Wednesday, May 21, 2008

Resource:Home and Community Based Services Manual

As part of OASIS, families will be able to "buy" services with their allocation. There will be brief descriptions of available services as part of the budget tool. However, it would be of benefit to families, especially those being implemented first in the pilot district (Benton, Carroll, Clay, Clinton, Fountain, Monroe, Montgomery, Owen, Parke, Putnam, Sullivan, Tippecanoe, Vermillion, Vigo, Warren, White counties) to become familiar with the services and allowable/non allowable activities. We are posting some of the most commonly accessed services. You can find the entire manual in the files section at http://groups.yahoo.com/group/FVIndiana

Behavior Modification
Allowable Activities
• Observation of the individual and environment for purposes of development of a plan and to determine baseline
• Development of a behavioral support plan and subsequent revisions
• Training in assertiveness
• Training in stress reduction techniques
• Training in the acquisition of socially accepted behaviors
• Training staff, family members, roommates, and other appropriate individuals on the implementation of the behavior support plan
• Consultation with members
• Consultation with HSPP
Activities Not Allowed
• Aversive techniques
• Any techniques not approved by the individual's person centered planning team and the provider's human rights committee


Community Transition

Allowable Activities
• Security deposits that are required to obtain a lease on an apartment or home.
• Essential furnishings and moving expenses required to occupy and use a community domicile including a bed, table or chairs, window coverings, eating utensils, food preparation items, bed or bath linens
• Set-up fees or deposits for utility or service access including telephone, electricity, heating, and water
• Health and safety assurances including pest eradication, allergen control, or one time cleaning prior to occupancy
• When the individual is receiving residential habilitation and support services under the DD or Autism Waiver, the Community Transition Supports service is included in the Cost Comparison Budget
Activities Not Allowed
• Apartment or housing rental expenses
• Food
• Appliances
• Diversional or recreational items such as hobby supplies
• Television
• Cable TV access
• VCRs

Day Services
Allowable Activities
• Direct supervision, monitoring, training, education, demonstration or support to assist with
• An individual's personal needs (feeding, toileting, and so forth)
• Transportation (excluding transportation that is covered under the Medicaid State Plan)
• Acquisition, improvement and retention of daily living skills
• Training and learning in the areas of employment skills, educational opportunities, hobbies and leisure activities
• Development of self-advocacy skills, acquiring skills that enable an individual to exercise control and responsibility over services and supports received or needed
• Activities that are directly related to the outcomes outlined in the Individualized Support Plan (ISP)
• Prevocational related activities that are compensated and paid to the individual at less than 50 percent of the minimum wage
Activities Not Allowed
• Services furnished to a minor by the parent(s), step-parent(s), or legal guardian
• Services furnished to an individual by the person's spouse
• Any service that is otherwise available under the Rehabilitation Act of 1973 or Public Law 94-124
• Services that are available under the Medicaid State Plan

Family and Caregiver Training
Allowable Activities
• Treatment regimens and use of equipment
• Stress management
• Parenting
• Family dynamics
• Community integration
• Behavioral intervention strategies
• Mental health
• Caring for medically fragile individuals
Activities Not Allowed
• Training/instruction not pertinent to the caregiver's ability to give care to the individual
• Training provided to caregivers who receive reimbursement for training costs within their Medicaid or state line item reimbursement rates
• Meals, accommodations, etc., while attending the training

Residential Habilitation
Allowable Activities
• Direct supervision, monitoring and training to implement the Individualized Support Plan (ISP) outcomes for the individual through the following:
• Assistance with personal care, meals, shopping, errands, chore and leisure activities and transportation (excluding transportation that is covered under the Medicaid State Plan)
• Coordination and facilitation of medical and non-medical services to meet healthcare needs, including physician consults, medications, development and oversight of a health plan, utilization of available supports in a cost effective manner and maintenance of each individual's health record
• Assurance that direct service staff are aware and active individuals in the development and implementation of ISP and Behavior Support Plans
Activities Not Allowed
• Services furnished to a minor by the parent(s), step-parent(s), or legal guardian
• Services furnished to an individual by the person's spouse
• Services to individuals in Adult Foster Care or Children's Foster Care
• Services that are available under the Medicaid State Plan
• Services furnished to an adult individual by a parent, step-parent or guardian, that exceed 40 hours per week

Respite Services
Allowable Activities
AD, TBI Waiver:
• Homemaker services
• Attendant care
• Home health aide services
• Skilled nursing services
• Nursing facility services – The care manager is required to receive prior authorization from the Indiana Family and Social Services Administration (IFSSA) with a completed Request for Approval to Authorize Services Form before Respite Care may be provided in a nursing facility.
DD, AU, SSW Waiver:
• Assistance with toileting and feeding
• Assistance with daily living skills, including assistance with accessing the community and community activities
• Assistance with grooming and personal hygiene
• Meal preparation, serving and cleanup
• Administration of medications
• Supervision
Activities Not Allowed
• Respite care shall not be used as day/child care to allow the persons normally providing care to go to work.
• Respite care shall not be used as day/child care to allow the persons normally providing care to attend school.
• Respite care shall not be used to provide service to a member while member is attending school.
• Respite care may not be used to replace skilled nursing services that should be provided under the Medicaid State Plan
• Services provided by the parent of a minor child or the individual's spouse
• Respite care must not duplicate any other service being provided under the individual's POC/ISP.
DD, AU, SSW Waiver:
• Reimbursement for room and board
• Services provided to an individual living in a licensed facility based setting
• The cost of registration fees or the cost of recreational activities (for example, camp)
• When the service of Adult Foster Care or Children's Foster Care is being furnished to the individual



No comments: