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AAU Form Update: Changes to Service Plan Cost Sheet and Addendum

May 17, 2011

As mentioned in the AAU Update sent on May 17, 2011 we are in the process of converting all ADvantage forms to meet the OKDHS guidelines for compliance with the Americans with Disabilities Act (ADA).

Mandatory Use of the Service Plan Cost Sheet and Addendum by July 1, 2011:

The Centers for Medicare and Medicaid Services (CMS) have implemented higher quality assurance expectations for all HCBS waivers. One particular expectation is documentation of member choice of services and providers. The philosophy of the ADvantage program has always been focused on member choice and member centered services, however; CMS now expects all states administering HCBS waivers to collect and maintain documentation proving that after determination of assessed needs, members have been given choice in the selection of services and providers of services. The ADvantage waiver renewal effective July 1, 2011 includes new performance measures to address this mandatory expectation from CMS. Consequently, the Service Plan form has been amended to include a section where members must indicate whether or not they have been informed of services that will meet their assessed needs and that they have been given a choice of services and service providers. The AAU has developed a method to maintain data related to the member choice selection on the new form and will begin collecting this information on July 1st in coordination with the start of the waiver renewal.

Other changes to the Service Plan (ADv6e) and Service Plan Addendum (ADv6e1) are as follows:

  • Form Title and Number Changes
    • The Service Plan (Adv6e) is now called the Service Plan Cost Sheet (02CB011E)
    • The Service Plan Addendum ( ADv6e1) is now called the Service Plan Cost Sheet Addendum (02CB012E)
  • Functionality
    • In order to meet ADA standards, the number of service lines on the Service Plan Cost Sheet and the Service Plan Cost Sheet Addendum has been reduced. However, the Word version will expand to include additional pages of service lines.
    • Also due to space, the separate columns for each type of pay source have been removed. Instead, you will need to enter a pay source code for each service type listed on each form
  • Signatures
    Since all cost sheets will be more than one page, the Member will need to initial all pages except the last page. The last page will always contain the signatures of the Member, any witnesses (if applicable), Case Manager, and Case Management Supervisor.

For more information on a specific form, please read the instructions provided on the AAU website. We will be sending you more updates as other forms are developed. If you have any questions or concerns regarding the information provided above, please feel free to contact us via email at Provider Questions.

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