Funding Committee monitors timely access of services and utilization of funding to ensure usage of available resources and network capacity for individuals eligible for intellectual and/or developmental disability (IDD) services. The information is also used to provide administrative oversight of the system. Targeted Case Managers are responsible for submitting this information to Funding Committee.
- Notifications / Updates must be submitted on the current Funding Committee Update form. All boxes on the form must be filled in, as applicable. Update forms are due by noon on Monday to the FundingRequests@sedgwick.gov.
- Upon receipt of notification the committee will review, determine if further action is needed and when applicable submit notification to Kansas Department for Aging and Disability Services (KDADS) and/or other affected parties.
- Funding Committee minutes will advise TCM of any further updates needed based on the type of update submitted and the information provided. Individual/guardian will be notified by Funding Committee via a letter if an action is being taken or if additional information is needed.
Type of Update
- Hold on services – Select when an individual has requested or needs to request a hold on services, this includes any approvals received by the Managed Care Organization (MCO). The dropdown includes the type of service that is being placed on hold (If there are multiple services, please use the Type in box for other and list all services).
- When an individual is requesting a hold on services; the update will include reason for request and projected date the individual will resume accessing services.
- Individual is incarcerated, institutionalized, or placed in a nursing facility for period of time that exceeds the limits of a temporary stay. A temporary stay is defined by the month of entrance and the following two months.
- Utilization of Services – Select when an individual has not utilized services per SCDDO Policy D-04 Monitoring of IDD Services, Funding Access and Utilization. TCM shall submit the Funding Committee Update form within 5 business days of being notified of the following circumstances:
- Individual receiving HCBS IDD program services or State Aid Day/Residential services does not complete the Medicaid application/renewal process.
- Services have not been accessed for 15 consecutive days, for example:
- Staffing difficulties
- Individual refuses services
- Individual is hospitalized and/or recovering from an illness and funded services are not being used
- The individual has left the State for any reason and funded services are not being used
- Services are being used at less than 75% of allocation for 3 consecutive months. The update should include, at a minimum:
- Service type and CSP
- Dates services were stopped or utilization was reduced
- Utilization records for the previous three months
- Reason the individual is not using services
- Barriers and solutions to accessing services
- Initial Access – Upon receipt of the funding allocation for Home and Community Based Services (HCBS) IDD Program funds or State Aid Day and Residential funds the TCM must submit updates to SCDDO as directed by the funding committee until services have been initiated. Select the appropriate category as defined below when the update pertains to an individual accessing new service(s).
- New allocation via crisis –Individual received Home and Community Based Services (HCBS) or State Aid Day/Residential access through the crisis exception process.
- New allocation via priority population – Individual received access to HCBS because as a priority population such as; kids in custody, waiver transition, or PRTF discharge.
- Pending HCBS approval – The recommendation to access HCBS has been submitted to KDADS by the CDDO however a decision has not been rendered by KDADS. This update keeps FC informed of the crisis situation to include any new or changes in circumstances.
- Wait List funds offered – Individual has accepted HCBS waiting list funds.
- Institutional Transition – Select when submitting an update regarding transition from an Institution. Funding Committee will request updates every 30 days at the beginning of the Institutional Transition referral based on SCDDO policy B-09. Once discharge is closer, the frequency of updates may increase.
Provider and Service Information
- MCO Name – List the MCO that has been assigned
- MCO allocated service – List the type of service(s) that have been approved by the MCO after a Health Risk Assessment has been completed.
- Options Counseling Completion Date – the date the provider was notified by the CDDO that they were chosen to serve.
- Provider’s Name – List the provider’s name if Options Counseling has been completed and a provider has been chosen, this is not to record a preferred provider.
- Start Date for Services – Date that individual entered services; this field is not intended to record anticipated start dates.