Self Directed Services

Did You Know You Have A Choice?

Self-Directed Services promotes personal choice and control over who provides your Personal Care and how services are provided.

Participants in Self-Direction have the authority to recruit, hire, train and supervise individuals who provide their services.

Self-Directed Services are offered as a service option in the Living Choice and Medically Fragile Programs.

For more information please contact your Transition Coordinator or Case Manager or visit our Fiscal Management Service (FMS) at www.morningstarfs.com.

Below are the forms required for the Self-Directed program. If you have any questions, please contact the Long Term Waiver Operations at 888-287-2443.

 

SELF-DIRECTED SERVICES PROCESS

Morning Star Financial Services LLC is the contracted FMS provider who is responsible for the financial management of Self-Directed services for Living Choice and Medically Fragile Members. Prior to implementing any Self-Directed Services (SDS), provider agency case managers should receive training from Morning Star; you may contact Morning Star by calling 1-877-450-5041 or via email at info@morningstarfs.com.

The following are steps taken for enrollment of a Member who has expressed interest or has been offered the option of Self-Directed Services.

 

Part I of the Process:

The Case Manager/TC is directed to the OHCA website to access the initial forms at www.OKHCA.org. When the initial forms are completed, they are submitted to OHCA via fax line at 405-530-7265 for review and approval.  Below is the list of internal documents required to initiate self-directed services.

Services offered under Self-Direction includes:

1.      Self-Directed Personal Care                                                   (S5125)

2.      Self-Directed Advanced Supportive Restorative                       (S5125TF)

3.      Self-Directed Respite Services (2-7hrs)                                  (T1005U4)

4.      Self-Directed Respite Services (8+hrs)                                   (S9125U4)

5.      Goods and Services                                                                (T1999)

 

The Case Manager will schedule a meeting with the IDT Team (member, case manager, family representative if designated) to review and discuss the Member’s request and to review the initial forms, which includes, Member/Employer Self-Assessment, Member’s UCAT, Budget Calculation Worksheet (to include PCA, ASR units for the plan year and a budget for goods and services if necessary), Member’s Service Plan and Back-Up Plan. 

Member or his/her representative will sign the (Acknowledgment of Informed Choice) form when he/she has agreed to assume responsibility for self-directed services. The Case Manager will inform the Member of his/her rights to terminate SDS at any time.  The Case Manager will fax the completed forms to the LCP, Waiver Program Coordinator or Program Manager via the fax line at 405-530-7265.

Upon review of the Member’s assessments during the IDT meeting, it is determined that the Member does not meet criteria for self-direction; the Case Manager will ensure that all provider agency services remain in place. The member is sent a letter detailing the reasons for the denial and given the right to appeal the decision; however if it is determined that the Member meets criteria, the TC/CM will notify Morning Star of the Member’s intent to self-direct their personal care services.

Part II of the Process:  

Morning Star or the TC/CM will direct the member to the Morning Star website to obtain the Member/Employer and Employee packets to be completed and returned to them for processing. Morning Star along with the Case Manager may assist Member in completing the documents and recruiting their employees as necessary.  
  
Morning Star will process background checks for each potential employee.  Case Manager or Member must inform Morning Star when there are plans to employ more than one employee and there will be a pay differential. Morning Star will conduct the background check and inform the TC/CM and Member when the employee/employees are approved.  (At a minimum it takes 5 days to complete the background check).  
  
Program Manager will fax the (Transition to Self-Directed Service Form) to the Case Manager as confirmation that the background checks are complete to begin processing the addendum.  Employees are not allowed to begin work until an approved service plan is received by Morning Star. 
  
LC or Waiver Program Coordinators will receive and process the addendum request and submit to OHCA Care Management for review and approval. When approved the LC or Waiver Program Coordinator will fax the approved service plan to the TC/CM and Morning Star. 
  
Morning Star will prepare a Monthly Budget Summary for each Member according to their service plan (6g) and send to the Case Manager, Member and Program Manager. 

Morning Star is responsible for submitting a detail report of all activities related to LCP and Waiver Program members participating in self-direction to the Program Manager by the 15th of each month.