Nurse Evaluator (NE)
The RRDC will employ, either directly or under contract, a Registered Nurse (referred to as "Nurse Evaluator") to assist the RRDC in the administration and monitoring of the NHTD waiver program. The role of the NE is not to duplicate the role of the RRDS, but to use his/her level of clinical expertise to support the RRDS and the successful implementation of the NHTD waiver.
The NE must:
- Possess excellent clinical assessment skills;
- Have excellent screening and interviewing skills;
- Have excellent problem-solving and investigating skills;
- Have professional experience working with people with disabilities and/or seniors;
- Possess excellent organizational and training skills;
- Have excellent communication skills and ability to resolve conflicts;
- Be able to coordinate activities, evaluate data and establish priorities;
- Have working knowledge of community-based resources for individuals with disabilities and/or seniors;
- Possess experience with developing relationships with institutional and/or community-based organizations;
- Maintain a working knowledge of services and supports available through Medicaid, Medicare and/or other third party payers; and
- Meet all additional qualifications outlined in the Nurse Evaluator contract.
Roles and Responsibilities of the NE
NE responsibilities include:
1. Technical Assistance and Support to the RRDC/RRDS
- Assist the RRDS in reviewing SPs that are medically complex to assure information is accurate and utilizes resources and available services to meet the health and welfare needs of the participant;
- Review and administer the PRI and SCREEN when there is a concern that the current PRI and SCREEN does not reflect LOC needs of the individual;
- Conduct annual LOC assessments for waiver participants as requested by the RRDS;
- Provide resource information and education regarding individuals with disabilities and seniors as requested by the RRDC;
- Assist the RRDC when requested with attracting quality new providers to offer needed services;
- Participate in local consortium on issues involving individuals with disabilities and seniors relevant to the NHTD waiver; and
- Attend Regional Forums as requested by RRDS.
2. Resource to Providers
- Attend Team Meetings where the participant's clinical needs may warrant further interpretation; and
- Provide training and technical assistance to waiver service providers on clinical aspects of the waiver program as needed.
3. Technical Assistance to QMS and Nurse Evaluator
- Provide training and technical assistance and share areas of expertise with QMSs and other NEs.
4. Technical Assistance to Participants, Family Members and Others
- Be available to participants family members/informal supports and legal guardians to answer questions and address concerns of a clinical nature; and
- Support the participant's right to be the decision maker regarding life goals, activities, services and providers.
5. Incident Reporting
- Provide feedback to RRDS and QMS during investigations of SRI as requested.
6. Develop and Submit Reports to DOH
- Maintain required documentation including visits, assessments, consultations recommendations, technical assistance, etc; and
- Prepare reports summarizing services provided and progress made toward attaining waiver program objectives in cooperation with RRDC requirements for submission of quarterly and annual reports to the regional QMS and DOH. (refer to Appendix B).