Treatment Modality: Wellness coordination services means the development, maintenance and routine monitoring of the individual’s wellness coordination plan and the medical services required to manage their health care needs. Wellness coordination services extend beyond those services provided through routine doctor/healthcare visits required under the Medicaid state plan and are specifically designed for individuals requiring the assistance of an RN or LPN to properly coordinate their medical needs.

Populations Served: MDS provides wellness services to adults with developmental disabilities. This service is only provided to those ages 21 and older and must meet a health score of 5 or higher through the state's objective-based allocation process.  

Setting for Services: Wellness coordination services are typically provided in the individual's home.

Hours of Service: Wellness coordination services typically take place during regular business hours Monday through Friday, however based on the clients' needs, staff may work outside of these hours. Services may also be provided on the weekends.

Frequency of Services: Frequency of services is determined by the individual's level of support. There are 3 tiers that determines the frequency:

Tier I: Healthcare needs require a face-to-face visit once a month with an RN or LPN and consultations/reviews based on the individual’s current healthcare needs.

Tier II: Healthcare needs require a face-to-face visit twice a month with an RN or LPN and consultations/reviews based on the individual’s current healthcare needs.

Tier III: Healthcare needs require a face-to-face visit once a week with an RN or LPN and consultations/reviews based on the individual’s current healthcare needs.

Payers and Funding Sources: Wellness coordination services are typically funded through the Medicaid Waiver; however, private pay options are also available.

Fees: The service rates are based on the funding source and the individual's level of support. Private pay rates are available as well.

Referral Sources: Most referrals come through word of mouth, current clients and families, and case managers. The Medicaid Waiver utilizes a "pick list" which identifies providers within a geographic area.

Credentialing of Staff: All staff are required to pass a criminal background check as well as a driving record check. Wellness coordination services must be provided by an RN or LPN, in addition to being CPR/First Aid certified and receiving Handle with Care training.