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V. Transfers Between Long Term Care Providers


TRANSFER OF CONSUMERS FROM ONE PROVIDER AGENCY TO ANOTHER AGENCY

  1. Transfer initiated by the system, i.e. EEU or Provider Agency:
    1. The first conversation about the pending transfer is between the Provider Agency and the Consumer, and should be held within the first 30 days after notification of intent to transfer. The EEU must be notified of the intent to transfer, unless it was initiated by the EEU.
    2. Within the next 30 days, the Provider Agency schedules a meeting with the Consumer, their Advocate and/or the Office of Consumer Affairs, and relevant Agency personnel.
    3. Following the meeting, it is the responsibility of the Provider Agency to contact the EEU within 3 business days, and discuss the outcome of the meeting.
    4. Unless there is compelling evidence that the transfer should not occur, the EEU approves the transfer request.
    5. Once the transfer is approved, within 5 business days, the Provider Agency must provide the Consumer with a written statement of intent to transfer, including information about how to appeal the decision.
    6. Upon receipt of the intent to transfer statement, the Consumer has the right to appeal the decision. The appeal should be in writing and delivered to the Ombudsman of the Provider Agency within 30 days. The Provider Agency must submit the appeal to the DSAMH Deputy Director. The Deputy Director will make a decision about the transfer within 14 days. The decision is communicated to the Consumer, their Advocate and/or the Office of Consumer Affairs, the EEU, and the Provider Agency.
    7. If the appeal is overruled, the Provider Agency, with the consumer, completes a transfer plan within 14 days that includes recommendations on treatment and support required to continue the Consumer’s recovery, including proposed treatment goals. Copies of this transfer plan are shared with the EEU, the Consumer and the Advocate.
    8. If the appeal is upheld, the Provider Agency will meet with the consumer, their Advocate and/or the Office of Consumer Affairs to develop a cooperative plan of action.
    9. If there is a waiting list for the new Provider Agency, the transferring consumer is placed at the end of the list while continuing to receive services through his/her current Provider Agency until an opening is available.
    10. Prior to actual transfer, the Provider Agency completes and submits a written discharge summary to the EEU.
    11. The EEU will notifies the receiving agency about the impending transfer and initiates sharing of documentation between providers (i.e., treatment plans, medication records, and other pertinent information required to promote successful transfer for the Consumer, including recommendations on treatment and support needs required to continue the Consumer’s recovery.)
    12. Based on shared information, the new Provider Agency develops a draft initial treatment plan.
    13. The new Provider Agency schedules a meeting with the Consumer and Advocate for intake, review, finalizing and signing of initial treatment plan.
  2. Consumer has choice of service provider within relevant guidelines:
    1. Transfer initiated by the Consumer.
      1. Guidelines:
        1. The Consumer contacts the Office of Consumer Affairs or the Provider Agency to request a transfer to another agency.
        2. If the request is made to the Provider Agency, that Agency will contact the Office of Consumer Affairs.
        3. If the contact is made to the Office of Consumer Affairs, that Office contacts the ombudsman of the Provider Agency where the consumer receives services to advise them of the consumer’s wish to transfer.
        4. In either case, that Provider Agency schedules a meeting with the consumer and his/her advocate to occur within 15 business days of the request. Unless the consumer has another advocate, the Office of Consumer Affairs as Advocate should be included in that meeting..
        5. Following the meeting and within 3 business days, it is the responsibility of the Provider Agency to contact the EEU and discuss the outcome of the meeting.
        6. Unless there is compelling evidence that the transfer should not occur, the EEU approves the transfer request.
        7. Once approved, the Provider Agency must provide the Consumer with a written statement of intent to transfer, with information about how to appeal the action. In addition, the Provider Agency completes a transfer plan that includes recommendations on treatment and support required to continue the Consumer’s recovery, including proposed treatment goals. Copies of this transfer plan are shared with the EEU, the Consumer, and the Advocate.
        8. If there is a waiting list for the new Provider Agency, the transferring consumer is placed at the end of the list while continuing to receive services through his current Provider Agency until an opening is available.
        9. Prior to the actual transfer, the Provider Agency completes and submits a written discharge summary to the EEU.
        10. The EEU will initiate sharing of documentation between Provider Agencies (i.e., treatment plans, medication records, and other pertinent information required to promote successful transfer for the Consumer, including recommendations on treatment and support needs required to continue the Consumer’s recovery).
        11. Based on shared information, the new Provider Agency develops a draft initial treatment plan.
        12. The new Provider Agency schedules a meeting with the Consumer and Advocate for intake, review, finalizing and signing of initial treatment plan.
        13. The consumer may choose a new service provider no more than once every two years of service, unless the Provider Agency and/or the EEU determine that more frequent choice is in the Consumer’s best interest.
        14. When a consumer transfers to a care provider outside of the DSAMH system, clinicians and other professionals need to make a good faith effort to ensure a treatment plan will be written by the new provider and continuity of care will occur.


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