Level of Care Evaluation/Reevaluation and Plan of Care Development

Level of Care Evaluation/Reevaluation and Plan of Care Development A. Level of care (LOC) evaluations and reevaluations for eligibility must be conducted by one (1) of the five (5) Diagnostic and Evaluation (D&E) Teams housed at the DMH’s five (5) comprehensive regional programs. 1. Re-evaluations are only required if the beneficiary has a significant change in condition. 2. Evaluations and reevaluations must be conducted in an interdisciplinary team format which must include a psychologist and social worker. a) Additional team members, including, but not limited to, physical therapists and dieticians, may be utilized dependent upon the needs of the individual being evaluated or reevaluated. b) All members of the D&E Teams must be licensed and/or certified through the appropriate State licensing/certification body for their respective disciplines. B. An initial Person-Centered Plan of Care must be facilitated by the Case Manager and be reviewed at least every twelve (12) months and when there is a significant change in the beneficiary’s circumstances that may affect his/her level of functioning and needs. The Case Manager must: 1. Have a minimum of a Bachelor’s degree in a mental health/IDD related field and be credentialed by the MS Department of Mental Health or be a Qualified Mental Retardation Professional (QMRP)/Qualified Developmental Disabilities Professional (QDDP). 2. Complete training in Person-Centered planning and demonstrate competencies associated with that process. 3. Seek active involvement from beneficiaries and their families and/or legal guardians to develop and implement a plan of care that is person-centered and addresses the outcomes desired by the beneficiaries. 4. Educate beneficiaries and their families and/or legal guardians about the person-centered planning process. 5. Assist beneficiaries participating in 1915(i) and/or their family members and legal representatives to determine who is included in their planning process. 6. Encourage the inclusion of formal and informal providers of support to the beneficiaries in the development of a person-centered plan.