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Reasons for Area Office Review

Certain situations result in area office reviews of a cost plans. A cost plan will automatically be checked for the
possibility of sending to the area office for review each time a WSC clicks the Save and Process button. When
the area office receives one of these cost plans in its queue or as an activity on the Activities page, a staff
member will read the reason in the Reason for Area Review box and verify that all health and safety needs
have been met before approving the cost plan

In the Area Office Processing box, you might see the following reasons for an area office review:

1. Reason: Automatically sent to Area Office Review
     a. Description: This happens when it is the first cost plan for a consumer or when the WSC wants 
         the area office to check something before approving. 
2. Reason: One or more of the consumer's needed services have not been budgeted in the cost plan
     a. Description: This happens when there is no service plan for a service that is needed to meet 
         the health and safety requirements of the consumer. To verify this, click on Consumer 
         Approved Services to make sure there is a service plan for all services listed.
3. Reason: The service Environmental Accessibility Adaptations has triggered an automatic 
    area review. Please verify that the total expenditure is not greater than $20,000 within the last five 
    years.
     a. Description: Environmental Accessibility Adaptations has a maximum allowed amount of 
         $20,000 per every five years of services. This alert reminds the area office staff to verify that 
         limit has not been met yet for this consumer.Area Office User Guide 01/14/13 Page 32 8.1b
4. Reason: One or more of the consumer's needed services have been budgeted less than the current 
    approved cost plan.
     a. Description: When a cost plan is built and copied for changing, those changes are tracked to 
         create a history or Historical Cost Plan. The plans are then compared to the current approved 
         plan to make sure that the changes will not affect the health and safety of the consumer. 
         When this alert appears, it means that a needed service has been reduced. The area office 
         needs to verify that this lesser amount will still meet the health and safety requirements of the 
         consumer.
5. Reason: Waiver Support Coordination has not been budgeted as required.
     a. Description: Waiver Support Coordination is a required service for all cost plans. This alert 
         verifies that it has been budgeted for every month of service in the cost plan. To check this,
         open the service plan for Support Coordination in the cost plan and verify that the amounts for 
         each month are correct.
6. Reason: Consumer does not accept the cost plan. Please review the Explanation for details.
     a. Description: When a consumer does not wish to accept the cost plan, the WSC will click No
         instead of Yes next to Consumer accepts the cost plan. The reason for the consumer’s nonacceptance of the cost plan will be inserted by the WSC in a section titled Explanation for Why 
Consumer Does Not Accept Cost Plan. The cost plan can still be approved, but this allows the 
area office to track which consumers did not accept the cost plan.                 

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