DDRS Waiver Manual
2dXf5Pj
2dXf5Pj
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
The participant requires assistance in coordinating medical needs beyond what can be provided<br />
through routine doctor/health care visits<br />
Wellness Coordination services are specifically included in the participant’s individualized support<br />
plan<br />
The participant has a wellness coordination plan<br />
Reimbursable Activities<br />
Coordination of Wellness services by the RN or LPN provider must include, but is not limited to, the<br />
following:<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Completion of the (medical/health care related section’s needs and risks) State-approved risk<br />
assessment tool<br />
Development, oversight, and maintenance of a Wellness Coordination plan<br />
Development, oversight, and maintenance of the (medical/health care) Risk Plan, which includes<br />
Training of Direct Support Professionals to ensure implementation of (medical/health care) Risk<br />
Plans<br />
Consultation with the individual’s health care providers<br />
Face-to-face consultations with the individual as described in the support plan<br />
Consultation with the individual’s support team<br />
Active involvement at all team meetings, reporting on the Wellness Coordination plan as it relates to<br />
the individual’s full array of services as listed in the ISP.<br />
Limitations<br />
The following limitations apply to Wellness Coordination services:<br />
Participants assessed with health scores of 0-4 would not require assistance of an RN or LPN to<br />
coordinate medical needs.<br />
Activities Not Allowed<br />
Reimbursement for Wellness Coordination services is not available under the following circumstances:<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
The individual does not require Wellness Coordination services.<br />
Wellness Coordination services are not specified in the Individualized Support Plan.<br />
Wellness Coordination services may not be provided by a provider of waiver-funded Case<br />
Management services.<br />
Residential, vocational, and/or educational services otherwise provided under other Supported<br />
Living Services cannot be billed as Wellness Coordination services.<br />
Services furnished to a minor by a parent(s), stepparent(s), or legal guardian.<br />
Services furnished to a participant by the participant’s spouse.<br />
Nurses rendering waiver-funded services must obtain/maintain Indiana licensure.<br />
161