DDRS Waiver Manual

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Documentation Standards SFC Services documentation must include: Written policies and procedures, including for screening and accepting family caregivers/foster parents Maintain financial and service records to document services provided to the participant Document provision of training to family caregivers according to agency policies/procedures Reimbursement of family caregiver/foster parent One entry per participant per week 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 Documentation by Families Under SFC services, families must provide the following documentation: One dated entry per day detailing an issue concerning the participant The entry should detail any outcome-oriented activities, tying those into measurable progress toward the participant’s outcome (as identified in the ISP) The entry should also include any significant issues concerning the individual, including Health and safety management Intellectual/developmental challenges and experiences aimed at increasing an participant’s ability to live a lifestyle that is compatible with the participant’s interest and abilities Modification or improvement of functional skills Guidance and direction for social/emotional support Facilitation of both the physical and social integration of an participant into typical family routines and rhythms Limitations The following limitations apply to Structured Family Caregiving services: Separate payment will not be made for homemaker or chore services furnished to an individual receiving SFC because these services are integral to and inherent in the provision of SFC services. Activities Not Allowed SFC services will not be provided to household members other than to the waiver participants. Reimbursement is not available through SFC in the following circumstances: Services provided by a caregiver who is the spouse of the participant or the parent of the minor participant. The service of Residential Habilitation and Supports (whether paid hourly or daily) is not available to participants receiving SFC services. 156
Transportation services through the waiver may not be used in conjunction with SFC services. Section 10.32A: Transportation – as specified in the Family Supports <strong>Waiver</strong> Service Definition Transportation services (as specified in the FSW) enable waiver participants to gain access to any nonmedical community services, resources/destinations, or places of employment, maintain or improve their mobility within the community, increase independence and community participation, and prevent institutionalization as specified by the ISP and POC. Reimbursable Activities Reimbursable activities under Transportation services (as specified in the FSW) include the following: Two one-way trips per day to or from a non-medical community service, resource or place of employment as specified on the ISP and provided by an approved provider of Residential Habilitation and Support, Community-Based Habilitation, Facility-Based Habilitation, Adult Day Services, or Transportation services. Bus passes or alternate methods of transportation may be utilized. May be used in conjunction with other services, including Community-Based Habilitation, Facility- Based Habilitation, and Adult Day Services. Service Standards The following service standards apply to Transportation services (as specified in the FSW): Transportation service is offered in addition to medical transportation required under 42 CFR 431.53 and transportation services under the State Plan, defined at 42 CFR 440.170(a) (if applicable), and shall not replace them. Transportation services under the waiver shall be offered in accordance with the ISP, and when unpaid transportation is not available. Whenever possible, family, neighbors, friends, or community agencies that can provide this service without charge will be utilized. Documentation Standards Transportation Services (as specified in the FSW) documentation must include: Service Notes: A service note can include multiple discrete services as long as discrete services are clearly identified. A service note entry for this service can be part of a comprehensive daily note with other services recorded, as long it is clearly separated from other services in the note. A service note must include Consumer name RID of the participant Date of service 157
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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
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Medicaid Waiver Services, Codes, an
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FSW CIH MFP- CIH INsite Code Servic
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The Case Manager should give the co
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Aversive techniques - any technique
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Services delivered to persons who d
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where services are not rendered wit
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Section 10.7: Community Based Habil
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Activities that do not foster the a
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The system to be installed must be
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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 and 138: The following activities are not al
Page 139 and 140: maintaining natural supports, physi
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
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Page 151 and 152: Services furnished to a minor by a
Page 153 and 154: Section 10.30: Speech/Language Ther
Page 155: to be utilized in service plan deve
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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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