New Provider Frequently Asked Questions

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1. When applying to be an SCL provider, does our agency need to be a Medicare-certified company?

No.

2. What are the differences between a Family Home Provider (FHP) and an Adult Foster Care (AFC) provider?

The most significant differences are that they have different billing codes, and if you are certified to provide AFC, then your AFC employees might be eligible for income tax exemptions. You should advise those employees to consult with someone who has expertise in tax laws.

3. What is the average time is takes to become certified as an SCL provider?

This greatly depends on the agency's level of preparation. An agency that is familiar with the regulations and has experience in developing policy, procedures and business plans will generally take approximately six to seven months from the date that New Provider Orientation, Level I has been successfully completed. Once the agency has been certified, it usually receives its provider number in about 45 days.

4. How much time do I have to complete the process of becoming certified?

There are no set timeframes, but if moving through the process takes longer than a year, it is likely that some documents will need to be resubmitted, and it will be necessary to attend New Provider Orientation again. Additionally, if regulations have changed or significant changes have been made to the material presented at the New Provider Orientation, it will be necessary to attend again, as well as revising previously submitted documents.

5. What is the first step in becoming certified as an SCL agency?

Contact the Provider Recruitment Specialist listed in the Contact Information box above, who will provide the name of the person who will be assisting you through the process.

6. What does the reimbursement rate for residential supports cover?

It covers the cost of:

• Staffing the home 24 hours a day, 7 days a week.
• Providing training and support to assist the individuals in obtaining their outcomes.
• Participation in medical appointments and follow-up care.
• Arrangement of or transportation to leisure activities, services and medical appointments.
7. Are any transportation costs covered?

Transportation is not a reimbursable service through the SCL Medicaid Waiver program. Transportation can be arranged through the appropriate provider for Medicaid Transportation. This generally will cover transporting someone from one service site to another (i.e., a staffed residence to a Supported Employment site).

8. If I want to provide day services (i.e., Adult Day Training or Children's Day Habilitation), is it necessary that I have a brick-and-mortar building?

No. Individuals could be picked up from home or meet with a Direct Support Professional at a mutually agreed-upon place and time. From there they would participate in social, civic and/or vocational activities in the community. The individual plans will direct the activity and schedule. This type of arrangement is particularly beneficial for those who prefer a very structured day, less noise, time with particular friends and staff, etc.

9. What area of the state has the greatest need?

We do not have or provide that information. Generally speaking, those agencies providing the highest quality of supports will rise to the top. Each individual or legal representative has a choice of agencies. If a person is dissatisfied with the supports he or she is receiving at one place, he or she may choose to move to another agency at any time. It is up to the agency to determine where its services are needed.

10. Do we have to apply for a National Provider Identifier (NPI) number or does that automatically occur?

Yes you have to apply. The link is https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart. This is a Medicaid requirement and must be obtained by May 23, 2007. Once you receive it, you should send a copy to First Health.

11. How hard is it to add a service in the future?

Adding a service in the future is much easier than the initial process of becoming a certified SCL provider. Most agencies pursue this by notifying their Area Administrator (AA) or Janet Beatty that they would like to add a service. The agency's AA would set a meeting date, then come to the site and review any required policy changes or additions and any other newly created documents relevant to the new service. Additionally, if a provider were adding a residential or day service that utilizes an actual building, the AA would also visit this site.

12. Are providers who provide day program services or Adult Day Training allowed to provide other services to other clients at the same facility? An example is an ADT program that also provides private-pay day program services or ABI-waiver day program services.

Yes, as long as the program complies with the SCL regulations. If children are receiving Children's Day Habilitation services, they should be separated from the adults who receive Adult Day Training supports.

13. When someone is being considered for an Executive Director position, can his or her additional education compensate for lack of experience, or vice versa?

No.

14. How do I obtain a check from the Nurse Aide Abuse registry?

Agencies may call (502) 429-3347 or 429-3300 if they have one or two names of people they would like to hire.

The Nurses Registry has a policy that it will not check on more than two people verbally, per facility, per day. If the agency has several people, it should fax the list with the person's name and social security number to (502) 696-3957.The turnaround time is two weeks or less for faxed requests.

There is no charge for this information. Each potential employee must be checked, even if s/he indicates that s/he is not a home health aide or a nurse aide. The website address to view the on-line listing is: https://secure.kentucky.gov/kbn/bulkvalidation/basic.aspx. Each page has a date on it and is updated daily.

The provider may print the page where a person's name would be listed, if s/he is a nurse aide or home health aide, for proof that the agency checked. If a person is not currently, and never was, a nurse aide or home health aide, his/her name will not be on the list. If the information is provided to the agency verbally, it should document that on the page and place it in the person's personnel record.

15. How do I obtain a check from the Central Registry?

Agencies should complete the form (this can be obtained on DDID's website) and write in under the types of employment OTHER section: "SCL Provider Agency, 907 KAR 1:145."

Because the registry check is required by our regulation, the agency does not need to request it through the Open Records mechanism. Please make sure the form is filled out completely, with no initials or abbreviations in place of names. These forms need to be filled out in blue or black ink. Include any nicknames, married names, and middle names given at birth.

Agencies should mail the two-page DPP-156 Central Registry Check, edition 12/05, to the address listed on the form. Forms should not be brought to Frankfort. The agency should retain a copy of the form in its files for proof of its attempt to get this information.

The office that manages these requests has indicated that the turnaround time is ten days. As long as the agency has maintained a copy of the request in its personnel records, we will not cite the agency if the response is 14 days past the date of hire. However, the agency is responsible for securing the response.

The cost of the request is $10.00 per person, payable to the Kentucky State Treasurer. Providers may request the form via email from Courtney.Murphy@ky.gov or via phone at (502) 564-3834. The form is also available from the DDID website.


16. Whom do I contact to find out more information regarding the 5.5 percent provider tax for Support for Community Living (SCL) providers?

Eric Daniels at (502) 564-9282.

17. Does the provider tax apply to those agencies providing Michelle P waiver services?

No.

18. Does someone receiving services through the Michelle P waiver have a limit/cap on their annual budget?

Yes, if s/he is receiving blended services the cap is $63,000 annually, and $40,000 if s/he is receiving traditional services.

19. Is becoming a provider of SCL supports the only way to become eligible to provide Michelle P waiver services?

No. If you are eligible to provide Home and Community Based Services (HCBS) then you are also eligible to provide Michelle P waiver services.

20. I want to care for someone in my home. What is the process for becoming a Family Home or Adult Foster Care Provider?

DDID does not place individuals with home providers. You must contact currently certified SCL agencies who provide those services and determine if they might be interested in working with you.

Use the "Provider Directory" link in the Related Links box to access the SCL Provider Directory, which lists all currently certified SCL providers.

Once you get to the SCL Provider Directory, in number 1 make sure the Program selected is "Supports for Community Living." From the "Region" dropdown list near the bottom, select the region in which you live, wait for the page to refresh, then click Submit.

If you scroll down the page you will see all the SCL-certified providers in your area. In the right hand column you will see "Services Available," which lists all the different service which those providers are certified to provide. Keep in mind that a provider's being certified to provide the service does not mean it is actually providing the service currently.

The services are "Family Home" or "Adult Foster Care." You can contact those agencies and see if they are interested in your services. It is up to the agency whether it chooses to work with you and, if so, how much it chooses to pay you.

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