DDRS Waiver Manual

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Rent and Food for an Unrelated Live-in Caregiver should be reflected in the ISP. Services must address needs identified in the person-centered planning process and be outlined in the ISP. Services must complement other services the participant receives and enhance increasing independence for the participant. The person-centered planning team will decide and assure that the individual who will serve as a live-in caregiver has the experience, skills, training, and knowledge appropriate to the participant and the type of support needed. Documentation Standards Rent and Food for Unrelated Live-in Caregiver services documentation must include: Identified in the ISP Documentation of how amount of rent and food was determined Receipt that funds were paid to the live-in caregiver Documentation in compliance with 460 IAC 6 Supported Living Services and Supports requirements As applicable, monthly/quarterly reports must be uploaded to Advocare by the chosen service provider on or before the fifteenth day of the following month Limitations The following limitations apply to Rent and Food for Unrelated Live-In Caregiver services: See Activities Not Allowed. Activities Not Allowed The following activities are not allowed under Rent and Food for Unrelated Live-in Caregiver services: When the participant lives in the home of the caregiver or in a residence owned or leased by the provider of other services, including Medicaid waiver services When the live-in caregiver is related by blood or marriage (to any degree) to the participant and/or has any legal responsibility to support the participant Section 10.26: Residential Habilitation and Support-Daily (RHS-Daily) (currently under CIHW only) Service Definition Residential Habilitation and Support – Daily (RHS Daily) services provide up to a full day (24-hour basis) of services and supports which are designed to ensure the health, safety, and welfare of the participant. RHS Daily services assist with the acquisition, improvement, and retention of skills necessary to support individuals to live successfully in their own homes; acquire and enhance natural supports; and become integrated and participate in their larger community. Services are designed to help individuals acquire and improve their self-help, socialization, and adaptive skills. Services should be directed toward increasing and 138
maintaining natural supports, physical, intellectual, emotional, and social functioning, and full community participation. Individuals Eligible for RHS Daily Services Individuals who choose Residential Habilitation and Support (RHS) and meet all of the following criteria are eligible for and will utilize RHS Daily Services: Individuals who have an ALGO score of 3, 4, or 5 on their Objective Based Allocation (OBA). Individuals who are living with housemates and are utilizing a shared staffing model. Individuals who are living outside of their family home. ALGO LEVEL DESCRIPTORS/ICAP/OBA The following descriptors appear in 460 IAC 13-5-1 Algo levels: Level: 0 (low) Descriptor: Algo level zero: (A) high level of independence with few supports needed; (B) no significant behavioral issues; and (C) requires minimal residential habilitation services. Level: 1 (Basic) Descriptor: Algo level one : (A) moderately high level of independence with few supports needed; (B) behavioral needs, if any, can be met with medication or informal direction by caregivers through the Medicaid state plan services; and (C) likely a need for day programming and light residential habilitation services to assist with certain tasks, but the individual can be unsupervised for much of the day and night. Level: 2 (Regular) Descriptor: Algo level two : (A) moderate level of independence with frequent supports needed; (B) behavioral needs, if any, can be met with medication or light therapy, or both, every one to two weeks; (C) does not require twenty-four hours a day supervision; and (D) generally able to sleep unsupervised, but needs structure and routine throughout the day. 139
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2016 DDRS Waiver Manual Our Mission
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Section 1: Roles and Responsibiliti
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Section 7.5: State Authorization of
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Section 10.23: Psychological Therap
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Section 1.1: The Centers for Medica
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ules or standards that may affect t
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Information Sharing The Individual
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Here are some tips on what to discu
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6. Does each person have his or her
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Section 3: Additional Medicaid Prog
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HCBS waiver services. HCBS waiver p
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Section 4.1: Medicaid Waiver Overvi
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Section 4.4: Coordination with Medi
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personal beliefs and customs, ensur
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Section 5.1: Request for Applicatio
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Internet access, call toll free 1-8
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understanding and use of language,
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If an individual declines the offer
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waiver slot when it appears that th
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Five calendar days to interview and
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The individual or guardian has sign
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Section 6: Objective Based Allocati
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adjustments to the allocation amoun
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BMAN Reserve $0 $0 $2,620.80 $5,241
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An individual’s behavioral condit
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An individual or the individual’s
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Your Appeal Right as an Applicant f
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Section 7.1: Level of Care Re-Evalu
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RN/LPN, who must be actively involv
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o Children receiving adoption assis
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including the DDRS Case Management
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When the individual “Re-Enters”
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(RHS) under the Community Integrati
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Section 8.1: Appeal Request The fol
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Objective-based allocation (OBA): T
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administrative hearing must still b
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The person testifying should be the
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In all cases, the decision of the A
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Section 9.1: Overview The Family an
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Structural or environmental issues
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implemented in order to ensure that
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conducted by the ombudsman must als
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Section 10.24: Recreational Therapy
Page 87 and 88: Medicaid Waiver Services, Codes, an
Page 89 and 90: FSW CIH MFP- CIH INsite Code Servic
Page 91 and 92: The Case Manager should give the co
Page 93 and 94: Aversive techniques - any technique
Page 95 and 96: Services delivered to persons who d
Page 97 and 98: where services are not rendered wit
Page 99 and 100: Section 10.7: Community Based Habil
Page 101 and 102: Activities that do not foster the a
Page 103 and 104: The system to be installed must be
Page 105 and 106: The monitoring base staff must have
Page 107 and 108: Electronic Monitoring may not be us
Page 109 and 110: Adaptations to service provider-own
Page 111 and 112: independence and are consistent wit
Page 113 and 114: Group supports delivered to individ
Page 115 and 116: o Small (4:1 or smaller) o Medium (
Page 117 and 118: The data may reside in multiple loc
Page 119 and 120: Providers must be able to indicate,
Page 121 and 122: programmed, constructive interactio
Page 123 and 124: The IBI Director will provide a nar
Page 125 and 126: As applicable, monthly/quarterly re
Page 127 and 128: participate in their communities, a
Page 129 and 130: Homeschooling, special education, a
Page 131 and 132: or before the fifteenth day of the
Page 133 and 134: o Medium (5:1 to 10:1) o Larger (la
Page 135 and 136: Services must address needs identif
Page 137: The following activities are not al
Page 141 and 142: tool for individual assessment. The
Page 143 and 144: o o o o o Individuals receiving RHS
Page 145 and 146: (C) requires minimal residential ha
Page 147 and 148: as well the development, oversight,
Page 149 and 150: Available only under the Community
Page 151 and 152: Services furnished to a minor by a
Page 153 and 154: Section 10.30: Speech/Language Ther
Page 155 and 156: to be utilized in service plan deve
Page 157 and 158: Transportation services through the
Page 159 and 160: Bus passes or alternate methods of
Page 161 and 162: The participant requires assistance
Page 163 and 164: Service Standards The following ser
Page 165 and 166: Section 11: Request for Approval (R
Page 167 and 168: Choice of Provider The individual c
Page 169 and 170: Reimbursement Reimbursement is avai
Page 171 and 172: Modifications/Items - Non-Covered E
Page 173 and 174: Authority: 42 CFR §441.302 Section
Page 175 and 176: Total Cost $$$$$ 175
Page 177 and 178: Items - Covered Justification and d
Page 179 and 180: These requests should be extremely
Page 181 and 182: Choice of Provider The individual c
Page 183 and 184: Completed by an approved Medicaid W
Page 185 and 186: The case management entity, working
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DDRS Waiver Manual

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