Welfare Funding (7) Plan Creation and Consultation Support
What are the remuneration unit prices for home service plans (care plans) in long-term care insurance services and service utilization plans in disability welfare services?
Since my main focus was on disability consultation, I cannot write in detail about long-term care insurance. However, here I would like to write about the characteristics and key points rather than the "unit prices."
Key Points
① Chief (Designated Office)
In short, the conditions are having extensive experience and having completed the chief training program. Having extensive experience means handling various cases, including difficult ones. Furthermore, conducting training, holding case study meetings, and addressing regional issues are evaluated.
By the way, just because someone is called a "chief" does not mean they are "capable at their job."
Also, a "designated office" is defined by conditions such as having at least one chief care manager or chief consultation support specialist (depending on the type of additional payment) and having at least four care managers or consultation support specialists (depending on the type of additional payment).
② Response during hospital admission and discharge
There is an additional payment when providing information at the time of admission and when participating in a conference at the time of discharge to share information and coordinate. It is not just about "accompanying" or "receiving an explanation," but also involves detailed interviews and communication during the hospital stay, as well as "planning for life after discharge."
③ Coordination
Coordination partners vary depending on the user's situation, including not only family members but also medical institutions, service providers, educational institutions (schools, special needs schools), and childcare facilities.
Well, when providing consultation, you may get involved with others as well. If necessary, this includes adult guardians or neighborhood association presidents.
④ User's situation
This is not necessarily about difficult situations, but times when coordination and support are particularly needed. For example, individuals requiring terminal care, medical care, those with severe behavioral disabilities, or those with mental disabilities.
Under the Long-Term Care Insurance Act, there is a "care prevention care plan" for those with mild needs (Support Level 1, 2). On the other hand, under the Services and Supports for Persons with Disabilities Act, plans are not separated by disability support classification. And when a person with a disability uses long-term care insurance services, additional payments can be claimed.
⑤ Meetings and conferences
There is an additional payment for close coordination and adjustment at service representative meetings, case conferences at medical institutions, and discharge adjustment meetings.
Even if you hold a meeting, it might not be decided in one go depending on the person's situation, but the additional payment is limited to once.
⑥ Concentration
There is a so-called "designated office concentration deduction," and the unit price is reduced when the number of plans created in one month exceeds 40 (degressive system). However, how many plans are created depends on the number of offices in the area, their reputation, and their standing.
⑦ Experience
In the case of "regional transition support" for disability welfare services, there is an additional payment for trial use of disability welfare services to evaluate the initial workload of conducting trials, from the perspective of ensuring opportunities for people with disabilities who wish to transition to the community to experience disability welfare services. Experience includes not only day services but also overnight services. However, you can use trial services without using this additional payment. It depends on the ability and motivation of the consultation support specialist and the user's situation.
⑧ Emergency response
Also, in "regional settlement support," there is an additional payment for responding to phone calls late at night. However, you need to discuss with the user "what to do" when an emergency response occurs.
That is how it is. There might still be things missing, but if I write any more, it will become confusing, so I will stop here.
And, as a matter of course, whether or not you can receive additional payments at the office requires submitting documents. Also, when you carry out the above initiatives, "records" and "reports" based on "plan -> implementation -> evaluation" become necessary.
I believe you will learn this during practical training and on-the-job training, but you do not create plans just for the money.
While steadily and diligently creating plans, "obtaining additional payments to meet the diverse needs of users" is what I believe it becomes. And I think the "execution ability" after creating the plan will also be reflected in the additional payments.