New Ongoing Service

Definition:

If the person needs a “New, Ongoing” service, then it signifies a new situation or circumstance has developed in their life that is unaddressed by the existing assortment of services prescribed in the Person Centered Support Plan (PCSP).  The “Ongoing” nature of the situation or circumstance means it is expected to be persistent and continuous for the foreseeable future.  Consequently, the service is expected to remain a necessary part of the person’s future PCSP cycles.

Procedure:  

If the person satisfies the service’s criteria, then the worker must respond to four questions that dynamically and automatically build the budget line for the “New, Ongoing” service in the Request.  Each one contributes information toward a holistic view regarding how much of the service the person needs to address their situation.  In addition, the system uses the information to dynamically estimate the impact the new service will have in both the Active and future PCSP cycles.

Explanation:

The following four questions must be completed in order to submit the Request for the “New, Ongoing” service.

What is the service code’s Rate?
This question asks for the new rate that will be billed per unit beginning on the Request’s Effective Start Date.

What date will the new service start?

This question asks for the date the service is scheduled to begin and represents its Effective Start Date.  The date cannot be arbitrary.  Rather, it must accurately reflect the expected date the provider will begin delivering the service.  If the date is unknown, then the worker should select the first day of the month in which  the provider is expected to begin delivering the service.  

How many units are needed in the Active plan?
This question asks for the total number of units the person is expected to use in the Active plan for the service.  The number of units cannot be arbitrary.  Rather, they must accurately reflect the amount the person needs to use between the Request’s Effective Start Date and the Active plan’s Effective End Date.  If the units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.

How many units are needed to cover 12 months in the next plan cycle?

This question asks for the number of service units the person is expected to use in the full twelve month duration of the next plan cycle.  The number of units cannot be arbitrary.  Rather, they must accurately reflect the amount the person needs to use over the course of twelve months.  If the units are not accurate, then the Plan Max may provide insufficient funds to cover the person’s need.