Georgia Association of Homes and Services for Children   

Provider Update - October 21, 2005 - LOC Contract Changes 

To:  All Level of Care Contract Providers 

GAHSC and providers received the proposed Level of Care contract from DHR and DJJ in early October.  Providers had some concerns about these contracts and related these concerns to the Departments and GAHSC.  The Departments agreed to work with providers over these concerns and to address the wording of the contracts within the constraints of department policy, the Kenny A Consent agreement, Federal Medicaid Regulations, the needs of the Departments and most importantly the needs of the children.  Several meetings were held to discuss these concerns.     

From these meetings, the Department has agreed to get back with providers no later than Monday, October 24, with a decision about how to proceed with the contracts.  There are questions that are yet to be decided by the Departments:  (1) Amending the contracts already sent out with language agreed upon with providers; or (2) Scraping the contract and mailing out a new contract with the new language suggested from providers (This may entail extending the old contracts through December 31, 2005). 

The following summarizes the discussion and changes agreed upon in principal from the discussions. 

PARA # 103, C. (Page 2) - DHR agreed to change the work "approval" to "notification" add language that would state "no guarantee on whether services will be purchased or used". 

PARA # 201, A. (Pages 9 -12)  

            A. 2.  The only agreed upon change to this paragraph was to the fourth line, add words after five "official business" days.  (A discussion also took place about adding words that would define when an application is considered complete.  This would define the time the clock should start regarding the process of accepting child for admission). 

       A. 3. Extensive discussion took place on this paragraph.  The Department will add language that includes "clinical" criteria and refers to mutual "discussion" rather than agreement. Additional language will be added that talks about discharges determined "in the best interests of the child" and 72 hour notice being made prior to discharge.  Also, the Department agreed that language should be changed that includes moving a child to a "different" level, rather than just to a lower level.  They also agreed change the language that clearly specifies what a Contractor cannot do regarding "changing a placement" versus "moving" a child. Finally, the Department agreed to include language that would allow a provider to reject a child for parental non-payment. 

A. 5.  The Department agreed to add language that would excluding Respite moves and change "move" to  "a placement change." 

A. 6.  Deleted the words "admission decisions and permit".  New paragraph reads:  To develop and implement a plan for admissions, which includes the use of qualified staff to make admission intakes seven (7) days a week from 7:00 A.M. until 9:00 P.M. daily. 

            A. 12.  Only change, delete the word "exclusive". 

A.      13  The Department agreed to expand the definition of participation by including supervisors or clinicians in meetings and adding language that would provide prior notice of the details of these meetings.  

            A. 23.  Cheryl Dresser is going to specifically address this a paragraph to insure the words are correct and don't commit providers to having specific medical staff on board regarding the dispensing of medications.  The word "administer" if used needs specific clarification. 

            A. 25.  Keep the paragraph as is but add the work "clinical" before appropriate on line 2. 

            A. 27.  Considering deleting this entire paragraph as it is redundant and will be covered by language in PARA # 103, C. (Page 2). 

            A. 32.  A short term work group of Cheryl Dresser and Jeff Lawrence will develop language that will allow the department to give a provider recourse if payment is not made.  Language will be added that specifically references this policy/procedure or as an addendum to the contract.  The State is in the process of setting up a state-wide sliding fee scale to cover this item and make it more equitable.  Language is being developed to make it very clear to parents that if they refuse to honor an agreement to pay, that termination may result.   

PARA # 201, B. 

The state agreed to add some paragraphs to this section on what the Department will do.  This includes language that will provide contractors with all supplemental documentation that impacts permanency.  It will also require the Department to provide contractors with the same type of access information (24-hour, 7 days a week) that that providers are being required to provide.  Finally, they will add language that requires the Department to notify contractors of any meetings regarding the child. 

Provider Instructions:  

Providers are asked to hold off mailing in their contracts until further word from the Departments about how they are going to proceed with these agreed upon changes.  As soon as we hear from the Departments, GAHSC will inform all providers concerning final determinations no later than October 25th.  The Departments assure us that the receiving of signed contracts by November 1st presents no problems.   

Call GAHSC for further information.  404 572 6170   

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