Project Description:
The Contractor shall:
1. The Contractor will become a Medicaid vendor and obtain a New Mexico Medicaid billing number.
2. The Contractor will submit necessary information to the Human Services Department (HSD) Medical Assistance Division (MAD) to maintain an ongoing provider agreement as a qualified Medicaid vendor to conduct SIS assessments in New Mexico.
3. The Contractor will recruit and train sufficient numbers of qualified assessors so that they are ready to begin conducting SIS assessments no later than June 1st, 2014. Individuals recruited must include sufficient numbers of individuals capable of conducting interviews in Spanish to accommodate individuals being assessed who require Spanish-language interviews. When bilingual SIS assessors are not available for Spanish or other languages, the Contractor will coordinate with University of New Mexico (UNM)-approved vendors to provide interpreter services.
4. The training required for assessors includes the following three items (A-C), as well as the internal training described in #5 below. DDSD will arrange for the training in A, B and C. The Contractor is responsible for providing training in #5 below and ensuring that all assessors attend all training sessions.
A. Required SIS training provided by American Association on Intellectual and Developmental Disabilities (AAIDD);
B. Training through the Human Services Research Institute or designee regarding administration of Supplemental Questions; and
C. Training through AAIDD or its designee regarding use of SIS Online and SIS venture to record and upload interview ratings.
5. The Contractor will develop and deliver an internal training program for assessors, schedulers and others involved in the project using a curriculum developed by Contractors staff and approved by DDSD. The goal of the training is to ensure that assessors, schedulers and other project staff have a solid understanding of the context in which the SIS is used in New Mexico, including but not limited to the following:
A. An Overview of Medicaid, Medicaid Waivers and the Developmental Disabilities Waiver, the Organization of DD Waiver Services in New Mexico (waiver administration, HSD, DEPARTMENT/DDSD, provider agencies, etc.);
B. The Individual Service Plan (ISP) (how it is created and revised, individuals involved, etc.);
C. Advocacy and Rights for persons with developmental disabilities;
D. New Mexico cultural and linguistic factors that have an impact on SIS interviews; and
E. Supplemental Inter-Rater Reliability Training to ensure that SIS assessors develop and maintain consistently high inter-rater reliability.
F. The Contractor will maximize AAIDD initial SIS assessor training and the existing DDSD training curriculum for individuals providing services under the DD waiver in the internal training curriculum.
G. The training will be developed and delivered so that SIS assessors are ready to begin assessments no later than June 1st, 2014.
6. The Contractor will recruit sufficient numbers of administrative staff to be ready to begin scheduling SIS assessments as described in A C below no later than March 1st, 2014, including coordinating with Developmental Disabilities Medicaid Waiver (DDW) case managers and staff of provider agencies, preparing travel reimbursement forms for project staff, maintaining project data as required for reports to DDSD, and providing other administrative support as needed.
A. For individuals eighteen and older on the DDW, assessments must occur at least four months prior to the expiration of the individuals ISP;
B. For eligible DDW participants reaching their eighteenth birthday, initial assessments must be conducted at least four months prior to the date of their eighteenth birthday; and
C. For individuals on the DDW for whom reassessments are approved by DDSD, reassessments include a document review as requested by the DEPARTMENT.
In scheduling SIS assessments, the Contractor will follow the scheduling guidelines approved by DDSD in New Mexico SIS Scheduling Guidelines to include guardian contact, collaboration with key interdisciplinary team members such as the case manager and others.
7. For any assessments completed by Contractors staff in Fiscal year 2014 (e.g., assessments completed as part of the required training), the Contractor will enter data into SIS Online no later than one business day after each completed SIS assessment and reassessment and upload SIS assessment checklists and other documents related to individual SIS records as determined necessary by DDSD and the Contractor. DDSD will have oversight over edit permissions for use of SIS Online.
8. In collaboration with DDSD, the Contractor will develop an educational outreach program to be used by schedulers as they schedule SIS Interviews that will provide information on the SIS interview process for respondents. This will include information to be provided during telephone calls with respondents, distribution of printed materials via e-mail and or U.S. Mail, and materials available on a dedicated SIS Interview Information website to be developed by the Contractor no later than April 1, 2014. Materials used in the education program may be provided by DDSD, developed internally, or located on other external sites. All materials to be placed on the SIS Interview Information website will be approved by DDSD.
9. The Contractor will collaborate with DDSD to develop regional on-site trainings for SIS respondents, using materials provided by DDSD and/or developed by the Contractor in collaboration with DDSD. The Contractor will pilot, evaluate and revise the training program no later than June 30, 2014.
10. The Contractor will develop a quality assurance plan that includes initial training of new assessors, schedulers and other project staff; continuing professional development training and assessment of inter-rater reliability of assessors; assessment of the work of the schedulers, and other elements as determined by the Contractor. The plan will be delivered to DDSD for approval no later than March 1, 2014 and will be put into place as staff are hired for the project.
11. When scheduling has begun on March 1, 2014 the Contractor will provide to DDSD on a monthly basis, copies of schedules of SIS interview appointments made, completed and rescheduled and a summary list of individuals interviewed and their status (initial interview, interview for upcoming ISP expiration, reassessment). Contractor will use SIS Online functionality for scheduling as much as possible.
12. The Contractor will meet monthly with DDSD staff during the project period to summarize progress made to date on activities in this Scope of Work, discuss gaps or obstacles encountered and actions taken to address those gaps.
13. The Contractor will provide DDSD with access to documentation maintained by the Contractor throughout the scheduling process beginning on March 11, 2014 including scheduler notes.
14. The Contractor will provide technical assistance regarding proper administration of the SIS to the HSD/DDSD and participants as requested by the HSD/DDSD.
15. The Contractor will provide information to the Advisory Council on Quality related to administering the SIS, quality assurance activities and other relevant areas as requested by DDSD, including attending meetings of the Advisory Council as requested by DDSD.
16. The Contractor will comply with the Federal Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), and applicable regulations, and all other State and Federal rules, regulations and laws protecting the confidentiality, privacy and security of health information.
2/25/14 to TC
