Provider Bulletin | July 2010

Welcome to the July edition of the Provider Bulletin. In this edition you will find useful information about the newly passed Clean Indoor Air Act, submitting your Evidence of Insurance Declaration, and upcoming training classes on submitting claims.

WI Clean Indoor Air Act and Assisted Living Facilities

If you’ve been paying attention to recent news stories or visited a restaurant in the past week, you may have noticed a new law prohibiting smoking in common and public areas. This new law does not limit itself solely to restaurants and bars. If you operate a Licensed Adult Family Home, Community Based Residential Facility, or a Residential Care Apartment Complex, this law applies to you.

This new law does permit the facility’s administrator to grant an exception that allows a resident to smoke in a room used only by that person or for two or more residents to smoke in the room in which they reside provided that every person who lives in the room smokes and each occupant has submitted a written request to the person in charge to be placed in a room that allows smoking.

What if I already have a policy on smoking in designated areas?
According to the new Wisconsin Clean Air Act guidelines, you will need to revise your policy based on the information outlined in the new Act. Designated smoking areas are not allowed within the facility. There are specific rules for creating an outdoor smoking area:

• The area must be provided with an adequate number of ash trays made of non-combustible material.
• Oxygen tanks should not be allowed in the area.
• If the area is designated for protection from the weather, the area may not meet the definition of an “enclosed space”. If the area meets the definition of an enclosed space, smoking would be prohibited within that area.

Wis. Stat. § 101.123(2m) specifies that no person in charge may allow any person to smoke in violation of the Wisconsin Clean Indoor Air Act.

Your residents need to be given notice of any changes in your policy. It is important to know that current residents are NOT grandfathered for smoking inside the facility.

For additional information regarding the Wisconsin Clear Indoor Air Act and its impact on your facility, visit http://dhs.wisconsin.gov/rl_dsl/Publications/10-016.htm.

New Adult Family Home Certification Contact Info

Community Care is responsible for completing all aspects of the certification process for 1-2 bed Adult Family Homes. A phone number and email address has been established for you to inquire about AFH certification:
414-902-2482, AFH.Certification@communitycareinc.org

DME/DMS Bench

All DME/DMS providers must submit a current MSRP along with their quote to the IDT team for all miscellaneous items prior to authorization issuance.

For questions regarding this requirement, contact: Tracy.Thompson@communitycareinc.org

Complete Your Residential Summary

We recently sent you an assessment to help us identify the level of care you are able to provide at each of your facilities. Complete the Residential Summary and return it by email to ContractInquiries@communitycareinc.org, fax to 262-446-6707 or mail to:

Community Care, Provider Management, 1801 Dolphin Dr., Waukesha, WI 53186

Need another form? Download one at www.communitycareinc.org/ForProviders.

If you have any questions, call the Provider Hotline at 866-937-2783.

Provider Claims Education Training Schedule

Community Care conducts claims education training to providers on a monthly basis. You are welcome to attend any of the sessions listed below. Current and new non-medical providers are welcome.

Waukesha County Site
When: July 15, 2010
Time: 1:00 to 3:00 p.m.
Where: Community Care, 1801 Dolphin Drive, Waukesha, WI 53186

Milwaukee County Site
When: July 23, 2010
Time: 9:00 - 11:00 a.m. or 1:00 - 3:00 p.m.
Where: Community Care, 3220 W. Vliet St., Milwaukee, WI 53208

Additional training sessions will be provided in other counties on future dates. If you have any questions, or would like to sign up for a session, email provider.education@communitycareinc.org.

Evidence of Insurance Declaration

Community Care Network Providers are required to provide Evidence of Insurance Declaration to Community Care at 12-month intervals for all contracted entities. Copies of the following are mandatory:

• General Liability
• Professional or Umbrella Liability
• Worker’s Compensation & Employers Liability Insurance (if three or more employees)
• Vehicle Liability Insurance

If you haven’t already submitted this information for 2010 please do so now. You may submit to:
Community Care, Inc.
Attn: Phyllis Salley
1555 S. Layton Blvd.
Milwaukee, WI 53215

or FAX: 414-383-9346 | EMAIL at Phyllis.Salley@communitycareinc.org

Behavior Support Plans

A “Behavior Support Plan” (BSP) is a plan that assists a member in building positive behaviors to replace or reduce challenging behaviors.

Behavior Support Plans (BSP) are indicated when “problematic behaviors” are present, and may include self-injury, aggression, loss of educational experiences, loss of life opportunities, and diminished quality of social interactions. Problematic behaviors put at risk the health, safety, or welfare of the member or others and/or jeopardize the member’s ability to reside in the community. A theory of what causes the behavior is required to formulate a Behavior Support Plan. Medical and environmental factors must first be ruled out.

A Behavior Support Plan consists of five components: 1) a description of a behavior; 2) situations in which the behavior is likely to occur; 3) signs/signals that the behavior may occur; 4) how staff and others can encourage and support more appropriate behavior; and 5) how staff should respond to the behavior. Behavior Intervention Plans, as part of the Support Plan are required when restrictive measures are employed. A Behavior Support Plan, if effective, may forestall or eliminate the need for a Behavior Intervention Plan. Data about a behavior must be collected both before and after a Behavior Support Plan
is implemented. A Behavior Support Plan should only change one thing at a time.

We developed tips for Behavior Support Plans that are available at www.communitycareinc.org/ForProviders/behavioral.htm

Are You Planning An Open House?

If you are having an open house, we want to hear about it! Email your open house information to Residential Vacancies@communitycareinc.org and include:
• County location
• Facility name
• Size of facility (Number of beds and indicate AFH, CBRF, RCAC)
• Address
• Date
• Time
• Contact name & telephone number
• Brief description of your home

Once we receive the information, we will notify the care teams of your open house. For any questions, email ResidentialVacancies@communitycareinc.org.