Rogram Direct Service Worker DSS EPS Friend/Neighbor Guardian Home Health Hospital HSS Law Enforcement OAD OMH OPH Other Parent Physician Provider Support Coordination Agency: Agency Telephone #: Support Coordinator (SC) Name: Supervisor Self Sibling Spouse Support Coordinator Under Curator SC Telephone Direct Service Provider: Issued 09/18/09, Effective 10/01/09; Reissued 05-12-2010 Replaces July 22, 2008 OCDDWSS-PF-08-001 DSP Telephone #: OCDDWSS-PF-09-002 Page 3 of 6 Department o.
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How to fill out the LA DHH ocddwss-pf-09-002 online
Filling out the LA DHH ocddwss-pf-09-002 form is an essential step in reporting critical incidents related to Home and Community Based Services for individuals with developmental disabilities. This guide will provide you with clear instructions on how to complete this form online effectively and accurately.
Follow the steps to complete the form successfully.
- Click ‘Get Form’ button to access the LA DHH ocddwss-pf-09-002 form and open it in the editor.
- Begin by entering the participant identifying information in the designated fields. This includes the participant's first name, middle name (if known), last name, address, city, state, region, date of birth, telephone number, and social security number.
- Provide the name and contact information of the family or legal guardian. It is crucial to also include their relationship to the participant.
- For service type, select the appropriate option from the provided categories such as NOW, CC, SW, ROW, State Funded.
- Indicate the marital status of the participant by selecting from single, married, divorced, separated, or widowed.
- Select the participant's race from the provided options, ensuring to respect the privacy and dignity of the individual.
- Identify the disabilities the participant may have by checking all that apply from the list of conditions.
- Fill in the living situation and legal status of the participant, ensuring you accurately describe their current living arrangements.
- Document the incident information, including the date, time, and location of the incident along with when it was discovered.
- Describe the incident in detail, addressing who was involved, what happened, when and where it took place, and any other relevant information.
- If additional pages are necessary, number, date, and sign each page accordingly.
- Complete the follow-up section by providing any necessary information regarding medical appointments or other follow-up actions taken.
- Once all sections are completed, ensure to review the form for accuracy. Finally, save changes, and you may choose to download, print, or share the form as needed.
Complete the LA DHH ocddwss-pf-09-002 form online today to ensure timely reporting of critical incidents.
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What is the phone number for Medicaid waiver program in Louisiana?
Enrollment Services: 1-855-229-6848 The following benefits are available to all Medicaid eligible children and youth under the age of 21 who have a medical need: Mental Health and Rehabilitation Services. Psychological and Behavioral Services.
What is HCBS waiver in Louisiana?
The Office of Aging and Adult Services (OAAS) administers home and community based long-term care services (HCBS) through various waiver and state plan programs for individuals who are elderly or have disabilities, assisting them to remain in their homes and in the community.
What is the Medicaid waiver program for adults in Louisiana?
Overview of Louisiana Medicaid Community Choices Waiver The Louisiana Community Choices Waiver, abbreviated as CCW or CC Waiver, provides home and community-based services (HCBS) for seniors and adults with disabilities (adult on-set) who are at risk of nursing home admission.
How do I become a waiver provider in Louisiana?
To become a med waiver provider in Louisiana, call (225) 216-6370. The Children's Choice Waiver offers supplemental support to children through age 18 who currently live at home with their families or with a foster family. The New Opportunities Waiver assists people age 3 and older to live in their communities.
What is the residential options waiver in Louisiana?
Residential Options Waiver (ROW) This program provides supports and services in the home and in the community to individuals of all ages, who are eligible to receive OCDD waiver services. It is a capped waiver where each person's individual annual budget is based upon his/her assessed support needs.
How do I apply for a children's choice waiver in Louisiana?
The process works as follows: The family accepts Children's Choice Services. A support coordinator is chosen and development of a Plan of Care (POC) begins. The child is determined eligible for the Children's Choice Waiver; and. The POC is approved.
What is the Louisiana Department of Health OCDD?
OCDD provides monthly stipends to families of eligible children with severe or profound developmental disabilities from birth to age 18 to help their families meet extraordinary costs. These subsidies are offered on a first-come, first-served basis.
What is the now waiver program in Louisiana?
The New Opportunities Waiver (NOW) program provides services in the home and in the community to individuals 3 years of age or older who are eligible to receive OCDD waiver services. The NOW is intended to provide specific activity-focused services rather than continuous custodial care.
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