DDRS Waiver Manual

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16. How are behavior problems handled? Are staff allowed to contact a behavioral support provider? How are new staff trained on the behavior support plan? Are they trained before working with waiver participants? What is the relationship between residential provider and behavioral provider? 17. How is medication handled? What happens if medication is refused? 18. What is the smoking policy? 19. How are planning meetings scheduled and conducted, and who attends? Can a family member call a meeting? How does the provider assure that what is agreed on in the meeting is actually provided? 20. Who would be the provider’s contact person, how will that contact occur, and how often? Is someone available 24 hours a day in case of emergencies? 21. How many people with disabilities has the agency terminated or discontinued from services? Why? What happened to them? 22. Has the agency received any abuse or neglect allegations? Who made these allegations? What were the outcomes? What is the process for addressing allegations of abuse or neglect? 23. What challenges does the provider think the waiver participant will create for him or her? 24. As a provider of waiver services, what are the provider’s strengths and weaknesses? 25. What is the process for hiring staff? Are background checks conducted and training given? What happens to the waiver participant while a new staff person is hired and trained? 26. How is direct staff supervised? What training does the staff receive? What is the average experience or education of staff? 27. How is staffing covered if regular staff is ill? What happens if staff does not show up for the scheduled time? How often does it happen? 28. What is the staff turnover rate? How are staff’s respite needs handled? 29. What kind of support does staff have? Who can staff call if a problem develops? What to Look for and Ask During Visits to Supported Living Settings Consider these issues when looking for a supported living setting: 1. How do the staff and housemates interact? Do they seem to respect and like each other? 2. Does the environment look comfortable? Is there enough to do? Are there regular activities happening in the home? 3. What kind of food is available and who selects it? Are choices encouraged and available? Are diets supervised? 4. Do people have access to banks, shops, restaurants, and so on? How is transportation handled? Are trips to access these resources planned or do they occur as needed? 5. Is there a telephone available to housemates (with privacy)? Is the telephone accessible (equipped with large buttons, volume control, other access features) if needed? 16
6. Does each person have his or her own bedroom? Is each person allowed to individually decorate the bedroom? 7. Do housemates seem to get along well? What happens when they don’t? 8. Are there restrictions on personal belongings? What are the procedures for lost personal items? Are personal items labeled? Are lost items replaced? 9. Are pets allowed? What are the rules regarding pets? 10. How much time is spent in active learning (neighborhood, home, or community) and leisure activities? Is there a good balance with unstructured time? 11. Is there evidence that personal hygiene and good grooming (hair, teeth, nails, and so on) are encouraged? 12. How are personal items, clothing, and so on, paid for? 13. Does each person have privacy when he or she wants to be alone or with a special friend? 14. Does each person have the opportunity to belong to a church, club, community group, and so on? 15. Do staff knock on doors and wait for a response before entering a private room? 16. What kind of rules are there within the living situation? What are the consequences for breaking rules? 17. Does each housemate have opportunities to pursue his or her own individual interests, or do they travel in a group with everyone doing the same thing, attending the same movie, and so on? 17
Page 1 and 2: 2016 DDRS Waiver Manual Our Mission
Page 3 and 4: Section 1: Roles and Responsibiliti
Page 5 and 6: Section 7.5: State Authorization of
Page 7 and 8: Section 10.23: Psychological Therap
Page 9 and 10: Section 1.1: The Centers for Medica
Page 11 and 12: ules or standards that may affect t
Page 13 and 14: Information Sharing The Individual
Page 15: Here are some tips on what to discu
Page 19 and 20: Section 3: Additional Medicaid Prog
Page 21 and 22: HCBS waiver services. HCBS waiver p
Page 23 and 24: Section 4.1: Medicaid Waiver Overvi
Page 25 and 26: Section 4.4: Coordination with Medi
Page 27 and 28: personal beliefs and customs, ensur
Page 29 and 30: Section 5.1: Request for Applicatio
Page 31 and 32: Internet access, call toll free 1-8
Page 33 and 34: understanding and use of language,
Page 35 and 36: If an individual declines the offer
Page 37 and 38: waiver slot when it appears that th
Page 39 and 40: Five calendar days to interview and
Page 41 and 42: The individual or guardian has sign
Page 43 and 44: Section 6: Objective Based Allocati
Page 45 and 46: adjustments to the allocation amoun
Page 47 and 48: BMAN Reserve $0 $0 $2,620.80 $5,241
Page 49 and 50: An individual’s behavioral condit
Page 51 and 52: An individual or the individual’s
Page 53 and 54: Your Appeal Right as an Applicant f
Page 55 and 56: Section 7.1: Level of Care Re-Evalu
Page 57 and 58: RN/LPN, who must be actively involv
Page 59 and 60: o Children receiving adoption assis
Page 61 and 62: including the DDRS Case Management
Page 63 and 64: When the individual “Re-Enters”
Page 65 and 66: (RHS) under the Community Integrati
Page 67 and 68:
Section 8.1: Appeal Request The fol
Page 69 and 70:
Objective-based allocation (OBA): T
Page 71 and 72:
administrative hearing must still b
Page 73 and 74:
The person testifying should be the
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In all cases, the decision of the A
Page 77 and 78:
Section 9.1: Overview The Family an
Page 79 and 80:
Structural or environmental issues
Page 81 and 82:
implemented in order to ensure that
Page 83 and 84:
conducted by the ombudsman must als
Page 85 and 86:
Section 10.24: Recreational Therapy
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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
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Services delivered to persons who d
Page 97 and 98:
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
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Electronic Monitoring may not be us
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Adaptations to service provider-own
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independence and are consistent wit
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Group supports delivered to individ
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o Small (4:1 or smaller) o Medium (
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The data may reside in multiple loc
Page 119 and 120:
Providers must be able to indicate,
Page 121 and 122:
programmed, constructive interactio
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The IBI Director will provide a nar
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As applicable, monthly/quarterly re
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participate in their communities, a
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Homeschooling, special education, a
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or before the fifteenth day of the
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o Medium (5:1 to 10:1) o Larger (la
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Services must address needs identif
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The following activities are not al
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maintaining natural supports, physi
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tool for individual assessment. The
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o o o o o Individuals receiving RHS
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(C) requires minimal residential ha
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as well the development, oversight,
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Available only under the Community
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Services furnished to a minor by a
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Section 10.30: Speech/Language Ther
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to be utilized in service plan deve
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Transportation services through the
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Bus passes or alternate methods of
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The participant requires assistance
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Service Standards The following ser
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Section 11: Request for Approval (R
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Choice of Provider The individual c
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Reimbursement Reimbursement is avai
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Modifications/Items - Non-Covered E
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Authority: 42 CFR §441.302 Section
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Total Cost $$$$$ 175
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Items - Covered Justification and d
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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
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The case management entity, working
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DDRS Waiver Manual

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