part 21

[Virtual Presenter] We will establish the monitor positions for the Personal Emergency Response System (P-E-R-S-) based on the person-centered service planning process. In the event of equipment failure, the state has a backup plan in place. The care manager serves as the central point of communication for the state to provide information to the participant, their family, and the entire circle of support, which is an integral part of the person-centered planning process. The following activities are not permitted under the pers service: replacement cost of lost or damaged equipment, services provided to participants receiving the Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. Provider qualifications for the pers service are outlined in Table 24, which includes provider licensure/certification, other standards, and compliance with applicable building codes and permits. Provider qualifications are also FSSA-approved. The provider qualifications requirements include general requirements, maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and warranty required..

[Audio] We are discussing Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. We are specifically discussing Pest Control services for H&W and T-B-I Waivers. Pest Control services are designed to prevent, suppress, or eradicate anything that competes with humans for food and water, injures humans, spreads disease to humans, or annoys humans, and is causing or is expected to cause more harm than is reasonable to accept. These services target pests such as insects like roaches, mites, ticks, rats, and mice, and vertebrates like bed bugs and fleas. Pest Control services aim to prevent, suppress, or eradicate pest infestation. Reimbursement for approved Pest Control expenditures is through the local A-A-A or other approved F-S-S-A provider, which maintains all applicable receipts and verifies the delivery of services. Providers can directly communicate with the state Medicaid agency at their discretion. Allowable Activities We add Pest Control services to the service plan when the care manager, through direct observation or participant report, determines that a pest is present and is causing or is expected to cause more harm than is reasonable to accept. These services aim to prevent, suppress, or eradicate pest infestation. Service Standards Pest Control services must follow a written service plan addressing specific needs determined by the individual's P-C-A--. Documentation Standards The care manager is responsible for documenting the need for Pest Control, the types of pests to eradicate through the P-C-A--, and any limitations, such as an annual cap of $4000. Activities Not Allowed We do not allow services used solely as a preventative measure..

[Audio] We are gathered here today to discuss the monitor positions for the Personal Emergency Response System (P-E-R-S-) in line with the person-centered service planning process. We are pleased to inform you that in the event of equipment failure, the state has a backup plan in place to ensure the continuity of the service. The care manager is the central figure in the state's efforts to provide information to the participant, their family, and the entire circle of support, which is a critical aspect of the person-centered planning process. The following activities are prohibited under the pers service: the replacement cost of lost or damaged equipment, services provided to participants receiving the Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. Provider qualifications for the pers service are presented in Table 24, which includes provider licensure/certification, other standards, and compliance with applicable building codes and permits. We are pleased to inform you that the provider qualifications are FSSA-approved, and meet the general requirements, maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and warranty required..

[Audio] We are thrilled to present to you a discussion on determining the optimal positions of Personal Emergency Response System (P-E-R-S-) monitors based on the person-centered service planning process. In the event of equipment failure, the state has a contingency in place. The care manager plays a critical role in providing information to the participant, their family, and the entire support network, which is an integral part of the person-centered planning process. Under the pers service, there are specific activities that are prohibited. These include the replacement cost of lost or damaged equipment, services provided to individuals receiving Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. The qualifications required for pers service providers are detailed in Table 24. These qualifications include provider licensure/certification, compliance with applicable building codes and permits, and F-S-S-A approval. The provider qualifications requirements also include general requirements, maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and a warranty. Now, let's turn our focus to the DDRS HCBS Waivers Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. These waivers cover a range of activities related to living in the community, including bed making and household chores, meal planning, and money management. Residential-Based Habilitation services must adhere to a written service plan that outlines specific measurable goals and objectives to help individuals acquire, retain, or improve skills lost due to T-B-I--. These services must be monitored monthly. Under the C-A-R-E-S Act, R-H-S services may be provided to individuals in an acute care hospital when such services are identified in an individual's person-centered service plan (or comparable plan of care), designed to meet needs not met through hospital services, not a substitute for services that the hospital is obligated to provide through its conditions of participation or under federal or state law, or under another applicable requirement, and to ensure smooth transitions between acute care settings and home and community-based settings, while preserving the individual's functional abilities..

[Audio] We will determine the monitor positions for the Personal Emergency Response System (P-E-R-S-) through a person-centered service planning process. The state has a backup plan in case of equipment failure. The care manager plays a central role in providing information to the participant, their family, and the entire circle of support, which is part of the person-centered planning process. The following activities are not allowed under the pers service: replacement cost of lost or damaged equipment, services provided to participants receiving the Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. Provider qualifications for the pers service are presented in Table 24 and include provider licensure/certification, other standards, and compliance with applicable building codes and permits. The provider qualifications are also FSSA-approved. The provider qualifications requirements include general requirements, maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and warranty required..

[Audio] We are pleased to present our findings on the Personal Emergency Response System (P-E-R-S-) service. This service allows us to determine monitoring positions for participants through a person-centered service planning process. In our state, we have a backup plan in place in case of equipment failure. Our care manager acts as the central vehicle for providing information to participants, their families, and their entire support network. It is important to note that there are certain activities that are not allowed under the pers service, such as replacement cost of lost or damaged equipment, services provided to participants receiving Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. To ensure quality and safety, we have specific provider qualifications for the pers service, which are outlined in Table 24. These qualifications include provider licensure/certification, adherence to other standards, and compliance with applicable building codes and permits. We are proud to say that our provider qualifications are FSSA-approved and meet all general requirements, including maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and warranty requirements. Moving on, let's discuss the DDRS HCBS Waivers, specifically the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. Under these waivers, certain activities are allowed under Skilled Respite services, such as home health aide services and skilled nursing services. These services can be provided in both home and community-based settings, and the level of professional care provided depends on the needs of the participant and caregiver as determined in the P-C-A--. If Skilled Respite occurs in an HCBS-certified facility targeting children and young adults, the staff-to-participant ratio cannot exceed one staff member for every two participants. This is designed to support families and prevent the institutionalization of their children. It is the responsibility of the care manager to maintain documentation standards, including identifying the primary caregiver being relieved, documenting needs and activities that require respite, and ensuring that each staff member providing direct care or supervision of care to the participant makes at least one entry on each day of service describing an issue or circumstance..

[Audio] Section 12 of our presentation covers the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers provided by DDRS HCBS for the Personal Emergency Response System (P-E-R-S-). These waivers are intended to offer necessary support and services for individuals with disabilities, including respite care. It is essential to document any intervention from a healthcare professional in the participant's record, along with the involvement of their designated care manager. Any respite care given must be clearly noted, including the reason and type of care provided. Please be aware that there may be limitations on the amount, frequency, or duration of respite care available under these waivers. This information should be effectively communicated to the participant and their care manager. In the case of any changes to the participant's person-centered service plan, their care manager and other unskilled providers must be notified within 48 hours to ensure everyone is aware and can adjust accordingly. Additionally, personal records should be kept in an easily accessible and confidential manner, following all applicable laws and regulations. We appreciate your attention to these crucial details regarding the H&W and T-B-I waivers offered by DDRS HCBS. Our priority is to provide exceptional care and support for individuals with disabilities, and these waivers aid in achieving that goal. For more information about provider qualifications for the pers service, please refer to Table 24, which outlines licensure and certification requirements, compliance with building codes and permits, and more. Thank you..

[Audio] We are currently discussing the coverage of specialized medical equipment and supplies under the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Participants in these waivers can request these items, which are essential for their service plan and help them maintain their health, well-being, and safety. Approval from the waiver program is required before these items can be provided. Before the waiver program can consider the request for specialized medical equipment and supplies, the Indiana Medicaid State Plan must be fully utilized. Additionally, participants must adhere to proper billing procedures and ensure that the requested items are covered under the Indiana Medicaid State Plan fee schedule before the waiver program can approve the request. It is important to note that the waiver program will reject any provider claims that do not comply with the correct billing practices. The following activities are permitted for specialized medical equipment and supplies: lift chairs, medication dispensers, and toileting and/or incontinence supplies that do not duplicate the services covered under the Indiana Medicaid State Plan. Justification and documentation must be provided to demonstrate that the request for these items is necessary to meet the participant's identified needs. In conclusion, specialized medical equipment and supplies play a vital role in the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Prior approval from the waiver program is required for these items to be provided..

[Audio] Section 12 of our presentation will cover the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers, which pertain to the DDRS HCBS waivers. These waivers allow for the provision of certain items and devices to participants. These items include slip-resistant socks, self-help devices such as over-the-bed tables, reachers, and adaptive plates, bowls, cups, drinking glasses, and eating utensils. Strollers may also be provided in cases where the participant's primary mobility device cannot fit into their vehicle or mode of transportation, and when a stroller is needed for mobility outside of the home. In addition to these physical items, voice-activated smart devices are permitted, providing a convenient and accessible means of accessing information and communication. It's important to note that there is a maximum annual maintenance cost of $1000 for these items, ensuring proper repairs and servicing for the safety and comfort of our participants. Service standards for the Specialized Medical Equipment and Supplies must also be met, including compliance with building codes and permits, as well as proper provider licensure or certification. All of these requirements have been approved by F-S-S-A-. Our providers must also adhere to general requirements, maintain records of services provided, have liability insurance, and possess specific professional qualifications and requirements. This guarantees the highest level of care and support for our participants. To summarize, these are the specific items and standards allowed under the pers service. Our commitment to person-centered service planning ensures the best care possible, and the state has a backup plan in place in case of equipment failure. Thank you for your attention..

[Audio] We will now discuss slide number 10 and examine the limitations and guidelines for the Personal Emergency Response System (P-E-R-S-) service under the DDRS HCBS Waivers section. The state has a contingency plan in place in the event of equipment failure and the care manager has a critical role in relaying information to the participant, their family, and their entire support circle through the person-centered service planning process. Before discussing the specific requirements for providers of the pers service, there are certain activities that are not permitted under this waiver. These include covering the cost of lost or damaged equipment, providing services to participants receiving the Assisted Living or Adult Family Care waiver services, and monitoring participants' bedrooms or bathrooms remotely. It is crucial to follow these limitations to ensure proper use of waiver funds and to maintain the integrity of the service. Now, let us focus on the qualifications for providers of the pers service, which are outlined in Table 24. These qualifications have been approved by F-S-S-A and include licensure/certification, compliance with other standards, and adherence to building codes and permits. It is essential for providers to meet these requirements to guarantee the safety and well-being of participants utilizing the pers service. One of the general requirements for providers is to keep records of the services provided, including any maintenance or repairs done to the pers equipment. Additionally, providers must have liability insurance and meet specific professional qualifications to offer this service. All documentation of qualifications should be clearly indicated, and a warranty is also mandatory. Moving on to the restrictions for maintenance, providers may only receive a maximum of $1000 annually for the repair and service of pers equipment. Any requests for service must clearly outline the costs of parts and labor involved. If the maintenance costs exceed $1000, the care manager will work with other available funding sources and community agencies to fulfill the need. It is important to note that if the total service costs exceed the annual limit, providers must itemize the costs of parts and labor that are covered by the waiver and those that are not..

[Audio] Good afternoon, everyone. I am here to discuss the positions of the monitor for Personal Emergency Response System (P-E-R-S-) based on the person-centered service planning process. I would like to inform you that in case of equipment failure, the state has a backup plan in place. The primary purpose of the care manager is to provide information to the participant, their family, and the entire circle of support, which is an integral part of the person-centered planning process. It is important to note that certain activities such as replacement cost of lost or damaged equipment, services provided to participants receiving the Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms are not allowed under the pers service. Provider qualifications for the pers service are presented in Table 24, which includes provider licensure/certification, other standards, and compliance with applicable building codes and permits. The provider qualifications are also FSSA-approved. It is important to note that the provider qualifications requirements include general requirements, maintenance of records of services provided, liability insurance, professional qualifications and requirements, documentation of qualifications, and warranty required..

[Audio] We are excited to share our plan for determining the monitor positions for the Personal Emergency Response System (P-E-R-S-) based on our person-centered service planning process. We have established a backup plan in case of equipment failure and identified the care manager as the central vehicle for providing information to participants, their families, and the entire circle of support. We want to make it clear that certain activities are not allowed under the pers service, such as replacement cost of lost or damaged equipment, services provided to participants receiving the Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. We have provided detailed information on the provider qualifications for the pers service and the Structured Day Program, which are presented in Tables 24 and 29, respectively. These qualifications include provider licensure/certification, other standards, and compliance with applicable building codes and permits. It is important to note that the provider qualifications are FSSA-approved and meet general requirements, maintain records of services provided, have liability insurance, have professional qualifications and requirements, document qualifications, and have a warranty required. We emphasize that services provided through Structured Day Programs should not duplicate any services provided under the Indiana Medicaid State Plan or other waiver service. Additionally, it is crucial to maintain a data record of services provided, including complete date and time of service, specific services/tasks provided, and signature of the employee providing the service (minimally the last name and first initial) for all entries on each day of service from each staff member providing direct care or supervision of care to the individual. This includes copies of personal records 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. Thank you for your time and attention..

[Audio] Structured Family Caregiving is a caregiving arrangement in which a principal caregiver provides daily care and support to a participant based on the participant’s daily care needs. The person responsible for providing day-to-day support (hereafter known as principal caregiver) may be a nonfamily member or a family member (except as limited below) who lives with the participant in the private home of the participant or the principal caregiver. The principal caregiver must be qualified to meet all federal and state regulatory guidelines and be able to provide care and support to a participant based on the participant’s assessed needs. Principal caregivers receive training based on their assessed needs and are paid a per diem stipend for the care and support they provide to participants. The goal of this service is to provide necessary care while fostering and emphasizing the participant’s independence in a home environment that will provide the participant with a range of care options as the needs of the participant change. The service is designed to provide options for alternative long-term care to persons who meet Nursing Facility Level of Care and whose needs can be met in Structured Family Caregiving. Only agencies may be Structured Family Caregiving providers, with the home settings being assessed and accessible, and all paid caregivers (including principal caregivers) being qualified as able to meet the participant’s needs. The agency provider must conduct at a minimum of two quarterly home visits. Additional home visits and ongoing communication with the principal caregiver is based on the assessed needs of the participant and the principal caregiver. Home visits are conducted by a registered nurse and/or a caregiver coach as determined by a person-centered plan of care. The agency provider must make a substitute caregiver available to allow opportunities for primary caregiver wellness and skill development in alignment with the needs of the primary caregiver as identified by the caregiver coach, up to 15 days per year. The agency provider must capture daily notes that are completed by the principal caregiver in an electronic format, and use the information collected to monitor participant health and principal caregiver support needs. The agency provider must make such notes available to waiver care managers and the state, upon request. There are three service levels of Structured Family Caregiving each with a unique rate..

[Audio] We presented a discussion on Personal Emergency Response System (P-E-R-S-) on slide 14. In case of equipment failure, the state has a backup plan in place. The care manager plays a crucial role in providing information to participants, their families, and support circles. This is part of a person-centered planning process. It's important to note that certain activities are not allowed under pers service. These include replacing lost or damaged equipment, services provided to participants receiving Assisted Living or Adult Family Care waiver services, and remote monitoring in participant bedrooms or bathrooms. Provider qualifications for pers service are specified in Table 24, which covers provider licensure/certification, other standards, and compliance with applicable building codes and permits. The provider qualifications requirements include general requirements, maintenance of records of services provided, liability insurance, professional qualifications, documentation of qualifications, and warranty required. These qualifications are FSSA-approved..