GField 2 – Opening a Case

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When CHFS has been appointed limited guardian, guardian, limited conservator, or conservator for an adult, the Division of Guardianship shall meet specific guidelines and adhere to designated time frames. Following these guidelines and time frames will help to ensure the protection of the individual’s basic human rights and resources. Time frames vary from 3 to 30 working days and include inserting documentation into KYGFIS, being assigned as the Guardianship State Social Worker (GSSW), meeting with the individual, and gathering information about the individual.

Let’s take a look at the following scenarios.

Scenario #1:

The Cabinet for Health and Family Services (CHFS) was appointed over Tuva Smith out of Spencer County today in court. This is a brand-new case with no referral information, and the applicant did not show up to be appointed after the court found the person to be wholly disabled. The Guardianship State Social Worker called the GFSOS, and they initiated the new case checklist which involves the Admin, GSSW, and the GFSOS.

Whose role is it to input case information and create a case into the KYGFIS system?

Anyone whom the GFSOS designates. It is typically the role of the Office Admin, however, all field staff have the ability and shall know how to enter a case into the system.

Whose role is it to input case information and create a case into the KYGFIS system?

Anyone whom the GFSOS designates. It is typically the role of the Office Admin, however, all field staff have the ability and shall know how to enter a case into the system.

After the case is created in the system, what happens next if you are the Office Admin?

The Office Admin should create a hard file within 5 working days. The hard file (or paper file) is expected to contain certain records, which are:

Certified copy of the Guardianship Appointment
Disability Judgment/Adjudication
Other Legal Documents
Health Insurance Cards: Medicaid, Medicare, Medical
Secondary Health Information
Contact Information

Scenario #2

GSSW Sally Sue has been feverishly calling and checking on her clients all week. She has spoken with Dr. Mittal about Jimmy Carter needing an x-ray because might have pneumonia and spoke with a facility about Tommy Lee throwing his clothes in the dumpster, and lastly spoke with Betty Crocker about her request for additional personal needs to go to the store to get more cigarettes. Sally has also been out covering court and doing visits. Sally felt she was pretty accomplished this week, and everything she has done has been logged in her notebook.

Does Sally deserve a pat on the back? Why or why not?

YES and NO. Sally has done great work this week.

All this great work is not reflected or counted since she has not documented anything in the KYGFIS system.

Did you know that the KYGFIS system, when used regularly, keeps running records known as events? It is a great tool when used consistently.

What are events?

Events are case records. They should be entered into KYGFIS ongoingly and are to be thorough and accurate. Workers should articulate clearly and concisely all details relevant to the event. Examples of events are:

Contacts made or received, whether collateral or directly with the individual
Face-to-face contacts, collateral or directly with the individual
Consents for services or treatment
Court matters and hearing attendance
Appointment paperwork and documentation of all legal matters
Medical, mental health and psychological records
Allegations of abuse, neglect, exploitation
Care plans, risk assessments, and rights restrictions
Contracts, lease, and facility agreements
Written correspondences, including emails
Benefits and Fiduciary Information
Veteran Information
Voting Information
Listing of all property
DNR/EOL documentation
Burials
Medical Insurance and Insurance Cards

Guardianship intent is to be a paperless (or as close to paperless as possible) program and uses a documentation system called Kentucky Guardianship/Fiduciary Information System (KYGFIS, or GFIS as it is commonly called). KYGFIS is a gatekeeper for all documents and information pertaining to an individual. When used correctly and consistently, it is a one-stop shop for you to find out and learn anything and everything there is to know about an individual.

But what is key?

Workers must put the information into the system accurately and concisely.

Do you know what happens when a worker inputs an address change into KYGFIS?

For starters, it keeps the worker up to date on where the client is physically residing and where the client can be found during the day. It can also tell us who we are supposed to be paying monthly rent/facility payments to. A simple address change can also alert Fiduciary that a person’s Level of Care (LOC) has changed in case an individual needs more medical coverage or the state supp needs to end.

What would happen if the worker failed to change the address timely?
Well you are going to make a few people aggravated. You not only have potentially caused money to be sent to the wrong facility, and now must be tracked down for recovery, but you also have potentially affected an individual’s benefits as the nursing home was expecting payment, and they are still listed in the hospital for the last month. Keeping addresses up to date is as important as keeping your running records (a.k.a. events) up to date.

Each Section in KYGFIS is equally as important as the one before. Each section has its own purpose, and no, the purpose is not to make the worker do more work. The electronic file shall be updated in a timely, thorough, and precise manner, within five (5) business days of the receipt of information. The electronic file shall be kept current and reflect an ongoing accounting of the individual’s status, so that any member of the Guardianship Services team can review, ascertain case details, and make informed decisions.

Sections include:

Events – running case notes
Address History – running log of the past residential addresses, current residential address, and the location where the client can be found during the day (adult day program, etc.)
Status History – whether the person is active, resigned or expired
Appointment History – CHFS’s past and current roles
Contacts – family contact, funeral home information, pertinent people you may need to contact
Transactions – Similar to a check book register for the individual. The Guardianship worker never writes a check. That task belongs to the Fiduciary Branch. The Guardianship worker requests and views the status of transactions in the individual’s account.
Assets – find property, life insurance, trust, annuities (only Fiduciary has access to enter)
Liabilities – credit card bills, bills in default, bills the individual cannot currently pay during a normal monthly budget cycle (only Fiduciary as access to enter)
Tasks – things to do list, workers can assign themselves a task, or their supervisor can assign
Annual Reports – running record of all court reports that have been completed and approved
Diagnosis – A summary of the individual’s medical conditions
Incidents – events that have happened to the individual under guardianship or actions of the individual
Reports – Various reports are accessible to Guardianship Staff to gather information, assess data and utilize as needed to meet the ongoing needs of the individual
Attachments – The GSSW shall enter all health, medical and psychological records as attachments under this section.
Victimization – if the client is listed on the face sheet as being a victim, here is where you put what made them a victim.

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