Direct Service Provider: Recovery Manager
★ Have at least 2 years of experience working with people with severe mental illness;
★ Have a master’s degree in human services or related field;
★ Demonstrate knowledge of issues affecting people with severe mental illness and community-based interventions/resources for this population; and
★ Complete DSHS-required training in the HCBS-AMH program.
Service Description: Services assisting individuals in gaining access to needed Medicaid State Plan and HCBS-AMH services, as well as medical, social, educational, and other resources, regardless of funding source.
Recovery Management includes services assisting beneficiaries in gaining access to needed Medicaid State Plan and HCBS-AMH services, as well as medical, social, educational, and other resources, regardless of funding source.
A recovery management reimbursable contact is:
• Provided by an authorized recovery manager;
• Face-to-face and telephone contact with the individual and/or IDT; and
• Coordination of services to assist the individual in gaining access to needed services
The following activities are billable to HCBS-AMH Recovery Management:
1. Development of IRP using a person-centered recovery planning approach;
2. Monitoring the provision of services included in the IRP to ensure that the individual’s needs, preferences, health, and welfare are promoted;
3. Assisting the individual identify and select service providers;
4. Facilitation of resolution, created with the individual, to resolve issues that impede access to needed services;
5. Assisting the individual identify and develop natural supports (family, friends, and other community members) and resources to promote the individual’s recovery;
6. Assisting the individual with fair hearing requests upon request and when needed;
7. Assisting the individual with retaining HCBS and Medicaid eligibility;
8. Educating and Informing the individual about services, the individual recovery planning process, recovery resources, rights, and responsibilities;
9. Monitoring health, welfare, and safety through regular contacts;
10. Responding to and assessing emergency situations/incidents and making referrals;
11. Monitoring the individual’s IRP, including progress towards goal. Caseload sizes for the individual RM shall preferably be 10 or less and shall be no more than 15 individuals and should account for individuals in other waiver or state plan programs and other funding sources.
Note: This page is intended to provide a brief overview and summary and does not contain all associated program requirements. For complete information, please refer to the Provider Manual and Billing Guidelines.
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