(DD) Waiver Service Standards - New Mexico Department of Health

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(b) Goals must be measurable and shall be revised when an individual has met the goal and has the potential to attain additional goals or no longer requires supports in order to maintain the goal. (c) Approaches described in the plan shall be individualized to reflect the individual’s unique needs, provide guidance to the caregiver(s) and designed to support successful interactions. Some interventions may be carried out by staff, family members or other team members, and other interventions may be carried out directly by the nurse – persons responsible for each intervention shall be specified in the plan. (d) Healthcare plans shall be written in language that will be easily understood by the person(s) identified as implementing the interventions. (e) The nurse shall also document training on the healthcare plan delivered to agency staff and other team members, clearly indicating competency determination for each trainee. If the individual receives services from separate agencies for community living and community inclusion services, nurses from each agency shall collaborate in the development of and training delivery for healthcare plans to assure maximum consistency across settings. (f) Healthcare plans must be updated to reflect relevant discharge orders whenever an individual returns to services following a hospitalization. (g) All crisis prevention and intervention plans and healthcare plans shall include the individual’s name and date on each page and shall be signed by the author. (h) Crisis prevention and intervention plans as well as healthcare plans shall be reviewed by the nurse at least quarterly, and updated as needed. (4) General Nursing Documentation: (a) The nurse shall complete legible and signed progress notes with date and time indicated that describe all interventions or interactions conducted with individuals served as well as all interactions with other healthcare providers serving the individual. All interactions shall be documented whether they occur by phone or in person. (b) For individuals with a HAT score of 4, 5 or 6, or who have identified health concerns in their ISP, the nurse shall provide the interdisciplinary team with a quarterly report that indicates current health status and progress to date on health related ISP desired outcomes and action plans as well as progress toward goals in the healthcare plan. 10
F. Sanitation. When services are provided in a setting under the management of the Provider Agency that delivers Community Living or Community Inclusion services, the environment shall be maintained in a functional, sanitary, and safe condition. Any Provider Agency that prepares and serves food to individuals or allows individuals to prepare and eat meals while in the Provider Agency setting shall meet the following requirements: (1) Equipment and utensils shall be kept clean and in good repair; and (2) Food shall be stored, prepared, distributed and served under sanitary conditions that prevent spoilage or contamination. G. Quarterly Reports of Service Location. All Provider Agencies shall include in their quarterly report to the DDSD Regional Office, documentation that fully discloses the physical location of individuals who are currently receiving services operated by or under the primary supervision of the Provider Agency. The Provider Agency shall include the following: (1) The physical address of each service location; and (2) The Provider Agency contact for each location. IV. GENERAL REQUIREMENTS FOR PROVIDER AGENCY SERVICE PERSONNEL. The objective of this section is to establish personnel standards for DD Medicaid Waiver Provider Agencies for the following services: Community Living Supports, Community Inclusion Services, Respite, Substitute Care and Personal Support Companion Services. These standards apply to all personnel who provide services, whether directly employed or subcontracting with the Provider Agency. Additional personnel requirements and qualifications may be applicable for specific service standards. A. Communicable Diseases. Provider agencies shall develop and implement written policies for control of communicable diseases that ensure that employees and volunteers with symptoms or signs of communicable disease or infected skin lesions shall not be permitted to work unless authorized in writing to do so by a physician or other qualified health professional. B. Volunteers. Provider agencies shall not use volunteers prior to ensuring that a system exists for the effective orientation, training, and supervision necessary to protect the health and safety of individuals served. Natural supports listed as such in an individual’s ISP are not considered volunteers for the purposes of this standard. C. Orientation and Training Requirements. Orientation and training for direct support staff and his or her supervisors shall comply with the DDSD/DOH Policy Governing the Training Requirements for Direct Support Staff and Internal Service Coordinators Serving Individuals with Developmental Disabilities to include the following: 11
Page 1 and 2: Developmental Disabilities (DD) Wai
Page 3 and 4: Developmental Disabilities (DD) Wai
Page 5 and 6: TABLE OF CONTENTS C. Adult Habilita
Page 7 and 8: TABLE OF CONTENTS V. REQUIREMENTS U
Page 9 and 10: TABLE OF CONTENTS A. Provider Agenc
Page 11 and 12: TABLE OF CONTENTS D. Consultation w
Page 13 and 14: TABLE OF CONTENTS D. Non-Medical Tr
Page 15 and 16: DOH/DDSD (Appendix A) Individual Tr
Page 17 and 18: (b) Emotional, psychological, and p
Page 19 and 20: AD. AE. IDEA. means Individuals wit
Page 21 and 22: includes a functional assessment of
Page 23 and 24: CHAPTER 1 INTRODUCTION These standa
Page 25 and 26: (2) On the day a Provider Agency is
Page 27 and 28: provided to the receiving agency wh
Page 29 and 30: G. Transportation. Provider agencie
Page 31: equires delivery by licensed or cer
Page 35 and 36: (6) Report required personnel train
Page 37 and 38: implemented, and return the plan to
Page 39 and 40: (g) Reduction in term of the agency
Page 41 and 42: (10) Non-Medical Transportation; (1
Page 43 and 44: (4) Physical Therapy (limited and w
Page 45 and 46: (l) Non-Medical Transportation; (m)
Page 47 and 48: (3) Service Options in Addition to
Page 49 and 50: age 22 or older who are receiving D
Page 51 and 52: CHAPTER 3 BEHAVIORAL SUPPORT CONSUL
Page 53 and 54: (2) Guide the IDT members in assess
Page 55 and 56: B. Behavioral Support Consultation
Page 57 and 58: (4) All Behavioral Support Consulta
Page 59 and 60: (d) Functional evaluations/assessme
Page 61 and 62: the training is not offered by DDSD
Page 63 and 64: K. Inform the individual of his or
Page 65 and 66: (2) A new history and physical; (3)
Page 67 and 68: of the Case Manager and all IDT mem
Page 69 and 70: (b) A change from a less restrictiv
Page 71 and 72: (b) Case Management Provider Agenci
Page 73 and 74: for at least 30 hours per week of p
Page 75 and 76: (c) Bachelor’s or Master’s degr
Page 77 and 78: its designee and will include the n
Page 79 and 80: (2) Services furnished to an indivi
Page 81 and 82: (6) Identification of barriers to i
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(4) Volunteer time in the community
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conservator, physician’s name(s)
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(2) Whenever possible, direct suppo
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(9) Job coaching; (10) Situational
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(6) Individuals are not excluded fr
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Individual Supported Employment, a
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E. Reimbursement. (g) Assess barrie
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service are determined by the indiv
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(6) Community Access Coaching is al
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(10) The individual is provided opp
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(p) Implement recommendations from
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The Adult Habilitation Service Prov
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(25) Development of increased indep
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XV. PROVIDER AGENCY STAFF QUALIFICA
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CHAPTER 6 COMMUNITY LIVING SERVICES
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(4) Internal service coordination.
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(a) Documentation of determination
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(b) That each individual with a sco
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individual’s home and an updated
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G. IDT Coordination. (1) Appropriat
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J. Qualification for Agency Supervi
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(a) At a maximum of two (2) individ
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(2) Up to 1000 hours of substitute
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(15) Handrails, grab-bars, door han
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(5) Written verification that the c
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Funding for adaptations is availabl
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of a work uniform for an employed i
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CHAPTER 9 OUTLIER SERVICES I. OUTLI
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Necessity Outlier services, the ind
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(b) The billable unit for Outlier A
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III. PERSONAL PLAN FACILITATION REQ
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CHAPTER 11 PERSONAL SUPPORT SERVICE
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(4) Personal Support Services may n
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CHAPTER 12 RESPITE SERVICES I. RESP
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(c) Direct Support Staff are requir
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B. Eligibility for Medicaid DD Waiv
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(b) Therapy Provider Agencies shall
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D. Integrating Therapy Strategies i
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(f) An Occupational Therapy Aide/Te
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(3) Designing, building or preparin
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(12) Providing other non-administra
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(2) Collaborative therapy services
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F. Training Family/Support Staff. (
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(b) Relevant background information
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listed in the ISP. The therapy inte
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L. Discontinuation of Services Repo
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(c) Caregiver training and consulta
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(3) In the first year of service or
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G. Attend IDT meetings. H. The Tier
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E. Reimbursement. (e) Required DDSD
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R. Skin care; S. Weight management;
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CHAPTER 16 NUTRITIONAL COUNSELING S
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CHAPTER 17 NON-MEDICAL TRANSPORTATI
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support the planning process. This
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CHAPTER 18 SUPPLEMENTAL DENTAL CARE
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(DD) Waiver Service Standards - New Mexico Department of Health

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