2016 Proposed Changes to Amend the P/FDS and Consolidated Waivers Effective May 1, 2016 KEY – Bold = Recommended additions Strikethrough= Recommended removal Appendix Waiver Section Current Language Recommended Revised Language Reason for Change Comment/Commenter Main Module Main Module Additional Needed Information - Appendix C, Quality Improvement Performance Measure Remediation Continuation Performance Measure a.i.c.2. Number and percent of non-licensed providers that meet training requirements in accordance with state requirements in the approved Waiver. Through the Provider Monitoring process, ODP or AEs conduct onsite reviews of 100% of providers on a one-year cycle for SCOs and a two year cycle for all other providers using the standardized monitoring tools developed by ODP. ODP reviews the training records for all Supports Coordinators and Supports Coordinator Supervisors with a waiver caseload to determine that they attended and completed all required trainings. The AE reviews the training records of the 10 most recently hired staff members who were hired on or before August 1st or all records of staff hired within the prior 12 months (in cases where less than 10 staff were hired). If the required staff training is not documented in the record, ODP or the AE will notify the provider and the provider must locate missing documentation or ensure that training is provided within 30 days. The remediation for this process will occur as outlined in Performance Measure a.i.c.2. Number and percent of non-licensed providers that meet training requirements in accordance with state requirements in the approved Waiver. Through the Provider Monitoring process, ODP or AEs conduct onsite reviews of 100% of providers on a one-year cycle for SCOs and a two year cycle for all other providers using the standardized monitoring tools developed by ODP. ODP reviews the training records for all Supports Coordinators and Supports Coordinator Supervisors with a waiver caseload to determine that they attended and completed all required trainings. The AE reviews the training records of the 10 most recently hired staff members who were hired in the prior fiscal year on or before August 1st or all records of staff hired within the prior 12 months fiscal year (in cases where less than 10 staff were hired). If the required staff training is not documented in the record, ODP or the AE will notify the provider and the provider must locate missing documentation or ensure that training is provided within 30 days. The remediation for this process will Align waiver with current provider monitoring process and guidance.
(Consolidated Waiver Only) The capacity that the State reserves in each waiver year is specified in the following table: Year 1 – 20 Year 2 – 50 Year 3 – 120 Year 4 – 120 Year 5 – 20 The capacity that the State reserves in each waiver year is specified in the following table: Year 1 – 20 Year 2 – 50 Year 3 – 120 Year 4 – 120 Year 5 – 20 60 emergencies based on past need and usage. B-3-c Reserved Waiver Capacity – (Consolidated Waiver Only) Hospital/Rehabilitation Care The capacity that the State reserves in each waiver year is specified in the following table: Year 1 – 750 Year 2 – 750 Year 3 – 550 Year 4 – 550 Year 5 – 550 Hospital/Rehabilitation Care The capacity that the reserves in each waiver year is specified in the following table: Year 1 – 750 Year 2 – 750 Year 3 – 550 Year 4 – 550 200 Year 5 – 550 200 The Department has found in the first three years of implementation of reserved capacity for this purpose that this number is higher than necessary to serve those individuals that require hospital/rehabilitation care. B-3-c Reserved Waiver Capacity – (P/FDS Waiver Only) Waiting List Initiative The capacity that the State reserves in each waiver year is specified in the following table: Year 1 – 700 Year 2 – 700 Year 3 – 700 Year 4 – 0 Year 5 – 0 Waiting List Initiative The capacity that the reserves in each waiver year is specified in the following table: Year 1 – 700 Year 2 – 700 Year 3 – 700 Year 4 – 0 600 Year 5 – 0 Increase the number of individuals that can be served in the P/FDS waiver to accommodate the FY 15/16 waiting list initiative if approved Appendix C C-1/C-3 Provider Qualification Criteria Nothing is currently in the waivers standards will apply to all providers with the exception of support service workers in the participant directed service models and public transportation providers. Standard: Moving the requirement for new providers to complete a self-assessment from a provider monitoring requirement to a provider qualification requirement.
New providers demonstrate compliance with ODP standards through completion of a self-assessment and validation of required documentation, policies and procedures. Comply with and meet all standards as applied through each phase of the ODP Provider Monitoring Process. C-1/C-3 Home and Community Habilitation (Unlicensed) – Service Specification (The language regarding residential habilitation will only be written in the Consolidated Waiver) This is a direct service (face-to-face) provided in home and community settings to assist participants in acquiring, maintaining, and improving self-help, domestic, socialization, and adaptive skills necessary to reside successfully in home and community based settings. Services consist of support in the general areas of self-care, communication, fine and gross motor skills, mobility, personal adjustment, relationship development, socialization, and use of community resources. When services are provided by agency-based providers, this service also includes transportation services necessary to enable the participant to participate in the Home and Community Habilitation Service, in accordance with the participant’s ISP. Through the provision of this service participants will acquire, maintain, or improve skills necessary for participants to live in the community, to live more independently, or to be more productive and participatory in community life. Participants receiving Residential Habilitation Services may elect to receive Home and Community Habilitation Home and Community Habilitation is a direct service (face-to-face) service provided in home and community settings to assist participants in acquiring, maintaining and improving the skills necessary to live and participate fully in community life. self-help, domestic, socialization, and adaptive skills necessary to reside successfully in home and community based settings Services consist of assistance, support and guidance (physical assistance, instruction, prompting, modeling, and reinforcement) in the general areas of self-care, health maintenance, decision making, home management, managing personal resources, communication, mobility and transportation, relationship development and socialization, personal adjustment, participating in community functions and activities and use of community resources. The type and degree of assistance, support and guidance are informed by the assessed need for physical, psychological and emotional assistance established through the assessment and planning processes. The type and Align the service definition with the CMS HCBS Final Rule requirements. Allow relatives/legal guardians to provide companion services.
Services as an alternative to a licensed Day Habilitation or Prevocational Services. Under these circumstances the Home and Community Habilitation Service must occur anytime during the hours of 8:00 am – 5:00 pm, Monday through Friday. Refer to the service limit section below for information related to unit limitations when this occurs. Home and Community Habilitation Services may provide the following supports to meet participants’ habilitative outcomes as documented in the ISP: 1.Support that enables the participant to access and use community resources such as instruction in using transportation, translation and communication assistance related to a habilitative outcome, and services to assist the participant in shopping and other necessary activities of community life. 2.Support that assists the participant in developing or maintaining financial stability and security, such as plans for achieving self-support; general banking; personal and estate planning; balancing accounts; preparing income taxes; and recordkeeping. 3.Support that enables a participant to participate in community projects, associations, groups, and functions, such as support that assists a participant to participate in a volunteer association or a community work project. 4.Support that enables a participant to visit with friends and family in the community. degree of assistance are delivered to enhance the autonomy of the person, in line with their personal preference and to achieve their desired outcomes. When Home and Community Habilitation services occur in the community and are provided by agency-based providers, this service also includes the necessary transportation to enable community participation in accordance with the participant’s ISP. Through the provision of this service participants will acquire, maintain, or improve skills necessary for participants to live in the community, to live more independently, and to participate meaningfully in community life. Participants receiving Residential Habilitation Services may to receive Home and Community Habilitation Services as an alternative to a licensed Day Habilitation or Prevocational Services. Under these circumstances the Home and Community Habilitation Service must occur anytime during the hours of 8:00 am – 5:00 pm, Monday through Friday. Refer to the service limit section below for information related to unit limitations when this occurs. Home and Community Habilitation Services may provide the following supports to meet participants’ habilitative outcomes as documented in the ISP: 1. Assistance, support and guidance (prompting, instruction, modeling, reinforcement) in carrying out activities of
As indicated above for participants residing in residential settings, Home and Community Habilitation Services may be used as an alternative either part-time or full-time for a Licensed Day Habilitation Service or a Prevocational Service. When this occurs the Home and Community Habilitation units are included in the combined unit limit for services that may not exceed 40 hours (160 15-minute units) per participant, per calendar week based on a 52 week year (Transitional Work Services, Supported Employment Services, licensed Day Habilitation Services and Prevocational Services). Home and Community Habilitation Services cannot be provided in a licensed setting, unlicensed residential setting or camp. This service is provided in a participant’s private home or other community setting. projects and events with volunteer associations and groups; to serve on public and private boards, advisory groups, and commissions, as well as develop confidence and skills to enhance their contributions to the community. 13. Assistance, support and guidance that encourages the development of the participant’s personal interests, such as hobbies, appreciation of music, and other experiences the individual enjoys or may wish to discover 14. Assistance, support and guidance in engaging in the necessary and preferred activities of community life such as shopping, going to restaurants, museums, movies, concerts, dances and faith based services. 15. Identification of risk to the person and the implementation of actions such as reporting incidents as required by ODP , the Adult Protective Services Act and the Child Protective Service Act, and/or calling emergency officials for immediate assistance 16. Support provided during overnight hours when the participant needs the habilitation service to protect their health, safety and well-being. The staff providing the Home and Community Habilitation Service must be awake. If the participant only needs supervision during overnight hours, while he or she sleeps, the appropriate service is Companion Services.
obtain and sustain competitive integrated employment is utilized as specified in the plan. Payment will be made only for the training and supports required by the participant and will not include payment for the supervisory activities rendered as a normal part of the employment setting. Supported Employment services do not include facility based, or other similar types of vocational services furnished in specialized facilities that are not integrated or part of the general workforce. Supported Employment services can be provided for two different purposes: 1. Vocational Development which includes assisting participants in acquiring, maintaining or improving job skills; and 2. Rehabilitation which includes assisting participants in regaining lost skills or functioning due to illness or injury. Federal Financial Participation through the Waiver may not be claimed for incentive payments, subsidies, or unrelated vocational expenses such as the following: • Incentive payments made to an employer of participants receiving services to encourage or subsidize the employer's participation in a supported employment program; • Payments that are passed through to participants receiving Supported Employment; or • Payments for vocational training that are not directly related to a participant's Supported Employment program. competitive integrated employment is utilized as specified in the plan. Payment will be made only for the training and supports required by the participant and will not include payment for the supervisory activities rendered as a normal part of the employment setting. Supported Employment services do not include facility based, or other similar types of vocational services furnished in specialized facilities that are not integrated or part of the general workforce. Supported Employment services can be provided for two different purposes: 1. Vocational Skill Development which includes assisting participants in acquiring, maintaining or improving job skills; and 2. Rehabilitation which includes assisting participants in regaining lost skills or functioning due to illness or injury. Federal Financial Participation through the Waiver may not be claimed for incentive payments, subsidies, or unrelated vocational expenses such as the following: • Incentive payments made to an employer of participants receiving services to encourage or subsidize the employer's participation in a supported employment program; • Payments that are passed through to participants receiving Supported Employment; or • Payments for vocational training that are not directly related to a participant's Supported Employment program.
employment related personal skills instruction, support to relearn job tasks, training to assist participants in transportation to and from work, worksite orientation, job aide development, coordination of accommodations, ensuring assistive technology is utilized as specified in the plan, maintenance of appropriate work and interpersonal behaviors on the job, follow-along services at the work site after OVR funded services are discontinued, and technical assistance and instruction for the participant’s that will enable peer support. Ongoing use of the service is limited to support for participants that cannot be provided by the employer through regular supervisory channels, natural supports and/or on-the-job resources that are available to employees who are The provision of job finding services must be evaluated at least every six months by the ISP team or more frequently as needed to assess the continued need for the service and whether the service is assisting the participant with the outcome of finding community employment. If the service is not assisting the participant with this outcome, the ISP team must identify changes to the Supported Employment Service to realize this outcome or other service options to meet the participant’s needs. The provision of job support services must be evaluated at least annually, as part of the ISP process, to determine whether the participant tasks, training to assist participants in using transportation to and from work, worksite orientation, job aide development, coordination of accommodations, ensuring assistive technology is utilized as specified in the plan, maintenance of appropriate work and interpersonal behaviors on the job, follow-along services at the work after OVR funded services are discontinued, and technical assistance and instruction for the participant’s co-workers that will enable peer support. Ongoing use of the service is limited to support for participants that cannot be provided by the employer through regular supervisory channels, natural supports and/or on-the-job resources that are available to employees who are The provision of job finding services must be evaluated at least every six months will be evaluated during participant monitoring by the SC ISP team or more frequently as needed to assess the continued need for the service and whether the service is assisting the participant with the outcome of finding community employment. If the service is not assisting the participant with this outcome, the SC will convene an ISP team meeting to must identify changes to the Supported Employment Service to realize this outcome or other service options to meet the participant’s needs. The provision of job support services must be evaluated at least annually, as part of the ISP process, to determine whether the participant continues to require the current level of
Service Delivery Method (check each that applies): Participant-directed as specified in Appendix E Provider managed Specify whether the service may be provided by (check each that applies): Legally Responsible Person Relative Legal Guardian Service Delivery Method (check each that applies): Participant-directed as specified in Appendix E Provider managed Specify whether the service may be provided by (check each that applies): Legally Responsible Person Relative Legal Guardian C-1/C-3 Therapy Services – Service Specification and Provider Specifications Therapy services include the following: Visual/mobility therapy provided by a trained visual or mobility specialist/instructor based on an evaluation and recommendation by a trained mobility specialist/instructor or a physician… Visual/Mobility Therapy: This therapy is for participants who are blind or have visual impairments… Provider Category – Agency and Individual Provider Type Title – Visual/Mobility Therapy Agency Provider Qualifications Certificate – Employees (direct, contracted, or in a consulting capacity) providing Visual/Mobility Therapy must be trained visual or mobility specialists/instructors. Other Standard 3. Agree to carry out the Visual/Mobility Therapy outcomes included in the ISP. Therapy services include the following: • Visual/mobility Orientation, mobility and vision therapy provided by a trained visual or orientation and mobility specialist/instructor based on an evaluation and recommendation by a trained mobility specialist/instructor or a physician… Visual/Orientation, mobility and vision therapy: This therapy is for participants who are blind or have visual impairments… Provider Category – Agency and Individual Provider Type Title – Visual/Orientation, Mobility and Vision Therapy Agency Provider Qualifications Certificate – Employees (direct, contracted, or in a consulting capacity) providing Visual/Orientation, Mobility and Vision therapy must be certified orientation and mobility specialists by the Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) be trained visual or mobility specialists/instructors. Align with current terminology and standards