A. KOKUA’S MISSION
Provide citizens with disabilities the support needed to live full and meaningful lives.

B. VISION

A welcoming, compassionate community organization providing information, support and services to individuals with disabilities and their families.

  • Teach self advocacy and independent living skills.
  • Provide access to therapeutic services.
  • Provide sponsorship for consumer driven initiatives.
  • Create an environment of respect, dignity and integrity.
  • Build and strengthen positive community and family relationships.
  • Provide access to a variety of life enriching activities.
  • Provide assistance with life transitions.
  • Offer continuing education opportunities.
  • Educate the community on disability-related issues.
  • Promote personal independence and responsibility
  • Foster creative community partnerships to benefit the disability community.

C. ADMISSION:

Kokua may accept or reject any referral. The decision to accept a referral will be based upon the agency’s capacity to effectively support the individual and upon an agreement reached between all parties as to the types of support to be provided.

D. NONDISCRIMINATION:

Kokua will not discriminate against any client or prospective client based upon the person’s race, religion, marital status, age, gender, sexual orientation, color, creed, national origin, veteran or Vietnam era veteran status, use of a trained dog guide or service animal by a person with a disability, or a handicapping condition, the presence of any sensory, mental or physical disability, including communicable diseases and HIV/AIDS.

E. DISCHARGE:

If Kokua cannot provide the type of service required for a client, Kokua may request DSHS to locate a more appropriate service provider. Clients, guardians, or DSHS may also make requests to discontinue services. Attempts will be made to resolve conflicts prior to any discharge decision.

F. SERVICES:

Kokua will provide services to people in a manner that encourages, supports, and allows them to have as much power in their own lives as possible. Success will be measured by the quality of life for each person in the program.

G. REFERRAL PROCESS

The referral process begins when Kokua receives a referral packet from DDD or request for service is received from a private party. The Executive Director will do an initial review of the request. If it appears that the request is not a good match for Kokua or if insufficient staffing resources exist to provide adequate services, the referral will be declined. In the case of DDD referrals, the referral packet will be returned to DDD. It is DDD expectation that it will receive a response to a referral within 10 days.

If the Executive Director believes that the referral is a good match for Kokua, the Executive Director will share the referral packet with the Director of Client Services and the Service Coordination Team. The Director of Client Services will make contact with the individual and their family/guardian. The Director of Client Services will provide the individual and their family/guardian with a Kokua Information Packet (copy of the Annual Report, copy of the Client Grievance Policy, copy of the Client Rights Policy, copy of the Kokua newsletter) and will offer the individual the opportunity to tour some homes supported by Kokua. During this process, the Director of Client Services will keep the DDD Resource Manager apprised of the progress of the referral.

If the individual and their family/guardian select Kokua as their residential provider, the Director of Client Services will provide the individual and their family/guardian with an Intake Information Sheet to complete prior to the Intake Meeting. The individual should be requested to bring copies of the following documentation to the Intake Meeting:

  • Washington State ID
  • Social Security Card
  • Guardianship documents (if applicable)
  • Power of Attorney (if applicable)
  • Provider One Medicaid Card
  • Medicare Card
  • Private insurance coverage card
  • Pre-Arranged Funeral Plan (if such a plan has been purchased)
  • Drug plan card
  • Lease or rental agreement (if the individual already lives in the residence where they will be receiving support)
  • Signed releases of information for all medical or mental health providers and for all other organizations which Kokua staff might contact on the client’s behalf
  • Restraining Orders (if applicable)

H. INTAKE PROCESS

The Director of Client Services, Client Finance Coordinator, Mental Health Coordinator, Medical Services Coordinator and the Client Services Coordinator should be present at the Intake Meeting. The purpose of the Intake Meeting is to:

  • Introduce the individual and their family/guardian to the Service Coordination Team members
  • To receive from the individual and their family/guardian all of the necessary information and releases to begin preparing for the individual’s support services
  • To give the individual and their family/guardian a rough timeline for the move planning process and to explain their role in assisting with the process.

When the Intake Meeting is completed, each Service Coordination Team member involved in helping the client move will begin working on the tasks on their portion of the Move-In Checklist. It is the Director of Client Services’ responsibility to convene regular meetings to assess the progress of the client’s move planning. During the move planning process, the Director of Client Services will communicate frequently with the DDD Resource Manager and the Executive Director to assure all parties are coordinated. The Executive Director will meet with the DDD Resource Manager to set the contracted rate for the new client.

  PHASE ONE:  NEW CLIENT PRE-INTAKE

 1.         Referral Packet received from DDD or request for service received from a private party.

2.  The Executive Director and the Director of Client Services will do an initial review of the request.  If it appears that the request is not a good match for Kokua or if insufficient staffing resources exist to provide adequate services, the request will be declined.  In the case of DDD referrals, the referral packet will be returned to DDD.  It is expected that DDD will receive a response to a referral within 10 days following the receipt of the referral packet.

3.    If the Executive Director and the Director of Client Services agree that the request for services should be accepted, the referral packet information will be shared with the Service Coordination Team.  If the referral has been sent by DDD, Service Coordination Team members will help prepare the proposal for services.  When the proposal is finalized, a copy of the proposed staffing schedule will be given to the Hiring Coordinator.

4.  The referral packet information will be given to the Training Coordinator so that client-specific training can be developed for the new staff.

5.  If the proposal for services is accepted, the Director of Client Services will mail a pre-intake packet to the client, family member or guardian for completion.  (See the following page for a description of a Pre-Intake Packet.)  If a client has a guardian, a copy of the packet will also be given to the client for their reference.  The pre-intake packet will consist of a cover letter, forms and authorizations that are needed to complete the intake process. A list of the forms to be included in the intake packet can be found in Appendix A of these instructions.

6.  The pre-intake packet will include a SASE and a request that the material be returned by a specific date.

7.  When the pre-intake packet is returned, the Director of Client Services will schedule an intake meeting.  Material from the pre-intake packet should be shared with the members of the Service Coordination Team and a pre-intake meeting should be held.

8.  The Client Services Coordinator will complete a Face Sheet and submit it to the Business Operations Coordinator.  The Client Services Coordinator will complete Releases of Information and Authorizations for signature at the intake meeting.

9.  The Director of Client Services will determine whether or not the new client will need a guardian.  If a guardian is needed, a written request to initiate a guardianship will be sent to the client’s DDD Case Manager.

                                                   CONTENTS FOR PRE-INTAKE PACKET

For the client or guardians information:

  • Cover letter welcoming the client
  • Agency brochure
  • “What are Supported Living Services?”
  • Client Grievance Policy
  • Client Rights Policy

   For the family or guardian to fill out and return:

  Intake Information Sheet

   List of what copies to bring to the Intake Meeting:

  •  WashingtonState ID
  • Social Security Card
  • Guardianship papers
  • Power of Attorney
  • Medical coupon
  • Private insurance card
  • Drug plan card
  • Pre- Arranged Funeral Plan (if a plan has already been made)

  PHASE TWO:   INTAKE

 1.  At the intake meeting, make the new client and their family feel at home and explain any questions they may still have about Supported Living Services.  Hospitality and trust building should be a high priority.

2.  During the intake meeting, the following tasks will be completed:

Ask the family member, client or guardian to proof the Face Sheet for accuracy.

  • Obtain signatures on releases and authorizations for treatment.
  • Negotiate and sign a Service Agreement.
  • Complete a Service Plan.
  • Complete an Individual Financial Plan.
  •  Identify what household items or adaptive equipment will be needed before move-in and who will be responsible for obtaining those items.
  •  Determine whether a Positive Behavior Support Plan is needed.
  •  Identify any issues that may need an Exception to Policy.
  •  Set a tentative move-in date.

 3.  If DDD start up funds will be needed to help a client with move-in expenses, the Director of Client Services will complete a list of needed items and will request pre-approval from the DDD case manager.

4.  The Director of Client Services will determine whether or not the new client will need nurse delegation.   If delegation is needed, the Delegating Nurse will be contacted. 

5.  The Team Leader for the new client will set up the client’s documentation books.

6.  The Director of Client Services will convene planning meetings, as needed, to coordinate the progress of the move-in.  The Director of Client Services will complete the move-in checklist to assure that all necessary steps have been completed and all health and safety supports are in place prior to the move-in.  The Move-In Checklist is found in Appendix B of these instructions.

7.  Copies of receipts for start-up purchases will be given to the Client Finance Coordinator.  The Client Finance Coordinator will submit a request for Client Allowance to the DDD case manager.

8.  A preliminary IISP, IFP, PBSP or other indicated plans will be sent to DDD prior to the client move-in.

9.  The Executive Director or the Director of Client Services will meet with the DDD Resource Manager to do a rate setting for the new client.

    PHASE THREE: PREPARATION FOR MOVE-IN

 FINAL MOVE-IN CHECKLIST

 At the end of the Intake Meeting, these checklists should be distributed to the team who will be assisting with the client’s move.  These checklists should be completed  prior to move-in.

  Client Service Coordinator Checklist:
___      Releases in place for all vocational, social and legal contacts.
___      Authorizations for Treatment signed for all medical and mental health   providers.
___      Face sheet completed and turned in to Diane for addition to the client database.
___      Copy of guardianship obtained.
___      Copies of WA State ID, Social Security card, Medicare Card, Birth Certificate,  Provider One Medical Card, Part D Insurance Card are obtained.
___      Set up new ISP (Assessment) with DDD Case Manager.

___      Provide the Client finance Coordinator with a list of needed household  items and prices at least three weeks prior to purchasing the items
___      IISP Support Goals completed (after ISP)
___      Client has been added to the phone list.
___      Client demonstrates the ability to access after hours on-call support.            (Independent Living)
___      Client information has been added to the on-call books.
___      Safety equipment in place, if needed (first aid kit, fire extinguisher, door            alarms,  outlet covers, etc)
___      Move-in PPL has been completed.  Original copy placed in CSC master file.
___      Work with landlord to get an extra set of keys, if needed.
___      New landlord notified of the move
___      Hold responsibility for communication between the office and the house            involved about important move information and needs.

   Medical Services Coordinator’s Checklist:

___      The new client is enrolled with a physician, dentist, eye doctor and any  other required medical service providers.

___      POLST form completed with the physician and guardian.

 ___      Copies of all medication prescriptions are obtained from client’s doctor.

 ___      All needed medical supplies are present in the home.
___      Master Medication List completed.
___      All needed protocols are in place (bowel, seizure, feeding, behavioral)
___      All of the client’s medications are in place in the client’s home.

___      Ensure that current pharmacy suits the client’s needs.

 ___      Nurse Delegation is in place, if needed.

 Client Finance Coordinator’s Checklist:
___      Individual Financial Plan completed.
___      Payeeship application turned in to Social Security (if applicable)
___      Application for Food Stamps and Section 8 have been completed.

 ___      Submit a list of needed household items and prices to the DDD Case Manager for pre-approval.  Notify the Client Services Coordinator when pre-approval is received.

___      Obtain a copy of the new lease or rental agreement.
___      Utilities and cable are turned on.
___      Change of address turned in to the Post Office
___      Notify power company, cable company and phone company and make  any necessary changes to service and service location (if opening a new home).
___      Fill out the HUD “move packet”
___      Make arrangements for guardian/client to sign HUD “move packet”
___      Receive HUD “leasing packet” and notify CSC.

___      Attend lease  signing
___      Give HUD copy of lease, original to be kept in CSC file.
___      Process move expenses, including sending Residential Allowance            Requests for reimbursement of start-up funds loaned from Kokua Client            Account.
___      Set up financial book.

  Team Leader:
___      Create a complete set of client books
___      Completed Evacuation Plan in the home.
___      Update the Emergency Book (disaster preparedness, exposure control plan, etc.)

___      Exposure Control Plan completed and in the home.
___      Go with client to the Department of Licensing to obtain a new ID Card with new address.
___      Contact all doctor’s, Dial-A-Lift, pharmacy, necessary family members, counselors, etc. to inform them of the new address.

  Training Coordinator:
___      Ensure that all staff have background checks, initial training and nurse delegation.
___      Ensure that the PPE is in the home.
___      Ensure that the Exposure Control Plan is in the home and accurate.
___      Ensure that the Emergency Plan is in the home and is accurate.
___      Organize a client-specific training for all staff .
___      Home has been inspected to assure that there are no existing health or safety hazards.

  Resource Team:
___      All adaptive equipment in place and staff trained on proper use.

___      Written protocols in place for all adaptive equipment, transfers, feeding needs, PT, communications plans, etc.
___      Records created on all of the client’s medical equipment

  Mental Health Specialist:
___      Positive Behavior Support Plan and Functional Assessment are in place, if needed.
___      Work with Training Coordinator to ensure that staff have been trained on information regarding mental health,  the mental health plans and the implementation of  behavior supports.
___      Schedule appointments for any needed Psychoactive Med Plans.
___      If needed create a behavior data log.

  Director of Client Services’s Checklist:

___      Schedule weekly meetings about move progress.
___      Assure that a Payee Account has been established, if needed.
___      Requests for Exceptions to Policy turned in to DDD, if needed.
___      Keys are available for staff.  Diane has a set of all keys.
___      Coordinate start-up needs with financial coordinator and ensure that purchases  have been made.
___      Designate power of attorneys if starting a checking account.

  Human Resource Coordinator:
___    Ensure that the house has accurate and appropriate schedules
___      Ensure that the policy and procedures manual is in the new home.
___      Ensure that L& I injury packets are in the home.

___   Ensure that copies of the house schedule are in the On-Call Books

 PHASE FOUR-WELCOME AND FOLLOW-UP

  At the time of the move-in, the Director of Client Services will:

  • Send a “Welcome Packet” to the new client and their family or guardian.  This packet will contain a cover letter; a copy of the staff schedule; the address and phone number of the client’s home; emergency and after hours contact information; and a directory of “Who to Call” with different issues.
  • The Director of Client Services will give the Administrative Assistant contact information for the client’s family so that they can receive the newsletter.
  • The Director of Client Services will make a follow-up contact with the family or guardian by phone two weeks after the move-in to be sure that there are no unresolved issues.

  INTRA-AGENCY MOVE/RECONFIGURATION

 FINAL MOVE-IN CHECKLIST

 Client Service Coordinator’s Checklist:
___      Releases in place for any new medical, vocational, social and legal contacts.
___      Contact the DDD Case Manager and guardians  informing them of the move and the new address.
___      Authorizations for Treatment signed for any new medical and mental health providers.
___      Face sheet change completed and turned in to Diane for updating the client database.
___      Client’s new address and phone number changed on the phone list.
___      Client information has been changed in the on-call books.
___      Safety equipment in place, if needed (first aid kit, fire extinguisher, door alarms, outlet covers, etc)
___      PPL has been updated.  Original copy placed in CSC master file.
___      Clients books are transferred to the new home, updated as needed.
___      Obtain a copy of the new lease or rental agreement.
___      Work with landlord to get an extra set of keys, if needed.
___      Hold responsibility for communication between the office and the house(s)involved about important move information and needs.
Client Finance Coordinator:

 ___      Give a 30-day notice to Housing Authority and current landlord.

___      Send the DDD Case Manager a list of anticipated moving expenses for pre-            approval.

____     Set up a meeting with the new landlord and client/guardian to sign HUD “leasing packet”
___      Deliver HUD “leasing packet” (complete) to HUD
___      Attend lease signing
___      Give HUD copy of lease, original to be kept in CSC file.
___      Update the client’s IFP budget plan.
___      Utilities are turned on.
___      Change of address turned in to the Post Office
___      Notify Social Security of the move.
___      Notify CSO or WASHCAP of the move.
___      Notify power company, cable company and phone company and make any necessary changes to service and service location.
___      Fill out the HUD “move packet”
___      Make arrangements for guardian/client to sign HUD “move packet”
___      Receive HUD “leasing packet” and notify CSC
___      Process move expenses, including reimbursements for items needed and paid for through Kokua client accounts.

Medical Services Coordinator’s Checklist:

___      All of the client’s medications are in place in the client’s home.
___      All needed medical supplies are present in the home.

___      All medical and health protocols are in place.

___      Delegating Nurse notified of clients’ address change.

  Team Leader:
___      Complete set of client’s books are in place.
___      Completed Evacuation Plan in the home.
___      Update the Emergency Book (disaster preparedness, exposure control plan, etc.)
___      Go with client to the Department of Licensing to obtain a new ID Card with new address.
___      Contact all doctors, Dial-A-Lift, pharmacy, necessary family members, counselors, etc. to inform them of the new address.

  Training Coordinator:
___      Ensure that all new staff have background checks, initial training and nurse delegation (as needed).
___      Ensure that the PPE is in the home.
___      Ensure that the Exposure Control Plan is in the home.
___      Ensure that the Emergency Plan is in the home and accurate.
___      Organize a client specific training if the move involves a new combination of clients unfamiliar to the staff
___      Home has been inspected to assure that there are no existing health or safety hazards.

Resource Team.
___      All adaptive equipment in place.

___   Protocols in place for all medical equipments, transfers or feeding needs
___      Records created on all of the client’s medical equipment

 Mental Health Specialist:
___      Positive Behavior Support Plan and Functional Assessment are in place, if         needed.
___      Work with Training Coordinator to ensure that staff have been trained on            information regarding mental health, the mental health plans and the implementation of  behavior supports.
___      Create a behavior data log, if needed

  Director of Client Services’s Checklist:
___      Schedule weekly meetings about move progress.
___      Requests for Exceptions to Policy turned in to DDD, if needed.
___      Keys are available for staff.  Diane has a set of all keys.