CW Frequently Asked Questions

Reimbursable mileage is miles traveled for business minus commuter miles. Commuter miles are miles from the colleague’s home to the colleague’s assigned office. Reimbursable mileage is calculated by adding together all business miles traveled in a workday and then subtracting commuter miles.  

We are currently reviewing the options related to PTO for those impacted by the Care Wisconsin changes. 

We are currently reviewing the options related to PTO for those impacted by the Care Wisconsin changes. As mentioned, we continue to work through other organizational opportunities as it relates to the merge of three organization’s various compensation structures. Experience and education are considered at the time of an offer.   

Yes, MATRIX has several sections (case notes included) that can be used without an internet connection although we encourage colleagues to work online as much as possible because it is more reliable.

While we don’t provide individual hotspots, we do have a limited number available within each office for staff to check out for short periods of time.   

All colleagues are provided with the following equipment:

• HP Elitebook 840 or HP Elitebook 850 depending upon preference (Laptops are replaced every three years to minimize downtime and disruption due to mechanical issues.)
• Laptop messenger bag or backpack
• HP 24″ Monitor with built-in docking station, webcam, speakers and microphone
• Wireless Keyboard & Mouse
• Jabra Headset

Teams do not have access to CARES; however, Eligibility and Finance staff have access to CARES and work with IDT and members to ensure that members maintain eligibility. 

Yes, we absolutely support continuing education for Social Workers, both in–house and through external learning opportunities. We continue to enhance our offerings for colleagues as well.  Inclusa does not require that Care Managers be certified Social Workers.  

Yes, you can indicate your address and home county on the Care Wisconsin landing page. Through the application process we will dig further into your needs, along with the member outcomes we must achieve. It is most certainly taken into consideration!  

Inclusa has access to Electronic Health Records (EHR) systems for many healthcare partners. 

These include: 

• Ascension (Athenahealth) 
• Aspirus (EPIC and Meditech which is specific to Riverview Hospital) 
• CIOX/IOD – a third party administrator for medical records management for health systems such as Essentia Health.  This allows for the electronic distribution of medical records. 
• Gundersen Health System (GHS Link) 
• Marshfield Clinic Health System (Cattails), including Registry for Effectively Communicating Immunization Needs (RECIN) 

• Mayo Clinic Health System (CareLink) 
• Tomah Memorial Hospital (EPIC CareLink) 
• UW Health (Care Link) 
• Wisconsin Immunization Registry (WIR) 

The Quality Innovation team continues to work to secure access to additional EHR systems.  Quality Innovation also oversees Inclusa‘s management of user access and performs regular auditing to ensure appropriate use. 

We do not have access to Aurora Health Systems EHR at this time; however, we will plan to pursue outreach with them.  

Access to electronic health records is by employee. HWCs (nurses), CSS (Certified Screen Specialist), and DME Coordinators are granted access to appropriate EHRs, as needed. 

Other roles (CRCs -Care Managers and others) are not granted access as a standard practice but instead can access EHRs with the assistance of an HWC. However, CRCs and others can request special access when needed. These are evaluated on a case by case basis.  

Matrix, which is a Care Management system unique to Inclusa. 

As of this time, we are awaiting clarification from DHS on communication to members as we proceed to transition.  It is not clear at this time what messages members will receive between the August 15, 2019 date of certification and January 1, 2020.  Inclusa expansion leads are in communication with DHS officials and have posed this and a series of related questions.  As we gain clarity, we will share the information with Care WI employees. 

This is still to be determined and will likely be based on the number of enrollments.   

Typically, at least one Member Support Manager supports an office.  There have been instances, where a drop-in office with assigned staff is supported by an MSM in another Inclusa office.   

Member Support Managers (MSM’s) are the main support for IDT.  Each MSM supports a unit serving 250-300 members and 12-15 staff.  Unit meetings occur twice per month and are generally in person. These meetings are a critical part of  Inclusa’s strategy to  ensure that IDT receive accurate and timely information.  Included are updates on the following subjects: new or revised policies/procedures, organizational information, provider relations, discussion of local issues and general brainstorming.    MSM’s support to IDT is tailored to the needs of the teams at any given time. Generally, MSM have regular 1:1 meetings with IDT, as well as case consultations with teams. Our goal is to provide teams with the information and support they need to effectively manage workload and provide excellent customer service to our members and other stakeholders.  

This varies according to the membership of the county; we do have county specific teams when there is membership to support this approach.  We make every effort to assign caseloads that minimize travel and allow teams to know the communities they work in.  

Typical caseloads are 1:36 for Community Resource Coordinators (Care Managers) and 1:72 for Health and Wellness Coordinators (Nurses).  Mental Health Teams, which are in the larger offices, have slightly lower caseloads.   

The RFP identifies the 1/1/20 start date, DHS would need to amend that for individuals to begin supports with Inclusa prior to then.   

Inclusa uses a dedicated Certified Screen Specialist (CSS) model to complete all Long-Term Care Functional Screens. The ratio we use at Inclusa is 1 CSS to 250 members.     

 The CSS at Inclusa work professionally by representing Inclusa in the community, reaching out to collateral sources, accessing medical records, sending letters to members, and managing their own calendars for work assignment completion.  The CSS are required to attend one screening unit meeting per month and will meet with their supporting manager at least monthly or more often as appropriate for the individual. 

 CSS are all certified Long-Term Care Functional Screeners and work from various locations within Inclusa’s service regions to complete all screens in the most efficient, accurate, and cost–effective manner based on the location of the member and the screen’s due date.  The LTCFS Managers and Liaison are also certified screeners and work collaboratively to provide screen assignments, support and oversight for CSS screen quality and timeliness. 

The expectation for workload of a CSS is generally to complete and calculate 25-35 screens per month.  This number may vary depending on the coverage area, travel time, and other circumstances.  The numbers each CSS completes and the area that each CSS covers ensures that we have the appropriate number of CSS to meet the needs of the screening unit.  Screeners in the metropolitan areas where travel is less and screens can be grouped more easily per trip, will likely complete more screens per month than a screener covering a larger area and is not able to group as many screens in one trip.  

Annual Screen assignments are provided to the CSS 2 months ahead of the month the screen is due giving ample time to the CSS to schedule and complete the screens.   Change in Condition screens are assigned as request are made by IDT staff.  These requests have varying due dates depending on their priority and are blended into the CSS monthly assignments according to their due date as they are assigned.   The LTCFS Managers keep master spreadsheets and run reports to ensure all screens are completed. 

Inclusa has written Best Practice guidelines and a CSS handbook to assist with the completion of the screening process.   The LTCFS Managers and Liaison are available every work day to answer questions and provide support and guidance. 

We will begin reaching back out to those that expressed interest in the next couple of weeks to schedule interviews. As always, you can contact us with additional questions along the way. We are certainly here to support you!  

We are still reviewing the training timelines and locations. This will be a partnership with DHS and Care Wisconsin. We want to support Care Wisconsin’s commitment through December.  

We plan to set up offices in Green Bay and Marinette.  Based on the conversation with Care Wisconsin staff on 7/24/19, we will revisit the feasibility of a Shawano location.