Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 78 - Amount, Duration and Scope of Medical and Remedial Services › Rule 441-78.38 - Hcbs Aids/hiv 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 AIDS/HIV waiver services 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)
Counseling services.
Counseling services are face-to-face mental health services provided to the
				member and caregiver by a mental health professional as defined in rule
				441-24.1(225C) to facilitate home management of the member and prevent
				institutionalization. Counseling services are nonpsychiatric services necessary
				for the management of depression, assistance with the grief process,
				alleviation of psychosocial isolation and support in coping with a disability
				or illness, including terminal illness. Counseling services may be provided
				both for the purpose of training the member's family or other caregiver to
				provide care, and for the purpose of helping the member and those caring for
				the member to adjust to the member's disability or terminal condition.
				Counseling services may be provided to the member's caregiver only when
				included in the case plan for the member.
Payment will be made for individual and group counseling. A
				  unit of individual counseling for the waiver member or the waiver member and
				  the member's caregiver is 15 minutes. A unit of group counseling is 15 minutes.
				  Payment for group counseling is based on the group rate divided by six, or, if
				  the number of persons who comprise the group exceeds six, the actual number of
				  persons who comprise the group.
(2)
Home health aide
				services.
Home health aide services are personal or direct care
				services provided to the client which are not payable under Medicaid as set
				forth in rule 441-78.9 (249A). A unit of
				service is a visit. Components of the service are:
a. Observation and reporting of physical or
				emotional needs.
b. Helping a
				client with bath, shampoo, or oral hygiene.
c. Helping a client with toileting.
d. Helping a client in and out of bed and
				with ambulation.
e. Helping a
				client reestablish activities of daily living.
f. Assisting with oral medications ordinarily
				self-administered and ordered by a physician.
g. Performing incidental household services
				which are essential to the client's health care at home and are necessary to
				prevent or postpone institutionalization in order to complete a full unit of
				service.