CMS 372 Report - OMB Control Number: 0938-0272

Annual Number of Section 1915c Waiver Recipients and Expenditures:

(Specify each service as in the approved waiver)

Service Name	Level of Care	Expenses	Participants
-- Other If Other, specify: Adult Day Care	NF	$0	0
-- Other If Other, specify: Adult Residential Services (Adult Host Homes)	NF	$0	0
-- Other If Other, specify: Adult Residential Services (Assisted Living Facilities)	NF	$11,464,038	638
-- Other If Other, specify: Adult Residential Services (Community Residential Care)	NF	$1,550,119	99
-- Other If Other, specify: Adult Residential Services (Community Residential Care- Intensive)	NF	$546,370	39
-- Other If Other, specify: Assistive Technology Services	NF	$0	0
-- Other If Other, specify: Attendant Care Services	NF	$156,207	74
-- Other If Other, specify: Caregiver Training	NF	$0	0
-- Other If Other, specify: Case Management Service	NF	$2,864,199	766
-- Other If Other, specify: Chore Services	NF	$11,064	5
-- Other If Other, specify: Consumer Preparation Services	NF	$0	0
-- Other If Other, specify: Environmental Accessibility Adaptations (Home Modifications)	NF	$0	0
-- Other If Other, specify: Environmental Accessibility Adaptations (Vehicle modification)	NF	$0	0
-- Other If Other, specify: Financial Management Services	NF	$6,240	15
-- Other If Other, specify: Habilitation Services	NF	$22,397	16
Home Delivered Meals	NF	$12,588	20
-- Other If Other, specify: Homemaker Service	NF	$66,294	37
-- Other If Other, specify: Institutional Transition Services	NF	$31,399	71
-- Other If Other, specify: Medication Assistance Services (Medication Reminder System)	NF	$251	4
-- Other If Other, specify: Personal Budget Assistance	NF	$61,583	244
-- Other If Other, specify: Personal Emergency Response System (Installation, Testing & Removal)	NF	$296	4
-- Other If Other, specify: Personal Emergency Response System (Purchase, Rental, Repair)	NF	$195	6
-- Other If Other, specify: Personal Emergency Response System (Response Center Service Fee)	NF	$8,442	33
-- Other If Other, specify: Respite Care (Routine)	NF	$2,204	1
-- Other If Other, specify: Respite Care (Client's Home)	NF	$1,456	2
-- Other If Other, specify: Respite Care (Room and Board Included)	NF	$1,108	1
-- Other If Other, specify: Specialized Behavioral Health Services (Level I)	NF	$0	0
-- Other If Other, specify: Specialized Behavioral Health Services (Level II)	NF	$0	0
-- Other If Other, specify: Specialized Behavioral Health Services (Level III)	NF	$0	0
Specialized Medical Equipment and Supplies	NF	$54,084	141
-- Other If Other, specify: Supportive Maintenance	NF	$129	1
-- Other If Other, specify: Transportation - Non Medical (Per Mile)	NF	$0	0
-- Other If Other, specify: Transportation - Non Medical (Per One-Way Trip)	NF	$52,081	113
-- Other If Other, specify: Transportation - Non Medical (Public Transit Pass)	NF	$9,715	47
-- Other If Other, specify: Medication Assistance Services(Medication Setup)	NF	$13,784	17

Assurances:

Assurances were submitted with the initial report. (If you are submitting a lag report this item must be checked.)
All provider standards and health and welfare safeguards have been met and corrective actions have been taken where appropriate
All providers of waiver services were properly trained, supervised, and certified and/or licensed, and corrective actions have been taken where appropriate.

Documentation:

Provide a brief description of the process for monitoring the safeguards and standards under the waiver:

On April 1, 2010, the New Choices Waiver Operating Agency created and filled a new position dedicated to quality assurance. The initial focus of the QA Coordinator has been to analyze current procedures and to create new protocols and tools to be utilized in the monitoring process for each of the performance measures found in the State Implementation Plan QIS. To date, newly developed protocols and tools include the Health Status Screening Report, Financial Accountability Monitoring Process, Paid Claims Review Tool, Level of Care Monitoring Process, Level of Care Determination Review Tool, Qualified Provider Monitoring Process, and the Self Administered Service Back-up Plan Monitoring Process. Providers will be advised of the new QA procedures in the annual training in November, and the review process will begin shortly thereafter. Level of Care Review 331 applicants were admitted to the New Choices Waiver during FY 2010. Level of Care for one hundred percent (100%) of these participants was initially determined and approved by RN’s from the Bureau of Health Facility Licensing, Certification and Resident Assessment. RN’s from the individual Case Management agencies completed MDS-HC assessments and confirmed continued Level of Care prior to admission. One hundred percent (100%) of the Level of Care determinations for new enrollees were reviewed by the New Choices Waiver Operating Agency. Medicaid eligibility was verified by the New Choices Waiver Operating Agency for one hundred percent (100%) of the applicants. Written Medicaid approval was obtained for all New Choices Waiver participants prior to enrollment. The Operating Agency approved all enrollments to the New Choices Waiver. Care Plan Review The New Choices Waiver Operating Agency received Comprehensive Care plans for all waiver participants. One hundred percent (100%) of all Care Plans were reviewed and approved by the Operating Agency. Qualified Providers The Bureau of Health Facility Licensing, Certification and Resident Assessment (BHFLCRA) licenses and regulates assisted living providers. The SMA has a contract with this agency to report survey information of providers that serve waiver participants. When adverse survey findings are reported to the SMA, any information related to New Choices Waiver participants is forwarded to the Operating Agency. The Operating Agency can then take action to assure the health and welfare of waiver participants. This usually happens by notifying the Case Management Agencies of concerns that are reported, so they can make on-site visits to verify and resolve any problems with waiver participants. During fiscal year 2010, the BHFLCRA surveyed a total of 81 Assisted Living Facilities serving New Choices Waiver participants. Of these Assisted Living Facilities, 62 were cited for at least 1 or more deficiencies. All deficiencies had an appropriate follow up survey by the BHFLCRA that assured compliance with regulations. Health and Welfare There were four critical incident investigations involving New Choices Waiver participants during the time period April 1, 2009 through March 31, 2010. All four incidents were resolved and safeguards were put in place to assure the health and welfare of all participants. Two of the four incidents (50%) were participants who were involved in criminal activity. One of the four incidents (25%) was an accident resulting in an injury. One of the four incidents (25%) was an event that compromised waiver participants' living environment. As a result of these investigations, an initiative was put in place by the NCW operating agency to include incident reporting protocol in their annual provider training. Financial The New Choices Waiver Operating Agency performed a financial audit of 41 waiver participants. Recoupment for all identified overpayments was initiated

Findings of Monitoring:

No deficiencies were detected during the monitoring process;
Deficiencies were detected.

Provide a summary of the significant areas where deficiencies were detected, (Note: Individual reports or assessment forms for waiver individuals and/or providers disclosing deficiencies and which document the summary are not necessary):
Deficiencies have been, or are being corrected.

Provide an explaination of how these deficiencies have been, or are being corrected as well as an explanation of what steps have been taken to ensure the deficiencies do not recur:

372 - Annual Report on Home and Community-Based Services Waivers