part 20

[Virtual Presenter] We'll be discussing the guidelines and qualifications for Home Modification Assessment services. We'll be outlining the restrictions on using the service for living arrangements owned by providers and disqualifying services provided by parents or spouses of participants. Under Section 12 of the H&W and T-B-I waivers, providers can use the Home Modification Assessment service only for living arrangements owned or leased by someone else. Payment will not be made for Home Modifications under this service. Additionally, Home Modification Assessment services provided by parents of minor child participants or spouses of participants (also known as L-R-I-s-) will not be reimbursed. In terms of provider qualifications, we'll be presenting the requirements for Home Modification Assessment services, which include a license or certification, financial information, liability insurance, and professional qualifications and documentation of qualifications. The National Association of Home Builders offers the In-Place Specialist (C-A-P-S-) Certification, which is a requirement for some providers. Additionally, some providers must comply with applicable building codes and permits, have a certificate in Home Modifications, and undergo compliance checks every three years. Overall, these guidelines and qualifications aim to ensure that Home Modification Assessment services are provided by qualified and trustworthy providers who adhere to important regulations and standards..

[Audio] We are excited to present the next slide in our presentation on Home Modification Assessment services. This slide will outline the guidelines and qualifications for providers of this service, as well as the restrictions and disqualifications for using the service for living arrangements owned by providers and services provided by a parent or spouse of a participant. Under Section 12 of the DDRS HCBS Waivers, Home Modifications are physical adaptations to the home that are necessary to ensure the health, welfare, and safety of the participant and enable them to function with greater independence in their home. When the participant owns a home, home modifications are considered. Rented homes or apartments or family-owned homes are allowed to be modified only when a signed agreement from the property owner is obtained. The signed agreement must be submitted along with all other required documentation. Disputes between different parties may not be within the scope of the Bureau of Disabilities Services to be able to intervene in a resolution. The participant chooses the certified providers to submit bids for the Home Modifications. If the participant chooses to continue with the Home Modification after receiving the bids, then the lowest bid that meets the minimum requirements shall be chosen. There is a minimum requirement to gather two bids for any expected amount over $5000. Modifications allowed under the Home Modifications service may include but are not limited to adaptive door openers and locks, bathroom modification, home control units, and kitchen modification. Home safety devices such as door alarms are also allowed. It’s important to note that services provided by a parent or spouse of a participant will not be reimbursed, and there are specific provider qualifications and standards outlined in the H&W and T-B-I waivers. Providers must comply with all requirements and guidelines outlined in these waivers to be eligible for reimbursement. In summary, Home Modifications are physical adaptations to the home that are necessary to ensure the health, welfare, and safety of the participant and enable them to function with greater independence in their home. Providers must comply with all requirements and guidelines outlined in the H&W and T-B-I waivers to be eligible for reimbursement, and services provided by a parent or spouse of a participant will not be reimbursed..

[Audio] Our objective is to enhance the quality of life for individuals with health and wellness requirements and those with traumatic brain injury. We believe that our guidelines and qualifications will assist in ensuring that our Home Modification Assessment services are offered safely, effectively, and efficiently. Thank you for taking our presentation into account..

[Audio] We are here to discuss the guidelines and qualifications for providers of Home Modification Assessment services. These guidelines set out specific requirements to ensure that home modification services are safe, effective, and meet the needs of participants. In this presentation, we will be covering the guidelines and qualifications for providers of Home Modification Assessment services, including restrictions on using the service for living arrangements owned by providers and disqualification for services provided by a parent or spouse of a participant. We will also be discussing the documentation standards and limitations that apply to these services, including a lifetime cap of $20000 for home modifications and an annual allowance of $1000 for repairs, replacements, or adjustments to existing home modifications. We hope that this presentation will provide you with a better understanding of the guidelines and qualifications for providers of Home Modification Assessment services. Thank you for your attention..

[Audio] Home Modification Assessment services are available for repair and service of home modifications provided through H-C-B-S waivers. However, certain restrictions and guidelines must be followed in order to receive these services. Firstly, requests for service must detail parts cost and labor cost. If the need for maintenance exceeds $1000, the care manager will work with other available funding streams and community agencies to fulfill the need. If service costs exceed the annual limit, those parts and labor costs funded through the waiver must be itemized clearly to differentiate the waiver service provision from those parts and labor funded through a nonwaiver funding source. Additionally, items requested that are not listed in the Allowable Activities section must be reviewed and a decision rendered by the state F-S-S-A director or state agency designee. Requests for modifications at two or more locations may only be approved at the discretion of the F-S-S-A director or designee. Requests for modifications may be denied if the state F-S-S-A director or state agency designee determines the documentation does not support residential stability and/or the service requested. It is important to note that Home Modifications services are limited to additional services not otherwise covered under the Indiana Medicaid State Plan, including EPSDT, but consistent with waiver objectives of avoiding institutionalization. Activities not allowed under Home Modifications include but are not limited to the following: Adaptations or improvements that are not of direct medical or remedial benefit to the participant, such as central heating and air conditioning, routine home maintenance, roof repair, structural repair that is not incidental to the original modification, driveways, decks, patios, publicly owned sidewalks and household furnishings, swimming pools, spas, or hot tubs, outside storage spaces, and home security systems. Modifications that create living space or facilities where they did not previously exist (for example, installation of a bathroom in a garage/basement and so on). Modifications that will add non-incidental square footage to the home. Home Modifications services for participants living in foster homes, group homes, assisted living facilities or homes for special services (any licensed residential facility) are not allowed. Additionally, Home Modifications services for participants living in a provider-owned or controlled residence are not allowed. Completion of, or modifications to, new construction or significant remodeling/reconstruction are also excluded, unless there is documented evidence of a significant change in the participant's medical or remedial needs that now require the requested modification..

[Audio] Our purpose for gathering is to discuss the requirements and criteria for individuals or organizations seeking to provide Home Modification Assessment services under H&W and T-B-I waivers. It is important to note that providers who have any ownership in the organization are not eligible to offer Home Modification services to participants under these waivers. This includes parents of minor child participants, spouses of participants, attorneys-in-fact (or poas), H-C-R-s-, and legal guardians of participants. Furthermore, any Home Modification services provided by the aforementioned individuals, also known as L-R-I-s-, will not be reimbursed under H&W and T-B-I waivers, as outlined in C-2-d and C-2-e of the waivers. In order to become an approved provider of Home Modification services, certain requirements and standards must be met, as stated in the H&W and T-B-I waivers. These qualifications include possessing a valid FSSA-approved license or certification, adhering to relevant building codes and permits, maintaining appropriate liability insurance, and providing documentation of professional qualifications and requirements. Additionally, providers must ensure that they remain in good standing with the 455 I-A-C 2, IC 25-20.2, and IC 25-28.5 standards, and comply with any other applicable standards outlined in the H&W and T-B-I waivers. We hope that the information provided has clarified the guidelines and qualifications for providers of Home Modification Assessment services under H&W and T-B-I waivers..

[Audio] This meeting is held to discuss the guidelines and requirements for providers of Home Modification Assessment services under the H&W and T-B-I waivers. The first topic of discussion will be the general requirements for provider qualifications, including financial information, liability insurance, and professional qualifications. These qualifications must be documented and providers must also comply with warranty requirements and applicable building codes and permits. We will then move on to the specific qualifications and requirements for becoming an approved provider. These include obtaining a license or certification from the appropriate state agency, receiving approval from the F-S-S-A-, and following relevant building codes and permits. Next, we will discuss the Integrated Health Care Coordination (I-H-C-C-) services available under the H&W and T-B-I waivers. These services aim to improve health status and quality of life, prevent health deterioration, manage chronic conditions in collaboration with physicians, and integrate medical and social services. Activities such as developing and overseeing a healthcare support plan, collaborating with all service providers, and coordinating with social supports are allowed under IHCC. It is crucial to note that Home Modification Assessment services cannot be provided for living arrangements owned by providers, and any services provided by a parent or spouse of a participant will not be reimbursed. Providers must also adhere to specific qualifications and standards outlined in the H&W and T-B-I waivers. In conclusion, it is necessary for providers of Home Modification Assessment services to meet specific qualifications and standards in order to offer these services under the H&W and T-B-I waivers. It is essential for providers to fully understand and comply with these guidelines to ensure the delivery of high-quality and effective services to their clients..

[Audio] This presentation is about the Home Modification Assessment services offered under the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Our discussion will focus on the guidelines and qualifications for providers of Home Modification Assessment services, which include limitations on using the service for accommodations owned by providers and disqualification for services provided by a parent or spouse of a participant. These service standards must be adhered to in order for the care manager to coordinate and collaborate with the participant's integrated healthcare coordination provider, stay updated on the participant's status from the healthcare coordination provider, and work together to address any unmet needs. It is important to note that I-H-C-C services will not duplicate any other waiver services, and that at least one face-to-face visit per month is required. Thank you for your attention to this crucial topic..

[Audio] Providers of Home Modification Assessment services under the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers must adhere to specific restrictions and qualifications outlined in Section 12 of the waiver. These include not providing skilled nursing services covered under the Indiana Medicaid State Plan, or any other services already available through the waiver. To be eligible as a provider, one must be approved by the Family and Social Services Administration (F-S-S-A-) as a Home Health Agency, physician practice, Adult Day Facility, or Assisted Living Facility under the H&W and T-B-I programs. Nutritional supplements must be prescribed by a physician, physician assistant, or nurse practitioner and can only be reimbursed through a local Area Agency on Aging (A-A-A--) or approved F-S-S-A provider who maintains receipts and verifies services. Providers may also communicate with the state Medicaid agency at their own discretion. It is important to note that providers cannot use Home Modification Assessment services for their own living arrangements, and services provided by a participant's parent or spouse will not be reimbursed. These restrictions are in place to ensure that participants receive the best quality of care and support..

[Audio] This discussion aims to outline the guidelines and qualifications necessary for providers who offer Home Modification Assessment services under H&W and T-B-I waivers, specifically related to Nutritional Supplements services. The care manager has the responsibility of completing certain documentation tasks when requesting Nutritional Supplements for a participant. These tasks include documenting the delivery date, number of meals provided, and the care professional or manager involved in the participant's care. Furthermore, personal records must be kept in a prominent location in the participant's file and given to them when they transfer for medical care or move from their residence. There are limitations to the Nutritional Supplements services. A yearly cap of $1200 is available for these services, and they can only cover additional services not already included in Indiana's Medicaid State Plan, such as EPSDT, but still align with the goal of avoiding institutionalization. The meals provided as part of these services cannot constitute a full nutritional regimen. Certain activities are not permitted under Nutritional Supplements services. Services that are already covered by Indiana's Medicaid State Plan will not be reimbursed, and this service will not be reimbursed when provided by the parent of a minor child participant or the spouse of a participant, as described in C-2-d and C-2-e of the H&W and T-B-I waivers. Providers must meet specific qualifications outlined in Table 22 in order to offer Nutritional Supplements services to participants. We appreciate your attention to these guidelines and qualifications for providers of Home Modification Assessment services under H&W and T-B-I waivers..

[Audio] Our purpose for gathering is to discuss the criteria and qualifications for individuals who want to provide Home Modification Assessment services under the H&W and T-B-I waivers. These requirements are outlined in the DDRS HCBS Waivers and Table 22 Provider Qualifications for Nutritional Supplements. To become an approved provider, it is necessary to maintain proper licensure/certification and adhere to other standards. Furthermore, the Participant-Directed Home Care Service (P-D-H-C-S) within the H&W Waiver has specific definitions and guidelines which must be followed. This service can be carried out by either licensed medical personnel or trained nonmedical personnel and must include skilled or attendant care activities. It is available 24 hours per day, seven days a week, with a maximum of five slots, and must be approved by the F-S-S-A-. In order to be eligible, the participant must have a chronic medical condition and receive Indiana Medicaid State Plan Home Health Services. Lastly, the participant must be willing to take on the risks and responsibilities associated with hiring a caregiver and directing their own care. These guidelines and standards are in place to ensure that individuals receive high-quality care and services..

[Audio] We are present today to discuss the guidelines and qualifications for providers of Home Modification Assessment services under Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. These waivers are intended to support individuals with disabilities who require assistance in living arrangements and care management. However, there are specific limitations and documentation standards that must be followed by service coordinators and care managers. Firstly, P-D-H-C-S is only offered to individuals in a non-congregate setting and living alone without family or other informal supports willing and able to be trained to care for the participant and assume a portion of the participant’s care. Secondly, P-D-H-C-S is only available to individuals residing in certain postal codes. Thirdly, P-D-H-C-S does not include administration of level II, III, IV, and V medications. Service coordinators and care managers play a crucial role in the success of PDHCS. They must maintain documentation standards such as providing oversight and monitoring of the service plan of the participant, assessing the participant for participation in the PDHCS, completing the participant-directed checklist, assisting the participant in directing care, evaluating whether the P-D-H-C-S is appropriate for meeting their needs, assessing the needs of the participant through a person-centered planning process, establishing an annual cost limit, documenting the medical need for a skilled service and types of skilled care required, documenting the frequency, duration, and types of appropriate skilled activities, having the participant sign a waiver liability form, documenting who is the employer and employee/direct worker and their relationship to the participant, documenting the backup plan for the participant when the direct worker is unavailable, monitoring the enrollment process, collecting all training paperwork containing signatures, and monitoring service delivery every month..

[Audio] We have rewritten and removed mentions of the slide references from the following text: In order to become a paid caregiver, the caregiver applicant must enter into the I-H-C-P agreement. The caregiver authorized to provide home care attendant services to participants must meet the personnel qualifications specified in IC.16-27-1 or successfully complete the following requirements: * If applicable, a competency evaluation program or training and competency evaluation program approved or conducted under section 10.2.2 of the American Association of Respiratory Care (A-A-R-C-) Clinical Practice Guideline and/or * A program that includes cardiopulmonary resuscitation (C-P-R--), basic first aid, and any applicable durable medical equipment (D-M-E--) training The paid caregiver must identify and document participant needs in the provider service plan. Services must be outlined in the provider service plan, and a data record of services must be provided and maintained, including: * Complete date and time of service (in and out) * Specific services or tasks provided * Signature of the paid caregiver providing the service (minimally the last name and first initial) Each paid caregiver providing direct care or supervision of care to the participant must make at least one entry on each day of service. All entries must describe an issue or circumstance offered to the individual. Daily documentation of service delivery is to be signed by the participant. If the participant cannot sign, then the paid caregiver must self-attest and sign in lieu of the participant. The paid caregiver is required to coordinate information about the participant's care, including backup plan, with any and all other providers and care manager rendering services to the participant. Provider coordination shall occur among providers/paid caregivers during shift changes for the participant and at any other time where the participant experiences a healthcare change..

[Audio] Thank you for joining us for this presentation on DDRS HCBS Waivers and the guidelines for Personal Emergency Response System under H&W and T-B-I waivers. This information is important for anyone looking to serve as a provider and ensure that their services are following the necessary standards. We want to remind you that Home Modification Assessment services are not to be used for living arrangements owned by providers. This is to avoid any conflicts of interest and maintain a fair and unbiased approach to the services provided. Furthermore, services provided by a parent or spouse of a participant will not be reimbursed. This is to ensure that the participant receives appropriate care from an external, unbiased source. The Personal Emergency Response System, or pers, is an essential electronic device that enables at-risk participants to receive help in an emergency. It includes a portable help button for increased mobility. The pers system is connected to the participant's phone and is programmed to signal a response center when activated. This center is staffed 24/7 by trained professionals to ensure quick and effective emergency response. Under the pers service, the following activities are allowed: device installation, ongoing monthly maintenance, and electronic services such as a portable help button. However, remote monitoring will not be placed in participant bedrooms or bathrooms for privacy reasons. To ensure quality care, the pers service must follow a written service plan that addresses the specific needs of the individual as determined by their assessment. This is to ensure that the participant receives personalized and appropriate care. In the event that a participant experiences a fall, the care manager is required to be contacted by the pers provider. This is to ensure that the participant receives the necessary follow-up care. Finally, it is the responsibility of the care manager to document any important information regarding the pers service. Thank you for joining us for this presentation on DDRS HCBS Waivers and the guidelines for Personal Emergency Response System under H&W and T-B-I waivers. We hope you found this information useful. Have a great day..