| Effective Date |
Summary of Revisions |
||
| P-003 | Recoupment and Sanctions Policy (PDF) | 10/06 | |
| Human Resources | |||
|---|---|---|---|
| 10.2.7 | Title VI Compliance (PDF, WORD) | 10/1/2012 | |
| Title VI Complaint Form (WORD ) | |||
| 10.4.1 | Intern Policy (PDF, WORD) | 5/15/13 | |
| A Student Intern Application Form (PDF, WORD) | |||
| B Student Intern Program Plan (PDF, WORD) | |||
| C Student Intern Service Agreement (PDF, WORD) | |||
| D Student Intern Evaluation (PDF, WORD) | |||
| Policy & Innovation | |||
| 30.1.2 | Policy Committee (PDF, WORD) | 7/1/12 | |
| 30.1.6 | Exemption Policy (PDF, WORD) | 5/5/12 | |
| Exemption Request Form | |||
| Quality Management | |||
| 70.1.1 | Fiscal Accountability Review Policy (PDF, WORD) | 8/3/12 | |
| 70.2.1 | Reporting Fraud Waste and Abuse of Government Funds and Property (PDF, WORD) | 8/3/12 | |
| Program Operations | |||
| 80.2.1 | Abuse Neglect Prevention Committee (PDF, WORD) | 8/3/12 | |
| 80.2.2 | Abuse Registry Review Committee (PDF, WORD) | 5/2/13 | |
| 80.3.2 | Level of Care Reevaluations Policy (PDF, WORD) | 8/3/12 | |
| Guidelines LOC Reevaluations & Annual Reevaluation LOC (PDF, WORD) | |||
| 80.3.4 | Authorization of Services (PDF, WORD) | 3/15/13 | |
| ISP with Person Centered Prompts (WORD) | |||
| Annual ISP Review and Update Documentation (WORD) | |||
| ISC/CM Monthly Documentation Form (PDF) | |||
| 80.3.5 | Continued Stay for Children Enrolled in Waiver Before Age Six (PDF, WORD) | 8/3/12 | |
| 80.3.6 | Amending the Initial Plan of Care Before Development of the ISP (PDF, WORD) | 8/3/12 | |
| Amending the Initial Plan of Care Form (PDF, WORD) | |||
| 80.3.7 | Requests for Emergency Service Authorization (PDF, WORD) | 7/6/12 | |
| Request for Emergency Service Authorization form (PDF, WORD) | |||
| 80.3.8 | Termination of Participant Direction of Waiver Services (PDF, WORD) | 10/10/12 | |
| 80.4.1 | Program Participant Experience Surveys (PDF, WORD) | 7/6/12 | |
| 80.4.2 | Medicaid HCBS Waiver Personal Assistance Services (PDF, WORD) | 10/10/12 | |
| 80.4.3 | Personal Funds Management (PDF, WORD) | 9/17/12 | |
| 80.4.4 | Electronic Records and Signatures (PDF, WORD) | 10/10/12 | |
| 80.4.6 | Sanctions (PDF, WORD) | 3/15/13 | |
| Examples of Violations (PDF, WORD) | |||
| 80.4.7 | Community Transition Policy (PDF, WORD) | 6/1/12 | |
| Community Transition Planning Form (PDF, WORD) | |||
| Community Transition Notify Form (PDF, WORD) | |||
| 80.4.8 | Limited English Proficiency Policy (PDF, WORD) | 10/1/12 | |
| 80.5.1 | Establishment Funds (PDF, WORD) | 10/1/12 | |
| 80.5.2 | Housing Cost Subsidy (PDF, WORD) | 10/10/12 | |
| Housing Cost Subsidy Form (PDF, EXCEL) | |||
| Instructions for Completing Housing Costs Subsidy (PDF) | |||
| 80.5.3 | Vehicle Protective Barrier Subsidy (PDF, WORD) | 10/10/12 | |
| Vehicle Protective Barrier Subsidy Form (PDF, WORD) | |||
| 80.5.4 | Transportation Cost Subsidy (PDF, WORD) | 10/1/12 | |
| Transportation Subsidy Cost Form (WORD) | |||
| Health Services | |||
| 90.1.1 | Nursing Health Care Management (PDF, WORD) | 3/23/12 | |
| 90.1.2 | Death Review Policy (PDF, WORD) | 3/23/12 | |
| Reportable Incident Forms Reportable Incident Form Instructions and Definitions (PPT) West Region (WORD) Middle Region (WORD) East Region (WORD) |
|||
| Death Review Attendance Form (PDF, WORD) | |||
| Notice of Death Form (PDF, WORD) | |||
| Initial Agency Death Review Form (PDF, WORD) | |||
| Links End-of-Life Planning ResourcesTennessee Department of Health for Advance Directives, Physician Orders Scope of Treatment (POST),Do-Not-Resuscitate Orders (DNR's) Last Passages |
|||
| Intermediate Care Facilities for Individuals with Intellectual Disabilities | |||
| 100.1.5 | Personal Property (PDF, WORD) | 7/6/12 | |
| 100.1.8 | Individual Support Planning Process (PDF, WORD) | 3/15/13 | |
| ISP with Person Centered Prompts Form (WORD) | |||
| 100.1.15 | Staff Development (PDF, WORD) | 11/27/12 | |
| 100.1.16 | Leave and Attendance (PDF, WORD) | 11/27/12 | |
| 100.1.18 | Complaint Resolution (PDF, WORD) | 3/15/13 | |