Hawaii Case Management Service Provider Policy Manual
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The Hawaii Case Management Service Provider Policy Manual establishes a comprehensive framework for delivering case management services to individuals requiring assistance in accessing and coordinating care and resources to meet their health, social, and community needs. This manual aligns with the Hawaii Revised Statutes (HRS) §321-11, Medicaid Home and Community-Based Services (HCBS) waiver program requirements, and applicable federal guidelines to ensure full regulatory compliance and high-quality service delivery. It serves as a critical resource for providers supporting individuals with disabilities, chronic conditions, or other complex needs.
Key components of the manual include:
- Licensing and Certification: Guidance on meeting state requirements for case management service providers, including certification under Medicaid HCBS waiver programs and compliance with Hawaii Department of Health (DOH) regulations.
- Service Delivery Standards: Protocols for providing person-centered case management services such as needs assessments, care planning, service coordination, monitoring, and advocacy to ensure clients receive appropriate support.
- Individualized Service Plans (ISPs): Requirements for developing ISPs based on comprehensive assessments of client needs, goals, and preferences, with regular updates to reflect changes in circumstances or progress toward goals.
- Client Rights and Advocacy: Policies ensuring client rights are upheld, including informed consent, confidentiality, equitable access to services, and advocacy for client independence and self-determination.
- Emergency Preparedness: Procedures for addressing emergencies or crises affecting clients’ safety or access to essential services.
- Staffing Requirements: Standards for employing qualified case managers with appropriate training in care coordination, cultural competency, and client-centered practices.
- Quality Assurance and Monitoring: Processes for evaluating service effectiveness through outcome tracking, client feedback, performance reviews, and compliance audits to ensure continuous improvement.
- Coordination of Care: Guidelines for integrating case management services with other supports such as medical care, behavioral health services, housing assistance, transportation services, or vocational programs to provide holistic care.
This manual also addresses operational aspects such as documentation requirements, billing and reimbursement processes under Medicaid waiver programs, training protocols for staff on best practices in case management services, and adherence to state and federal accessibility standards. It serves as an essential resource for Hawaii case management service providers to deliver high-quality support that promotes client well-being, independence, and successful navigation of available resources.