Effective January 1st of this year, the state began requiring a weekly Plan of Care for clients receiving personal care or skills acquisition services. The plan sets a maximum number of hours that a client can assign to a provider in a week, based on the individual’s monthly hours.
The weekly plans are intended to limit the amount of overtime paid to an Individual Provider when a plan of care is less than 40 hours per week. And exception can be requested when the client’s health and safety and/or community placement is at risk.
How It Works
The client receives notice of a weekly maximum of hours of care based on his/her total monthly hours. S/he chooses the times of day and hours for each day for a provider to work within that weekly maximum, unless an exception is approved (see below.
The weekly maximum is based on a short month (29 days). This means that the individual may need to schedule below the weekly limit to make sure every day is covered during the longer months. (See example below where the weekly maximum is 28 hours, but the weekly hours were shortened by the client to make sure s/he has coverage over a 31 day month).
Because the weekly Plan of Care will take some time for providers and individuals to adapt to, the state is asking clients to make a good faith effort for January, February and March. Beginning in April, when the overtime law goes into effect, the weekly Plan of Care must comply with the weekly maximum.
You can request an exception to the weekly Plan of Care when a client’s health and safety and/or community placement may be at risk. An exception can allow for the flexibility of hours between weeks, but may not exceed the individual’s monthly assessed hours.
If a request would exceed the monthly assessed hours, then an Exception to Rule (ETR) would need to be submitted.
Why is this Happening?
The change to a weekly Plan of Care is in response to the overtime payment requirement and is not related to the payment system, Individual Provider One. If you are a client of DDA and are having trouble creating your weekly Plan of Care, talk to your DDA case manager.
View a Sample Plan
Download our printable bulletin for a sample weekly plan of care calendar to see how it works.