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HPR I REVIEW AND APPROVAL PROCEDURES FOR NEW ONGOING AND ONE-TIME IDAPPs

Effective July 1, 2014

Revised July 1, 2015

 

  • The Regional Utilization Management and Consultation Team (RUMCT) is tasked with reviewing and approving all new ongoing and one-time DAP plans (excluding DAP MH2014 plans)
  • The RUMCT will have representation from all 9 HPR I CSBs and will be comprised of:
  1. DAP Coordinator, Harrisonburg-Rockingham CSB or designee
  2. DAP Coordinator, Horizon Behavioral Health or designee
  3. DAP Coordinator, Northwestern CSB or designee
  4. DAP Coordinator, Rappahannock Area CSB or designee
  5. DAP Coordinator, Rappahannock Rapidan CSB or designee
  6. DAP Coordinator, Region Ten CSB or designee
  7. DAP Coordinator, Rockbridge Area CSB or designee
  8. DAP Coordinator, Valley CSB or designee
  9. DAP Coordinator, Alleghany Highlands CSB
  10. Social Work Director, Western State Hospital (for WSH IDAPPs)
  11. Social Work Director, Catawba State Hospital (for Catawba IDAPPs)
  12. Social Work Director, Piedmont Geriatric Hospital (for Piedmont IDAPPs)
  13. Regional Initiatives Director, HPR I
  • When developing an IDAPP, the respective CSB DAP Coordinator (or designee) will first determine if there are adequate funds available within the CSB’s allocation of Regional DAP funds to cover the cost of the IDAPP. If such funds are available, this information will be included in the DAP request to the RUMCT. If funds are not available within the respective CSB’s DAP allocation, the DAP Coordinator (or designee) will contact the HPR I Regional Initiatives Director (or designee) to determine if other funds from the Region would be available to cover the IDAPP costs. If funds are not available from either source, the IDAPP should not be submitted to the RUMCT for approval.

 

  • CSB DAP Coordinators will alert their respective finance department and the Regional Initiatives Director (or designee) whenever an IDAPP is to be terminated, specifying the amount of regional DAP funding included in the IDAPP and the effective date of the plan termination.

 

  • The CSB that manages the terminated IDAPP will have exclusive rights to the recovered funds for a period of 14 calendar days from the date of plan termination. During that time, the CSB may utilize these recovered funds to support IDAPPs for consumers currently on the EBL at a state hospital.

 

  • If, after 14 calendar days (or if the CSB waives their rights to these funds as reported to the Regional Initiatives Director or designee), the CSB is unable to utilize these recovered funds to support a new IDAPP for an EBL-designated individual, the recovered funds will be made available for use across HPR I and will be prioritized via the RUMCT to be used for the individual who has the longest tenure on the EBL and whose plan could be supported within the amount of funds recovered.

 

  • After a new IDAPP is created and it has been determined that adequate funding is available, it will be sent via encrypted email to the RUMCT group along with a written narrative that provides justification for the requested funds and services.

 

  • The body of the email should also include whether the individual is currently on the Extraordinary Barriers List (EBL) and, if so, how long they have been on it. This information will be used to provide further justification for the plan as well as assist in prioritizing the IDAPP in question when DAP funds are limited.

 

  • The RUMCT representative from each CSB will then send a response email to the RUMCT email group either endorsing or objecting to the IDAPP by the close of the next business day at the latest. The RUMCT representative from the CSB from which the IDAPP originates will not be asked to vote on the plan as it is assumed that the plan is endorsed by that CSB.

 

  • Because the RUMCT representatives often travel and are out of the office frequently, a quorum of four (4) approvals will be required at minimum for an IDAPP to be approved for funding.

 

  • The HPR I Regional Initiatives Director will generally not vote as part of the approval process. However, if a quorum of RUMCT CSB representatives is not available, the Regional Initiatives Director may provide the final vote of approval if appropriate to ensure the timely approval and processing of the IDAPP.

 

  • Once an IDAPP has been approved by a quorum of the RUMCT, the Regional Initiatives Director will sign off on the plan on behalf of the RUMCT and send the plan, via encrypted email or FAX, to Rappahannock Area CSB (fiscal agent CSB) no later than the close of the next business day for processing and payment.

 

  • If an IDAPP is not approved by RUMCT, the RUMCT will, to the extent possible and appropriate, provide constructive feedback for modifications to the IDAPP that may make it more appropriate for RUMCT approval.