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PROCESS FOR RECEIVING SOUND RESPONSE SUPPORTS

For individuals receiving funding through Dane County Contracted Services (DCCS) and individuals directing their own supports (SDS):

• Sound Response Referral submitted by the individual, support broker, or contracted case manager.
• Sound Response will evaluate the referral by:
  
  • Location of residence
  • Current residential supports
  • Costs savings of utilizing Sound Response supports
• Sound Response contacts Monica Bear, Dane County DD Case Manager Supervisor, for approval. In some cases, the individual, support broker, or the contracted case manager has already obtained prior approval from the Dane County DD Case Manager Supervisor.
• Once approval has been given, Sound Response will meet with the individual and their respective circle of supports to discuss expectations of services.
• Sound Response will assess the residence and consult with the individual and their respective circle of supports on appropriate sensing devices. A Sound Response Permission to Proceed form will need to be filled out and signed by the participating individual, support broker, and or the contracted case manager.

The following Medicaid Waiver or HCBW Documentation will be necessary to prior to beginning supports:

• Revised ISP and signature page, which lists Sound Response as an on-going service as well as, lists the adaptive equipment that will be purchased. The ISP should specify the equipment’s cost. No receipt is necessary, as J&K will bill the county directly.
• If the request is part of a new CIP application, follow the above procedures. The description of Sound Response services and equipment should be included in the narrative. In some cases, a recommendation from Sound Response can be used for part of the above statement.
• If a person is in SDS, a broker should complete an IFP, recording Sound Response as a contracted service. If the needed adaptive equipment exceeds a person’s rate an exceptional expense request must be completed.
• Authorization for an exceptional expense must be obtained from Monica Bear via e-mail.
• If the item cost is estimated over $1,000, the Sound Response Permission to Proceed form will meet the criteria of a required statement from a Rehabilitation Organization or Therapist
• A Sound Response Permission to Proceed form with a detailed description of equipment and installation, Sound Response authorization and, authorization from the individual, support broker or contracted case manager.
• Sound Response will then install equipment and train staff on use of SR equipment