护理协调机构提供者注册
辅助生活豁免计划
Care Coordination Agencies (CCA) are responsible for developing and implementing the Individualized Service Plan (ISP) to identify the participant’s needs and the methodology to meet those needs while participating in the Assisted Living Waiver (ALW) program. They will explain to individuals or their legal representative, the services offered through the waiver. CCAs can help individuals make decisions about their choices of living arrangements by explaining the differences between receiving long-term services and supports in a nursing facility, a Residential Care Facilities for the Elderly (RCFE), or the Public Subsidized Housing (PSH) setting. The CCA is also responsible for informing individuals about resources available to them for determining financial eligibility for long-term services and supports.
CCA基本要求
招生机构：
- 必须成立并运营至少12个月。
- 必须在过去 12 个月内完成 8-10 次转型。
- 必须聘请一名拥有社会工作、心理学、咨询、康复、老年学或社会学硕士学位以及一年相关工作经验的社会工作者。
- Must employ a Registered Nurse (RN) to administer the Assessment Tool developed by the ALW program. The RN must have and maintain a current, unsuspended, unrevoked license to practice as an RN in the State of California. Work experience requirements include:
- 在急性护理环境中为具有类似护理需求的患者提供护理的至少 1,000 小时经验。
- 拥有至少 2,000 小时的家庭护理经验，为有类似需求的患者提供护理。
- 必须为员工提供强制性的在职培训计划。
- 需要有一个流程来征求和/或获取客户对服务满意度的反馈。
- 必须有一个质量保证计划来跟踪客户的投诉和事件报告。
- Must maintain a service record/case file for each client containing all required program forms, completed assessments, signed care plans, and progress notes. Agencies must make these records available to DHCS for audit upon request.
- 必须证明与 4-6 个专业护理机构和 4-6 个辅助生活设施存在现有关系，其中一个必须是成人住宅护理机构 (ARF)。
家庭健康机构申请人没有资格注册成为 Medi-Cal ALW 计划下的 CCA 提供商。 Medi-Cal ALW 计划下的 CCA 提供商没有资格提供直接家庭健康机构服务（公共补贴住房 HHA 除外），因为这将被视为利益冲突。 作为管理 ALW 参与者的 CCA 提供商案例，请参见下文：
CMS Guidance: “Case management activities must be independent of service provision. An entity agency or organization (or their employees) cannot provide both direct service and case management activities to the same individual except in very unique circumstances set forth in regulation. Conflict occurs not just if they are a provider but if the entity has an interest in a provider or if they are employed by a provider.”
CCA provide the following services:
- 招募客户
- Conducting assessments and reassessments using the ALW Assessment Tool
- 确定每个客户的护理级别
- Developing ISP
- 根据个人评估结果安排必要的服务
- 每月拜访参与者
请参阅 HCBS 豁免 了解完整的 ALW 要求。
CCA 提供商注册步骤：
卫生保健服务部 (DHCS) 已收到大量供应商的申请，这些供应商有意成为经批准的 ALW 计划供应商，成为护理协调机构 (CCA)。 DHCS 处理申请的时间比平时要长，并且会根据地理覆盖范围和受益人护理协调需求对申请进行优先排序。
DHCS 对此事态发展可能造成的任何不便表示歉意，并期待将来与贵组织合作。
If you are interested in becoming an approved ALW CCA, please submit an email with your interest to WaiveProEnroll@dhcs.ca.gov prior to submitting your application for review. The email shall include but not limited to the following information:
- CCA 名称
- CCA 的位置（城市和县）
- CCA 计划服务的覆盖区域（城市和县）
- 联络人
一旦审查了询问并确定某个特定地理区域需要 CCA，DHCS 团队将通知您提交申请包。
为了参与 ALW 计划，需要以下申请包：
- The Initial Program Application – This portion of the application must be emailed directly to the Provider and Facility Site Review Unit (PFSRU). There is no need to mail this in. Applications and questions regarding this portion can be sent to ProFacWAIVER@dhcs.ca.gov.
- The Medi-Cal Enrollment Packet – This portion of the application must be mailed in as our office needs original wet signatures. Questions regarding this portion of the application can be sent to the Provider Enrollment Unit (PEU): WaiveProEnroll@dhcs.ca.gov.
将完整的 Medi-Cal 注册申请材料邮寄至下列地址。 忽略 Medi-Cal 表格上填写的地址。 重要提示：请勿将申请发送至提供商注册部门。
邮寄至：
Department of Health Care Services
综合护理系统科
提供者注册单位
1501 国会大道，密西西比州 4502
邮局 信箱 997437
萨克拉门托，加利福尼亚州 95899-7437
For a Change of Ownership or Change of Location, contact: ProFacWAIVER@dhcs.ca.gov.
For Revalidations, contact: WaiveProEnroll@dhcs.ca.gov.
提交申请
准备邮寄申请包时，请按以下方式发送所有纸质文件：
- 切勿使用订书钉。
- 请勿使用活页夹、分隔符或文件整理器。
- 请勿使用粘性标签、便利贴或标签。
- 请勿使用大于 Letter 尺寸（8.5 x 11 英寸）的纸张。
- 请勿使用修正带、涂改液、荧光笔或类似类型的墨水。 如果必须进行更正，请用墨水划线、注明日期并签名。
- 可以使用回形针、夹子和橡皮筋。
- 确保所有 Medi-Cal 表格页面的顺序正确。