Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 78 - Amount, Duration and Scope of Medical and Remedial Services › Rule 441-78.41 - Hcbs Intellectual Disability Waiver Services

Current through Register Vol. 47, No. 3, July 24, 2024
Payment will be approved for the following services to
				  members eligible for the HCBS intellectual disability waiver as established in
				  441-Chapter 83 and as identified in the member's service plan. Effective March
				  17, 2022, payment shall only be made for services provided in integrated,
				  community-based settings that support full access of members receiving Medicaid
				  HCBS to the greater community, including opportunities to seek employment and
				  work in competitive integrated settings, engage in community life, control
				  personal resources, and receive services in the community, to the same degree
				  of access as individuals not receiving Medicaid HCBS.
(1)
Supported community living
				services.
Supported community living services are provided by the
				provider within the member's home and community, according to the
				individualized member need as identified in the service plan.
a. Available components of the service are
				personal and home skills training services, individual advocacy services,
				community skills training services, personal environment support services,
				transportation, and treatment services.
(1)
				Personal and home skills training services are activities which assist a member
				to develop or maintain skills for self-care, self-directedness, and care of the
				immediate environment.
(2)
				Individual advocacy is the act or process of representing the member's rights
				and interests in order to realize the rights to which the member is entitled
				and to remove barriers to meeting the member's needs.
(3) Community skills training services are
				activities which assist a member to develop or maintain skills allowing better
				participation in the community. Services shall focus on the following areas as
				they apply to the member being served:
1.
				Personal management skills training services are activities which assist a
				member to maintain or develop skills necessary to sustain the member in the
				physical environment and are essential to the management of the member's
				personal business and property. This includes self-advocacy skills. Examples of
				personal management skills are the ability to maintain a household budget, plan
				and prepare nutritional meals, use community resources such as public
				transportation and libraries, and select foods at the grocery store.
2. Socialization skills training services are
				activities which assist a member to develop or maintain skills which include
				self-awareness and self-control, social responsiveness, community
				participation, social amenities, and interpersonal skills.
3. Communication skills training services are
				activities which assist a member to develop or maintain skills including
				expressive and receptive skills in verbal and nonverbal language and the
				functional application of acquired reading and writing skills.
(4) Personal and environmental
				support services are activities and expenditures provided to or on behalf of a
				member in the areas of personal needs in order to allow the member to function
				in the least restrictive environment.
(5) Transportation services are activities
				and expenditures designed to assist the member to travel from one place to
				another to obtain services or carry out life's activities. The services exclude
				transportation provided as nonemergency medical transportation pursuant to rule
				441-78.13(249A).
(6) Treatment
				services are activities designed to assist the member to maintain or improve
				physiological, emotional and behavioral functioning and to prevent conditions
				that would present barriers to the member's functioning. Treatment services
				include physical or physiological treatment and psychotherapeutic treatment.
1. Physiological treatment includes
				medication regimens designed to prevent, halt, control, relieve, or reverse
				symptoms or conditions that interfere with the normal functioning of the human
				body. Physiological treatment shall be provided by or under the direct
				supervision of a certified or licensed health care professional.
2. Psychotherapeutic treatment means
				activities provided to assist a member in the identification or modification of
				beliefs, emotions, attitudes, or behaviors in order to maintain or improve the
				member's functioning in response to the physical, emotional, and social
				environment.