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Options for Designing Service Coverage: General Considerations 73individuals who reside in ICFs/MR.Adult day health: Health, therapy, and social servicesneeded to ensure an individual’s optimal functioning,furnished in an outpatient setting, four ormore hours per day on a regularly scheduled basis,for one or more days per week.These services are generally provided to olderpersons at senior centers or similar communityfacilities. Most states require that adult health programshave medical personnel available on site toSupported Employment Services in Colorado’sHCBS Waiver Program for People withDevelopmental DisabilitiesThe following are included in Colorado’s supportedemployment services:• Individualized assessment that may include communityorientation and job exploration• Individualized job development and placementservices that produce an appropriate job match forthe individual and his/her employer• Ongoing support, training, and facilitation in jobfinding, job skill acquisition, job retention, careerdevelopment, and work-related activities• Intervention and training needed to benefit fromsupported employment services and other supportsthat would help remove or diminish commonbarriers to participation in employment and to thebuilding of community relationships.address health care needs. Coverage of these servicesis nearly universal in HCBS waiver programsthat serve seniors with severe impairments.As a component of adult day health services,states have the option to cover transportationbetween the individual’s place of residence andthe adult day health center.Services for individuals with seriouspersistent mental illnessA state may cover three specialized services forindividuals who have serious persistent mentalillness: (a) clinic services; (b) day treatment orother partial hospitalization services; and (c) psychiatricrehabilitation services. These services alsomay be offered in HCBS waiver programs servingother target populations that include individualswho have a “dual diagnosis” (e.g., mental retardationand a psychiatric condition). Clinic andday treatment services are primarily for diagnosisand treatment of mental illness. In contrast, psychiatricrehabilitation services are aimed primarilyat achieving maximum reduction of physical ormental disability and restoration of maximumfunctioning.The standard HCFA definitions of these servicesencompass a wide range of assistance to individualswho have a mental illness and are in keepingwith contemporary views on mental health services.These views stress the need not only to treatthe mental illness but also to assist individuals tofunction in their communities.Clinic services: Outpatient mental health therapyand treatment.States that select this option may offer mentalhealth clinic services to HCBS waiver participants.The advantage of covering these services under anHCBS waiver program is that they may be furnishedin locations other than clinic sites. 31Day treatment or other partial hospitalization services:Services necessary for diagnosis or treatmentof an individual’s mental illness. These servicescan include diagnostic services, psychotherapy,family counseling, occupational and activitytherapy, medications, and training and educationof the individual.Day treatment services are akin to outpatientmental health services. Their purpose is to maintainthe individual’s condition and functionallevel and to prevent relapse or hospitalization.Partial hospitalization services are very similar toa hospital inpatient program, except the individualdoes not stay in the hospital 24 hours a day.With respect to adult services, day treatment is aterm sometimes used interchangeably with partialhospitalization. But for children, it often means afacility-based day program that includes schooling,with supplemental mental health rehabilitationand/or counseling as well. The scope of servicesa state may furnish under an HCBS waiver