new functional needs assessment has been knowing full well we’d have to change assessments again at the beginning of 2015. Recent actions from the state suggest that we will be working to make the current brokerage tool (the Adult Needs Assessment) work well into the future. For brokerage customers, this is promising. We need consistency, stability, and some time to do some in-depth analysis on the efficacy of the current tool first. This decision deserves kudos.
Perhaps most significantly, Oregon is focusing on individual goals – again. If you have been working in the system or receiving services for the last year and a half, you’ve no doubt noted the troubling focus on deficits-based language and approach. I remember being in a meeting very, very early on in the K Plan implementation when it was announced by someone with significant influence that “this is no longer about goals, it’s about needs.” Soon, that refrain began to echo. Fortunately, that interpretation is no longer alive and well. What some people didn’t understand early on in the transition process was this: Brokerages have always addressed disability-related support needs. And we have done so while helping people reach their goals. You don’t provide publicly-funded services without making sure needs are documented and necessary. A sophisticated, supportive, holistic system addresses health and safety while placing a premium on the wants, needs, and goals of the individual. We know it can work because we’ve been doing it for thirteen years. I can’t say enough how pleasing it is to hear high-ranking leaders in our state stating that goals matter.
There are many issues we must continue wrestling with: the eXPRS payment system and pending Personal Support Worker entry, the monthly versus annual services issue, the ongoing review of Behavioral Supports, changes to supported employment, and many more. But as we inch ever closer to the new year, it’s safe to say that we all hope for continued positive developments in the Oregon I/DD service delivery system. We’re a resilient, engaged, and growing community. Fingers crossed we can focus the coming year’s efforts on enhancing, expanding, and enriching the lives and experiences of the individuals, families, and communities we support. Oregon was once at the forefront of community-based services in our country; with continued focus, effort, and partnership there’s no reason that can’t be a reality again.