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1 Pre-Service Manual For Case Managers and Service Coordinators Part Two: On-Site Skills Assessment NM DOH/DDSD On-Site Skills Assessment Revised July 25, 2013

2 Instructions This PSM On-Site Skills Assessment is Part Two of the assessment that is required to complete Pre-Service Manual for Case Managers and Service Coordinators. If you haven t already completed Part One, you can access the on-line modules and Part One Assessment on-line at: A Case Manager or Service Coordinator cannot be entered into the Training Database as having Completed this assessment (Part Two) without first having successfully completed Part One. After passing the on-line competency assessment at the end of Part One, you must print out the certificate of completion and make sure your agency has a copy for their files. You must also show the certificate to the person who will be certifying that you have completed this part of the assessment. When you have successfully completed Part One, bring a printed version of this document and your Part One Certificate of Completion to your Agency Trainer or Training Coordinator. If your agency does not have a trainer certified to train Part Two, please contact your DDSD Regional Coordinator. Please note that some questions have required attachments, and some questions are verified skills demonstrations (to be verified by a manager/supervisor). If you have questions regarding the content of this Assessment that can t be answered by someone at your agency, please contact your DDSD Regional Coordinator. A oriented copy of the Part Two 2 Assessment should be kept in the participant s personnel file at the agency. To obtain a transcript or a certificate of completion, please see your agency s Training Coordinator, or contact the DDSD Database. A Note to Training Coordinators: Upon participant s completion of the Part Two Assessment, please enter the Part Two assessment completion into the DDSD Training Database as you would with any other course. For questions on how to enter this training, please contact the DDSD Database Coordinator: James Johnson (505) ltsddatabase@salud.unm.edu 1

3 PSM On-Site Skills Assessment 1. Explain the Code of Ethics for Case Manager Conduct. 2. Explain the rights (human, civil and legal) that people with disabilities have to a person and/or family member/guardian. 3. Given a completed individual assessment of a person served by your agency (provided by your supervisor), identify two appropriate natural supports and describe how to go about linking the individual to those supports. 4. Identify where to look for current information about DDW standards and rates. 2

4 PSM On-Site Skills Assessment 5. Complete an LOC Packet including relevant assessments (attach copy to assessment). 6. Explain how the LOC is processed. 7. Correctly complete MAD046 (attach copy to assessment). 8. Explain the parameters for Annual Resource Allotments (ARA) for Jackson Class Members and children/youths 18 and under. 9. Explain how NM DD Waiver Group Packages are different from the ARA for individuals over the age of 18 who are not Jackson Class Members. 10. Indicate case managers authority in approving individual service plans under the ARA system, and circumstances that require prior authorization from Medicaid. 3

5 PSM On-Site Skills Assessment 11. Explain the difference in prior-authorization requirements for individuals over the age of 18 who are not Jackson Class Members. 12. Given a file from your caseload or agency s files and a copy of the Policy Governing Primary Records and Documentation Requirements, verify the completeness of the record or note all the missing items. 13. Identify where to find the legal Policies and Procedures of DOH/DDSD. 14. Develop a written ISP meeting agenda with time frames (attach to assessment). 4

6 Verified Skills Demonstration For Service Coordinators Who Facilitate ISP Meetings: Supervisor s Feedback Checklist The following portion of the assessment must be completed by all Case Managers, and only by Service Coordinators who facilitate ISP meetings. These items are a verified skills demonstration of an ISP meeting facilitation. SUPERVISOR S FEEDBACK CHECKLIST VISION: Did the Case Manager helped the team stay focused on the individual s vision? PHILOSOPHY AND VALUES: Did the Case Manager demonstrate the following? The person with developmental disabilities had control, choice, and ownership over the planning process; the team may need to provide assistance if the individual is unable to speak for him/herself. The Case Manager maintained the self-esteem of the individual with developmental disabilities and all participants. TEAM FACILITATION: Did the Case Manager effectively include family/guardian issues during the ISP process? (Please note: if family/guardian not in attendance, Case Manager should state their issues to the team, and it should be obvious that communication with the family/guardian occurred prior to the meeting.) 5

7 PSM On-Site Skills Assessment SUPERVISOR S FEEDBACK CHECKLIST (continued) Did the Case Manager do meeting preparation? Did he/she clearly review the purpose, outcome, ground rules, and agenda for the meeting? Was he/she able to stick fairly close to the agenda? If yes, what did they do well? If no, why? Did everyone participate? If yes, why? If no, why? Did he or she summarize, clearly stating meeting results, follow-up tasks, persons responsible and dates to complete tasks? 6

8 NEW MEXICO DEPARTMENT OF HEALTH DEVELOPMENTAL DISABILITIES SUPPORTS DIVISION PRE-SERVICE MANUAL FOR CASE MANAGERS AND SERVICE COORDINATORS, PART TWO COMPETENCY ACHIEVEMENT FORM TRAINEE S UNIQUE IDENTIFIER: - - TRAINEE S NAME (PLEASE PRINT): TRAINEE S AGENCY NAME AND CITY: TRAINING DATES: BEGIN: / / END: / / MM DD YEAR MM DD YEAR By checking the box below, I certify that the individual named above has passed the Preservice Manual for Case Managers and Service Coordinators Part Two competency assessment with a score of 100%. ed TRAINEE SIGNATURE: TRAINER PRINTED NAME: TRAINER AGENCY: TRAINER SIGNATURE: After the trainee and trainer have completed and signed this for, it should go in the trainee s file at his or her agency. The trainer should then enter the completion of the course Pre Service Manual Part Two in the DDSD Statewide Training Database. Revised 7/31/2013