When it’s necessary to make an addendum
The Life Plan is a living document subject to continuous updating and monitoring by the Care Manager. Sometimes, changes occur outside the annual or semi-annual review meeting. When changes occur, the Care Manager must ensure the Life Plan is revised; however, not all changes require an addendum.
Updates requiring an addendum
- Changes to the Member’s services, including starting or ending a service, increase or decrease in units, and changing Providers
- SART service requests
- Changes or errors which impact the Provider’s ability to bill
- Sentinel events such as:
- Major medical events
- Accidents or events resulting in significant personal injury
- Significant changes or improvement in behavior or physical functioning
- Major psychiatric event or decompensation resulting in extended inpatient psychiatric evaluation
- Changes requiring updates to the Member’s safeguards, such as changes in medication administration, supervision levels, or support services following hospitalization discharge or other sites of care change
- Telehealth preferences for CCO and HCBS waiver services
- Requests for fewer face-to-face visits for Tier 4 Members
- Member, family, or representative requests to add or change information in the Life Plan
Other updates that can wait until the next review meeting
- Changes to health and safety that are not a sentinel event as described above
- Changes to medical or healthcare Providers
- Non-goal-related activities or changes that do not impact billing