DDRS Waiver Manual

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Section 10: Service Definitions and Requirements Sections 10.1 – 10.34 Section 10.1: Service Definition Overview Section 10.2: Medicaid Waiver Services, Codes, and Rates Section 10.3: Adult Day Services Section 10.4: Behavioral Support Services Section 10.5: Case Management Section 10.6: Community Based Habilitation – Group Section 10.7: Community Based Habilitation – Individual Section 10.8: Community Transition (currently under CIHW only) Section 10.9: Electronic Monitoring (currently under CIHW only) Section 10.10: Environmental Modifications (currently under CIHW only) Section 10.11: Extended Services Section 10.12: Facility Based Habilitation – Group Section 10.13: Facility Based Habilitation – Individual Section 10.14: Facility Based Support Services Section 10.15: Family and Caregiver Training Section 10.16: Intensive Behavioral Intervention Section 10.17: Music Therapy Section 10.18: Occupational Therapy Section 10.19: Participant Assistance and Care (PAC) (currently under FSW only) Section 10.20: Personal Emergency Response System Section 10.21: Physical Therapy: Section 10.22: Prevocational Services Section 10.23: Psychological Therapy 84
Section 10.24: Recreational Therapy Section 10.25: Rent and Food for Unrelated Live-in Caregiver (currently under CIHW only) Section 10.26: Residential Habilitation and Support-Daily (RHS-Daily) (currently under CIHW only) Section 10.27: Residential Habilitation and Support (provided hourly) (currently under CIHW only) Section 10.28: Respite Section 10.29: Specialized Medical Equipment and Supplies Section 10.30: Speech/Language Therapy Section 10.31: Structured Family Caregiving (currently under CIHW only) Section 10.32A: Transportation – as specified in the Family Supports Waiver Section 10.32B: Transportation - as specified in the Community Integration and Habilitation Waiver Section 10.33: Wellness Coordination (currently under CIHW only) Section 10.34: Workplace Assistance Return to Table of Contents 85
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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
Page 7 and 8:
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
Page 13 and 14:
Information Sharing The Individual
Page 15 and 16:
Here are some tips on what to discu
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6. Does each person have his or her
Page 19 and 20:
Section 3: Additional Medicaid Prog
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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
Page 75 and 76: 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: conducted by the ombudsman must als
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 and 138:
The following activities are not al
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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
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(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
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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
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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
Page 177 and 178:
Items - Covered Justification and d
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These requests should be extremely
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Choice of Provider The individual c
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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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