Options Counseling (OC) is defined as counseling that supports an individual and/or the individual’s representative to make an informed choice about which Long Term Supports and Services (LTSS) option is the best fit for that person.
This includes:
- Evaluating the information gathered to determine if the individual should receive OC.
- Gathering information from the individual and others, as requested by the individual, about the individual’s wants, preferences, goals and interest in receiving OC.
- Communicating pros and cons of LTSS options.
- Providing and reviewing written information (i.e. brochures, contact information, applications, etc.) to the individual and other involved parties.
- Explaining and discussing the OC process and the role of the Options Counselor.
- Supporting and advocating for the individual’s decisions about services and supports.
- Developing and recording action plans that support the individual’s values, needs and preferences.
- Reviewing and adjusting action plans as needed to meet the individual’s preferences or needs and arranging for other identified services.
- Following up with an OC participant including time spent locating and reviewing the individual’s records, talking with the individual about how a plan developed as part of the OC process was working, updating the plan and time spent traveling to an in-person meeting with the individual.
This code should be used for all activities related to Options Counseling, including:
- Paperwork
- Clerical activities
- Time spent reviewing voicemails or emails
- Time spent consulting with a supervisor or supervising
- Travel including time spent arranging transportation
- Time spent entering information about the activity into a database or software program
- Calls, emails, or other communications to obtain clarification of an inquiry
5a. Medicaid or potentially Medicaid eligible
Use when providing OC to an individual who either is eligible for Medicaid or for whom Medicaid is being considered as an option for providing LTSS. This includes individuals who are on a waiting list or registry for a Medicaid-funded service, such as the Older Adult Waiver.
Once Medicaid-funded services have been ruled out as an option, these activities should be coded under 5c.
5b. Follow-up for Medicaid or potentially Medicaid
Use when following up with someone who had received OC and Medicaid-funded services remain an option. 5b. Follow-up for Medicaid or potentially Medicaid
If Medicaid-funded services have been ruled out as an option, this activity should be coded under 5d.
5c. Medicaid Ruled Out as an Option
Use when providing OC to an individual for whom Medicaid-funded services are no longer being considered as an option.5d. Follow-up for Not Medicaid Related
Use when following up with someone who had received OC and for whom Medicaid-funded services are no longer being considered as an option.If Medicaid-funded services are being considered for the individual, this activity should be coded under 5b.
