M&Y Care Autism Behavioral Health Services Proposal

Subject: Healthcare Financing
Pages: 10
Words: 3308
Reading time:
10 min
Study level: PhD

Organizational Overview, Service Charter, Objectives, and Mission

Organizational Overview

M&Y Care, LLC is a home health care agency, specializing in Medicaid community-based services and Medicare certified home health care. Founded in 1999, M&Y Care, with its corporate headquarters in West Bloomfield, Michigan for the past 16 years, now has (6) offices located in Michigan and Ohio. M&Y Care provides compassionate care to nearly 3000 clients and employs a similar number of thoroughly screened and qualified care-giving staff, making M&Y Care one of the largest providers of home health care in the Michigan region. M&Y Care has unique programs specifically catering to the Jewish, Arabic, Russian, Armenian, and Ukrainian communities and is contracted with a wide array of payer sources. M&Y Care is currently contracted with multiple Mental Health authorities and providing services to 100 consumers. However, the organization currently is not providing any ABA Therapy services. In order to be a more dynamic therapy center, M&Y has formed a new business Laugh & Learn Therapy, LLC located at 5400 Gateway Centre Drive, Suite E, Flint, MI 48507. The new center is expected to be operational by October 31, 2018.

Service Charter

M&Y Care, LLC main service charter is to offer clinic-based and home-based care therapy to children and teenagers above 10 years and below 21 years. The following are the primary services offered by the organization;

  • Registered Nursing, Physical Therapy, Occupational Therapy, Social Worker, Home Health Aide
  • Personal Care, Homemaking
  • Community Living Support/ In Home Respite

Objectives

The objectives of M&Y Care, LLC:

  • To develop and continuously improve services at the center.
  • To implement modern, friendly and effective treatment to clients.
  • Improve the service charter to meet the demand and needs of all stakeholders.
  • Continuously review the service charter for relevant and effectiveness for optimal service delivery outcome.
  • Review client feedback from environmental, treatment and cultural perspectives.

Service Description

REP Service Description for Autism Behavioral Health Treatment Services

M&Y Care, LLC offers a myriad of services for Autism Behavioral Health Treatment such as diagnosis, standardized and behavioral assessments, direct one-to-one therapy, school shadowing, behavior management services, medical procedure facilitation services, speech and language services, social skills groups, training for parents, practitioners and schools, relationship development and sibling programs. The organization also offers workshop services on a need basis, especially to the non-profit community-based projects dealing with home-based care.

These programs are aligned to quality and consistency for optimal results within a short timeline. As a home care provider, M&Y Care provides services for a wide range of disabilities and handicaps to individuals from different cultures and diverse groups, each with their own unique requirements. The services are tailored into therapy options that respond to specific needs of clients. Each customer is motivated by the service charter to be part of the comprehensive and individualized program. The new center proposed will integrate an innovative outpatient rehabilitation service charter offering sensory integration therapy, speech/language therapy, music therapy, physical therapy, hypnotherapy and therapeutic yoga.

BHTS-ABA (Service Model Delivery)

M&Y Care, LLC has an individualized service model delivery that is pivoted on helping clients, irrespective of economic class, religious affiliation or race. The service charter is focused on going the extra mile to create a conducive therapy environment that is sensitive to the needs of each client. Each customer is treated as a unique client who should be respected and understood for the therapy outcome to the optimal. Specifically, the center is compassionate in balancing the short- and long-term perspectives in autism treatment angled on evidence-based diagnosis, treatment and assessment tools. The center strives to establish a connection in the spirit, body and mind between practitioners and clients at any time during therapy.

Staffing

Organization Credential Staff

Lorretta Robinson M.A., BCBA: Lorretta is a Behavior Consultant with over ten years experience, especially in provision of autism therapy to client ranging in ages from 3 years old to 20. Loretta understands the various levels of development and how to deal with clients struggling with functional communication. She has successfully provided therapy to clients engaging in high rates of challenging behaviors including aggression, property destruction and self-injurious behaviors. Other areas of experience are speech, sensory and general treatment. Lorretta passed her board exam in November 2017 and has progressed to positive behavior supports where her clients range from 8-18 years. Lorretta takes pleasure to work with these clients and their families to help them be able to function in a socially acceptable manor so they can reach the highest levels of independence possible.

Dmitry Turbovsky: For almost ten (16) years, Dmitry has served as chief administrator for M&Y Care. His responsibilities include identifying and implementing the overall organizational structure, as well as planning, organizing, and directing the Facility’s ongoing operations. Key to the success of M&Y Care, is his ability to select, hire, and develop qualified and culturally sensitive staff, which has built the firm’s solid reputation. Dmitry oversees all compliance and interactions with federal and state regulatory agencies responsible for governing home healthcare services. On the business development side, he ensures the company has solid mutually beneficial relationships with all third-party stakeholders, vendors, and the local business community.

Greg Babayan: For almost 10 years, Greg provides daily administrative oversight to supervise in accordance with scope of practice guidelines. Reviews employee and patients charts for accuracy, completeness and quality to ensure compliance with state and federal mandates. Provides feedback, recommendations and suggestions to staff on special, complicated or problem cases. Greg assures that staff members are informed of new developments and changes within the organization. He works in collaboration with Dmitry to conduct meeting and training with staff to review and implement policies and procedures, discuss quality of care, and level of services provided. Greg attends trainings and workshops as required for professional development and per compliance of regulatory bodies. Ensure by supervision that all staff is providing services daily as required. Provides training to new staff in order to provide guidance and explain expectations of program, instruct staff on work assignments, evaluate staff performance, and manage staff schedules.

Staffing and Meeting the Needs of Children over 10 and Under 21 Years

The center has more than 100 personnel who are competent and has long experience in provision of autism therapy to clients over 10 years and under 21 years. Under the leadership of the experienced Lorretta Robinson, the center has the capacity to meet the needs of clients between the age bracket of 10-21 years. Moreover, the inputs of Dmitry Turbovsky and Greg Babayan ensure that the staff members are continuously trained and assessed for competency.

Crisis Response Preparedness

M&Y Care, LLC has a state of art ultra modern training facility that equips personnel with the relevant training needs on risk assessment and response in a timely manner. The center has adequate resources to monitor and manage situations to avert possibility of a crisis.

Hours of Operations/Team Availability

M&Y Care, LLC is flexible to offer 24 hour services on a need basis. However, the official operating hours are from 8.00 am to 5.00 pm on weekdays and 10.00 am to 3.00 pm on weekends. Depending on medical necessity, the center can make arrangements to provide care beyond these hours through its 10 personnel standby team. At any given time, the service authorization is simplified and commences upon approval by the administration supervisor.

Capacity to Provide Appointments within 14-Days of Referral

M&Y Care, LLC has a modern center equipped with necessary resources to offer initial BHT-ABA service appointment to a child/family within 14 days of GHS referral data. The more than 100 dedicated staff and additional contracted practitioners ensure that appointments are honored within a maximum of two weeks.

Management and Internal Control

Strategy for Collaboration among Stakeholders

M&Y Care, LLC has an administrative department tasked with connecting the stakeholders and following up on any communication with schools, teachers, providers, program agencies, administrators and other resources that are tailored to benefit autism clients within the age bracket of 10 and 21 years.

Supervision Model and Practices

M&Y Care, LLC center has a comprehensive management team tasked with the responsibility of monitoring all activities and delegating duties at a departmental level. Each department has a supervisor who is the link to management and all activities must be verified and approved at each management level to ensure that the needs of clients are addressed in a timely manner with compassion and understanding.

Staff Hiring, Training, Development and Supervision

Personnel are hired on a competitive manner with focus on experience in provision of therapy to clients within the age bracket of 10 to 21 years. The personnel are subjected to continuous training every three weeks in addition to daily assessment on therapy progress. The training model is designed to accommodate the cultural, professional and environment needs of personnel and clients.

Policy and Procedural Alignments to the Management Strategy

M&Y Care, LLC policy framework is aligned to health safety standards stipulated in the Accreditation Commission for Health Care (ACHC). Management of the center functions on consistency, relevancy, and competency frameworks for optimal outcome. The management plans are reviewed semi-annually and adjustments made whenever appropriate.

Service Delivery System and Consumer Care Management

Current Excess Capacity to Provide Clinical-Based and Home-Based Care outside Business Hours

M&Y Care, LLC has 100 full time personnel and more than 50 contracted part-time employees. Each practitioner has the capacity to handle at least ten clients in a day. Out of the 100 full time employees, ten are always on standby to provide services beyond 5.00 pm. Thus, M&Y Care, LLC has at least 10 dedicated practitioners willing to provide clinical-based and home-based care outside the business hours.

Provision of Observation/Supervision with Home-Based Care outside Business Hours

Within the standby team of ten practitioners, there is a supervisor who has an access to the necessary resources to provide therapy in home-based care beyond the working hours. However, a waiting period of two hours must be given to assemble relevant personnel after the official business hours.

Evidence of Prior and Proven Experience, Population Served and Treatment Methods

M&Y Care, LLC has more than ten year experience in providing therapy to children with autism in Michigan and Ohio. The center has served clients of African America, Jews, Latino, and Caucasian descents. The center has worked in collaboration with other organizations such as Medicare, Medicaid, Medicaid Waiver (Area Agency on Aging 1B, Oakland, Macomb, Washtenaw, Area Agency on Aging 1C, Wayne County, MI, Tri-County Office on Aging, Lansing, MI, Detroit Area Agency on Aging 1A, Detroit, MI, and Reliance Community Care Partners, Grand Rapids), department of human services– home help program, mental health authorities (Macomb County Community Mental Health, Oakland Community Living Services, and Lansing Community Mental Health). At present, M&Y Care, LLC is serving more than 100 clients under the age of 21 years and above 10 in CLS and respite services.

The center has practitioners specializing in neurology, gastroenterology, pain management, psychiatry, allergy and immunology and psychopharmacology. The treatment methods are speech/language therapy, sensory integration therapy, physical therapy, hypnotherapy, music therapy, and therapeutic yoga.

Implementation of Person Centered Planning and On-Going Commitment to PCP

The center has a continuous 360-degree performance tracking feedback system than monitors and assesses progress every two months from which adjustments are made. The feedback is subjected to a management review and current policies are adjusted based on the majority vote. In the event of extreme poor result, new behavioral support plan is put in place.

Procedures Relating to Recipient Rights Process and Compliance

Procedures relating to M&Y Care, LLC’s recipient rights process, staff training, and compliance are compliant to the Michigan Mental Health Code. The center also has internal regulations monitoring compliance to compassion, respect, and understanding in the process of providing therapy.

Consumer Involvement with Operations

Direct consumer involvement with operation includes support during therapy by parents, teacher or other relevant stakeholders. These customers ensure consistency in attending therapy session since most of the targeted clients are disabled. The indirect involvement involves stakeholders attending training sessions on how to care for the clients beyond the clinic-based or home-based sessions.

Process of Maintaining Consumer’s Health

M&Y Care, LLC has a comprehensive plan for maintaining complete health of the clients. Apart from the direct treatment therapies, the center has entertainment, sporting, music, and dietary services to clients. These services are customized to meet the needs of each client.

Physical Location of Offices and Accommodation of Physical Handicaps

M&Y Care, LLC is located at 7125 Orchard Lake Rd., Suite# 210, West Bloomfield, MI 48322. The center’s contact is fax: 248-757-2412 and phone: 248-757-2410. The center is made friendly to the physical handicaps by ensuring that all buildings comply to the Americans with Disability Act. For instance, there are slopping ramps, lifts, wider corridors, friendly bathrooms, and standby assistants at any given time.

Capacity to Complete the Developmental Work Necessary

M&Y Care, LLC has a strong capital base of over $50 million dollars, extensive networks, and competent personnel that will ensure that the new center will be running by the end of October, 2018. As at now, all the physical and technical support requirements are in place awaiting necessary tests and approvals. All systems are already in place to meet program components such as hiring, staffing, credentialing and training personnel.

Internal Policies and Procedures

Personnel Policies and Procedures

The personnel policies and procedures specific to ABA service provider credentialing, licensing and staff competency, training, orientation, recruitment and selection, performance evaluation monitoring safety, managing clinic risks, termination and follow up, corporate compliance program and plan, documentation guidelines, and health and safety are attached in appendices 1 to 11 (kindly attach these).

Organization’s Procedure for Promoting Safety within Clinic-Based Care Environment

  • M&Y Care, LLC has an up-to-date policy on health and safety.
  • The content of the policy is made available to all stakeholders.
  • M&Y Care, LLC has a clear reporting, investigation and resolution procedures.
  • M&Y Care, LLC provide appropriate workstation equipment.
  • M&Y Care, LLC has an effective work standard that must be adhered to by all employees.
  • The center periodically carries a comprehensive risk assessment and management.
  • The plan spells out emergency actions (see figure 1).
Personnel policies and procedures at M&Y Care, LLC
Figure 1: Personnel policies and procedures at M&Y Care, LLC

(Source: Self-generated)

Organization’s Procedure for Promoting Safety within Home-Based Care Environment

The procedure for promoting safety within home-based care environment will involve training the parent or guardian on the same procedure with special attention given to safekeeping of objects and making the home friendly to the client to avoid injuries.

Organization’s Accessibility, Cultural Competency and Diversity Planning

M&Y Care, LLC is a multifaceted organization with a unique organizational culture angled on promoting diversity, integrating gender balance, and improving service accessibility. The center has made it a policy to hire personnel that is reflective of the cultural, racial, and religion affiliation within the service area. The center has hearing, speech and sensory aids in addition to walkers, braces, and wheelchair to serve clients with communication and mobility impairments.

Administrative Capability and Information Systems

M&Y Care, LLC has a comprehensive database that can keep and automatically update customer records once the treatment has commenced. The structure has capacity to bill insurance that is compatible to the Genesee Health System. The system is programmed to electronically capture data and collect ability to pay and excess assets amounts. Also, the system is capable of submitting Medicaid spend-down statements and bill primary insurance carriers.

Performance Improvement

M&Y Care, LLC organization plans to monitor, track and report quality assessments, performance, and quality improvement through an integrated quality management system with a functional 360-degree feedback. This system can track and record performance against set goals besides given periodic alerts based on its programming module. M&Y Care, LLC plans to comply with MSA Bulletin Number MSA 15-59 through integration of consistency, dependability, speed, and cost in the quality matrix. The center will strive to manage these components to ensure that any unit of input generates optimal output at the least possible costs to make the center sustainable in the short and long-term.

Documentation

(Insert list of organizations, contact names, and phone numbers of organizations your company has provided services).