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ເຄືອຂ່າຍການດູແລຜູ້ບໍລິໂພກໂດຍກົງໃນລັດ Colorado
In-Home Support Services (IHSS)
Consumer Direct Care Network Colorado (CDCO) serves as the Training and Support contractor for IHSS. We guide individuals through training and provide program guidance.
We work collaboratively with the IHSS agencies, case management agencies, and Colorado Department of Health Care Policy & Financing (HCPF) to ensure individuals successfully enroll as IHSS members.
ມີສິດໄດ້ຮັບ
To use IHSS, you must:
- ໄດ້ລົງທະບຽນຮຽນ ສຸຂະພາບກ່ອນລັດໂຄໂລຣາໂດ (ໂຄງການ Medicaid ຂອງລັດໂຄໂລຣາໂດ)
- ຕອບສະໜອງເງື່ອນໄຂການມີສິດໄດ້ຮັບໂຄງການ CFC, ລວມທັງ:
- ມີຄວາມຕ້ອງການທີ່ໄດ້ຮັບການປະເມີນສຳລັບກິດຈະກຳການດູແລສ່ວນຕົວ, ວຽກບ້ານ, ແລະ/ຫຼື ການຮັກສາສຸຂະພາບ
- ການຕອບສະໜອງລະດັບການດູແລຂອງສະຖາບັນ
- ຖ້າທ່ານໄດ້ລົງທະບຽນໃນການຍົກເວັ້ນ HCBS ແລ້ວ, ທ່ານຈະຕອບສະໜອງລະດັບການດູແລຂອງສະຖາບັນໂດຍອັດຕະໂນມັດ
- ເຂົ້າຮ່ວມໃນການວາງແຜນການບໍລິການກັບທ່ານ ອົງການຄຸ້ມຄອງກໍລະນີ (CMA)
ຖ້າທ່ານຍັງໄດ້ຮັບ CDASS ຜ່ານການຍົກເວັ້ນ ແລະ ຍັງບໍ່ທັນໄດ້ປ່ຽນໄປໃຊ້ CFC, ຜູ້ຈັດການກໍລະນີຂອງທ່ານຈະແນະນໍາທ່ານກ່ຽວກັບເວລາ ແລະ ຂັ້ນຕອນຕໍ່ໄປ.
ຮຽນຮູ້ເພີ່ມເຕີມກ່ຽວກັບ ເງື່ອນໄຂ ແລະ ການບໍລິການຂອງ CFC ແລະເຊື່ອມຕໍ່ກັບເຈົ້າ ອົງການຄຸ້ມຄອງກໍລະນີທ້ອງຖິ່ນ ເພື່ອເລີ່ມຕົ້ນ.
ຍັງບໍ່ໄດ້ລົງທະບຽນໃນ Health First Colorado ບໍ?
8 ຂັ້ນຕອນໃນການລົງທະບຽນ
There are eight steps to enrolling in the IHSS program:
1. Enroll in Community First Choice
- IHSS is available to members through Community First Choice (CFC).
- ຮຽນຮູ້ເພີ່ມເຕີມກ່ຽວກັບ ທາງເລືອກທຳອິດຂອງຊຸມຊົນ (CFC).
- ຕິດຕໍ່ທ່ານ ອົງການຄຸ້ມຄອງກໍລະນີທ້ອງຖິ່ນ ເພື່ອເລີ່ມຕົ້ນຂະບວນການ.
2. ພົບກັບຜູ້ຈັດການກໍລະນີຂອງທ່ານ
- Meet with your case manager to discuss why IHSS is right for you compared to other options.
- ກຳລັງຊອກຫາອົງການຄຸ້ມຄອງກໍລະນີຂອງທ່ານຢູ່ບໍ? ຊອກຫາມັນໂດຍໃຊ້ Colorado Department of Health Care Policy & Financing (HCPF) case management agency directory.
- When you meet with your case manager, you will complete an assessment of your care needs and additional enrollment paperwork.
- After completing the assessment process, your case manager will provide you a list of IHSS agencies in your area. or you may review the HCPF IHSS Provider List for approved agencies in your area.
3. Begin to complete required IHSS forms
Below are forms required to enroll into IHSS:
- Physician Attestation of Consumer Capacity is completed by your (the member’s) physician and helps determine what supports you need to be safe in your home and community. The physician also determines if you require an Authorized Representative (AR). This form is required at initial enrollment and any documented change in your condition. An additional form is required for ARs. It is important to know that a person can be an AR or attendant, but not both.
- The Direct Care Services Calculator is a tool used by the case manager to indicate the number of hours of attendant services a member needs for each covered service (Personal Care, Homemaker, and Health Maintenance Activities).
The IHSS Shared Responsibilities Plan is required for all members. This form should not be completed before you have your Physician’s Attestation form completed. The Shared Responsibilities Plan is completed by you (or your AR) and your chosen IHSS agency during initial enrollment and any documented change in your condition.
4. Select your IHSS agency
- Choose the IHSS agency that is the best fit for you. You may contact them and ask questions about their services.
- After picking an IHSS agency, your case manager will check that it is accepting new members. If they are not, work with your case manager to choose another agency or look into other service options.
- Your case manager will send your chosen IHSS agency a referral and your enrollment paperwork.
5. Enroll with your IHSS agency
- Your IHSS agency will review your referral and contact you to set up an intake assessment.
- Attend your intake assessment and share with your agency your needs and desires for care.
- After your intake assessment, your IHSS agency will create a care plan and send it to your case manager for approval.
6. Case Manager approves care plan and completes the Prior Authorization Request (PAR) Process
- Your case manager will review and approve your care plan. They will work with your IHSS agency to make corrections if needed.
- If additional information is needed, your case manager will contact you.
- After your case manager approves your care plan, they will enter your PAR in HCPF’s system called the interChange (also called Bridge). A PAR has information about your authorized services, service hours, and certification period for IHSS.
7. IHSS agency begins staffing and orientation
- Your IHSS agency will hire your attendants. As the employer, your agency is responsible for your attendants, but you are welcome to participate in the selection and interview process.
- Attend your IHSS agency’s orientation.
- Work with your IHSS agency to train your attendants.
8. ການບໍລິການເລີ່ມຕົ້ນ
- Once your attendants are hired and trained, your IHSS agency will set up their work schedule and begin services.
- If at any time an attendant cannot come to work or doesn’t show up, your IHSS agency is responsible for sending a backup attendant.
- Stay in communication with your IHSS agency to manage your attendants and get ongoing support. If you are struggling to work with your agency, you can contact Consumer Direct for Colorado (CDCO) or HCPF at HCPF_PDP@state.co.us ຫຼື 303-866-5638.
- After services begin, CDCO is always available to help answer questions about IHSS. As the Training and Support contractor, we have many resources available to help you navigate IHSS!
IHSS Program Guide – CFC & Waiver
The IHSS Program Guide is your comprehensive materials to understanding the roles of everyone in the IHSS program. This training tool will provide you with answers to many of your questions about IHSS.
ແບບຟອມ IHSS
ຊັບພະຍາກອນ IHSS
ຊັບພະຍາກອນ HCPF
ຖ້າທ່ານມີບັນຫາໃດໆທີ່ກ່ຽວຂ້ອງກັບການຢັ້ງຢືນການຢ້ຽມຢາມທາງອີເລັກໂທຣນິກ (EVV), ການລົງທະບຽນ, ພາສີ ຫຼື ຫົວຂໍ້ອື່ນໆ, ທ່ານສາມາດສົ່ງຄຳຕິຊົມໂດຍກົງໄປຫາໜ່ວຍງານໂຄງການທີ່ກຳກັບໂດຍຜູ້ເຂົ້າຮ່ວມ (PDP) ຂອງກົມນະໂຍບາຍ ແລະ ການເງິນດ້ານການດູແລສຸຂະພາບຂອງລັດ Colorado (HCPF).
ລາຍຊື່ອົງການ
Visit the In-Home Support Services Provider List on the DHCPF website.
ການບໍລິການໄກ່ເກ່ຍ
ການບໍລິການໄກ່ເກ່ຍສຳລັບສະມາຊິກ ແລະ ຜູ້ຈັດການກໍລະນີ
Consumer Direct Care Network Colorado (CDCO) helps mediate concerns about the services Health First Colorado (Medicaid) Members receive through In-Home Support Services (IHSS). If Members are unable to work with their Case Manager to achieve the care they believe is needed, Members and Authorized Representatives (AR) have the option to utilize the mediation process.
ການບໍລິການໄກ່ເກ່ຍແມ່ນໃຫ້ໂດຍ CDC ເປັນສ່ວນໜຶ່ງຂອງ ການບໍລິການຂໍ້ມູນຂ່າວສານ ແລະ ການຊ່ວຍເຫຼືອ ສະເໜີໃຫ້ສະມາຊິກ ແລະ ARs. ການໄກ່ເກ່ຍຜ່ານ CDCCO ສາມາດຊ່ວຍໃນການອຳນວຍຄວາມສະດວກໃນການສົນທະນາ ແລະ ການສົນທະນາກ່ຽວກັບຄວາມບໍ່ເຫັນດີໃນແຜນການດູແລ ແລະ ການບໍລິການທີ່ໄດ້ຮັບອະນຸຍາດ.
Requests for mediation can be submitted by the Member, an AR, Case Managers, or the provider agency. The Member or AR must consent to mediation. When requested, reasonable accommodations will be provided for people with disabilities by notifying CDCO prior to the scheduled mediation call.
ຫຼັງຈາກກອງປະຊຸມໄກ່ເກ່ຍ, CDCCO ຈະອອກຄໍາແນະນໍາເທົ່ານັ້ນ, ບໍ່ແມ່ນການຕັດສິນໃຈທີ່ແນ່ນອນ. ສະມາຊິກຍັງຄົງມີສິດໃນການອຸທອນທາງກົດໝາຍທັງໝົດສໍາລັບການຕັດສິນໃຈທີ່ເຮັດໂດຍອົງການຄຸ້ມຄອງກໍລະນີ. ຜູ້ຈັດການກໍລະນີຈະຮັບຜິດຊອບໃນການສໍາເລັດການຕັດສິນໃຈສໍາລັບການບໍລິການ, ເມື່ອໄດ້ຮັບອະນຸຍາດ, ເປັນຜົນມາຈາກການໄກ່ເກ່ຍ.
ແບບຟອມຮ້ອງຂໍການໄກ່ເກ່ຍ - ພະຈິກ 2024
ຂະບວນການໄກ່ເກ່ຍ
- ບຸກຄົນທີ່ຮ້ອງຂໍການໄກ່ເກ່ຍຕ້ອງຕື່ມຂໍ້ມູນໃຫ້ຄົບຖ້ວນ ແບບຟອມຮ້ອງຂໍການໄກ່ເກ່ຍ ແລະສົ່ງມັນໄປຫາ CDC.
- CDCCO ຈະດຳເນີນການສົ່ງຕໍ່ໄປຫາການໄກ່ເກ່ຍ ແລະ ຕິດຕໍ່ຜູ້ຈັດການກໍລະນີພາຍໃນໜຶ່ງມື້ເຮັດວຽກເພື່ອເກັບກຳຂໍ້ມູນ.
- CDCCO ຈະຕິດຕໍ່ຫາສະມາຊິກ ຫຼື AR ເພື່ອເກັບກຳຂໍ້ມູນ ແລະ ເພື່ອຮ້ອງຂໍການຍິນຍອມໃຫ້ເຂົ້າຮ່ວມໃນການໄກ່ເກ່ຍ.
- CDCO will contact the IHSS Provider Agency to collect information.
- CDCCO ຈະຈັດການໂທຫາໄກ່ເກ່ຍກັບທຸກຄົນທີ່ກ່ຽວຂ້ອງ ແລະ ໃຫ້ການອຳນວຍຄວາມສະດວກທີ່ສົມເຫດສົມຜົນເມື່ອຖືກຮ້ອງຂໍ.
- After listening to information from all the participants during the mediation call, CDCO will provide a recommendation for services and notify the IHSS Agency.
- ຜູ້ຈັດການກໍລະນີຈະອອກແຈ້ງການການດຳເນີນການຂອງ Health First Colorado ພ້ອມກັບການຕັດສິນໃຈ, ແລະການບໍລິການໃໝ່ ຫຼື ການບໍລິການທີ່ໄດ້ຮັບການປັບປຸງໃໝ່ທີ່ອາດຈະໄດ້ຮັບອະນຸຍາດ, ແລະຂໍ້ມູນກ່ຽວກັບສິດຂອງສະມາຊິກໃນການອຸທອນ.
ວິດີໂອ IHSS
ການບໍລິການທີ່ມຸ່ງໄປສູ່ຜູ້ບໍລິໂພກ
ຂໍ້ຄວນລະວັງມາດຕະຖານ
ພາບລວມຂອງ IHSS
Introducción a IHSS
Case Manager Role in IHSS
Puesto de gestor de casos a IHSS
Agency Role in IHSS
El rol de una agencia a IHSS
ການປ້ອງກັນການສໍ້ໂກງ
ການປ້ອງກັນການສໍ້ໂກງ, ການສຶກສາອົບຮົມ ແລະ ການລາຍງານແມ່ນຢູ່ໃນບັນດາຄວາມຮັບຜິດຊອບທີ່ສຳຄັນທີ່ສຸດຂອງ Consumer Direct Care Network.
ມັນຍັງເປັນຄວາມຮັບຜິດຊອບຂອງທ່ານທີ່ຈະຮັບຮູ້ສັນຍານຂອງການສໍ້ໂກງ. ຮຽນຮູ້ກ່ຽວກັບສິດ ແລະ ຄວາມຮັບຜິດຊອບຂອງທ່ານໃນການປ້ອງກັນ ແລະ ລາຍງານການສໍ້ໂກງໃນວິດີໂອປ້ອງກັນການສໍ້ໂກງນີ້.
ການລາຍງານການສໍ້ໂກງ
ເພື່ອລາຍງານການສໍ້ໂກງທີ່ສົງໃສຕໍ່ກະຊວງນະໂຍບາຍ ແລະ ການເງິນດ້ານການດູແລສຸຂະພາບ, ໃຫ້ເຂົ້າໄປທີ່ ເວັບໄຊທ໌ການສໍ້ໂກງ, ການເສຍ ແລະ ການລ່ວງລະເມີດ.
ລາຍງານທາງອອນລາຍ
https://hcpf.colorado.gov/how-report-suspected-fraud