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Appendix I 175help, socialization and adaptive skills which takes place in a non-residential setting,separate from the home or facility in which the individual resides. Servicesshall normally be furnished 4 or more hours per day on a regularly scheduledbasis, for 1 or more days per week unless provided as an adjunct to other dayactivities included in an individual's plan of care.Day habilitation services shall focus on enabling the individual to attain or maintainhis or her maximum functional level and shall be coordinated with any physical,occupational, or speech therapies listed in the plan of care. In addition, dayhabilitation services may serve to reinforce skills or lessons taught in school, therapy,or other settings.__ Prevocational services not available under a program funded under section 110 ofthe Rehabilitation Act of 1973 or section 602(16) and (17) of the Individuals withDisabilities Education Act (20 U.S.C. 1401(16 and 17)). Services are aimed atpreparing an individual for paid or unpaid employment, but are not job-task oriented.Services include teaching such concepts as compliance, attendance, taskcompletion, problem solving and safety. Prevocational services are provided topersons not expected to be able to join the general work force or participate in atransitional sheltered workshop within one year (excluding supported employmentprograms).Check one:__ Individuals will not be compensated for prevocational services.__ When compensated, individuals are paid at less than 50 percent of theminimum wage.Activities included in this service are not primarily directed at teaching specificjob skills, but at underlying habilitative goals, such as attention span and motorskills. All prevocational services will be reflected in the individual's plan of careas directed to habilitative, rather than explicit employment objectives.Documentation will be maintained in the file of each individual receiving thisservice that:1. The service is not otherwise available under a program funded underthe Rehabilitation Act of 1973, or P.L. 94-142; and__ Educational services, which consist of special education and related services asdefined in sections (15) and (17) of the Individuals with Disabilities EducationAct, to the extent to which they are not available under a program funded byIDEA. Documentation will be maintained in the file of each individual receivingthis service that:1. The service is not otherwise available under a program funded underthe Rehabilitation Act of 1973, or P.L. 94-142; and__ Supported employment services, which consist of paid employment for personsfor whom competitive employment at or above the minimum wage is unlikely,and who, because of their disabilities, need intensive ongoing support to performin a work setting. Supported employment is conducted in a variety of settings,particularly work sites in which persons without disabilities are employed.
176 UNDERSTANDING MEDICAID HOME AND COMMUNITY SERVICES: A PRIMERSupported employment includes activities needed to sustain paid work by individualsreceiving waiver services, including supervision and training. When supportedemployment services are provided at a work site in which persons withoutdisabilities are employed, payment will be made only for the adaptations,supervision and training required by individuals receiving waiver services as aresult of their disabilities, and will not include payment for the supervisory activitiesrendered as a normal part of the business setting.Supported employment services furnished under the waiver are not availableunder a program funded by either the Rehabilitation Act of 1973 or P.L. 94-142.Documentation will be maintained in the file of each individual receiving thisservice that:1. The service is not otherwise available under a program funded underthe Rehabilitation Act of 1973, or P.L. 94-142; andFFP will not be claimed for incentive payments, subsidies, or unrelated vocationaltraining expenses such as the following:1. Incentive payments made to an employer to encourage or subsidizethe employer's participation in a supported employment program;2. Payments that are passed through to users of supported employmentprograms; or3. Payments for vocational training that is not directly related to an individual'ssupported employment program.The State will require prior institutionalization in an NF or ICF/MR before a recipient is eligible forexpanded habilitation services (pre-vocational, educational and supported employment).1. ___Yes 2.___NoTransportation will be provided between the individual's place of residence andthe site of the habilitation services, or between habilitation sites (in cases wherethe individual receives habilitation services in more than one place) as a componentpart of habilitation services. The cost of this transportation is included in therate paid to providers of the appropriate type of habilitation services.1. ___Yes 2.___No__ Other service definition (Specify):____________________________________________________________________________________________________________The State requests the authority to provide the following additional services, not specified in the statute.The State assures that each service is cost-effective and necessary to prevent institutionalization. The costneutrality of each service is demonstrated in Appendix G. Qualifications of providers are found inAppendix B-2.__________________________________________________________________________________________________________________________________________________________________________________________
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Understanding MedicaidHome and Comm
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Gary Smith, the Primer’s principa
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viiiUNDERSTANDING MEDICAID HOME AND
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IntroductionPeople of all ages with
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Introduction 31998—is the group m
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Introduction 5This Primer has been
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CHAPTER 1Medicaid Coverage of Home
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Medicaid Coverage of Home and Commu
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CHAPTER 2Financial Eligibility Rule
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Financial Eligibility Rules and Opt
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CHAPTER 3Health and Functional Crit
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Health and Functional Criteria for
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CHAPTER 4Options for Designing Serv
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Options for Designing Service Cover
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Factors to Consider WhenChoosing Co
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Transitioning People from Instituti
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Guide to Chapter 7Consumer Directio
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