Unsuccessful Outreach

Used to document unsuccessful outreaches to the participant. Coordinators MUST call all other contacts/emergency contact and PAS agency after unsuccessfully reaching the participant in order to document as an Unsuccessful Outreach

Note: This session cannot be submitted if the participant has Inactive Eligibility.

Document the call as “Office Note” or “Other”

• Session Requires:
  • Appropriate answers to all required fields

Process:

1. Service Coordinators are responsible for documenting all attempts to reach a participant, their Providers (PAS/PERS/HDM), their Emergency Contact, and their PCP.
2. Each participant is required to have 2 visits per year and 2 Quarterly contacts, an SC should begin attempts to schedule and complete these visits at least fourteen (14) days prior to the due date.
   1. If an SC is making attempts to schedule and is unable to reach the participant to schedule before the due date then there must be clear documentation that the participant is “Unable to locate” prior to the actual due date.
3. Before a participant can be considered Unable to locate, the following must take place
   1. Three (3) consecutive days of Unsuccessful calls with Unsuccessful sessions documented in Function Portal, all taking place within the same month.

Documentation:

Section 1: Visit Conditions

1. Where did the visit take place? – Better known as “where did the contact take place?
   • Answer should always be Other
     • Then in Other visit location, details and reason, you should put Telephonic and then list the specifics of the call

Example:

2. Where does the participant currently reside? – Coordinator should be confirming the client’s address and type of residence, then choose the appropriate answer.

• If you do not know where the participant currently resides answer “Other”
  • In Other Residential Location put “Unknown due to Unsuccessful Outreach”
• If the answer was “Home (with a caregiver)” then the coordinator needs the following information about the caregiver.
  • Caregiver name
  • Caregiver relationship
  • Does the caregiver live with member?
  • Does the caregiver provide natural support? – meaning does the caregiver provide informal/unpaid support?
  • Is the caregiver paid?– meaning does the caregiver provide formal/paid support?
• If the answer was “Other” then the coordinator needs to state what the

Other residential location is

• If the answer was: “AFCH, ALF, Hospice, or Nursing Home” the the caregiver must state what the Residential location facility name

Section 2: Unsuccessful Contact

1. Who were you trying to contact?- Which primary contact were you calling?
2. Which contact is past due? – Select if there are any past due contacts. Select no past due contact if none exist.
3. Reason for contact – What type of session were you trying to complete? Select the appropriate option.
4. Details of the call: Type in details of the unsuccessful outreach in the text box provided.
5. Reason for Unsuccessful contact: Member Unable to Locate should be the ONLY option selected. PHW uses this as a metric to track unsuccessful outreaches. 
6. Details of the call: Type in details of the unsuccessful outreach in the text box provided.
7. Result of PAS/Emergency Contact outreach: If a client has PAS or an emergency contact, we must outreach to the PAS agency/emergency contact to attempt contact with PTP. Select the appropriate option regarding PAS/EC contact.
8. Contact attempt number – Number of consecutive unsuccessful attempts that have been made. This is done by the system automatically.

UTL/Refusal Process

Refusals and UTL’s AFTER the Annual/NPO due date only:

1. Three (3) call attempts on three (3) different days/times made to participant (back-to-back with no successful calls in between and all attempts in the same month) prior to the visit due date.
2. Call all Providers prior to visit due date
3. Supervisor calls PTP prior to wellness check
   1. If successful, then schedule visit
   2. If unsuccessful, then have SC schedule Wellness check
4. Wellness Check by police prior to pop up visit
   1. If successful, then schedule visit
   2. If unsuccessful, then have SC schedule pop up visit in a Visit Scheduled session in FP
5. Complete POP-UP Visit
6. If the Pop-up visit was unsuccessful, then the AVP notifies the Account Manager that all unsuccessful contacts were completed and documented.
   1. PAHW will send certified letter 30 days from the date of the Pop-up visit
7. At day 30, the Amcord Supervisor will check FP to see if any successful contact has been made since the Pop-up visit and if not, PAHW will mail a UTL letter.
   1. If the Supervisor sees a Successful contact to the participant/POA was made, the Supervisor must email the AVP, so the termination process is stopped.
8. SCE will get a task to complete 1768 after additional 20 days (and approval of OLTL), Supervisor will check FP to see if any successful contact has been made since the Pop-up visit.
   1. If the Supervisor sees a Successful contact to the participant/POA was made, the Supervisor must email the AVP so the termination process is stopped.
9. On the day the 1768 is submitted to the AM only (NOT CAO), the Supervisor uploads the 1768 into Envolve and completes Certified UTC Letter Session (SC is not completing this, supervisor is)

1. What is the frequency of the service(s)
   1. For example, PAS: 20 hours/week or Home Delivered Meals: 2 meals/day or PERS 1 time per month or Nursing Facility 1 time per day

2. If any authorized services are not currently being provided, when was the last date said service was provided?

Pop up Visits

Visit Scheduled

This session is used ONLY to schedule Pop Up Visits.  All other types of visits are scheduled within other sessions.  

Process:

1. Service Coordinator will ensure that participant is BOTH in Unable to locate (UTL) status and has a Annual/NPO visit past due.
   1. UTL status means the participant has 3 consecutive Unsuccessful calls during the same calendar month in which attempt to participant, Providers, and Emergency Contact have all taken place.
   2. Pop ups are not done for participants that are not past their due date for their Annual or NPO visit.
      1. We do not do pop ups for participants that are past due for Quarterlies or Change events.

Documentation:

Section 1: Scheduled Visit

1. Scheduled Visit: ONLY select Pop up Visit and select the date and time the Pop up visit will take place

Comment: Service Coordinator will write a brief description of why the pop up is needed (ie. Pop up visit scheduled for Annual past due or Pop up visit scheduled for NPO past due)

Upon filling out the visit scheduled note for the pop up visit, the following will appear:

Successful Pop Up Visit Documentation

If the pop up was successful, you will select the successful pop up visit document option. The pop up is only successful if you make contact with the participant.

Section 1: Visit Conditions

1. Where did the visit take place?

• Select the appropriate option

2. Where does the participant currently reside?

• Select the appropriate residential status.
• If selecting “Home with a caregiver”, you will need to fill in the following information.
  • Name of caregiver
  • Relationship of caregiver
  • Live with member?
  • Natural support?- This means does the individual provide unpaid support
  • Paid caregiver?

3. Information provided by?

• Select whomever you spoke with during the pop up visit

Section 2: Results

1. What is the purpose of the contact?

• Select the appropriate reason for the type of visit you are conducting the pop up for.

2. Is the contact follow up visit scheduled?

• The contact follow up visit is scheduled.
  • Place visit date and time in the text box provided.
• The contact follow up visit is not scheduled.
  • Select if the PTP does not schedule at the time of the pop up visit or refuses. 

3. Reason for contact

• Select the appropriate reason for the type of visit you are conducting the pop up for.

Unsuccessful Pop Up Visit Documentation

If the pop up was unsuccessful, you will select the unsuccessful pop up visit document option. The pop up is unsuccessful if you are unable to make contact with the participant (PTP does not answer the door, a neighbor or other person answers and tells you the person doesn’t live there, someone else answers and states that the PTP is not home at the time of the pop up visit). 

Section 1: Visit Results

1. Reason for Contact

• Select the appropriate reason for the type of visit you are conducting the pop up for.

2. Reason for Unsuccessful Outreach

• Select the appropriate reason for the unsuccessful outreach.

3. Specify details

• This will automatically populate based on Question 2’s response.

Example: