Kentucky Administrative Regulations › Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES › Chapter 12 - Supports for Community Living Waiver › Section 907 KAR 12:010 - New Supports for community living waiver service and coverage policies

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				205.520,
				205.5605,
				205.5606,
				205.5607,
				42 C.F.R.
				441 Subpart G,
				42 U.S.C.
				1396a, b, d, n
NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Health and
				Family Services, Department for Medicaid Services, has responsibility to
				administer the Medicaid Program.
				KRS
				205.520(3) authorizes the
				cabinet, by administrative regulation, to comply with any requirement that may
				be imposed, or opportunity presented, by federal law to qualify for federal
				Medicaid funds. This administrative regulation establishes the service and
				coverage policies for the Supports for Community Living (SCL) waiver program.
				The SCL waiver program is federally authorized via a 1915(c) home and community
				based waiver that enables individuals with an intellectual or developmental
				disability to reside and receive services in a community setting rather than in
				an intermediate care facility for individuals with intellectual disabilities,
				including a participant directed services option pursuant to
				KRS
				205.5606.
Section
			 1. Definitions.
(1) "1915(c)
			 home and community based waiver program" means a Kentucky Medicaid program
			 established pursuant to, and in accordance with,
			 42 U.S.C.
			 1396n(c).
(2) "Abuse" is defined by
			 KRS
			 209.020(8).
(3) "Adult day health care center" means an
			 adult day health care center licensed in accordance with
			 902 KAR 20:066.
(4) "Adult foster care home" means a home:
(a) Not owned or leased by an SCL
			 provider;
(b) In which a
			 participant:
1. Is at least eighteen (18)
			 years of age; and
2. Receives SCL
			 services and resides in the family occupied (leased or owned) home;
			 and
(c) In which the
			 family:
1. Includes the participant in the
			 family's household routines;
2.
			 Provides training and supervision; and
3. Ensures that the participant's needs are
			 met in accordance with the participant's person-centered service
			 plan.
(5)
			 "Advance directive" is defined by
			 KRS
			 311.621(2).
(6) "Aversive technique" means:
(a) Withholding:
1. Food or hydration as a means to control or
			 impose calm;
2. Access to a legal
			 advocate or ombudsman;
3. Access to
			 toilet, bath, or shower;
4. Access
			 to personal belongings; or
5.
			 Access to natural supports;
(b) Depriving medical attention or prescribed
			 medication; or
(c) Depriving
			 sleep.
(7) "Behavior
			 intervention committee" or "BIC" means a group of individuals:
(a) Established to evaluate the technical
			 adequacy of a proposed behavioral intervention for a participant; and
(b) That meets in accordance with the BIC
			 policies established in Section 8 of this administrative regulation.
(8) "Board" means three (3) meals
			 a day or other full nutritional regimen of a caregiver for the purpose of
			 providing shared living services.
(9) "Case manager" means an individual who:
(a) Meets the requirements for a case manager
			 established in Section 6 of this administrative regulation; and
(b) Meets all personnel and training
			 requirements established in Section 3 of this administrative
			 regulation.
(10) "Case
			 manager supervisor" means an individual who:
(a) Provides professional oversight of case
			 managers;
(b)
1. Has a bachelor's or higher degree in a
			 human service field from an accredited college or university;
2. Has a bachelor's degree in any other field
			 from an accredited college or university with at least one (1) year of
			 experience in the field of intellectual disability; or
3. Is a registered nurse;
(c) Has at least two (2) years of
			 experience of case management responsibility in an organization that serves
			 individuals with intellectual or developmental disabilities;
(d) Completes a case management supervisory
			 training curriculum approved by DBHDID within six (6) months of beginning
			 supervisory responsibilities; and
(e) Meets all personnel and training
			 requirements established in Section 3 of this administrative
			 regulation.
(11)
			 "Certified nutritionist" is defined by
			 KRS
			 310.005(12).
(12) "Certified psychologist" means an
			 individual who is recognized as a certified psychologist in accordance with 201
			 KAR Chapter 26.
(13) "Certified
			 psychologist with autonomous functioning" means a person licensed pursuant to
			 KRS
			 319.056.
(14) "Certified school psychologist" means an
			 individual certified by the Kentucky Education Professional Standards Board
			 under 16 KAR 2:090.
(15) "Chemical restraint" means a drug or
			 medication:
(a) Used to restrict an
			 individual's:
1. Behavior; or
2. Freedom of movement; and
(b)
1. That is not a standard treatment for the
			 individual's condition; or
2.
			 Dosage that is not an appropriate dosage for the individual's
			 condition.
(16)
			 "Community access specialist" means an individual who:
(a) Provides support and training that
			 enables a participant to develop a network of natural supports to achieve a
			 clearly defined and valued social role within the participant's
			 community;
(b) Has:
1. Previously qualified or been credentialed
			 by the department to provide community access services prior to the effective
			 date of this administrative regulation; or
2.
a. At
			 least one (1) year of experience in the field of intellectual or developmental
			 disabilities; and
b. Completed a
			 department approved training program within one (1) year of application while
			 providing community access services under the direct supervision of a community
			 access specialist; and
(c) Meets the personnel and training
			 requirements established in Section 3 or 10 of this administrative
			 regulation.
(17)
			 "Community guide" means an individual who:
(a)
			 Has been selected by a participant to provide training, technical assistance,
			 and support including individual budget development and implementation in
			 aspects of participant direction; and
(b) Has:
1.
			 A bachelor's degree in a human services field from an accredited college or
			 university;
2. A bachelor's degree
			 in any other field from an accredited college or university plus at least one
			 (1) year of experience in the field of intellectual or developmental
			 disability; or
3. Experience in the
			 field of intellectual or developmental disabilities that will substitute for
			 the educational requirements stated in subparagraph 1. or 2. of this paragraph
			 on a year-for-year basis;
(c) Meets the personnel and training
			 requirements established in Sections 3 and 10 of this administrative
			 regulation;
(d) Completes a
			 community guide training curriculum approved by DBHDID within six (6) months of
			 being employed by the first participant supported; and
(e) Provides services to a participant in
			 accordance with Section 4 or 10 of this administrative regulation.
(18) "Controlled substance" is
			 defined by KRS
			 218A.010(6).
(19) "Covered services and supports" is
			 defined by KRS
			 205.5605(3).
(20) "DBHDID" means the Department for
			 Behavioral Health, Developmental and Intellectual Disabilities.
(21) "DCBS" means the Department for
			 Community Based Services.
(22)
			 "Department" means the Department for Medicaid Services or its
			 designee.
(23) "Developmental
			 disability" means a disability that:
(a) Is
			 manifested prior to the age of twenty-two (22);
(b) Constitutes a substantial disability to
			 the affected individual; and
(c) Is
			 attributable either to an intellectual disability or a condition related to an
			 intellectual disability that:
1. Results in an
			 impairment of general intellectual functioning and adaptive behavior similar to
			 that of a person with an intellectual disability; and
2. Is a direct result of, or is influenced
			 by, the person's cognitive deficits.
(24) "Direct support professional" means an
			 individual who:
(a) Provides services to a
			 participant in accordance with Section 4 of this administrative
			 regulation;
(b) Has direct contact
			 with a participant when providing services to the participant;
(c) Is at least:
1. Eighteen (18) years old and has a high
			 school diploma or GED; or
2.
			 Twenty-one (21) years old;
(d) Meets the personnel and training
			 requirements established in Section 3 of this administrative
			 regulation;
(e) Has the ability to:
1. Communicate effectively with a participant
			 and the participant's family;
2.
			 Read, understand, and implement written and oral instructions;
3. Perform required documentation;
			 and
4. Participate as a member of
			 the participant's person-centered team if requested by the participant;
			 and
(f) Demonstrates
			 competence and knowledge on topics required to safely support the participant
			 as described in the participant's person-centered service plan.
(25) "Direct support professional
			 supervisor" means an individual who:
(a)
			 Provides oversight of direct support professionals in the provision of services
			 to participants;
(b) Is at least:
1. Eighteen (18) years old and has a high
			 school diploma or GED; or
2.
			 Twenty-one (21) years old;
(c) Meets the personnel and training
			 requirements established in Sections 3 and 10 of this administrative
			 regulation;
(d) Has the ability to:
1. Communicate effectively with a participant
			 and the participant's family;
2.
			 Read, understand, and implement written and oral instructions;
3. Perform required documentation;
			 and
4. Participate as a member of
			 the participant's person-centered team if requested by the
			 participant;
(e) Has at
			 least two (2) years of experience in providing direct support to persons with a
			 developmental disability;
(f)
			 Demonstrates competence and knowledge on topics required to safely support the
			 participant as described in the participant's person-centered service plan;
			 and
(g) Completes a supervisory
			 training curriculum approved by DBHDID within six (6) months of beginning
			 supervisory responsibilities.
(26) "Drug paraphernalia" is defined by
			 KRS
			 218A.500(1).
(27) "Early and periodic screening,
			 diagnostic, and treatment services" is defined by
			 42 U.S.C.
			 1396d(r).
(28) "Electronic signature" is defined by
			 KRS
			 369.102(8).
(29) "Employee" means an individual who is
			 employed by an SCL provider.
(30)
			 "Executive director" means an individual who shall:
(a) Lead the design, development, and
			 implementation of strategic plans for an SCL provider;
(b) Maintain responsibility for the
			 day-to-day operation of the SCL provider organization;
(c)
1. Have
			 a bachelor's or higher degree from an accredited institution; or
2. Be a registered nurse;
(d) Have at least two (2) years
			 of:
1. Experience in the field of intellectual
			 or developmental disabilities; and
2. Administrative experience:
a. In an organization that served individuals
			 with an intellectual or developmental disability; and
b. That includes experience in the execution
			 of the overall administration of an agency including:
(i) Development, implementation, and
			 maintenance of the agency's budget;
(ii) Development, review, implementation, and
			 revisions as needed of the organization's policies and procedures;
			 and
(iii) Supervision of employees
			 including conducting performance evaluations;
(e) Meet all personnel and
			 training requirements specified in Section 3 of this administrative regulation;
			 and
(f) If providing professional
			 oversight or supervision of employees, meet the supervisory qualifications
			 specified for each service.
(31) "Exploitation" is defined by
			 KRS
			 209.020(9).
(32) "Extended family member" means a
			 relative of an individual by blood or marriage beyond the individuals included
			 in the definition of immediate family member.
(33) "Family home provider" means a home:
(a) Not owned or leased by an SCL
			 provider;
(b) In which a
			 participant receives SCL services and resides in the family occupied (leased or
			 owned) home; and
(c) In which the
			 family:
1. Includes the participant in the
			 family's household routines;
2.
			 Provides training and supervision; and
3. Ensures that the participant's needs are
			 met in accordance with the participant's person-centered service
			 plan.
(34)
			 "Financial management agency" means an agency contracted by the department that
			 manages individual participant-directed service plans.
(35) "Functional assessment" means an
			 assessment performed using evidenced based tools, direct observation, and
			 empirical measurement to obtain and identify functional relations between
			 behavioral and environmental factors.
(36) "Good cause" means a circumstance beyond
			 the control of an individual that affects the individual's ability to access
			 funding or services, which includes:
(a)
			 Illness or hospitalization of the individual that is expected to last sixty
			 (60) days or less;
(b) Required
			 paperwork and documentation for processing in accordance with Section 2 of this
			 administrative regulation has not been completed but is expected to be
			 completed in two (2) weeks or less; or
(c) The individual or his or her guardian has
			 made diligent contact with a potential provider to secure placement or access
			 services but has not been accepted within the sixty (60) day time
			 period.
(37) "Group home"
			 means a residential setting:
(a) That is
			 licensed in accordance with
			 902 KAR 20:078;
(b) That is managed by a provider who meets
			 the SCL provider requirements established in Section 3 of this administrative
			 regulation; and
(c) In which no
			 more than eight (8) participants reside.
(38) "Guardian" is defined by
			 KRS
			 387.010(3) for a minor and
			 by KRS
			 387.812(3) for an
			 adult.
(39) "Homicidal ideation"
			 means thoughts about homicide that may range from vague ideas to detailed or
			 fully formulated plans without taking action.
(40) "Human rights committee" means a group
			 of individuals:
(a) Comprised of
			 representatives from home and community based waiver provider agencies in the
			 community where a participant resides; and
(b) Who meet:
1. To ensure that the rights of participants
			 are respected and protected through due process; and
2. In accordance with the human rights
			 committee requirements established in Section 7 of this administrative
			 regulation.
(41) "Human services field" means:
(a) Psychology;
(b) Behavioral analysis;
(c) Counseling;
(d) Rehabilitation counseling;
(e) Public health;
(f) Special education;
(g) Sociology;
(h) Gerontology;
(i) Recreational therapy;
(j) Education;
(k) Occupational therapy;
(l) Physical therapy;
(m) Speech-language pathology;
(n) Social work; or
(o) Family studies.
(42) "ICF-IID" means an intermediate care
			 facility for individuals with intellectual disabilities.
(43) "Illicit substance" means:
(a) A drug, prescription or not prescription,
			 used illegally or in excess of therapeutic levels;
(b) A prohibited drug; or
(c) A prohibited substance.
(44) "Immediate family member" is
			 defined by KRS
			 205.8451(3).
(45) "Impact service" means a service
			 designed to decrease the amount of paid supports a participant requires as the
			 participant becomes:
(a) More independent;
			 and
(b) Less reliant on an
			 employee.
(46)
			 "Individual family service plan" or "IFSP" is defined by
			 KRS
			 200.654(9).
(47) "Integrated employment site" means the
			 location of an activity or job that provides regular interaction with people
			 without disabilities, excluding service providers, to the same extent that a
			 worker without disabilities in a comparable position interacts with
			 others.
(48) "Integrated setting"
			 means a setting that:
(a) Enables a
			 participant to interact with nondisabled persons to the fullest extent
			 possible;
(b) Includes access to
			 community activities and opportunities at times, frequencies, and with persons
			 of a participant's choosing; and
(c) Affords a participant choice in the
			 participant's daily life activities.
(49) "Intellectual disability" or "ID" means:
(a) A demonstration:
1. Of significantly sub-average intellectual
			 functioning and an intelligence quotient (IQ) of seventy (70) plus or minus
			 five (5); and
2. Of concurrent
			 deficits or impairments in present adaptive functioning in at least two (2) of
			 the following areas:
a.
			 Communication;
b.
			 Self-care;
c. Home
			 living;
d. Social or interpersonal
			 skills;
e. Use of community
			 resources;
f.
			 Self-direction;
g. Functional
			 academic skills;
h. Work;
i. Leisure; or
j. Health and safety; and
(b) An intellectual
			 disability that had an onset before eighteen (18) years of age.
(50) "Legally responsible
			 individual" means an individual who has a duty under state law to care for
			 another person and includes:
(a) A parent
			 (biological, adoptive, or foster) who provides care to the parent's minor
			 child;
(b) A guardian who provides
			 care to the guardian's minor child; or
(c) A spouse of a participant.
(51) "Level of care determination"
			 means a determination by the department that an individual meets patient status
			 criteria for an intermediate care facility for individuals with intellectual
			 disabilities as established in
			 907 KAR 1:022.
(52) "Licensed clinical social worker" means
			 an individual who meets the licensed clinical social worker requirements
			 established in KRS
			 335.100.
(53) "Licensed dietitian" is defined by
			 KRS
			 310.005(11).
(54) "Licensed marriage and family therapist"
			 or "LMFT" is defined by
			 KRS
			 335.300(2).
(55) "Licensed medical professional" means
(a) A physician;
(b) An advanced practice registered
			 nurse;
(c) A physician
			 assistant;
(d) A registered
			 nurse;
(e) A licensed practical
			 nurse; or
(f) A
			 pharmacist.
(56)
			 "Licensed practical nurse" is defined by
			 KRS
			 314.011(9).
(57) ''Licensed professional clinical
			 counselor" or "LPCC" is defined by
			 KRS
			 335.500(3).
(58) "Licensed psychological associate" means
			 an individual who:
(a) Currently possesses a
			 licensed psychological associate license in accordance with
			 KRS
			 319.010(6); and
(b) Meets the licensed psychological
			 associate requirements established in 201 KAR Chapter 26.
(59) "Licensed psychological practitioner"
			 means an individual who meets the requirements established in
			 KRS
			 319.053.
(60) "Licensed psychologist" means an
			 individual who:
(a) Currently possesses a
			 licensed psychologist license in accordance with
			 KRS
			 319.010(6); and
(b) Meets the licensed psychologist
			 requirements established in 201 KAR Chapter 26.
(61) "Life history" means an account of the
			 series of events making up a participant's life including:
(a) Developmental and historical information
			 regarding family of origin, childhood experiences, and life events to
			 present;
(b) History of supports
			 received across the life span; and
(c) Life style practices that may lead to
			 greater insight regarding a participant's current preferences, behavioral
			 patterns, wants, and needs.
(62) "Medical order for scope of treatment"
			 is defined by KRS
			 311.621(12).
(63) "Medically necessary" or "medical
			 necessity" means that a covered benefit is determined to be needed in
			 accordance with
			 907 KAR 3:130.
(64) "MWMA" means the Kentucky Medicaid
			 Waiver Management Application internet portal located at
http://chfs.ky.gov/dms/mwma.htm
.
(65) "National Core Indicators" means:
(a) A collaboration between the National
			 Association of State Directors of Developmental Disability Services and the
			 Human Services Research Institute;
(b) An effort by public developmental
			 disabilities agencies to measure and track their own performance; and
(c) Standard measures:
1. Used across states to assess the outcomes
			 of services provided to individuals and families; and
2. That address key areas of concern
			 including employment, rights, service planning, community inclusion, choice,
			 and health and safety.
(66) "Natural supports" means assistance,
			 relationships, or interactions that:
(a) Allow
			 a participant to be in the community;
(b) Include working in a job of the
			 participant's choice in ways similar to people without disabilities;
			 and
(c) Are based on ordinary
			 social relationships at work and in the community.
(67) "Neglect" is defined by
			 KRS
			 209.020(16).
(68) "Occupational therapist" is defined by
			 KRS
			 319A.010(3).
(69) "Occupational therapy assistant" is
			 defined by KRS
			 319A.010(4).
(70) "Office of Vocational Rehabilitation"
			 means the agency mandated:
(a) By the
			 Rehabilitation Act of 1973, as amended; and
(b) To provide individualized services to
			 eligible individuals with disabilities with a substantial impediment to
			 employment in order for the individual to gain and maintain
			 employment.
(71)
			 "Participant" means a Medicaid recipient who:
(a) Meets patient status criteria for an
			 intermediate care facility for individuals with intellectual disabilities as
			 established in
			 907 KAR 1:022;
(b) Is authorized by the department to
			 receive SCL waiver services; and
(c) Utilizes SCL waiver services and supports
			 in accordance with a person-centered service plan.
(72) "Participant-directed service" or "PDS"
			 means an option established by
			 KRS
			 205.5606 within the 1915(c) home and
			 community based service waiver programs that allows recipients to receive
			 non-medical services in which the individual:
(a) Assists with the design of the
			 program;
(b) Chooses the providers
			 of services; and
(c) Directs the
			 delivery of services to meet his or her needs.
(73) "Person-centered coach" means a person
			 who:
(a) Assists a participant and the
			 participant's person-centered team in implementing and monitoring the
			 effectiveness of the participant's person-centered service plan;
(b) Models person-centered
			 thinking;
(c) Is responsible for
			 training a participant, family, guardian, natural and unpaid supports, and
			 other members of the person-centered team when barriers challenge the success
			 of the participant in achieving his or her goals;
(d) Has:
1.
			 A high school diploma or GED; and
2.
a. Two
			 (2) years of experience in the field of intellectual or developmental
			 disabilities; or
b. Completed
			 twelve (12) hours of college coursework in a human services field;
(e) Meets all personnel
			 and training requirements established in Section 3 of this administrative
			 regulation; and
(f) Performs
			 documentation necessary to facilitate compliance with the documentation
			 requirements established in Section 4(12)(d) of this administrative
			 regulation.
(74)
			 "Person-Centered Employment Plan" means a document that identifies the unique
			 preferences, strengths, and needs of a participant in relation to the
			 participant's work.
(75)
			 "Person-centered service plan" means a written individualized plan of services
			 for a participant that meets the requirements established in Section 5 of this
			 administrative regulation.
(76)
			 "Person-centered team" means a participant, the participant's guardian or
			 representative, and other individuals who are natural or paid supports and who:
(a) Recognize that evidenced based decisions
			 are determined within the basic framework of what is important for the
			 participant and within the context of what is important to the participant
			 based on informed choice;
(b) Work
			 together to identify what roles they will assume to assist the participant in
			 becoming as independent as possible in meeting the participant's needs;
			 and
(c) Include providers who
			 receive payment for services who shall:
1. Be
			 active contributing members of the person-centered team meetings;
2. Base their input upon evidence-based
			 information; and
3. Not request
			 reimbursement for person-centered team meetings.
(77) "Physical restraint" means any manual
			 method or physical or mechanical device, material, or equipment that:
(a) Immobilizes or reduces the ability of a
			 person to move his or her arms, legs, body, or head freely; and
(b) Does not include orthopedically
			 prescribed devices or other devices, surgical dressings or bandages, protective
			 helmets, or other methods that involve the physical holding of a person for the
			 purpose of:
1. Conducting routine physical
			 examinations or tests;
2.
			 Protecting the person from falling out of bed; or
3. Permitting the person to participate in
			 activities without the risk of physical harm.
(78) "Physical therapist" is defined by
			 KRS
			 327.010(2).
(79) "Physical therapist assistant" means a
			 skilled health care worker who:
(a) Is
			 certified by the Kentucky Board of Physical Therapy; and
(b) Performs physical therapy and related
			 duties as assigned by the supervising physical therapist.
(80) "Positive behavior support specialist"
			 means an individual who;
(a) Provides
			 evidence-based individualized interventions that assist a participant with
			 acquisition or maintenance of skills for community living and behavioral
			 intervention for the reduction of maladaptive behaviors;
(b) Has a master's degree in a behavioral
			 science and one (1) year of experience in behavioral programming;
(c) Has at least one (1) year of direct
			 service experience with individuals with intellectual or developmental
			 disabilities; and
(d) Meets all
			 personnel and training requirements established in Section 3 of this
			 administrative regulation.
(81) "Prohibited drug" means a drug or
			 substance that is illegal under KRS Chapter 218A or other statutes or
			 administrative regulations of the Commonwealth of Kentucky.
(82) "Registered agent" means an individual
			 meeting the requirements of
			 KRS
			 14A.4-010(1)(b).
(83) "Registered nurse" is defined by
			 KRS
			 314.011(5).
(84) "Registered office" means an office
			 meeting the requirements of
			 KRS
			 14A.4-010(1)(a).
(85) "Representative" is defined by
			 KRS
			 205.5605(6).
(86) "Rights restriction" means any
			 intervention that restricts a participant's:
(a) Movement;
(b) Access to other individuals, locations,
			 or activities; or
(c)
			 Rights.
(87) "Room" means
			 the aggregate expense of housing costs for the purpose of providing shared
			 living, including:
(a) Rent, lease, or
			 mortgage payments;
(b) Real estate
			 taxes;
(c) Insurance;
(d) Maintenance; and
(e) Utilities.
(88) "SCL intellectual disability
			 professional" or "SCL IDP" means an individual who:
(a) Has at least one (1) year of experience
			 working with persons with an intellectual or developmental
			 disability;
(b) Meets all personnel
			 and training requirements established in Section 3 of this administrative
			 regulation; and
(c)
1. Is a doctor of medicine or
			 osteopathy;
2. Is a registered
			 nurse; or
3. Holds at least a
			 bachelor's degree from an accredited institution in a human services
			 field.
(89)
			 "SCL provider" means an entity that meets the criteria established in Section 3
			 of this administrative regulation.
(90) "Seclusion" means the involuntary
			 confinement of a participant alone in:
(a) A
			 room; or
(b) An area from which the
			 participant is physically prevented from leaving.
(91) "Serious medication error" means a
			 medication error that requires or has the potential to require a medical
			 intervention or treatment.
(92)
			 "Shared living caregiver" means an unrelated individual who:
(a) Resides with a participant in the
			 participant's home;
(b) Provides
			 supervision and necessary personal assistance services as specified in the
			 participant's person-centered service plan;
(c)
1. Is
			 at least eighteen (18) years of age and has a high school diploma or GED;
			 or
2. Is at least twenty-one (21)
			 years old;
(d) Meets all
			 personnel and training requirements established in Section 10 of this
			 administrative regulation;
(e) Has
			 the ability to:
1. Communicate effectively
			 with a participant and the participant's family;
2. Read, understand, and implement written
			 and verbal instructions; and
3.
			 Perform documentation necessary to facilitate compliance with the documentation
			 requirements established in Section 4(20)(j) of this administrative
			 regulation;
(f) Has been
			 determined by the participant's person-centered team, prior to being alone with
			 the participant, to meet the following qualifications:
1. Demonstrate competence and knowledge on
			 topics required to safely support the participant as described in the
			 participant's person-centered service plan; and
2. Have the ability to participate as a
			 member of the participant's person-centered team if requested by the
			 participant; and
(g) Does
			 not have any of the following relationships to the participant:
1. Immediate family member;
2. Extended family member;
3. Guardian; or
4. Legally responsible individual.
(93) "Speech-language
			 pathologist" is defined by
			 KRS
			 334A.020(3).
(94) "Staffed residence" means a residential
			 setting:
(a) That is owned or leased by a
			 provider who meets the SCL provider requirements established in Section 3 of
			 this administrative regulation; and
(b) In which no more than three (3)
			 participants reside.
(95)
			 "State plan" is defined by 42 C.F.R. 430.10.
(96) "Subcontractor" means an entity or an
			 individual:
(a) Who is a currently
			 credentialed professional or other service provider;
(b) Who has signed an agreement with a
			 certified SCL agency to provide SCL services and supports; and
(c) To whom the employee requirements in this
			 administrative regulation apply.
(97) "Suicidal ideation" means thoughts about
			 suicide that may range from being fleeting in nature to detailed
			 planning.
(98) "Supported
			 Employment Long-Term Support Plan" means a document that identifies the amount
			 and kind of support necessary for a participant to maintain employment and
			 achieve individualized employment goals.
(99) "Supported employment specialist" means
			 an individual who:
(a) Provides ongoing
			 support services to eligible participants in supported employment jobs in
			 accordance with Section 4 or 10 of this administrative regulation;
(b)
1. Has
			 previously qualified or been credentialed by the department to provide
			 supported employment services prior to the effective date of this
			 administrative regulation; or
2.
a. Has at least one (1) year of experience in
			 the field of intellectual or developmental disabilities; and
b. Has completed a department required
			 training program within one (1) year of application while providing supported
			 employment services under the direct supervision of a supported employment
			 specialist; and
(c) Meets the personnel and training
			 requirements established in Sections 3 and 10 of this administrative
			 regulation.
(100)
			 "Supports for Community Living" or "SCL" means home and community-based waiver
			 services for an individual with an intellectual or developmental
			 disability.
(101) "Supports
			 Intensity Scale" or "SIS" means an assessment tool developed by the American
			 Association on Intellectual and Developmental Disabilities that:
(a) Measures practical support requirements
			 of individuals with intellectual or developmental disabilities in daily living,
			 medical, and behavioral areas; and
(b) Is administered by a trained professional
			 in the human services field as approved by the department.