Coastal Home Care is deeply disappointed with the outcomes on the Parrish case, and we sympathize with the family.
We began services for this family at the request of the regional office of the state department of behavioral health services with the understanding that the state would approve the program. Before the Atlanta office provided written authorization we responded to a request by the family and the Savannah regional office to send nurses to care for this child beginning on August 1. Regional representatives assured our company that the case would go forward. It turned out that they had no authority to do so. The state office chose to not approve the program for the family, and Coastal was left with no options but to discontinue service. We are a private company with no authority to serve individuals in these programs unless we are authorized to do so.
We understand that the family continues to have access to services through another program (known as the GAPP waiver) specifically for children with disabilities.
The Department of Behavorial Health & Developmental Disabilities:
- Region 5 has a letter of agreement with Coastal Home Care.
- Coastal Home Care is an enrolled Medicaid Waiver provider in several home and community based programs in Georgia; the waiver programs for people with developmental and intellectual disabilities are included in the programs under which the agency provides services.
- A thorough clinical evaluation is conducted to determine if individuals who require exceptional support may be eligible for an exceptional rate.
- Individuals accepted into the Comprehensive Supports Waiver Program (COMP) receive notification of eligibility and admission through the regional office closest to their home or current location. The exceptional rate determination is a process between the provider, the regional office and the DBHDD central office since it involves dialogue with an identified provider about what additional support may be required to safely and effectively serve a particular individual. The rate will be determined based on proposed staffing by the provider and validated through clinical evaluations of specific needs.
- Any provider who has a relationship with a Medicaid member may and should engage in conversations with the member. As a matter of course and good practice, the department requests that such conversations take place in collaboration with the department using factual information.
- Exceptional rates are directly determined by evaluating the clinical need. Because of the direct correlation between the clinical assessment and the exceptional supports funded through the rate, additional clinical information may be submitted if the provider disagrees with the rate. The rate, however, does not impact the individual's ability to receive service.