Alabama Administrative Code › Title 560 - ALABAMA MEDICAID AGENCY › Chapter 560-X-35 - HOME- AND COMMUNITY-BASED WAIVER FOR PERSONS WITH INTELLECTUAL DISABILITIES › Section 560-X-35-.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 Waiver for Persons with Intellectual Disabilities (ID Waiver)
				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 ID Waiver will provide health, social, and
				related support needed to ensure optimal functioning of individuals with
				intellectual disabilities within a community setting. The Administering Agency
				may provide or subcontract for any HCBS under the ID Waiver. To qualify for
				Medicaid reimbursement, each individual HCBS must be necessary to prevent
				institutionalization of the waiver recipient. Each provider of HCBS 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 ID Waiver. The following are specific HCBS available under the ID
				Waiver:
(1) Residential Habilitation
			 Services
(a) Residential Habilitation shall
			 mean a type of residential service selected by the person supported, offering
			 individualized services and supports that enable the person supported to
			 acquire, retain, or improve skills necessary to reside in a community-based
			 setting and which supports each resident's independence and full integration
			 into the community, and ensures each resident's choice and rights.
(b) Residential Habilitation Services may be
			 provided either in a certified community setting or in the waiver recipient's
			 residence (family home, own home or apartment).
(c) Residential Habilitation Services provide
			 care, supervision, and skills training in activities of daily living, home
			 management and community integration in group homes.
(d) In-home Residential Habilitation Services
			 provide care, supervision, and skills training in activities of daily living,
			 home management and community integration to a waiver participant in their own
			 homes, but not in group homes or other facilities. The place of service will
			 primarily be the person's home but may include training in the community to
			 promote opportunities for inclusion, socialization, and recreation.
(e) Residential and In-home Habilitation
			 services include 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.
(f) Residential and In-home Habilitation
			 services will be delivered/supervised by a Qualified Intellectual Disabilities
			 Professional (QIDP) in coordination with the waiver's recipient's approved plan
			 of care.
(g) In-Home Residential
			 Habilitation Services can also be delivered by a Habilitation Aide. The
			 Habilitation Aide will work under supervision and direction of a
			 QIDP.
(h) A Habilitation Aide will
			 be required to be certified by the provider agency as having completed a course
			 of instruction provided or approved by the ADMH. Retraining will be conducted
			 as needed, but at least annually.
(i) In-Home Habilitation Service is limited
			 to 8 hours per day and cannot overlap other services.
(j) In-Home Habilitation Services are not
			 available for new waiver participants. Current waiver participants receiving
			 this service will continue at the current assessed need.
(k) Transportation costs to transport
			 individuals to day programs, social events or community activities when public
			 transportation and/or transportation covered under the Medicaid state plan are
			 not available will be included in payments made to providers of residential
			 habilitation. In-home Habilitation service workers may transport consumers in
			 their own vehicles as an incidental component of this service.