DDES Memo Series 2006-13
Date: August 25, 2006
To: Listserv
For: Area Administrators / Human Services Area Coordinators
Bureau Directors
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Licensing Chiefs / Section Chiefs
Tribal Chairpersons / Human Services Facilitators
From: Sinikka Santala
Administrator
Subject: Release of Revised Medicaid Waiver ISP form (DDE 445) and
new DDE 445a
Document Summary
This memo announces the release of a revised Individual Service Plan
(ISP) and a new companion document which addresses individual outcomes
(DDE-445a). The use of these new forms (DDE-445 and 445a) will be
required in all Medicaid waiver programs. Waiver agencies may use a
locally developed ISP form and Individual Outcomes ISP if the local
versions contain all of the information on the DDE 445 and the DDE 445a
and the agency receives prior approval from the Bureau of Long Term
Support or the Bureau of Mental Health and Substance Abuse Services.
Background
The Individual Service Plan (DDE-445) is a required document in all
of the Medicaid waiver programs. There are a number of versions
currently in use; many are local agency adaptations of the form, while
others are outdated versions of the model form produced by the
Department. The form has not been revised in several years while the
number of waiver programs have grown and a need for the collection of
new data has become apparent. In an effort to create a modern version of
the DDE-445, staff from the Developmental Disabilities Services Section,
the Children's Services Section and the Community Options Section of the
Bureau of Long Term Support and the staff from Bureau of Mental Health
and Substance Abuse Services have collaborated in the development of a
new Individual Service Plan (ISP) form.
The new ISP form has been reconfigured and is now applicable to all
of the Medicaid waiver programs, including the Children's waivers. The
form will also be used in the Community Opportunities and Recovery
waiver program when that waiver program becomes operational. The new ISP
also contains additional elements designed to gather information that
had heretofore not been collected on the form. These new elements
include fields to record the parental fee (if applicable), the personal
discretionary funds available to the participant, and a field to record
the total waiver program start up and/or one time costs.
Also new to the Individual Service Plan in this revision is a
companion document, the Individual Service Plan - Individual Outcomes,
the DDE-445a. The DDE-445a provides a means to identify and document the
participant's desired individual outcomes that the service plan will
address. The form will also allow the care manager/support and service
coordinator to monitor and document the progress/status toward the
achievement of the participant's individual outcomes.
Policy
As soon as practicable but no later than January 1, 2007, all waiver
agencies must begin to use the revised Individual Service Plan form
(DDE-445) and the companion document, the Individual Service Plan -
Individual Outcomes (DDE-445a) or a locally developed, Bureau approved
version of the form(s), as part of all new waiver applications. And,
after January 1, 2007, as agencies complete annual recertifications
throughout the year, the revised DDE-445 and the new DDE-445a or an
approved local version must be used.
With the introduction of the new ISP form the long established
requirements for the completion of the DDE-445, at application,
recertification and update do not change. The primary change is that
while agencies may continue to use locally designed ISP forms, these
form(s) must be prior approved by the appropriate Bureau.
Implementation
Individual outcomes have typically been a part of the conversation
between the participant and the care manager/support and service
coordinator, in the assessment process. Individual outcomes have also
been a part of the discussion in program monitoring (CIP II/COP-W). With
the implementation of the revised DDE-445 and with the addition of new
DDE-445a, a change in focus will occur as the participant's individual
outcomes become more formally integrated into service plan development.
As service plans are developed, local waiver agency staff will work with
participants to identify and prioritize their individual outcomes and to
put in place the waiver and non-waiver services that support the person
in achieving those outcomes.
As agencies begin to use the DDE-445a, waiver agency staff should be
identifying, prioritizing and documenting their participant's individual
outcomes on the form at the time of application. While every individual
outcome identified may not be directly associated with a service listed
on the ISP, all of the participant's individual outcomes that are
identified should be listed on the 445a. When an individual outcome does
correspond to a provided service, it must be indicated on the
corresponding service strip of the ISP. Thereafter, as individual
service plans are updated, and at plan review and recertification,
agency staff should be noting progress toward the individual outcomes
listed on the 445a and identifying any outcomes that should be added to
the plan.
This document announces the release of the revised ISP and the new
DDE-445a. To assist in the transition to incorporating outcomes into
care plan development, a Web-based training has been developed and will
be available soon. In addition, outcomes training will be a focus of
this year's Long Term Care Fall Conference. It is expected that there
will be a period of transition as agencies move toward integrating
individual outcomes into the plan development process. We recognize that
this transition will take time. However, we believe that as agencies
take advantage of the outcomes training provided and gain "on the
job" experience, this transition will be successfully accomplished.
Attached to this memo are instructions to guide agency staff in the
completion of both the DDE- 445 and the DDE-445a forms. As agencies
begin to work with these new forms and in the process, begin to
integrate individual outcomes into the service plan process it is
expected that questions will arise. Waiver staff should direct their
questions to their assigned quality assurance staff.
Local program staff working in the CIP II or COP-Waiver programs
should contact TMG. For CIP 1A/1B and BIW programs, agency staff should
contact the assigned CIS. For CLTS waivers, local agency staff should
contact central office.
Agencies that decide to use locally developed ISP and Individual
Outcomes forms should seek prior approval as follows:
- For CIP 1A/1B and BIW waivers, the agency should contact the DDSS
central office staff.
- For CLTS waivers, the agency should contact their regional CSS.
- For CIP II/COP-W, the agency should contact the COP Section
central office staff.
- For COR waiver (when that waiver becomes operational), the agency
should contact central office staff.
Action Required
Beginning January 1, 2007, the new DDE-445 and 445a or an approved
local version must be used as new waiver applications and annual
recertifications are completed. County agencies may begin to utilize the
revised forms prior to January 1, 2007, at their discretion.
REGIONAL OFFICE CONTACT: Community Integration Specialists
Human Services Area Coordinators
CENTRAL OFFICE CONTACT: John O'Keefe (CIP1A/1B, BIW)
Bureau of Long-Term Support
Developmental Disabilities Section
1 W. Wilson St. Room 418
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608- 261-6749 phone
Fax: 608- 261-6752
OKEEFJJ@dhfs.state.wi.us
Kevin Lafky, (CIP II/COP-W)
Bureau of Long-Term Support
Community Options Section
1 W. Wilson St. Room 450
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608 266-7754
Fax: 608- 2267-2913
lafkyke@dhfs.state.wi.us
Julie Bryda (CLTS)
Bureau of Long-Term Support
Children's Services Section
1 W Wilson St. Room 418
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608- 650-4445
Fax: 608- 261-6752
BRYDAJA@dhfs.state.wi.us
Cheryl Lofton (COR)
Bureau of Mental Health and Substance Abuse Services
1 West Wilson Street, room 850
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608 267-1427
Fax: 608 267-7793
LoftoCJ@dhfs.state.wi.us
Attachments:
Individual
Service Plan (DDE-445) (PDF, 75 KB)
DDE-445
Word Fillable version
Individual
Service Plan - Individual Outcomes (DDE-445a) (PDF,
79 KB)
DDE-445a
Word Fillable version
DDE-445
Instructions (PDF, 32 KB)
MEMO WEB SITE: http://dhfs.wisconsin.gov/dsl_info/
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Last Revised: August 10, 2009 |
