Completes needs assessment, advocacy, arranging for services from local resources, and coordination of services so a participant can realize his/her identified goals for living independently in the community
Performs level of care reevaluations annually, or more frequently, if needed
Maintains current documentation of the participant’s eligibility for waiver services, copies of the participant’s service plan and, financial data and related information
Provides information and assistance to participants regarding self-direction
Informs participants of rights, responsibilities and liabilities when choosing a service model
Monitors the health and welfare of the participant and the quality of services provided to the participant through personal visits at a minimum of twice per year, telephone calls at least quarterly or as defined in the service plan. Monitoring can be more frequent, but not less than specified
Provides notice of amount and frequency of waiver/program services
Works with the participant to develop a comprehensive service plan – including risk identification – that meets their needs, preferences and goals
Reviews the service plan at least once a year or more frequently, if needed, as applicable to service provisions and the participant’s assessed need
Ensures that services are provided as identified in the participant’s approved service plan and delivered appropriately to meet the participant’s needs.
Informs participants that their right to appeal is a separate process from calling the toll free hotline
Informs participant that the state does not permit and prohibits the use of restraints or seclusion. Reviews the process for reporting the use of Restraints and Restrictive Interventions which includes reporting it to the Service Coordinator.
Is responsible for notifying waiver/program participants that an RN is available should the participant wish to have a nurse included in the assessment process. The RN is required to review and sign the standardized needs assessment for individuals who are ventilator dependent, technology dependent, require wound care, are non-compliant with medications, non‐compliant with self-care or if the participant requests to have an RN involved with the assessment of needs. All service plan meetings and discussions with the participant are documented by the coordinator in the service notes.
141 Broadway, Suite 310 Hanover, PA 17331 717-698-3862
439 Ramsey Ave. , Section C Chambersburg, PA 17201 717-446-0045