This vacancy is located at SCLHSA's Developmental Disabilities Office located in Houma, LA. The incumbent is responsible for the delivery of a full array of community based services to persons with intellectual and developmental disabilities residing in Region including the parishes of Terrebonne, Lafourche, St. Charles, St. Mary, St. John the Baptist and St. James. The DD Program services are delivered through numerous programs provided directly or through contractual arrangements with a variety of providers form the private and public sector. The incumbent reports directly to the Executive Director for the South Central Louisiana Human Services Authority (SCLHSA).

All administrative, programmatic and professional activities of the Medical Certification Manager 1 are guided by the Person Centered System. This system is defined as including but not limited to the following:

• 
  A system having as its primary goal responding to “customer demand”;
• A system that moves decision making and resources as close as possible to persons with developmental disabilities;
• A system that organizes customer demand through initiating and supporting self-advocacy groups, customer driven governing and advisory boards and the inclusion of customers at all levels of planning;
• A system that utilizes individualized support approaches, such as supported living, family support, and supported community inclusion;
• A system that is open to external evaluation;

FUNCTION OF WORK:

45% Administrative Functions:

• Responsible for the supervision of all staff and staff personnel actions. Provides management leadership to insure cohesiveness, capability and accomplishment of all staff within the office being familiar with requirements of policy from the agency.
• Oversight of federal funds through assurance of fiscally sound decisions upon entry into Medicaid funded programs i.e. home and Community based wavier programs, and Intermediate Care Facility certification.
• Oversees negotiation process for service agency contracts for delivery of services to the region.
• Oversees process of family agreements for funding of and delivery of services directly to families in the region.
• Approves/denies leave requests for subordinates in the DD Program.
• Maintains system of personnel evaluations for supervisory staff.
• Disciplines/counsels personnel as needed and develops supervisory plans as necessary. Consults with SCLHSA Human Resources regarding Civil Service disciplinary actions to present to Executive Director for approval.
• Oversees purchasing and property control functions for the DD office.
• Ensures safety procedures are in place and functioning as required by SCLHSA and the Office of Risk Management.
• Provide leadership and direction during emergency preparedness activities and during any emergency event following applicable agency standards.
• Represents the agency in meetings/presentations/collaborations, in court appearance with judicial officials, or other meetings and other professionals regarding programs of the agency.
• Coordinates activities with the Regional Advisory Committee as set forth by legislative action working with the chairperson in maintaining membership, meetings and sharing of information as outlined in legislation.
• Responsible for implementation, coordination and follow up action on any complaints regarding any aspect of service delivery, staff actions, etc. as detailed in the SCLHSA Complaint Policy in consultation with the Executive Director.
• Responsible for management of the Quality Enhancement Plan, collecting data to indicate progress on performance indicators to SCLHSA and OCDD as well as overseeing development of regional QE plans that reflect regional indicators selected in collaboration with staff/customers/advisory committee and other stakeholders.
• Responsible for management of the ACT 421 Medicaid Children’s waiver, collecting data for billing and performance measures as specified in the LDH contract.

• Direct the implementation, monitoring and eligibility for a variety of service programs to include:
  • Systems entry for all developmental disability services.
  • ACT 421 Medicaid Children’s Waiver
  • Employment/vocational programs for adults.
  • OCDD eligibility and Services for children ages 0-3 through the Early Steps Program.
  • Residential option programs, i.e. Supported Living, Intermediate Care Facilities, and Nursing Facilities.
  • In home family support services, i.e. personal care services, respite services, home modifications, etc.
  • Cash Subsidy program of monthly stipend to families of children with severe disabilities.
  • Supervise staff responsible for technical assistance and training to service providers of programs assisting in mediation/negotiation as necessary to strive for high quality service delivery.
  • Maintain information regarding all appeals from customers regarding program decision, reviewing appeal information prior to submittal to Bureau of Appeals, participating with staff in appeal hearing with Administrative Law Judge. Implement agency/program changes, if needed, due to appeal decision in favor of appellant.
  • Maintain responsibility for inquires form State/Federal agencies regarding implementation of any programs.
• Direct and manage the funding sources and standards for delivery of each of the above named services.
  • Approve/deny through committee funding for services funded through state general fund dollars assuring monies are spent within appropriate policy parameters and that expenditures are properly monitored by staff.
  • Assist with investigations of alleged inappropriate expenditures by recipients.
  • Assure appropriate staff is making correct and fiscally sound decisions regarding approval of comprehensive plans of care for waiver funding as well as approval of intermediate care facility admissions; or nursing facility level of care approval.
  • Assist with mediation/consultation/negotiation between service agencies, support coordination agencies and OCDD staff regarding financing issues that may result due to differences between amount of funding requested and funding approved.
  • Assure that funding approvals for Medicaid services are within applicable federal guidelines for such.

• Develop, implement, and monitor policies and procedures as defined in the CEA with the State of LA Dept. of Health and Bureau of Health Services Financing.
• Review/approve annual level of care re-assessments for all individuals in the Act 421 CMO Program using nursing home/hospital level of care criteria to determine if the child continues to qualify.
• Review/approve all presentations/summary of evidence created by the assigned Act 421 CMO Program Medical Certification Specialist 2 that is a result from an appeal request.

• Participate on various agency task forces, policy committees, grant writing committees, state wide committees to represent SCLHSA
• Perform other duties as required for efficient operation of the DD Program and SCLHSA at the discretion of the Executive Director.