Case Management Forms
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NEW Comprehensive and Supports Waiver Forms
New Supervision Flexibility Form Posted 2-27-14
Note: Providers who are implementing staffing flexibility must discuss the changes in staffing with the participant or guardian and case manager. This form must be signed by all parties and uploaded to EMWS in the person's document library by June 1, 2014.
Note on opt out form:
Participant may request to opt out of receiving Support Brokerage services after the first year of self-directing at least one direct care service based on demonstrated competency in hiring, firing, training, supervising, scheduling workers, and reviewing timesheets in a timely manner.
The request to opt out shall be reviewed by the Participant’s Case Manager, who shall make an assessment of the Participant’s competency to self-direct successfully without a support broker.
The request and assessment shall be submitted to the Developmental Disabilities Sectionfor approval. Instructions are on the form.