Support Coordination > Limited > Questions & Answers

1. Will support coordination activities held during the 3 months of support plan development (paid at $161.60 per month) count toward the 9 hours of SC activities or be considered part of what the SC is to handle for $161.60 that month?
   

   No, during the 3 months of support plan development the support coordinator does not keep track of the 9 hours.

2. For example, during a month that the WSC is doing support plan development, the mother calls the WSC and wants the WSC to handle a situation with a provider, does that count as part of the 9 hours?
   

   The 9 hours begins in month 4 and continues through month 12. Services in months 1-3 are the same as those in full support coordination.

3. Does the WSC still have a responsibility to participate in the PCR with Delmarva if the family is now responsible to see that the consumer’s goals are being addressed?
   

   Yes, the 9 hours apply to "Billable" hours, which are the same as those listed in the handbook for full support coordination.

4. If Delmarva does a person centered review (PCR) with a Limited SC consumer, does the family do the follow-up after the PCR?
   

   The follow-up on recommendations made at the time of the PCR report would be a joint responsibility of the Waiver Support Coordinator and the individual, with the individual taking primary responsibility. The PCR report will continue to be mailed to the Waiver Support Coordinator and the individual, if requested. The individual/family and Waiver Support Coordinator should discuss the recommendations and determine what actions are needed. The WSC should review these with the individual by phone or at a face to face visit as appropriate to the person’s needs.

5. Please identify each and every specific "billable" activity that will count toward the 9 hours. For instance, what about:
   • Writing case notes?
   • Travel time to home visits?
   • Travel time to attend an IEP, due process hearing, etc., if so requested by the family?
   • Assisting providers with billing issues?
   • Copying/distributing service authorizations, updates, documentation required by Maximus, etc.?
   • Responding to requests from the department when caseload information is needed?
   • Please specify all activities that are and are not "billable."

   Billable activities are the same as those listed in the handbook for full support coordination.

6. The handbook requires that providers send copies of Implementation Plans and monthly summaries to the WSC, but under Limited SC, families have the responsibility to monitor services. Please explain how this will work.
   

   Providers will still be required to send implementation plans and monthly summaries to the WSC for oversight and the WSC should follow up on issues that surface with the individual/family after review of these summaries. However, the follow up will be more focused on families taking a greater role in overseeing and resolution of issues with the waiver support coordinator playing more of an advisory role.

7. Is writing the initial service authorizations part of the support plan development ($161.60 ) or does it count toward the 9 hours?
   

   Writing service authorization is part of the support plan development. Updates to support plan plans, cost plans, and services authorizations counts toward the 9 hours when they occur outside to the 3 months that was billed at the full support coordination rate.

8. Which are the 3 months of support plan development ($161.60)? The 3 months prior to the effective date? Or 2 months prior to the effective date plus the month the SP becomes effective?
   

   This may vary depending upon the extent of the plan. Support coordinators should use their own professional judgement to determine the time frames for completing the support plan development. It typically involves the 2 months prior to the support plan effective date and the one-month following the support plan effective date.

9. Is support coordination time tracked by the quarter hour (36 qtr. hrs. = 9 hours) or by the minute? For example, if one SC activity takes 9 minutes (1 qtr. hr.) and the next SC activity takes 26 minutes (2 qtr. hrs.) Does this count as 3 qtr. hrs. or 35 minutes? Please explain how time is counted.
   

   Support coordination time should be tracked by the quarter hour using the following guidelines. Nine hours is equal to 36 quarter hour units.

   1. 1-15 minutes are billed for one quarter hour
   2. 16-30 minutes are billed as two-quarter hours
   3. 31-45 minutes are billed as three-quarter hours
   4. 46–60 minutes are billed as four-quarter hours

10. Will Limited SC have a separate billing code or at least a modifier? This really is a different service, just like CDC consultant is a different service.; it's not just "less" of the same service. D-2 WSCs are very concerned about the matrix that indicates they can be paid $49.01 without providing any service or having any documentation.
    

    Not at this time, however, we will be requesting that option from AHCA. The expectation is that the WSC will conduct the activities each month that are necessary for the individual given the limited functions. However, there are several functions that will require some activities during a month such as Medicaid eligibility, monthly progress reports from providers, etc. Additionally, the WSC is on call as needed.

11. Please clarify the month that the consumer changes from Limited to Full SC - how the WSC is to bill? If a consumer uses 91/2 hours before the support plan year is up, is the month that exceeds 9 hours billed at $161.60 if the minimum billing activities are completed per the handbook, or does the Full SC start the month after the person reaches 9 hours? What if, in the month the 9 hours is exceeded, the WSC has put in quite a bit of work for an emergency, shouldn’t the WSC get paid the $161.60 if minimum activities per the handbook are completed?
    

    The change will be billed at the end of the month to reflect the service provided within that month.

12. Please clarify how monitoring will occur with Delmarva to "protect" the WSC when the consumer switches from Limited SC back to Full SC in the middle of a support plan year. For example, the WSC should not be penalized for not completing all face-to-face visits during time the consumer was under Limited SC.
    

    Delmarva will be made aware of the rules for limited support coordination so and the monitoring tools will be adjusted accordingly.

13. Can a WSC specify the number of Limited consumers they wish to serve?
    

    The WSC will notify the district if they will participate in the limited support coordination model and shall accept all individuals who choose this WSC for this model.

14. Can the WSC initiate contact with the consumer/family to ensure health and safety issues that the WSC suspects? This will count as part of the 9 hours. Under what circumstances may the WSC initiate contact, or is it the expectation that the WSC waits to be called by the family/consumer when needed?
    

    The WSC can initiate contact with the consumer/family to ensure health and safety issues. If these activities move the individual into more than 9 hours the WSC will notify the district that the individual is being returned to full support coordination. In general, the individual and family would initiate the contact but many of the functions like updates to service requests, monitoring of progress reports, maintaining eligibility, etc will warrant the waiver support coordinator to initiate contact with the individual.

15. Reviews and approvals from Maximus take a long time – usually 2 - 3 months. There is a lot of "behind the scenes" work in securing additional information from other providers, writing additional justification, etc. If there is a denial and it goes to a hearing, it can be an additional 3-4 months during which the WSC prepares the family for the hearing, provides documents to the district for use by the AG, possibly attends the hearing, etc. Even if a family is capable of carrying out the supports for their son/daughter within 9 hours in 9 months, if their service request or cost plan must go through a Maximus review, and particularly if they go on to a hearing, 9 hours of SC work will be used up quickly. Since the Maximus expansion is pretty much a done deal, this will affect just about everyone before long. It seems questionable that Limited SC will work given the amount of extra time, outside the 3 months of support plan development, that many Maximus reviews require.
    

    We will monitor this situation as limited SC is implemented and determine if any adjustments to the billing practices will be needed.

16. As a WSC can I participate in the limited SC model only with the individuals on my current caseload?
    

    No, if you choose to participate in the limited SC model, you cannot limit it to just those clients currently on your caseload. The option must be available for anyone who wishes to choose this model.