Adult Brain Injury Program Provider Manual

The Treatment Plan and Monthly Progress Report form provided by the ABI Program shall be used with the exception of Consultation Visit and Neuropsychological Evaluation and Consultation services.

Treatment Plan

A treatment plan must be submitted by the provider for each participant and service they provide for the ABI Program. The treatment plan shall be developed with the input of the participant’s planning and treatment team, which includes the ABI Service Coordinator. The ABI Service Coordinator serves as the central point of knowledge about the participant’s functioning and needs, and shall assure that the provider’s treatment plan matches the needs of the participant at the time of service.

A treatment plan that coincides with the dates of authorized services must be submitted to the ABI Service Coordinator upon the submission of a prior authorization for the services. When a new participant is referred for services, the provider has 30 days from the first date of services authorized to complete and submit the treatment plan. Subsequent treatment plans must be submitted along with the request for authorization for continued services. The ABI Service Coordinator may deny authorization of services if an acceptable treatment plan is not received from the provider.

Treatment plans are due to the ABI Service Coordinator by the 10th of the month, prior to the authorized service period. When the 10th falls on a weekend, treatment plans are due by close of business on the Friday before the 10th. The following is a schedule of treatment plan and prior authorization due dates for participants in continuous services:

The treatment plan shall be provided using the Treatment Plan provided by the ABI Program. The following are minimum elements contained in the treatment plan:

• Participant identification (name, DCN, etc.)
• Provider identification (name of provider agency, direct care worker contact information, etc.)
• Service dates (covers the time period of the authorization request)
• Identification of overall participant goals (independent living, community participation, and/or vocational/educational)
• Identification of specific participant goals to be worked on during the service dates requested (what are the barriers keeping the participant from independent living, community participation, and/or vocational/educational goals)
• Identification of specific activities/strategies/techniques planned for the service date period
• Identification of any anticipated obstacles/barriers in achieving the participant goals and strategies planned to overcome them
• Target date for expected completion of specific goals (expected duration of service to meet goals)

Monthly Progress Reports

A progress report (after each month of service provided) must be submitted to the ABI Service Coordinator by the 10th of the month following the month the services were received. When the 10th falls on a weekend, the monthly progress reports are due by close of business on the Friday before the 10th. The following is a schedule of progress report due dates:

The progress report is an update on the participant that communicates timely and relevant issues to the ABI Service Coordinator. The ABI Service Coordinator’s knowledge of these issues is key to enabling the ABI Service Coordinator to assist in the comprehensive service coordination needs of the participant. Significant changes in participant’s status or identification or concerns for the participant should be reported immediately to the ABI Service Coordinator without waiting for the submission of a progress report.

The following are minimum elements of the progress report:

• Participant identification (name, DCN, etc.)
• Provider identification (name of provider agency, direct care worker contact information, etc.)
• Reporting Month of Service
• Utilization of Services Authorized (Units Authorized, Units Delivered)
• Specific activities and strategies worked on during the month
• Overall progress toward participant goals and any goals completed during the month
• Any barriers (anticipated or unexpected) experienced
• Any linkages to other community resources or agencies
• Any changes in participant’s status and/or natural supports (e.g., change in address, illness of participant/family member, etc.)
• Any concerns of the provider relevant to the participant (participant attitude, participation, attendance, etc.)

The above requirements for monthly progress reports apply for Adjustment Counseling, Transitional Home and Community Support Training, Pre-Vocational/Pre-Employment Training, Special Instruction, and Supported Employment/Follow Along services provided.

A clinical evaluation report of a neuropsychological examination must be submitted to the ABI Service Coordinator following the examination.

The treatment plan and progress reports must be submitted typewritten or in legible handwriting. If submitted in handwriting that is not legible, the ABI Service Coordinator may request a type-written report. The ABI Service Coordinator may request additional information from the provider if needed to consider continuation of the service.

Participant Treatment Plan/Progress Meeting

In order to facilitate effective services for the participant, the ABI Service Coordinator, provider and participant shall have a team meeting at least once every six (6) months to discuss progress and further treatment plans. This meeting shall be facilitated by the ABI Service Coordinator. A ABI ServiceCoordinator, provider or the participant may request the team to meet more often.