Common use of Voluntary Enrollment Clause in Contracts

Voluntary Enrollment. Enrollment in the IRIS program is a voluntary decision on the part of the applicant who is determined to be eligible. The Department does not guarantee any minimum enrollment level. Individuals must make the choice to enroll in IRIS, over other adult long-term care programs; the choice to enroll is verified by the signature of the participant (or their legal decision maker) on an enrollment form provided by the Department. Service Timeline Expectations‌‌ The Enrollment and Orientation period is intended to take place 1-60 days from the referral date, to include the following required actions and deadlines: Welcome Call 3 business days from referral date IRIS Consultant Selection 3 business days from welcome call IRIS Consultant Auto-assign 4 business days from welcome call Initial Enrollment & Orientation Visit 14 calendar days from referral date ISSP Plan – Completed 30 calendar days from initial visit Implementation of ISSP Plan – Completed and Approved 45 calendar days from initial visit Transition Visit On or before 55 - 60 calendar days from welcome call Transition to participant- selected level of IRIS Consultant involvement On or before 61 calendar days from referral date Date of annual plan submission/approval Prior to current plan year end ICAs are responsible for enrolling participants in the program as well as providing orientation services. Orientation includes an introduction to the participant’s role and responsibility in the IRIS program and development of the Individualized Support and Services Plan (ISSP). Welcome Call & IRIS Consultant Selection The ICA will enter the referral into the Department case management system (WISITS) within one business day. The ICA will contact the individual within three business days after receiving the participant’s referral packet to assist the participant in choosing a consultant. The ICA should obtain information from the participant about special needs or preferences and, in turn, provide the participant with at least three available consultants who are most suited to meet the participant’s specified needs and provide IRIS consultant biographies, in the DHS required format. If the participant prefers to have a consultant chosen on his or her behalf, then the participant is assigned an IRIS consultant during this welcome call based on information provided by the participant to the ICA. If the participant does not identify a preferred consultant within three business days of the welcome call, then on the fourth business day, the ICA will notify the participant of the agency- selected consultant and notify the participant they can change consultants at any time, and for any reason. The ICA will advise the participant of the procedure to change consultants at this time. In addition to IRIS consultant selection, the welcome call will include a brief overview of the immediate next steps and the steps of the enrollment and orientation phase. After the welcome call, the appropriate ICA representative will schedule the initial enrollment and orientation meeting between the IRIS consultant and the participant. Enrollment and Orientation Meeting The enrollment and orientation meeting must be conducted within 14 calendar days from the referral date. The details of the meeting must also be documented in the Department case management system (WISITS) within 2 business days. During this meeting, the consultant shall, at minimum: Provide a review of the annual functional and financial eligibility requirements, and the role of the participant in maintaining their eligibility for Medicaid and IRIS. Provide the participant with the amount of their IRIS individual budget allocation. Provide a printed copy of the IRIS Participant Handbook (P-01008) to the participant. Discuss the required ICA service levels, including the reasons for and the process by which DHS may require an increase in ICA services, such as with a vulnerable high-risk designation. Provide information related to the ISSP, including allowable goods and services, planning tools, and available community resources. Ensure the participant understands that they must be available to speak with and/or meet with their IRIS consultant. Discuss the benefits, responsibilities, and alternatives to serving as the employer of record (e.g. hiring a vendor). Review the IRIS consultant’s contact information, contact information for the participant’s chosen ICA and FEA, and contact information for the IRIS Call Center. This information should be documented in front of the Participant Education Manual, and updated throughout the year, as needed when there are changes in consultant or Contractor. The contact information for the IRIS Call Center shall be pointed out in the IRIS Participant Handbook.

Voluntary Enrollment. Enrollment in the IRIS program is a voluntary decision on the part of the applicant who is determined to be eligible. The Department does not guarantee any minimum enrollment level. Individuals must make the choice to enroll in IRIS, over other adult long-term care programs; the choice to enroll is verified by the signature of the participant (or their legal decision maker) on an enrollment form provided by the Department. Service Timeline Expectations‌‌ The Enrollment and Orientation period is intended to take place 1-60 90 days from the referral date, to include the following required actions and deadlines: Welcome Call 3 business days from referral date IRIS Consultant Selection 3 business days from welcome call IRIS Consultant Auto-assign 4 business days from welcome call Initial Enrollment & Orientation Visit 14 calendar days from referral date ISSP Plan – Completed 30 calendar days from initial visit Implementation of ISSP Plan – Completed and Approved 45 calendar days from initial visit Transition Visit On or before 55 85 - 60 90 calendar days from welcome call Transition to participant- selected level of IRIS Consultant involvement On or before 61 91 calendar days from referral date Date of annual plan submission/approval Prior to current plan year end ICAs are responsible for enrolling participants in the program as well as providing orientation services. Orientation includes an introduction to the participant’s role and responsibility in the IRIS program and development of the Individualized Support and Services Plan (ISSP). Welcome Call & IRIS Consultant Selection The ICA will enter the referral into the Department case management system (WISITS) within one business day. The ICA will contact the individual within three business days after receiving the participant’s referral packet to assist the participant in choosing a consultant. The ICA should obtain information from the participant about special needs or preferences and, in turn, provide the participant with at least three available consultants who are most suited to meet the participant’s specified needs and provide IRIS consultant biographies, in the DHS required format. If the participant prefers to have a consultant chosen on his or her behalf, then the participant is assigned an IRIS consultant during this welcome call based on information provided by the participant to the ICA. If the participant does not identify a preferred consultant within three business days of the welcome call, then on the fourth business day, the ICA will notify the participant of the agency- selected consultant and notify the participant they can change consultants at any time, and for any reason. The ICA will advise the participant of the procedure to change consultants at this time. In addition to IRIS consultant selection, the welcome call will include a brief overview of the immediate next steps and the steps of the enrollment and orientation phase. After the welcome call, the appropriate ICA representative will schedule the initial enrollment and orientation meeting between the IRIS consultant and the participant. Enrollment and Orientation Meeting The enrollment and orientation meeting must be conducted within 14 calendar days from the referral date. The details of the meeting must also be documented in the Department case management system (WISITS) within 2 business days. During this meeting, the consultant shall, at minimum: Provide a review of the annual functional and financial eligibility requirements, and the role of the participant in maintaining their eligibility for Medicaid and IRIS. Provide the participant with the amount of their IRIS individual budget allocation. Provide a printed copy of the IRIS Participant Handbook (P-01008) to the participant. Discuss the required ICA service levels, including the reasons for and the process by which DHS may require an increase in ICA services, such as with a vulnerable high-risk designation. Provide information related to the ISSP, including allowable goods and services, planning tools, and available community resources. Ensure the participant understands that they must be available to speak with and/or meet with their IRIS consultant. Discuss the benefits, responsibilities, and alternatives to serving as the employer of record (e.g. hiring a vendor). Review the IRIS consultant’s contact information, contact information for the participant’s chosen ICA and FEA, and contact information for the IRIS Call Center. This information should be documented in front of the Participant Education Manual, and updated throughout the year, as needed when there are changes in consultant or Contractor. The contact information for the IRIS Call Center shall be pointed out in the IRIS Participant Handbook.