Life Plan Addendums 

When is it 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