Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 12 - NURSING FACILITY REGULATIONS › Section 471-12-008 - SPECIALIZED ADD-ON SERVICES FOR CLIENTS WITH INTELLECTUAL DISABILITIES OR RELATED CONDITIONS RESIDING IN NURSING FACILITIES

Current through June 17, 2024
008.01
SPECIALIZED ADD-ON
  SERVICES FOR CLIENTS WITH INTELLECTUAL DISABILITIES OR RELATED CONDITIONS
  RESIDING IN NURSING FACILITIES.
Medically necessary services
  intended to assist the nursing facility clients in obtaining, maintaining, or
  improving developmental-age appropriate skills. These services include
  habilitative training and are not provided by the nursing facility. These
  services are identified through the preadmission screening and resident review
  (PASRR) Level II assessment. Specialized add-on services must result in a
  continuous, aggressive individualized plan of care and be recommended and
  monitored by the individual's interdisciplinary team. Each specialized add-on
  service must be prior authorized separately.
008.02
SPECIALIZED ADD-ON
  SERVICES.
008.02(A)
HABILITATIVE SKILLS TRAINING.
Habilitative skills
  training supports individuals to acquire new skills or increase skills in the
  areas of hygiene, self-advocacy, activities of daily living and communication.
  Habilitative skills can occur on-site but may be expanded to also occur in the
  community such as grocery stores, financial institutions, movie theatres,
  recreational centers or events, and social activities so the individual learns
  these skills in a variety of settings. Services are expected to include both
  formal training and opportunities to practice the skills in various settings.
  This service is provided with a staff to individual ratio of one to one. This
  service is provided to individuals in order to meet the goals and outcome
  measurements as outlined in the individual's plan of care. Habilitative skills
  training consists of:
(1) Identification of
  skill needs requiring training with regard to individual rights and due
  process, advocating for their own needs, desires, future life goals and
  participation in the development of their plan of care, communication skills,
  personal hygiene skills, dressing skills, laundry skills, bathing skills, and
  toileting skills;
(2) Development
  and implementation of formal training goals related to identified skill needs;
  and
(3) Monitor and revise goals
  according to the individual's response to training.
008.02(A)(i)
LIMITATIONS.
Limitations are as follows:
(1) Transportation is not included in the
  reimbursement rates. Transportation services can be billed separately for
  off-site habilitative skills only and is limited to travel to and from the
  habilitative service. The individual must be present in the vehicle.
(2) This service can be authorized in
  combination with but cannot be provided during the same time period as
  habilitative community inclusion.
(3) This service must exclude any services
  available through public education programs funded under the Individuals with
  Disabilities Education Act (IDEA). This includes services not otherwise
  available through public education programs in the individual's local school
  district, including after school supervision and daytime services when school
  is not in session. Services cannot be provided during the school hours set by
  the local school district for the individual. Regular school hours and days
  apply for a child who receives home schooling.