Per LME-MCO Communication Bulletin #J256, “It is the expectation that if a provider or Employer of Record (EOR) staff member is unable to provide a service and the provider agency or EOR is unable to provide back-up staff, the provider or EOR is required to report this lack of staffing to the LME-MCO. This should be sent by the provider agency to the LME-MCO on a bi-weekly basis on a spreadsheet provided by the LME-MCO.”
The intent of the back-up staffing report is to document the reason that BACK-UP STAFF was not provided, NOT why regularly scheduled (primary) staff was unable to provide the service.
Back-up staffing reports should be submitted when:
- Regularly scheduled (primary) staff is unable to provide service(s) AND a back-up staff is not available
- Regularly scheduled (primary) staff is unable to provide service and back-up staff is available BUT declined by the individual/legally responsible person.
Back-up staffing reports should not be submitted to:
- Report the lack of regularly scheduled (primary) staff (back-up staffing reports should not be submitted for cases that are not fully staffed). General staffing concerns should be communicated to the provider’s assigned Provider Network Development Specialist.
- Record the difference between authorized hours and unused hours, unless unused hours are due to a lack of backup staff. Concerns related to deviations in service should be communicated to the UM I/DD Supervisor.
- Record reasons why a service date is not billable.
- Document breaks in service. These are defined as holidays, vacations (consumer), weather conditions, illnesses (consumer), and scheduling conflicts. Service breaks should be documented by the provider and communicated to the consumer’s Care Coordinator however, they should not be documented on the backup staffing report.
Completing the Form
Access the bi-weekly spreadsheet on the Innovations Reporting for Failure to Provide Back-Up Staffing. Reports for the 1st through the 15th of the month should be submitted to Alliance by the last day of the same month. Reports for the 16th through the last date of the month should be submitted to Alliance by the 15th of the following month. Reports should be submitted via email to [email protected].