DDRS Waiver Manual

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Provider rendering service Pick up point and destination If contract transportation is utilized, contractor must provide log and invoice support that includes dates of transportation provided. If bus passes or alternative methods of transportation are utilized, invoices and attendance logs must support calendar days for which round trips are billed to the waiver. Limitations The following limitations apply to Transportation services (under the Family Supports Waiver): Transportation services (as specified in the FSW) may not be used to meet medical transportation needs already available under the Indiana Medicaid State Plan. Section 10.32B: Transportation - as specified in the Community Integration and Habilitation Waiver Service Definition Transportation services (as specified in the CIH) enable waiver participants to gain access to any non-medical 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. Specific to the CIH Waiver only: Depending upon the needs of the participant, there are three levels of transportation. The level of transportation service needed must be documented in the ISP. Level 1: Transportation in a private, commercial, or public transit vehicle that is not specially equipped. Level 2: Transportation in a private, commercial, or public transit vehicle specially designed to accommodate wheelchairs. Level 3: Transportation in a vehicle specially designed to accommodate a participant who for medical reasons must remain prone during transportation (such as ambulette). Reimbursable Activities Reimbursable activities under Transportation services (as specified in the CIH Waiver) include the following: Two one-way trips per day to or from a non-medical community service or resource or place of employment as specified on the ISP and provided by an approved provider of Residential Habilitation and Support (a service available only under the Community Integration and Habilitation waiver), Community-Based Habilitation, Facility-Based Habilitation, Adult Day Services, or Transportation services. 158
Bus passes or alternate methods of transportation may be utilized for Level 1 or Level 2. Bus passes may be purchased on a monthly basis or on a per-ride basis, whichever is most cost-effective in meeting the participant’s transportation needs as outlined in the ISP. May be used in conjunction with other services, including Community-Based Habilitation, Facility- Based Habilitation, and Adult Day Services. Note: Whenever possible, family, neighbors, friends, or community agencies that can provide Transportation Services without charge will be utilized. Service Standards The following service standards apply to Transportation services (as specified in the CIH Waiver): Transportation Services are offered in addition to medical transportation required under 42 CFR 431.53 and transportation services under the Medicaid 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 CIH Waiver) 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 Provider rendering service Pick-up point and destination If contract transportation is utilized, contractor must provide log and invoice support that includes dates of transportation provided. If bus passes or alternative methods of transportation are utilized, invoices and attendance logs must support days for which round trips are billed to the waiver. Limitations The following limitations apply to Transportation services (under the Community Integration and Habilitation Waiver): Annual limits have been added to this non-medical waiver Transportation service, the costs of which have been removed from the Day Services Building Block of the annual allocation for each participant and are now paid from a stand-alone but limited bucket outside of and in addition to the participants’ annual allocation amount. 159
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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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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 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
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: Transportation services through the
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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