E. Coordination of Non-Waiver Services
In addition to the scheduling of waiver services, the SC must also identify and coordinate all non-waiver services deemed appropriate and necessary for the applicant. If the applicant is not currently receiving non-waiver services, the SC must work with him/her and all necessary partners to obtain any necessary referrals, assessments and approvals/authorizations.
If the applicant is currently receiving non-waiver services, the SC must work with him/her and all necessary parties to obtain any necessary referrals, re-assessment and re-approvals/re-authorizations for the potential continuation of these services.
It is the SC's responsibility to maintain a current understanding of the processes required to obtain necessary referrals, re-assessments and re-approvals for non-waiver services.
This includes understanding which services under Medicaid require a physician's order (e.g. personal care or private duty nursing) and re-approvals/re-authorizations (e.g. authorization from LDSS for personal care and/or prior approval from State DOH or the LDSS for private duty nursing). The RRDS and/or SC may identify that the applicant/participant requires the provision of skilled tasks. These tasks are not provided by NHTD waiver services. They are potentially provided to Medicaid recipients under State Plan services through Certified Home Health Agencies (CHHA), Private Duty Nursing or the Consumer Directed Personal Assistance Program (CDPAP). When Service Plans include State Plan services, the SC must work closely with LDSS assuring there is no duplication of services and that roles and responsibilities are clearly defined.
Once all non-waiver services are identified, the SC must include them in the Projected Weekly Schedule of the ISP to ensure the coordination of services, preventing unnecessary overlap and/or gaps in services. The SC must clearly articulate the provision of service the provider is responsible for.