Alabama Administrative Code › Title 560 - ALABAMA MEDICAID AGENCY › Chapter 560-X-52 - HOME AND COMMUNITY-BASED LIVING AT HOME (LH) WAIVER FOR THE MENTALLY RETARDED › Section 560-X-52-.02 - Description of Services

Current through Register Vol. 42, No. 9, June 28, 2024
Home and Community-Based Services (HCBS) under the Home and
				Community-Based Living at Home (LAH) Waiver for persons with Intellectual
				Disabilities are defined as Title XIX Medicaid-funded services provided to
				individuals with intellectual disabilities who, without these services, would
				require services in an Intermediate Care Facility for Individuals with
				Intellectual Disabilities (ICF/IID). These HCBS under the LAH Waiver will
				provide health, social, and related support needed to ensure optimal
				functioning of individuals with intellectual disabilities within a community
				setting. The operating agency may provide or subcontract for any services
				provided in this waiver. To qualify for Medicaid reimbursement each individual
				HCBS must be necessary to prevent institutionalization. Each provider of
				services must have a signed provider contract, meet provider qualifications and
				comply with all applicable state and federal laws and regulations. Services
				that are reimbursable through Medicaid's EPSDT Program shall not be reimbursed
				as HCBS under the LAH Waiver. The following are specific HCBS available under
				the LAH Waiver:
(1) In-Home Residential
			 Habilitation Training Services
(a) In-Home
			 Residential Habilitation Training Services provide care, supervision, and
			 skills training in activities of daily living (ADL)s, home management and
			 community integration.
(b) In-Home
			 Residential Habilitation Training Service includes the following:
1. Habilitation training and intervention in
			 the areas of self-care, sensory/motor development, interpersonal skills,
			 communication, behavior shaping, community living skills, mobility, health
			 care, socialization, community inclusion, money management, pursuit of leisure
			 and recreational activities and household responsibilities. Training and
			 intervention may consist of incidental learning in addition to formal training
			 plans, and will also encompass modification of the physical and/or social
			 environment, meaning, changing factors that impede progress (e.g. moving a
			 chair, substituting velcro closures for buttons or shoe laces, changing
			 peoples' attitudes toward the waiver recipient, opening a door for someone,
			 etc.) and provision of direct support, as alternatives to formal habilitative
			 training.
2. Habilitation supplies
			 and equipment; and
3.
			 Transportation costs to transport waiver recipients to day programs, social
			 events or community activities, when public transportation or transportation
			 covered under the Medicaid State Plan is not available, accessible or desirable
			 due to the functional limitations of the waiver recipient, will be included in
			 payments made to providers of Residential Habilitation. Residential
			 Habilitation service workers may transport waiver recipients in their own
			 vehicles as an incidental component of In-Home Residential Habilitation
			 Training Service.
(c)
			 In-Home Residential Habilitation Training Services are provided to waiver
			 recipients in their own homes, but not in group homes or other
			 facilities.
(d) A unit of service
			 is 15 minutes. The place of service will primarily be the waiver recipient's
			 home, but may include services in the community to promote opportunities for
			 inclusion, socialization, and recreation.
(e) In-Home Residential Habilitation Training
			 Service goals must relate to identified, planned goals. Training and
			 supervision of staff by a Qualified Intellectual Disabilities Professional
			 (QIDP) shall assure the staff is prepared to carry out the necessary training
			 and support functions to achieve these goals. Initial training requirements
			 must be met prior to the staff beginning work. Additional training to
			 specifically address and further the goals in the waiver recipient's plan may
			 occur on the job. Waiver recipients and family members shall be included in the
			 planning, and shall be offered and encouraged to use the opportunity to
			 participate in the training and supervision of the staff.
(f) In-Home Residential Habilitation Training
			 Service excludes the following:
1. Services,
			 directly or indirectly, provided by a member of the waiver recipient's
			 immediate family;
2. Routine care
			 and supervision which would be expected to be provided by a family
			 member;
3. Activities or
			 supervision for which a payment is made by a source other than Medicaid;
			 and
4. Room and board
			 costs.
(g) Providers of
			 Residential Habilitation must be certified by the Department of Mental
			 Health.