Wellness Counseling Service
Wellness Counseling Service is an individually designed service intended to assist the medically stable waiver participant in maintaining optimal health status. It is intended to be available to a waiver participant who does not otherwise have access to nursing services. Through Wellness Counseling, a Registered Professional Nurse assists the waiver participant to identify his/her health care needs and provides guidance to the waiver participant to minimize, or in some cases prevent, exacerbations of disease. This service differs from Medicaid State Plan Nursing Service as it provides wellness counseling as a discrete service to medically stable individuals.
Through Wellness Counseling, a Registered Professional Nurse can reinforce or teach healthy habits such as the need for daily exercise, weight control, or avoidance of smoking. Additionally, the Registered Professional Nurse will be able to offer support for control of any diseases or disorders such as high blood pressure, diabetes, morbid obesity, asthma or high cholesterol.
In addition to these services, the Registered Professional Nurse can assist the waiver participant to identify signs and symptoms that may require intervention so as to prevent further complications from the disease or disorder. If potential complications are identified, the Registered Professional Nurse will counsel the waiver participant about appropriate interventions including the need for immediate medical attention or contact the waiver participant's physician for referral to traditional Medicaid State Plan services. This service will assess the waiver participant's chronic care needs to assure the participant's health status remains stable and at an optimal level to avoid acute episodes and utilize health care resources efficiently and effectively.
Wellness Counseling Service will be limited to no more than twelve visits in a calendar year and will occur on an as needed basis.
Wellness Counseling Service may be provided by a Certified Home Health Agency or a Licensed Home Care Service Agency. Staff providing Wellness Counseling Service must be a Registered Professional Nurse licensed by the NYS Education Department.
Wellness Counseling Service can not be provided to a participant without a physicians' written order, which is obtained by the Wellness Counseling Service agency. The Wellness Counseling Service provider must obtain and maintain all physician's orders in the waiver participant's file at the agency.
Wellness Counseling Service must be provided by a DOH approved provider and must be included in the SP to be reimbursed.
Wellness Counseling Service is provided on an individual, per visit basis. It is limited to no more than twelve visits in a calendar year and will occur on an as needed basis.
Wellness Counseling Service providers participating in Team Meetings will be reimbursed at the per visit rate for their time at the Team Meeting.