VII Appendices Appendix A: Louisiana Master Work Plan (Includes all Programs)-Updated 9/6/16 Current Louisiana Work Plan Master – Public & Stakeholder Engagement Action Step OAAS Both Waivers OBH CSoC OCDD Children’s Choice Waiver OCDD NOW OCDD Supports Waiver OCDD ROW Change Note Reference Convene Interagency group to manage planning process Began 9/22/14 and continuing through 3/2019 9/22/14 and continuing 9/22/14 and continuing 9/22/14 and continuing 9/22/14 and continuing 9/22/14 and continuing 2015 Q4 OCDD Update II.A 2015 Q4 OAAS Update I.A 2015 Q4 OBH
Update III.A Identify all potential stakeholders including consumers, providers, family-members, state associations; advocacy organizations, and Began 10/1/14 Completed 10/15/14. All stakeholders identified on 10/31/14. All stakeholders identified on 10/6/14 to 11/15/14 All stakeholders identified on 10/6/14 to 11/15/14 All stakeholders identified on 10/6/14 to 11/15/14 All stakeholders identified on 10/6/14 to 11/15/14 Create portal on State Medicaid website. Provide transition information and plan. List end of comment period. OAAS website: OBH website: OCDD website: Website created and transition plan posted on 10/29/14. Comments due 3/13/15. Website created on 9/30/14. Issued white paper and transition plan. Public notice appeared in major newspapers on 10/10/14. Comments due 11/10/14. Appeared in major newspapers on 10/19/14. Website created on 10/6/14 with transition postings. Comments due 12/17/14. Website created on 10/6/14 with transition postings. Comments due 12/17/14. SW Plan was posted on 11/21/14 and comments are accepted until through 2/28/15 Website created on 2/11/15 with transition postings. Comments due 4/10/15 Support ongoing stakeholder communications. Held public forum (including OAAS stakeholders) on 11/19/14 and continuing as needed through 3/2019. Stakeholders are informed of STP’s Held public forum on 11/17/14. Presented information about the new HCB setting at the following: 1) 9/29/14 Held public forum on 11/17/14 in Baton Rouge. Using the LA System’s to continue Held public forum on 11/17/14. Using the LA System’s to continue discussion. Update website as needed. Held public forum on 11/17/14 in Baton Rouge. Using the LA System’s to continue Held public forum on 11/17/14 in Baton Rouge. Using the LA System’s to continue 2015 Q4 OCDD Update II. A
progress through provider association meetings, OAAS quarterly provider meetings, and support coordination executive meetings Statewide Coordinating Council; 2) 10/22/14 CSoC Governance Board meeting; 3) 10/23/14 Affinity call with CSoC Wraparound Facilitators, & 4) 11/3/14 Louisiana Behavioral Health Advisory Committee. Updating website as needed. discussion. Update website as needed. Held listening session on 10/28/14. Additionally, 2 public forums were held on 2/11/15 in Shreveport and 2/20/15 in Houma. All notices will appear in newspapers with details on how to access non-electronic format via the LGE offices Held listening session on 10/28/14 Additionally, 2 public forums were held on 2/11/15 in Shreveport and 2/20/15 in Houma. All notices will appear in newspapers with details on how to access format via the LGE offices discussion. Update website as needed. Held listening session on 10/28/14. Additionally, 2 public forums were held on 2/11/15 in Shreveport and 2/20/15 in Houma. All notices will appear in newspapers with details on how to access non-electronic format via the LGE offices discussion. Update website as needed. Held listening session on 10/28/14. Additionally, 2 public forums were held on 2/11/15 in Shreveport and 2/20/15 in Houma. All notices will appear in newspapers with details on how to access format via the LGE offices Reach-out to providers and provider associations to increase understanding of rule and maintain open lines of communication. ADHC providers were sent letters describing the new rule on 3/13/15 Meeting with ADHC providers Distribute letters to providers describing the transition, criteria for HCB setting, deadlines Held 5 provider meetings with OCDD providers, stakeholders and Support Held 5 provider meetings with OCDD providers, stakeholders and Support Coordinators on Held 5 provider meetings with OCDD providers, stakeholders and Support Held 5 provider meetings with OCDD providers, stakeholders and Support electronic
held 4/30/15 to review the rule, STP, and assessment process. Provider outreach continued through April 2016 for the self-assessment process and will continue through February 2017 to complete validation and remediation work. for compliance and availability of TA. Begin 4/1/15 and ends 5/1/15. Completed 4/1/15 Coordinators on 10/20/14 in Lafayette, 11/6/14 in Houma, 1/13/15 in Baton Rouge and 1/14/15 in Alexandria and 2/12/15 in Covington. Providers were notified of the meetings through the Local Governing Entities. Sent e-mail blasts to all providers and associations of upcoming remaining public forums on 2/3/15. Otherwise notices listed on the website. 10/20/14 in Lafayette, 11/6/14 in Houma, 1/13/15 in Baton Rouge and 1/14/15 in Alexandria and 2/12/15 in Covington. Providers were notified of the meetings through the Local Governing Entities. Sent e-mail blasts to all providers and associations of upcoming remaining public forums on 2/3/15. Otherwise notices were listed on the website. Coordinators on 10/20/14 in Lafayette, 11/6/14 in Houma, 1/13/15 in Baton Rouge and 1/14/15 in Alexandria and 2/12/15 in Covington. Providers were notified of the meetings through the Local Governing Entities. Sent e-mail blasts to all providers and associations of upcoming remaining public forums on 2/3/15. Otherwise notices were listed on the website. Coordinators on 10/20/14 in Lafayette, 11/6/14 in Houma, 1/13/15 in Baton Rouge and 1/14/15 in Alexandria and 2/12/15 in Covington. Providers were notified of the meetings through the Local Governing Entities. Sent e-mail blasts to all providers and associations of upcoming remaining public forums on 2/3/15. Otherwise notices were listed on the website.
Collect all public comments. Synthesize comments and develop responses to comments. See Appendix B for Comments received by OAAS See Appendix C for Comments received by OBH See Appendix D for Comments received by OCDD Began 11/13/14 and completed 3/13/15. Comments and responses are included in the Statewide transition plan. Second round of public notice: 9/14/16-10/14/16. Responses to comments and incorporation into STP will be completed by 10/30/16. Completed 11/12/14 and included in the Statewide Transition Plan. Second round of public notice: Responses to comments and incorporation into STP will be completed by 10/30/16. Began 11/15/14 and completed on 3/13/15. Comments and responses are included in the Statewide Transition Plan. Second round of public notice: Responses to comments and incorporation into STP will be completed by 10/30/16. Completed on 3/13/15. Comments and responses are included in the Statewide Transition Plan. Second round of public notice: 9/14/16-10/14/16. Responses to comments and incorporation into STP will be completed by 10/30/16. Completed on 3/13/15. Comments and responses are included in the Statewide Transition Plan. Second round of public notice: Responses to comments and incorporation into STP will be completed by 10/30/16. Comments are due 4/10/15. Comments and responses will be forwarded to CMS once they are finalized. Second round of public notice: Responses to comments and incorporation into STP will be completed by 10/30/16. Continued Community Outreach Continue to meet with participants, family members, providers, support coordinators, stakeholders, and providers to provide updates on the progress of STP Continue to meet with participants, family members, providers, support coordinators, stakeholders, Continue to meet with participants, family members, providers, support coordinators, stakeholders, and providers to provide updates on the progress of Continue to meet with participants, family members, providers, support coordinators, stakeholders, Continue to meet with participants, family members, providers, support coordinators, stakeholders, and providers to
activities. Contact methods include provider quarterly meetings, support coordinator executive meetings, conferences, correspondence, website, newspaper announcements and general meetings and providers to provide updates on the progress of STP activities. Contact methods include provider quarterly meetings, support coordinator executive meetings, conferences, correspondence, website, newspaper announcements and general meetings (See Appendix D for additional detail and activities held with stakeholders) STP activities. Contact methods include provider quarterly meetings, support coordinator executive meetings, conferences, correspondence, website, newspaper announcements and general meetings (See Appendix D for additional detail and activities held with stakeholders) and providers to provide updates on the progress of STP activities. Contact methods include provider quarterly meetings, support coordinator executive meetings, conferences, correspondence, website, newspaper announcements and general meetings (See Appendix D for additional detail and activities held with stakeholders) provide updates on the progress of STP activities. Contact methods include provider quarterly meetings, support coordinator executive meetings, conferences, correspondence, website, newspaper announcements and general meetings (See Appendix D for additional detail and activities held with stakeholders) Current Louisiana Work Plan Master – Systemic Assessment & Remediation
Current Louisiana Work Plan Master – Site Specific Assessment and Validation Action Step OAAS Both Waivers OBH CSoC OCDD Children’s Choice Waiver OCDD NOW OCDD Supports Waiver OCDD ROW Change Note Reference Draft a self-assessment tool that familiarizes providers with the new settings rule and allows an opportunity to measure compliance with the new requirements. The assessment tool will identify areas for the new rule for which the provider is non-compliant and will allow providers to target compliance efforts. The tool will include questions that accurately assess provider compliance; and methods to quantify provider assessment results. Develop a draft self-assessment tool that assesses non-residential settings – 3/13/15 Develop a draft self-assessment tool that assesses settings and settings 3/25/15 – 3/31/15 Completed 3/31/15 Assessment tool revised 12/22/15 Develop a draft self-assessment tool that assesses settings – 3/13/15 Completed 2/1/15 Develop a draft self-assessment tool that assesses non-residential settings – 3/13/15 Completed 2/1/15 Develop a draft self-assessment tool that assesses residential settings and settings 3/25/15 – 3/31/15 Completed 2/1/15 Develop a draft self-assessment tool that assesses settings – 3/13/15 Completed 2/1/15 . 2015 Q4 OBH Update III.A Post on the website. Completed 3/16/15 Completed 4/1/15 Revised assessment posted 1/12/16 3/18/15 Completed 3/18/15 3/18/15 Completed 3/18/15 3/18/15 Completed 3/18/15 3/18/15 Completed 3/18/15 2015 Q4 OBH Update III.A Circulate self-assessments to stakeholder groups 3/16/15 – 4/15/15 Completed 4/1/15 – 5/1/15 Completed 5/1/15 Revised assessment 3/18/15-5/2015 3/18/15-5/2015 3/18/15-5/2015 3/18/15-5/2015 -2015 Q2 OCDD Update II. A residential residential residential residential
circulated 1/12/16 Modify self-assessment tool and participant survey based on stakeholder comments. 4/15/15 4/15/15 Completed 4/22/15; Participant Survey Completed 2/1/16 Assessment modified 2/2016 4/19/15 Completed 4/19/15 -4/30/15 Completed 4/19/15 -4/30/15 Completed 4/19/15 Completed -2015 Q2 OAAS Update I. A -2015 Q2 OCDD Update II. A - 2016 Q1 OAAS Update I. A Provide Training to Providers Completed 4/30/15 Completed 2/23/16 Big Picture Training 6/30/15 Training 7/13 and 7/20/15 Completed Big Picture Training 6/30/15 Self-Assessment Training 7/13 and 7/20/15 Completed Big Picture Training 6/30/15 Self-Assessment Training 7/13 and 7/20/15 Completed Big Picture Training 6/30/15 Training 7/13 and 7/20/15 Completed Distribute assessment to providers Completed Round One: 5/4/15 to 6/12/15 Round Two: 3/14/16 to 4/1/16 Begin 3/1/16 forward 7-13-15 & Service providers to begin conducting assessments after 7-13-15 & Service providers to begin conducting assessments after completion of trainings. 7-13-15 & Service providers to begin conducting assessments after completion of trainings. 7-13-15 & Service providers to begin conducting assessments after -2015 Q2 OBH Update III. A -2015 Q2 OCDD Update II. A 4/30/15
Post Findings on Website Self-Assessments 5/2/16 Site Visits 1/31/17 5/1/17 – 5/30/17 5/1/17-5/30/17 5/1/17-5/30/17 5/1/17-5/30/17 5/1/17-5/30/17 2016 Q2 OAAS Update I.A Submit report to CMS 1/31/17 6/30/17 6/30/17 6/30/17 6/30/17 6/30/17 Draft participant survey for public review ADHC specific survey: Completed 8/1/15 Survey for all waiver participants: Completed 1/11/16 Completed 4/30/15 Revised survey drafted 12/22/15 1/1/16-4/15/16 1/1/16-4/15/16 1/1/16-4/15/16 1/1/16-4/15/16 -2015 Q2 OAAS Update I. A -2015 Q2 OCDD Update II. A 2015 Q4 OCDD Update II.A 2015 Q4 OBH Update III.A Post participant survey on the website and circulate to all stakeholders ADHC specific: 8/6/15-9/9/15 All waiver participants: 1/12/16-2/11/16 Completed 1/12/2016 4/20/16-5/20/16 4/20/16-5/20/16 4/20/16-5/20/16 4/20/16-5/20/16 -2015 Q3 OAAS Update I. A -2015 Q2 OCDD Update II. A 2015 Q4 OBH
Update III.A Modify participant survey based on comments N/A - no comments received for both surveys 2/2016 4/20/16-5/20/16 4/20/16-5/20/16 4/20/16-5/20/16 4/20/16-5/20/16 -2015 Q2 OCDD Update II. A Provide training on participant survey 1/14/16 – 2/29/16 Completed 2/23/16 5/25/16-5/31/16 5/25/16-5/31/16 5/25/16-5/31/16 5/25/16-5/31/16 -2015 Q2 OCDD Update II. A 2015 Q4 OCDD Update II.A 2015 Q4 OAAS Update I.A 2016 Q1 OAAS Update I.A Distribute participant survey Completed 3/1/16-6/30/16 Will occur annually beginning in 2016 during our 1915c QA 3/1/16 forward 6/1/16 6/1/16 6/1/16 6/1/16 -2015 Q2 OCDD Update II. A - 2016 Q2 OAAS Update I.A
tracked to ensure successful placement and continuity of service. Current Louisiana Work Plan Master –Ongoing Monitoring & Quality Assurance Action Step OAAS Both Waivers OBH CSoC OCDD Children’s Choice Waiver OCDD NOW OCDD Supports Waiver OCDD ROW Change Note Reference Continuous scrutiny will be provided to licensing, certification, policy and procedures, to ensure all document are compliant with the HCB Settings Rule. Completed 9/1/16 Scrutiny of new rules and regulations will continue to ensure compliance Completed 10/31/14 Scrutiny of new rules and regulations will continue to ensure compliance 12/15 – ongoing 12/15 – ongoing 12/15 – ongoing 12/15 – ongoing -2015 Q4 OCDD Update II.A -2016 Q2 OAAS Update I.A Specific quality assurance and improvement strategies are developed to ensure providers are evaluated against the HCB Setting Rule prior to enrollment. Completed 1/23/15 Completed 10/31/15 Begin 7/1/16 Begin 7/1/16 Begin 7/1/16 Begin 7/1/16 Practical performance measures are created to ensure providers continue to meet the HCB Settings Rule. Completed 1/23/15 Completed 12/1/15 Begin 1/1/16 Begin 1/1/16 Begin 1/1/16 Begin 1/1/16
based on the individual's needs, and preferences. 3 Ensures an individual's rights of privacy, dignity and respect, and freedom from coercion and restraint. Louisiana Administrative Code: Partially Compliant Current rule language (§4237, 4239) ensures participant rights of dignity, respect, and privacy while at the ADHC. Additionally, the right to privacy will be added to the participant rights and responsibilities document which already lists both dignity and respect. Rules and the participant rights and responsibilities document will be amended to prohibit all forms of restraint use and coercion. The title of the restraint training topic (§5049.C.19) will be amended to clarify the intent of the training – that participants remain free from restraints. The following rules will be amended: §4239.C.6 (Statement of Rights) - strike language and replace with “the right to be free from coercion and restraints” §4261.B.8 (Orientation & Training) – Clarify training module title to “Ensuring participants remain restraint free” §5049.C.19 The OAAS participant rights and responsibilities document will be amended Change 1st bullet to “Ensure rights of dignity, privacy, and respect” Change 8th bullet to “To be free from restraints” 12/1/17 4 Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily Louisiana Administrative Code: LAC 48:I:4239 Rights and Responsibilities of HCBSW EFF. 9-2-14), p.1. Partially Compliant The setting’s support for participants’ autonomy and independence in making ADHC provider manual revised language 10/31/16. The OAAS participant rights and responsibilities document will be by 10/31/16
Question Number Question Scoring Guidance Met/ Not Met Follow- up Questions 1 Provider service setting is located among other residential buildings, private businesses, retail businesses, restaurants, doctor’s office, etc. that facilities participant integration within the greater community. Score Met if the physical provider site integrated within the community of the members being served. If this question is scored NOT MET, please describe the setting of the provider site in detail. 2 The provider service setting is NOT located in a building that also provides inpatient institutional treatment (such as a nursing facility/nursing home Institute for Mental Disease (IMD), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), or a hospital). If this question is scored NOT MET, please describe the setting of the provider site in detail. 3 Provider service setting is NOT located in a building on the grounds of or immediately adjacent to a public institution. Public institution doesn’t include schools or universities or private entities, but rather means a public institution such as a nursing facility/home, IMD, ICF/IID, or hospital. If this question is scored NOT MET, please describe the setting of the provider site in detail. 4 Provider service setting is physically accessible. Physically accessible means that clients served by the providers are able to comfortably receive services in the provider’s location according to the client’s individual needs. If this question is scored NOT MET, please describe the setting of the provider site in detail.
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 Licensing Standards Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) Go to page 10 of TOC §5089 C. 3 – SFC Module – partially compliant – support individuals in home environment in community - similar to those enjoyed by most individuals living in community in all stages of life §5093 – SIL Module – Partially compliant in that it requires access to community services, client choice, proximity to client’s family and friends, access to transportation, proximity to health care services and place of employment when selecting setting §5107 –MIHC. This section is silent on access to greater community; however, it is specifically required to be a private residence §5059, Client Funds and Assets- Partially compliant. Does not specifically state that person has right to control personal resources, but does state that provider cannot require that they manage the client’s funds requirement language in each HCBS waiver versus licensing Will include statement in this Licensing Rule that client has right to control personal resources in Client Assets section. Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) §13701 – This section applies to all services in NOW. Partially compliant. Language states that mission is to Rule is silent on controlling personal resources. Need to December 2017
Click on “Title 50” Go to page 24 of TOC. supplement the family and/or community supports that are available to maintain the individual in the community §13901 – IFS – partially compliant §13905 – CID – compliant §13907 – SIL - partially compliant §13909 – SFC – silent §13929 – One time transitional expenses partially compliant §13931 – ACC – compliant §13935/13937 – Housing Stabilization – partially compliant add to residential settings (SIL, SFC, Housing Stabilization and One time transitional expenses) Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule NOW Manual Section 32.0 Overview – Partial Compliance –Does not mention integrated setting. It does promote independence and community inclusion for recipients through the provision of services Section 32.1 pg IFS – compliant – services provided in the home or the community that allow the participant to achieve and/or maintain increased independence, productivity, enhanced Insert overall language to support these setting/service requirements in each waiver manual Add control of personal resources to SIL, SFC, Housing Stabilization, and December 2017
in community because it is a private family residence. Community activities in POC are encouraged and supported in this services Section 38.1, Page 7 – Companion Care– Services are delivered in the recipient’s home and in the community as indicated in the POC. Section 38.1, Page 9 – Shared Living – Partial compliance/silent – place of service can be in person’s residence in the community or can be owned by the provider in the community. Does not address integration into the community, although the setting may exist in the community. Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50”, Go to page 22 of TOC. §5301 – Introduction -compliant – create options and provide meaningful opportunities through vocational and community inclusion. Provide services and supports that promote community inclusion and independence. §5707 – Respite – partially compliant – provided in participant’s home which is a Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule December 2017
private residence or in a respite care facility. Rule silent on integration and access to community regarding facility. §5709 – Habilitation – compliant – Is provided in the home or community. §5717 & §5719 – Housing Stabilization services – compliant - Allow participant to maintain their own housing in the community. Supports Waiver Manual Section 43.0 – Overview –Compliant - Mission is to create options and provide meaningful opportunities through vocational and community inclusion. Provides supports necessary for individual to achieve desired community living and work experiences. Objective is to promote independence, provide supports that promote community inclusion. Section 43.4, Page 28 – Respite – partially compliant - For relief of primary caregiver. May be provided in recipient’s home, a private residence, or Insert overall language to support these setting/service requirements in each waiver manual Add control of personal resources to Housing Stabilization (only true residential service) December 2017
in a respite facility. Silent on access to community and inclusion in community. Section 43.4 , page 32 Housing Stabilization Services – enable recipients to transition into permanent supportive housing. Implies private home setting with lease. Ability to secure housing is the service in the community is the service. Silent on control of personal resources Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to page 23 of TOC. §11101 – Introduction - Compliant – Setting is for children who live at home with their families. This is the same as setting for individuals without developmental disabilities. §11303 F – Family Support -Compliant – Services are provided in home or community (school programs, summer camps, etc.) Includes assistance with participating in community §11303 M & N – Compliant - Housing Stabilization services - enable waiver participants to maintain their own Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule. Control of personal resources is not applicable to children, and should not be hindered for December 2017
home or community setting. Silent on community integration. The setting is selected by the individual from among setting options including specific settings and an option for a private unit in a residential setting. The setting options are identified and documented in the person-centered service plan and are based on the individual's needs, preferences, and, for settings, resources available for room and board. DD Law RS28:451.1 – RS28:452.2 Partially compliant, silent on settings being identified and documented in service plan None- this law is not specific to HCBS waivers N/A LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards - Partially Compliant Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) §5094 A. – Supervised Independent Living Module – Partially compliant – living situation is freely selected by client. No mention of documenting setting options in service plan except agreement for shared living. §5094 10b. Each client shall have the right to choose whether or not to share a bedroom and a bed with another client. §5094 D. 2 – No clients shall be placed together in a living situation against their choice. The consent of each client shall be documented in the client’s record (for shared living). §5094 G. Selecting the location must be based on client choice and consider client cost, risks, proximity to family, friends, work, health care, community §5089 – Substitute Family Care – silent §5071- Adult Day Care – silent Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule. Require all settings offered to be documented in service plan. December 2017
§5079 – Personal Care Attendant – partially compliant –identifies services to be provided in community and promoting individualized community supports targeted towards inclusion into meaningful integrated experiences. §5107 – Monitored In Home Caregiving – compliant – requires setting to be a private residence occupied by the client and cannot be any type of licensed facility. Selection of the setting occurs when the service is requested, Adult Companion Care which is in the NOW rule Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50”, Page 24 of TOC. §13701 Introduction – Partially compliant / mostly silent. Plan of Care for services is developed using a person centered process. All services must be delivered in accordance with the approved plan of care (POC). No mention of listing setting options or including in the POC §13901 – Individualized and Family Support – silent – addressed in the person centered plan process Program office policy or manual will be revised to require documentation of choice of specific setting for these services. The person centered process December 2017
§13905 Community Integration Development – Silent – addressed in the person centered plan process §13907 – Supported Living – Silent §13909 – Substitute Family Care – Silent §13911 – Day Habilitation – Silent §13913 – Supported Employment – Silent §13917 – Employment Related Training – Silent §13925 – Professional Services - Silent §13927 – Skilled Nursing – Silent §13929 – Transitional Expenses – Silent §13931 – Adult Companion Care – partially compliant – setting is the individual’s home, is identified in the Plan of Care, service is based on individual needs but does not require all options to be documented in the POC. §13935 – Housing Stabilization Transition Services – Partially Compliant – does not require all options to be documented in POC documentation is currently under review and these requirements will be incorporated into the most appropriate document.
Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC. Silent Same as NOW remediation Same as NOW remediation Supports Waiver Manual Silent Same as NOW remediation Same as NOW remediation Guidelines for Support Planning Silent Same as NOW remediation Same as NOW remediation Ensures an individual's rights of privacy, dignity and respect, and freedom DD Law RS28:451.1 – RS28:452.2 Partially compliant. Does not address dignity, freedom from coercion or restraint None- this law is not specific to HCBS waivers N/A
from coercion and restraint. LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) §5049 – Client Rights – Compliant – privacy, dignity, respect, freedom from restraint §5021D – Revocation of license – compliant – cannot intimidate, threaten, coerce Will update client’s rights language to include freedom from coercion December 2017 Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” Go to page 24 of TOC NOW rule is silent Clients rights will be documented in licensing rule and in program manual December 2017 NOW Manual NOW manual is partially compliant on dignity and respect, silent on privacy and coercion, and is non-compliant because it Update Clients Rights and responsibilities to December 2017
Update settings to include right to privacy Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC. Silent on all Clients rights will be documented in licensing rule and in program manual December 2017 Supports Waiver Manual Silent on all except dignity and respect which are contained in “Rights and Responsibilities” document. Update Clients Rights and responsibilities to include right to privacy, freedom from coercion and restraint. Update settings to include right to privacy December 2017
Go to page 24 of TOC. NOW Manual Click on overview – Broad statements on principles of self-determination and services designed to promote independence and community inclusion. Partially compliant but not specific to the entirety of this requirement. Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC Partially compliant §16101 - to promote independence through strengthening the individual’s capacity for self-care, self-sufficiency and community integration §16103 - to utilize the principles of and to supplement the family and/or community supports that are available to maintain the individual in the community. Partially compliant but not specific to the entirety of this requirement. Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017 ROW Manual: Section 38.0 – Overview – Broad statement of program is to assist Update program rule and manual in December 2017
recipients to live productive lives to fullest extent possible and promote full exercise of rights as citizens. Supports the integration of recipients within their communities. Provides opportunity for community based alternatives in home settings. Partially compliant but not specific to the entirety of this requirement. introduction to require all services to fully meet this requirement. Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to 23 of TOC §11101 - program that offers supplemental support to children with developmental disabilities who currently live at home with their families. Silent on the flexibility of the services based on parent choice Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017 Children’s choice Manual Section 14.0 – Overview - offers supplemental support to children with developmental disabilities who currently live at home with their families. The service package is individually designed for maximum flexibility. Partially compliant but not specific to the entirety of this requirement. Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017
Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC §5301 - Purpose -The mission is to create options and provide meaningful opportunities that enhance the lives through vocational and community inclusion, promote independence for individuals with a developmental disability, and provide an alternative through services and supports that promote community inclusion and independence by enhancing and not replacing existing informal networks – Partial compliance Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017 Supports Waiver Manual Overview - The mission is to create options and provide meaningful opportunities for those individuals through vocational and community inclusion. The SW is available to provide the supports necessary in order for individuals to achieve their desired community living and work experience by providing the services needed to acquire, retain, and/or improve self-help, socialization and adaptive skills as well as providing the recipient an opportunity to contribute to his/her community. Update program rule and manual in introduction to require all services to fully meet this requirement. December 2017 Facilitates individual choice regarding services and DD Law RS28:451.1 – RS28:452.2 452.1 – partial compliance – (4) to receive services consistent with personal needs and choices, does not address None- this law is not specific to HCBS waivers N/A
supports, and who provides them. freedom of who provides the supports but could be implied LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Partially Compliant Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) §5049 Compliant - #10 – refuse specific services or participate in any activity, #23 discontinue services with one provider and freely choose another provider None N/A Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” Go to page 24 of TOC Silent Update rule to include this requirement or add this requirement to Rights and Responsibilities document December 2017 NOW Manual Compliant No action required NA
Section 32.4, page 1, Freedom of choice of program, Section 32.4, page 2, Choice of SC and Providers Section 32.4, page 2, Voluntary Participation – Recipients have right to refuse services and be informed of alternative services. Guidelines for Support Planning Compliant Page 19, 1.1 A. 5. a. plan is unique and focused on things important to participant Page 33 -2.4.A.2 – Support Coordination choice Page 83, 4.4.1, B – FOC of provider No action required NA ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” §16103 C Program Description – Partially compliant – Identifies freedom of choice for support coordination but not for provider. POC developed utilizing person-centered process. Update rule to include FOC for service provider December 2017
Section 43.2 – Page 2 - Support coordinators and service providers shall allow recipients/authorized representatives to participate in all person-centered planning meetings and any other meeting concerning their services and supports. The unit or dwelling is a specific physical place that can be owned, rented, or occupied under a legally enforceable agreement by the individual receiving services, and the individual has, at a minimum, the same responsibilities and protections from eviction that tenants have under the landlord/tenant law of the State, county, city, or other DD Law RS28:451.1 – RS28:452.2 Silent Will not be updated. Law not specific to HCBS services NA LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) Note: Most residences are personal residences chosen by the participant or his/her family and are separate from the actual HCBS services provided. However, in the case of provider owned or controlled residences, the following is applicable. §5094 – Supported Independent Living - Silent - No requirement for a lease agreement for the participant. §5089 – Substitute Family Care – Silent - No requirement for a lease agreement for participant. Lease requirements will be addressed at the program level, not the licensing level NA
§13909 – Substitute Family Care – Silent §13931 – Adult Companion Care – Services are provided in the participant’s home which is not owned or controlled by the provider. This is considered a private dwelling and not part of the service provided to the participant. §13935 and §13937 – Housing Stabilization services - Both require lease agreements that does not allow the provider to own or control, and that the setting is chosen by the participant separate from any ACC services received. NOW Manual Section 32.1 – Covered Services: Page 12 – Supported Independent Living - Partially compliant - Implies that a lease is required for provider owned/controlled property. Need more specific info on lease requirements in this section. Page 13 – Substitute Family Care – silent Pages 34-37 – Housing Stabilization services - compliant Update rule to require lease agreements for residential services. December 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Partially compliant §16303, E.3 – Community Living Supports – compliant -Services may not Update rule to require lease December 2017
Section 43.4, Page 32 – Housing Stabilization Services - lease agreements are implied as the service helps participants meet the terms of the lease. Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors. DD Law RS28:451.1 – RS28:452.2 Silent Will not be updated. Law not specific to HCBS services NA LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) Silent Update SIL and SFC requirements for doors lockable by individual December 2017 Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Silent Update SIL and SFC requirements for December 2017
Click on “Title 50” Go to page 24 of TOC. doors lockable by individual NOW Manual Silent Update SIL and SFC requirements for doors lockable by individual December 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC Silent Update Host Home, Shared Living, and Companion Care requirements for doors lockable by individual December 2017 ROW Manual: Silent Update Host Home, Shared Living, and Companion Care requirements for doors lockable by individual December 2017 Children’s Choice Rule Silent - No residential settings NA
Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to page 23 of TOC Children’s choice Manual Silent No residential settings NA Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC. Silent No residential settings NA Supports Waiver Manual Silent No residential settings NA
Individuals sharing units have a choice of roommates in that setting. DD Law RS28:451.1 – RS28:452.2 Silent Will not be updated. Law not specific to HCBS services NA LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) §5094 D. 2 Supervised Independent Living - Compliant– Consent for sharing is documented in participant’s record §5089 Substitute Family Care – silent §5101 – Monitored In Home Caregiving - silent Selection of roommates will be addressed in program rule and manual NA Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” §13901 – B. Individual and family support – Services may be shared when agreed to by participants. §13907 – Supported living – service is not the living arrangement, but the Update rule to require consent for roommates for SIL, SFC and ACC. December 2017
Go to page 24 of TOC. supervision of the home. The living arrangement is defined in the licensing standard, not the NOW program rule. Silent on roommate §13909 – Substitute Family Care – Silent on roommate §13931 – Adult companion care – Silent on roommate NOW Manual Covered Services Section 32.1 Individual and Family Support – Page 3 – Individual must agree to share services Supported Independent Living – silent on roommates Substitute Family Care – silent on roommates Update Manual for consent on roommates for SIL and SFC Add ACC December 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC. Silent Update rule for consent for roommates on Shared Living, Community Living Supports, Host Home, and Companion Care December 2017
Go to page 25 of TOC. ROW Manual: Silent Update program rule/manual to comply with this requirement December 2017 Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to page 23 of TOC. Silent Update program rule/manual to comply with this requirement December 2017 Children’s choice Manual Silent Update program rule/manual to comply with this requirement December 2017 Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Silent Update program rule/manual to comply with this requirement December 2017
Click on “Title 50” Go to page 22 of TOC. Supports Waiver Manual Silent Update program rule/manual to comply with this requirement December 2017 Individuals have the freedom and support to control their own schedules and activities, and have access to food at any time. DD Law RS28:451.1 – RS28:452.2 Silent Silent Will not be updated. Law not specific to HCBS services NA LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Click on Title 48, Public Health – General Partially compliant §5049 20. Broadly states right to receive services that are respectful of client’s wishes, but does not specifically address freedom to control schedules and activities. Silent on access to food at any time Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017
Click on Title 48:I, Public Health – General (Book 1 of 2) Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” Go to page 24 of TOC. Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 NOW Manual Section 32.8, Page 8, - Partially compliant – Allows for deviation from typical schedule and services if recipient driven, person-centered, and prior authorized. Silent on access to food Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017
Go to page 25 of TOC. ROW Manual: Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to page 23 of TOC. silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Children’s choice Manual Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter Silent Update in client’s rights in licensing rule as well as December 2017
Licensing Standards – Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) client’s rights in program rules Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” Go to page 24 of TOC. Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 NOW Manual Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 ROW Rule Title 50, Part XXI, Silent Update in client’s rights in licensing December 2017
Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC. rule as well as client’s rights in program rules ROW Manual: Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50” Go to page 23 of TOC. Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Children’s choice Manual Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017
Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC. Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 Supports Waiver Manual Silent Update in client’s rights in licensing rule as well as client’s rights in program rules December 2017 The setting is physically accessible to the individual. DD Law RS28:451.1 – RS28:452.2 Refers to ADA None NA LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Partial compliance §5073 Adult Day Care – E.3 facility shall be accessible to and functional for participants, silent on setting for supported employment Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are December 2017
Section 32.6 – Providers must comply with ADA requirements HCBS services are provided to be physically accessible by the participants. ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC. Silent Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are provided to be physically accessible by the participants. December 2017 ROW Manual: Silent Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are provided to be physically accessible by the participants. December 2017 Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters Silent Revise Licensing Rule, Program Rules and Program Manuals to require December 2017
111 Click on “Title 50” Go to page 23 of TOC. all settings in which HCBS services are provided to be physically accessible by the participants. Children’s choice Manual Silent Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are provided to be physically accessible by the participants. December 2017 Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50” Go to page 22 of TOC. Silent Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are provided to be physically accessible by the participants. December 2017
Supports Waiver Manual Silent Revise Licensing Rule, Program Rules and Program Manuals to require all settings in which HCBS services are provided to be physically accessible by the participants. December 2017 Non-Residential Systemic Review Specific Requirement Regulation Other Outcome of Review By Waiver Remediation Required by Waiver Timeline The setting is integrated in and supports full access of individuals receiving Medicaid HCBS to the greater community, including opportunities to seek employment and work in competitive integrated settings, DD Law RS28:451.1 thru RS28:452.2 Partially compliant – does not address control of personal resources None- this law is not specific to HCBS waivers N/A LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards Ctrl/click on §5071 – Adult Day Care Module General Provisions (page 200) -Not compliant – requires protective setting, restricts it to Revise language for ADC in Rule to comply with Settings 2017
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 Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) Go to page 10 of TOC functionally impaired adults, describes setting as a “facility”. Is silent on integrated employment in this section Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) Click on “Title 50” Go to page 24 of TOC §13701 – This section applies to all services in NOW. Partially compliant. Language states that mission is to supplement the family and/or community supports that are available to maintain the individual in the community §13911 – Day Hab – Partially compliant - provided in community setting but silent on full access to greater community§13917 – ERT– silent on setting §13913 – SE Compliant – definition is employment or competitive work in an integrated work setting. Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule Need to add language on controlling personal resources if paid employment 2017
NOW Manual Section 32.1 pg 14 - Day Habilitation – silent Section 32.1, pg 20 Related Training – Not compliant – training occurs at provider facility Section 32.1 – pg 16 Supported Employment – Compliant Insert overall language to support these setting requirements in each waiver manual 2017 Guidelines for Support Planning Setting is only described in the definition of services. Is partially compliant, compliant, or non-compliant in definitions. Update all definitions to ensure proper settings language is included 2017 ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50”, Go to page 25 of TOC §16307 Day Habilitation Services – silent §16323 Prevocational services – partial compliance – goals include regular community inclusion and development of work skills to improve employability. Actual setting is not described. Insert overall language to support these setting requirements in each waiver rule or overall HCBS rule Need to add language on controlling personal 2017
community because it is a private family residence. Community activities in POC are encouraged and supported in this services Section 38.1, Page 7 – Companion Care– Services are delivered in the recipient’s home and in the community as indicated in the POC. Section 38.1, Page 9 – Shared Living Services – Partial compliance/silent – place of service can be in person’s residence in the community or can be owned by the provider in the community. Does not address integration into the community, although the setting may exist in the community. Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 §5301 – Introduction – create options and provide meaningful opportunities through Compliant. Need to add language on controlling personal 2017
Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Click on “Title 50”, Go to page 23 of TOC. No “non-residential” services in rule or manual N/A N/A The setting is selected by the individual from among setting options including specific settings and an option for a private unit in a residential setting. The setting options are identified and documented in the service plan and are based on the individual's needs, preferences, and, for residential settings, resources available for room and board. DD Law RS28:451.1 – RS28:452.2 Partially compliant, silent on settings being identified and documented in service plan LAC Title 48, Part I, Chapter 50, HCBS Providers Licensing Standards – Partially Compliant Click on Title 48, Public Health – General Click on Title 48:I, Public Health – General (Book 1 of 2) Rule is silent on non-disability specific settings Will be addressed in program office policy or manuals, not at licensing level NA Title 50, Part XXI, Subpart 11, Chapters 137 and 139 (NOW) §13701 Introduction – Partially compliant / mostly silent. Plan of Care for services is Program office policy or manual will be revised to 2017
Click on “Title 50”, Page 24 of TOC. developed using a person centered process. All services must be delivered in accordance with the approved plan of care (POC). No mention of listing setting options or including in the POC §13911 – Day Habilitation – Silent §13913 – Supported Employment – Silent §13917 – Employment Related Training – Silent require documentation of choice of specific setting for these services. NOW Manual Silent Program office policy or manual will be revised to require documentation of choice of specific setting for these services. 2017
The person centered process documentation is currently under review and these requirements will be incorporated into the most appropriate document ROW Rule Title 50, Part XXI, Subpart 13, Chapters 161 Click on “Title 50” Go to page 25 of TOC. Silent Same as NOW remediation Same as NOW ROW Manual: Silent Same as NOW remediation Same as NOW Children’s Choice Rule Title 50, Part XXI, Subpart 9, Chapters 111 Silent Same as NOW remediation Same as NOW
Click on “Title 50”, Page 23 of TOC. Children’s choice Manual Silent Same as NOW remediation Same as NOW Supports Waiver Rule Title 50, Part XXI, Subpart 5, Chapter 53 Click on “Title 50”, Go to page 22 of TOC. Silent Same as NOW remediation Same as NOW Supports Waiver Manual Silent Same as NOW remediation Same as NOW Guidelines for Support Planning Silent Same as NOW remediation Same as NOW
Individuals have the freedom to furnish and decorate their sleeping or living units within the lease or other agreement. See Residential Settings – Systemic assessment – No changes for Non-residential services Individuals have the freedom and support to control their own schedules and activities, and have access to food at any time. See Residential Settings – Systemic assessment – No changes for Non-residential services Individuals are able to have visitors of their choosing at any time. See Residential Settings – Systemic assessment – No changes for Non-residential services The setting is physically accessible to the individual. See Residential Settings – Systemic assessment – No changes for Non-residential services
Validation Review Checklist Physical Location 3 2 1 Recommendations/Comments Acceptable evidence of support may include: notes/minutes where there is agreement between various stakeholders that this is true A copy of licenses inclusive of lack of license for private ICF/DD If the agency does own/operate housing is it done under a separate board and/or budget? If so, this could support it as a separate entity and be considered in compliance. Specifically, for site visits-LGE staff would be able to verify location in person and could visit some participant homes to assure compliance. The evidence provided clearly supports that the location where services are being provided are in the community among other private residences or retail businesses; have the same access to goods/services as persons not receiving HCBS; and do NOT have the following characteristics: Located in a building that is also publically or privately operated facility that provides inpatient institutional treatment Located on the grounds of or immediately adjacent to a public or private institution owned by the service provider Own or operate multiple homes located on the same street (excluding duplexes and multiplexes, unless there is more than one on the same street. Located in a gated/secured “community” for people with disabilities Designed specifically for people with developmental disabilities Choice of Setting/Person-Centered 3 2 1 Recommendations/Comments Acceptable evidence of support may include: Review a sample individual’s plans of care for agency Review applicable policy/procedures for the agency Review a sample of individual’s schedules Interview some of the individual’s supported by the agency If the agency completes satisfaction survey’s with the individual’s, they support could review a sample of those Evidence provided supports that individuals have been given choice as to where they will live and receive services. This includes: Choice of provider, services, and settings Opportunity to visit/understand options available Individual has opportunity to regularly update or change preferences Opportunity to participate in both work/non-work activities in the most integrated setting Opportunity and support to develop and update plans of care that reflect individual needs and preferences Individual understands how/when to request planning meetings
The staff that support the individual are knowledgeable about their capabilities, interests, preferences and needs Community Integration 3 2 1 Recommendations/Comments Acceptable evidence of support may include: Review a sample individual’s plans of care for agency Review applicable policy/procedures for the agency Review a sample of individual’s schedules Interview some of the individual’s supported by the agency If the agency completes satisfaction survey’s with the individual’s, they support could review a sample of those Evidence provided supports that individuals have choice and are able to access services in the community in the same way that persons not receiving Medicaid funded services have choice and are able to access the community: Individual is afforded opportunity to have knowledge of or access to information regarding age appropriate activities including competitive work, shopping, attending religious services, scheduling appointments, meeting with families/friends, etc. Individual is able to come and go in the same manner as person’s not receiving Medicaid funded services Individual regularly accesses the community and/or is engaged in activities/organizations of their choosing Individual and/or their representative is able to describe how he or she accesses the community, the type of assistance they need to access the community, and who will assist them in the community Individual has access to transportation Rights and Privacy/Individual Initiative, Autonomy, and Independence *** To rate this item you will need to look at appropriate description. If the assessment, you are looking at is for Residential you will look at the first description and if assessment is for vocational program look at non-residential description (second description). 3 2 1 Recommendations/Comments Acceptable evidence of support may include: Review a sample individual’s plans of care for agency Review applicable policy/procedures for the agency Review a sample of individual’s schedules Interview some of the individual’s supported by the agency If the agency completes satisfaction survey’s with the individual’s, they Residential Settings: evidence supports that the individual has the same rights/protections and privacy as person’s not receiving Medicaid services: Individuals who do not own their home have a legally enforceable agreement Agreement offers same responsibilities/protections from eviction
Survey Questions Does your staff at the Day Program give you information or tell you how you can request changes to the services they provide? For example, do you know how to ask your staff to update information in your plan of care? ☐Yes ☐No Does your day program staff allow you to leave during the day if you need to (i.e., can a family member/staff check you out)? ☐Yes ☐No ☐N/A –Not applicable (the individual participates in employment services only; does not participate in Day Services) Does your day program staff discuss with you the type of activities that you might like to do and do they help you plan for these types of activities? ☐Yes ☐No ☐N/A –Not applicable (the individual participates in employment services only; does not participate in Day Services) If you want to can you have a job? For example, do you have the help you need to look for a job if you want to? ☐Yes ☐No Does your staff regularly and periodically talk to you about other activities that you might be interested in? For example, do they ask you if you would like to try any new activities (non-work activities) or if you would like to explore work options? ☐Yes ☐No ☐N/A –Not applicable (the individual participates in employment services only; does not participate in Day Services) Do the people that help you treat you with respect and speak to you in a kind and respectful manner? ☐Yes ☐No Can you be alone if you want/need to be while participating in day activity? ☐Yes ☐No ☐N/A –Not applicable (the individual participates in employment services only; does not participate in Day Services)
☐No ☐No, but supported by the person-centered plan Do others knock before entering your home? ☐Yes ☐No Can you close and lock your bedroom door? ☐Yes ☐No ☐No, but supported by the person-centered plan Can you close and lock your bathroom door? ☐Yes ☐No ☐No, but supported by the person-centered plan Do you have a roommate? If yes, did you get to choose your roommate and the person you share your home with? ☐Yes ☐No ☐N/A –Not applicable-person does not have a roommate Do you know how to ask for a new roommate? ☐Yes ☐No ☐N/A –Not applicable-person does not have a roommate Is your home set-up/decorated in a way that you choose? For example, can you move the furniture where you want it? Can you hang things on the walls? Can you change things in your home? ☐Yes ☐No Do you participate in activities that you enjoy? For example, shopping, church, lunch, other activities noted on the CPOC. ☐Yes