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Provider Update: April 8, 2015

Update to State Plan Personal Care Forms

Updated versions of the following forms have been finalized with copies attached to this bulletin for you to start using now. The forms will be available on the website in the upcoming weeks:

  • Personal Care Provider Communication (02AG032E)
  • Personal Care Plan (02AG029E)

The layout of the Personal Care Plan (02AG029E) has changed; the form contains the same information as the template currently being used except that time is now  entered in Units instead of minutes. This change was necessary to provide consistency with other forms. Also, you will see 'Not Applicable' boxes that, when checked, collapse that specific section. This allows tasks that are not included on the member's care plan to be excluded.

All updated form versions are designed to be completed on a computer, have built-in functionality to expand fields as needed, and to auto-populate required demographic information to all pages. The forms may also be used manually, however fields may need to be enlarged before printing to accommodate hand-written notes.  

Please begin using the new forms now. Additional electronic copies are available upon request until placement on the website. Effective July 1, the previous version of the forms will no longer be accepted.

Thank you.

If you have any questions regarding the information provided above, please feel free to contact us via Smarter Mail at:

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