Form 8579, Notification of Service Coordinator (SC) Disagreement

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Documents

Effective Date: 4/2012

Instructions

Updated: 4/2012

Procedure

The Local Authority (LA) service coordinator (SC) reviews the intellectual disability related condition (ID/RC) assessment (Form 8578) and the individual plan of care (IPC) (Form 3608) in the Client Assignment and Registration (CARE) System and enter his:

  • electronic signature,
  • date of review, and
  • agreement or disagreement with information contained in the document.

The SC will enter a disagreement in CARE if he does not agree with:

  • a service component or the number of units of a service component on an individual's IPC, or
  • the level of need (LON) information on the individual's ID/RC assessment.

If a disagreement is entered, the SC must complete Form 8579.

GENERAL INSTRUCTIONS

The SC will complete:

  • his contact information,
  • the individual's name,
  • the individual's CARE ID, and
  • the individual's provider component code.

The SC will note the reason for the disagreement and enter any comments.

The SC must fax the form to HHSC Intellectual and Developmental Disability (IDD) Waivers Program Enrollment/Utilization Review (PE/UR) the same day the review is entered in CARE. The SC must also inform the provider of this action and may use this form as the method of notifying the program provider of their disagreement. Any disagreement with services on an individual's IPC must also be discussed with other members of the service planning team.

The SC should have first discussed any concerns with the program provider representative to attempt to resolve issues before the provider enters the IPC or ID/RC into CARE.

HHSC IDD Waivers PE/UR staff will review the form and determine if a review of LON or IPC is warranted. If a review is determined to be appropriate, PE/UR may contact the SC for additional information.