part 18

[Virtual Presenter] We hope that the information provided will be useful for you as you contemplate utilizing A-F-C services. If you have any inquiries, please don't delay in contacting us..

[Audio] AFSPs provide personal care and services, home and community assistance, and medication oversight to be eligible for the Health and Wellness waiver. They must have 24-hour, on-site response staff available to meet scheduled and unpredictable needs, provide documentation of their qualifications and maintain personnel records for their staff, adopt personnel policies and have an operations manual in place. A-F-S-Ps provide specialized medical equipment and supplies and care management services to be eligible for the Traumatic Brain Injury waiver. They must have 24-hour, on-site response staff available to meet scheduled and unpredictable needs, provide documentation of their qualifications and maintain personnel records for their staff, adopt personnel policies and have an operations manual in place..

[Audio] We are here to discuss the services provided by Assisted Living (A-L---) facilities in Indiana, specifically focusing on the payment options available to participants and the qualifications required for providers. Under the Indiana Adult Family Care Service Provision and Certification Standards, participants living in AL facilities are entitled to retain at least their Personal Needs Assessments (PNAs), as established by the state of Indiana. The P-N-A is currently $52.00 per month per IC 12-15-7-2. A provider, after ensuring that the participants retain their P-N-A-s-, may bill participants up to the current maximum federal Supplemental Security Income (S-S-I--). Providers may not charge Medicaid eligible individuals a room-and-board rate that exceeds the maximum S-S-I amount for a studio apartment. A participant who wishes to select a larger room, may pay extra for any unit exceeding the size of a studio based on the monthly amount determined by the facility. AL facilities offer a variety of services that are included in the daily per diem. These services include attendant care related to Activities of Daily Living (ADLs), home and community assistance care related to Instruments of A-D-Ls (IADLs), medication oversight (to the extent permitted under state law), nonemergency nonmedical transportation, and therapeutic social and recreational programming. The Assisted Living service must follow a written service plan addressing specific needs determined by the participant’s Personal Care Assistant (P-C-A--). If the participant requires skilled care, the care manager must justify how the skilled-care need will be met and by whom. The documentation must describe the following: reason to use the Assisted Living service, who will be providing this service, activities that are expected to be performed and frequency of the activities, and must give the completed P-C-A to the Assisted Living provider. The provider must follow these documentation standards: complete and accurate documentation to support daily services rendered by the Assisted Living service to address needs identified in the person-centered care plan, including participant’s status, including health, mental health, medication, diet, sleep patterns, social activity, updates, including health, mental health, medication, diet, sleep patterns and social activity and participation in consumer-focused activities..

[Audio] We are pleased to present to you on the advantages of Participant Payment for Room and Board, Facility Maintenance, and Personal Care Services that are integral to and inherent in the provision of Adult Family Care (A-F-C--). Our presentation will focus on the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Under Section 12, certain requirements must be met to provide qualified care to participants. These include maintaining medication management records, providing quarterly updated service plans to the participant's care manager, and notifying the care manager within 48 hours of any changes in the participant's care plan. Additionally, participants' personal records must include certain information, such as their social security number, medical insurance number, birth date, emergency contacts, available medical information, hospital preference, primary care physician, and mortuary (if known). Copies of these records must be placed in a prominent place in the participant's file, sent with the participant when transferred for medical care, or upon moving from the residence, and in accordance with state law. It is important to note that the Assisted Living service per diem or monthly rate does not include room and board. Separate payment will not be made for services furnished to a participant selecting the Assisted Living service that are integral to and inherent in the provision of the Assisted Living service, such as Adult Day Services, Adult Family Care, and Attendant Care. Personal care services provided to medically unstable or medically complex participants as a substitute for care provided by a registered nurse, licensed practical nurse, licensed physician, or other health professional are not allowed under the Assisted Living service. We hope that this information has been helpful in understanding the DDRS HCBS Waivers and the requirements for providing qualified care to participants. If you have any questions, please feel free to reach out to us..

[Audio] We are pleased to present our findings on the various services that can be provided under the Adult Family Care (A-F-C--) program. Specifically, we will discuss the payment options available for room and board, facility maintenance, personal care services, and activities integral to the provision of A-F-C-. In this presentation, we will focus on the qualifications for A-F-C service providers, specifically in the Assisted Living service. We will provide information on the provider qualifications for Assisted Living, including details on licensure or certification, other standards, and H&W/TBI waivers, in Table 11. We will also discuss Attendant Care services for H&W and T-B-I waivers, including the service definition, allowable activities, and relevant policies and procedures. We hope this presentation will be informative and helpful in understanding the various services and payment options available under the A-F-C program..

[Audio] We are now discussing the DDRS HCBS Waivers Section 12, which provides assistance with elimination, nutrition, safety, and service standards in relation to Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--)..

[Audio] We are pleased to inform you that the Indiana Adult Family Care Service Provider and Certification Standards require documentation for participants who receive payments for room and board, facility maintenance, personal care services, and activities that are integral to and inherent in the provision of Adult Family Care (A-F-C--). The documentation requirements are in place to ensure that the participant's needs are met and that the care provided is of high quality. We are pleased to inform you that the documentation standards for Attendant Care are outlined in Section 12. If a participant has skilled L-O-C (SK-LOC), documentation must be provided to indicate how the skilled need is being met and by whom. If Attendant Care is requested for an individual with skilled care, documentation must describe the following: who will be providing Attendant Care, the frequency of care and the activities being performed. If Attendant Care is participant-directed, documentation must describe the following: who the employer is, who the employee/direct worker is, and their relationship to the participant. We appreciate the efforts of attendant care providers in following these documentation standards, which include recording services provided, including complete date and time of service, specific services/tasks provided, signing the participant verifying the service was provided by the agency, and signing the employee providing the service. Each staff member providing direct care or supervision of care to the participant must make at least one entry on each day of service. We appreciate your understanding that documentation of service delivery must be signed by the participant or designated participant representative. It is important to note that when provided by a legal guardian of an adult, Attendant Care services are limited to a maximum of 40 hours per week. The following activities are not allowed and will not be reimbursed under Attendant Care services: services provided for a participant regarding specialized feeding, services provided to a participant requiring management of uncontrolled seizures, infusion therapy, venipuncture, injection, wound care for decubitus and incision, ostomy care, and tube feedings. We appreciate your understanding that services provided as a substitute for care provided by a registered nurse, licensed practical nurse, licensed physician or other health professional, setting up and administering medications, and assisting with catheter and ostomy care are also not allowed..

[Audio] We hope that this information will be beneficial to you as you evaluate attendant care providers for your family member's care. Attendant care providers are required to meet general qualifications such as liability insurance, personnel records and professional qualifications. The division has the authority to reject any applicant who has been convicted of a crime against a person or property, fraud or abuse in any federal, state or local government program or illegal drug possession. To find out more about the qualifications required for attendant care providers, please refer to the provider qualifications section of our website. Thank you for considering our services..

[Audio] We are interested in discussing the health and wellness (H&W) and traumatic brain injury (T-B-I--) waivers that providers who offer behavior management/behavior program and counseling services are allowed to have. It is important to note that individuals with a criminal background may only care for family members if the family member has been informed of the criminal background. The allowed activities under behavior management/behavior program and counseling services include observing the individual and environment for the purpose of developing a plan and determining a baseline, developing a behavioral support plan and subsequent revisions, providing training in assertiveness, stress reduction techniques, acquiring socially accepted behaviors, training staff, family members, roommates, and other appropriate individuals in implementing the behavior support plan, and consulting with members and health service providers in psychology (H-S-P-P-). We hope this information has been helpful. If you have any questions, please feel free to reach out to us..

[Audio] We are here to discuss the DDRS HCBS Waivers for Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) services. Our primary focus is on the service standards for Behavior Management/Behavior Program and Counseling services. To meet these standards, providers must develop a written service plan that addresses specific needs determined by the individual’s assessment. The behavior specialist will observe the individual in their own environment and develop a specific plan to address identified issues. The effectiveness of the plan must be reviewed no less than quarterly and adjusted as necessary. The behavior specialist will provide a written report to pertinent parties at least quarterly. In terms of documentation standards, providers must identify the need in the service plan, outline the services in the service plan, identify the level clinician in the service plan, and have a behavioral support plan. Providers must also document the date and time of service and the number of units of service delivered that day with the service type. If applicable, copies of personal records must also be placed in a prominent place in the participant’s file and sent with the participant when transferred for medical care or upon moving from the residence and in accordance with state law. It’s important to note that there are certain activities that are not allowed or reimbursed under Behavior Management/Behavior Program and Counseling services. These include aversive techniques, any techniques not approved by the individual’s person-centered planning team and the F-S-S-A-, services provided as an individual provider by certain family members or legal guardians, and any services provided by an attorney-in-fact (or P-O-A--) of a participant. Finally, we want to address the provider qualifications for Behavior Management/Behavior Program and Counseling services. These qualifications include licensure or certification, adherence to standards, and meeting the requirements of the Indiana Adult Family Care Service Provision and Certification Standards. In conclusion, the DDRS HCBS Waivers for Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) services have specific service standards and documentation requirements that providers must meet in order to receive reimbursement. It’s important to understand these standards and qualifications to ensure that participants receive the best possible care..

[Audio] The information we are presenting pertains to Participants who are eligible to receive payments for room and board or facility maintenance, personal care services, and activities as a substitute for care from a healthcare professional. These services are considered integral and inherent to Adult Family Care (A-F-C--). Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers contains information on the DDRS HCBS Waivers and the qualifications for behavior management/behavior programs and counseling for providers. The Care Management for H&W and T-B-I Waivers allows for person-centered assessment and planning, including the identification of the participant's strengths, needs, goals, and preferences. The assessment process is facilitated through the use of person-centered discovery tools and engaging the participant and their support system. Other activities that may be included in this phase are brokering community resources, action and/or service planning, and determining eligibility for funded services. Additionally, the development and implementation of a person-centered support plan, including action and/or service plans, is permitted. We hope this information is beneficial to you. Thank you for your attention..

[Audio] This presentation on the Indiana Adult Family Care Service Provider and Certification Standards will discuss the requirements for providers of adult family care services to ensure they meet high quality standards and provide the best care possible for clients. A crucial aspect of these standards is the care managers' responsibility to provide each waiver participant with a link to the Indiana Health Coverage Programs (I-H-C-P-) Division of Disability and Rehabilitative Services (D-D-R-S-) H-C-B-S Waivers Module, a document that serves as a resource for participants and support teams. This document aids care managers in ensuring their clients receive the best care and make informed decisions about their well-being. The care managers are also accountable for monitoring progress on action and/or service plans and coordinating high-quality services for the participant, promoting seamless and integrated care, and conducting face-to-face check-ins every 90 days from the initial service plan activation. Within 30-40 days of the initial activation, the care manager will reach out to the participant via phone or in-person to ensure the services are being implemented. In the case of reported incidents, the care manager must submit a follow-up report to the Bureau of Disabilities Services (B-D-S--) within seven days and every seven days thereafter until the incident is resolved. Furthermore, the care manager must inform families/guardians of any reported incidents and share the provider's investigation results. The care manager is responsible for completing annual person-centered assessments, determining eligibility and creating service plans. They are also in charge of coordinating any changes to the service plan, including notifying all providers of the change and the start or end date of services, as well as notifying providers of any terminated or restarted care plans..

[Audio] Our focus will be on the service standards for Care Management in Adult Family Care (A-F-C--) services. Care Management services are a crucial aspect of A-F-C services as they improve the individual's functional and social well-being. The care managers are responsible for identifying when a participant is living in a provider-owned or controlled setting. They also closely monitor any person-centered modifications to H-C-B-S characteristics and accurately document them in the person-centered service plan. The care manager must follow proper documentation standards to ensure that the person-centered support plan is effectively facilitated and that the individual's strengths, needs, goals, and preferences are identified. Along with this, the care manager must develop and implement a comprehensive person-centered support plan, which includes action and/or service plans. They are also responsible for monitoring the progress of all services listed on the action and/or service plans and ensuring the provision of high-quality services to the individual. This involves promoting seamless, integrated, and coordinated care. Additionally, the care manager must review the person-centered support plan every 90 days from its initial activation and complete the annual eligibility and service planning. They must also encourage the person to take the lead and direct their planning process as much as possible, including the people they wish to involve in their circle of support. It is important to note that care managers must adhere to the maximum Medicaid waiver caseload of 65 participants at any given time. They must also collaborate and coordinate with other care managers, organizations, community partners, and F-S-S-A staff to ensure the delivery of quality care management and explore all available options to optimize the individual's overall functioning capability..

[Audio] Care managers for adult family care services have the responsibility of helping individuals transition to a new agency or care manager. This includes educating them about the upcoming waiver transition and pathways program, working with the managed care entity enrollment broker and/or service coordinator to move them to the pathways waiver, ensuring they understand their ability to make choices regarding all services they receive, and providing ongoing support and guidance throughout the transition. It is crucial to complete all required paperwork and documentation accurately and promptly, comply with legal and regulatory requirements, and maintain the individual's privacy and confidentiality during the transition..