Wellness Coordination Providers

For the original publication, please click here. The following is a text version of the original publication. 
--
To: Division of Disability and Rehabilitative Services Providers 
From: Nicole Norvell, Director, Division of Disability and Rehabilitative Services 
Re: Wellness Coordination Providers 
Date: December 17, 2013 

As previously announced, Indiana's Division of Disability and Rehabilitative Services (DDRS) is adding Wellness Coordination as a new service to the Community Integration and Habilitation Waiver (CIH). The Centers for Medicare & Medicaid Services (CMS) is currently reviewing the proposed new service, and we anticipate that the service will be available during the first quarter of the 2014 calendar year. 

Wellness Coordination Service Definition:
Wellness Coordination is the development, maintenance and routine monitoring of the waiver participant’s Wellness Coordination plan and the medical services required to manage his/her health care needs. 

Wellness Coordination services extend beyond those services provided through routine doctor/health care visits required under the Medicaid State Plan and are specifically designed for participants requiring assistance of an RN/LPN to properly coordinate their medical needs. 

The service incorporates a tier- system based on health scores from the State’s objective-based allocation process. 

Provider Qualifications:
Provider Qualifications may be submitted starting Dec. 30, 2013. Providers will not be added to the consumer pick list until Wellness Coordination is approved through CMS. An announcement will be distributed upon approval. 

Providers approved for the CIH Waiver, who would like to add Wellness Coordination, must submit the following to Beth Goodrich, Director of Provider Relations, at Beth.Goodrich@fssa.in.gov. 

1. Provider Request to Add Counties and Services Form found on the Provider Relations’ webpage. A provider must submit a request form for each location in which they would like to add the service.
2. Qualifications of ALL RNs/LPNs who will provide Wellness Coordination. Qualifications include:
   1. College transcripts
   2. College diploma
   3. Resume
   4. Criminal background checks (must be less than 90 days old)
      1. State criminal background check
      2. County background check
      3. Nurse’s aide registry check, also available on the Provider Relations’ webpage.
   5. Copy of valid Indiana licensure

Once the information is received, Provider Relations will check to see if the provider has any open CAPs and/or open complaints. If the provider has none, the service will be added. If the provider has any open, they will need to be closed before the service can be added. 

Providers not currently approved for the CIH Waiver, must submit a new provider proposal packet along with the qualifications (listed above) of all of the RNs/LPNs who will perform the Wellness Coordination. To view the new provider proposal packet requirements, please refer to the Provider Relations’ webpage. 

DISCLAIMER: As the Division moves forward with implementation of Wellness Coordination services, please be advised that final approval of this service rests with the Centers for Medicare & Medicaid Services (CMS). Any subsequently required changes, additions or clarifications will be announced and posted on DDRS’ BDDS Webpage and included in the next update to the DDRS Waiver Manual. Upon approval by CMS, the entire 5th Amendment to the Community Integration and Habilitation Waiver will be posted to the BDDS webpage. 

In addition, the DDRS is currently working with INARF and other stakeholder groups to finalize the Wellness Coordination Plan and documentation requirements which will include 

identification of specific data points to assist in monitoring the overall outcome of the service. Prior to implementation a provider may withdraw their request to add the Wellness Coordination service based on any changes CMS may require or the Division’s finalized documentation requirements.