Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 122 - COMMUNITY WAIVER SRVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES › Section 12VAC30-122-550 - Therapeutic consultation service

Current through Register Vol. 40, No. 24, July 15, 2024
A. Service description. Therapeutic
				consultation service means professional consultation provided by members of
				psychology, social work, rehabilitation engineering, behavior
				analysis/consultation, speech-language pathology therapy, occupational therapy,
				psychiatry, psychiatric clinical nursing, therapeutic recreation, or physical
				therapy disciplines that are designed to assist individuals, parents,
				guardians, family members, and any other providers of support services with
				implementing the individual support plan. This service shall provide
				assessments, development of a therapeutic consultation support plan, and
				teaching in any of these designated specialty areas to assist family members,
				caregivers, and other providers in supporting the individual enrolled in the
				waiver. The individual's therapeutic consultation service support plan shall
				clearly reflect the individual's needs, as documented in the assessment
				information, for specialized consultation provided to family/caregivers and
				providers. Therapeutic consultation service shall be covered in the FIS and CL
				waivers.
A therapeutic consultation service support plan is the report
				  of recommendations resulting from a therapeutic consultation that is developed
				  by the professional consultant after he spends time with the individual to
				  determine the individual's needs in his area of expertise.
B. Criteria and allowable activities.
1. To qualify for therapeutic consultation
				service, the individual shall have a documented need for consultation.
				Documented need shall indicate that the ISP cannot be implemented effectively
				and efficiently without such consultation as provided by this covered service
				and approved through service authorization. The need for this service shall be
				based on the individual's ISP and shall be provided to an individual for whom
				specialized consultation is clinically necessary. Therapeutic consultation
				service may be provided in individuals' homes and in appropriate community
				settings, such as licensed or approved homes or day support programs, as long
				as they are intended to facilitate implementation of individuals' desired
				outcomes as identified in their ISP.
2. Allowable activities for this service
				shall include:
a. Interviewing the individual,
				family members, caregivers, and relevant others to identify issues to be
				addressed and desired outcomes of consultation;
b. Observing the individual in daily
				activities and natural environments and observing and assessing the current
				interventions, support strategies, or assistive devices being used with the
				individual;
c. Assessing the
				individual's need for an assistive device for a modification or adjustment of
				an assistive device, or both, in the environment or service, including
				reviewing documentation and evaluating the efficacy of assistive devices and
				interventions identified in the therapeutic consultation plan;
d. Developing data collection mechanisms and
				collecting baseline data as appropriate for the type of consultation service
				provided;
e. Designing a written
				therapeutic consultation plan or a behavioral support plan detailing the
				interventions, environmental adaptations, and support strategies to address the
				identified issues and desired outcomes, including recommendations related to
				specific devices, technology, or adaptation of other training programs or
				activities. The plan may recommend training relevant persons to better support
				the individual simply by observing the individual's environment, daily
				routines, and personal interactions;
f. Demonstrating (i) specialized, therapeutic
				interventions; (ii) individualized supports; or (iii) assistive
				devices;
g. Training
				family/caregivers and other relevant persons to assist the individual in using
				an assistive device; to implement specialized, therapeutic interventions; or to
				adjust currently utilized support techniques;
h. Intervening directly, by behavioral
				consultants, with the individual and demonstrating to family/caregivers or
				staff such interventions. Such intervention modalities shall relate to the
				individual's identified behavioral needs as detailed in established specific
				goals and procedures set out in the ISP; and
i. Consulting related to person centered
				therapeutic outcomes, in person , over the phone, or via video feed consistent
				with in accordance with the requirements of the Health Insurance Portability
				and Accountability Act (HIPAA).