part 9

[Virtual Presenter] We recommend thoroughly reviewing the DDRS HCBS Waivers to ensure compliance with service definitions and requirements for F-S-W and C-I-H Waivers. These waivers include important information such as the name of the provider, the date range of services, the primary type of service, and the notation of the ratio for service delivery. Providers should also provide a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and a positive event that occurred during the quarter that contributed to the individual's good life. All data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, further guidance related to day habilitation, including group services, is available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Providers should note that Day Habilitation services reimbursement does not include reimbursement for the cost of the activities in which the individual is participating when they receive skills training, such as the cost to attend a community event or a camp. The document also lists activities that are not allowed under Day Habilitation, such as services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse. We urge all providers to thoroughly review the DDRS HCBS Waivers and ensure that all data elements, including the name of the provider, the date range of services, the primary type of service, the notation of the ratio for service delivery, the percent of time in community, the percent of time in a facility, the brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress towards P-C-I-S-P outcomes, if applicable, and a positive event that occurred during the quarter that contributed to the individual’s good life, are made available to auditors, quality monitors, case managers, and any other government entity upon request..

[Audio] We recommend that you review the service definitions and requirements for F-S-W and C-I-H Waivers in the DDRS HCBS Waivers Section 10. This document contains important information such as the provider's name, date range of services, primary type of service, and ratio for service delivery. Additionally, it requires a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and a positive event that occurred during the quarter that contributed to the individual's good life. All data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, further guidance related to day habilitation is available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes for day habilitation services, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. Providers of Day Habilitation must meet the following criteria: enrolled as an active Medicaid provider, FSSA DDRS-approved, comply with Indiana Administrative Code, 460 I-A-C 6, including but not limited to: documentation of criminal histories, insurance, financial status of providers, requirements for direct care staff, health care coordination services provider qualifications, transportation services provider qualifications. Comply with any applicable B-D-S service standards, guidelines, policies and/or manuals, including FSSA DDRS policies and this module, accessible from the I-H-C-P Bulletins, Banner Pages and Reference Modules page at in.gov/medicaid/providers. Obtain or maintain accreditation (specific to Indiana programs) by at least one of the following organizations: The Commission on Accreditation of Rehabilitation Facilities (C-A-R-F-), or its successor, The Council on Quality and Leadership In Supports for People with Disabilities, or its successor, The Joint Commission on Accreditation of Healthcare Organizations (J-C-A-H-O), or its successor, The National Committee for Quality Assurance, or its successor, The ISO-9001 human services quality assurance (Q-A---) system, or an independent national accreditation organization approved by the F-S-S-A Secretary. The following subsections provide information and requirements for Extended Services for the F-S-W and C-I-H Waiver. Service Definition: Extended Services are ongoing employment support services that enable an individual to maintain integrated competitive employment in a community.

[Audio] We are here today to discuss the importance of understanding the service definitions and requirements for F-S-W and C-I-H Waivers. This document is crucial in ensuring compliance with the service definitions and requirements for F-S-W and C-I-H Waivers. The document includes vital information such as the name of the provider, date range of services, primary type of service, and the notation of the ratio for service delivery. For Group Services, we have additional guidance available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines the limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). It is important to understand that day habilitation services reimbursement does not include reimbursement for the cost of the activities in which the individual is participating when they receive skills training, such as the cost to attend a community event or a camp. The document also lists activities that are not allowed under Day Habilitation, such as services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse. All data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. In conclusion, we strongly recommend understanding the service definitions and requirements for F-S-W and C-I-H Waivers to ensure compliance with the service definitions and requirements for F-S-W and C-I-H Waivers. It is important to understand the limitations on group sizes and the reimbursable activities for Day Habilitation services. Thank you for your attention to this matter..

[Audio] We recommend that important information such as the name of the provider, the date range of services, the primary type of service, and the notation of the ratio for service delivery be reviewed. It is also important to include a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and a positive event that occurred during the quarter that contributed to the individual's good life. All data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, further guidance related to day habilitation, including group services, is available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Day Habilitation services reimbursement does not include reimbursement for the cost of the activities in which the individual is participating when they receive skills training, such as the cost to attend a community event or a camp. The document also lists activities that are not allowed under Day Habilitation, such as services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse. Extended services are provided in integrated community settings where persons without disabilities are also employed. Reimbursement will only be made for the employment support services required by the individual receiving services as a result of their disability. Extended services do not include sheltered work or other similar types of vocational services furnished in specialized facilities or volunteer endeavors. An individual's P-C-I-S-P should be constructed in a manner that reflects individual informed choice and goals relating to employment and ensures provision of services in the most integrated setting possible. The extended services supports should be designed to support employment outcomes that lead to further independence and are consistent with the individual’s goals. Individual informed choices and goals related to employment and the justification/need for extended services must be outlined in the PCISP. In addition to compliance with documentation requirements outlined in 460 I-A-C 6, the following data elements are required for each service rendered: Name of individual served, I-H-C-P Member ID of the individual, Name of provider, Identified employment need, Service rendered, Expected outcome, Date of service including the year, Time frame of service (include a.m. or p.m.), Notation of the primary location of service delivery, A summary of services rendered to include the specific reimbursable activities that were performed and the outcomes realized from those activities, and A description of any issue or circumstance concerning the individual including, but not limited to, significant medical or behavioral incidents or any other situation that may be uncommon for the individual..

[Audio] We recommend that you understand the policies and procedures for F-S-W and C-I-H Waivers. This information includes the name of the provider, the date range of services, the primary type of service, and the ratio for service delivery. Additionally, it requires a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and a positive event that occurred during the quarter that contributed to the individual's good life. All data elements must be available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, we suggest consulting the Current D-D-R-S Policies page at in.gov/fssa/ddrs and the direct link for Day Habilitation: Service Definition and Standards. This document outlines the limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Activities that are not allowed under Day Habilitation include services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse. As applicable, you must submit monthly/quarterly reports to the document library of the state's case management system by the chosen service provider on or before the 15th day of the following month. Limitations on Group services may only be rendered at the discretion of the I-S-T and in group sizes no greater than four individuals to one staff. You must also provide appropriate documentation, as outlined under Documentation Standards for Extended Services, demonstrating that the ratio for each claimed time frame of services did not exceed the maximum allowable ratio determined by the I-S-T for each group individual, and identify other group individuals, by using the individuals’ Health Insurance Portability and Accountability Act (H-I-P-A-A) naming convention. Activities Not Allowed Reimbursement is not available under Extended Services for the following activities: Any non-community-based setting where the majority (51% or more) of the individuals have an intellectual or developmental disability, Sheltered work observation or participation, Volunteer endeavors, Any.

[Audio] We will discuss the importance of understanding the service definitions and requirements for F-S-W and C-I-H Waivers. Providers must comply with Indiana Administrative Code 460 IAC 6 and any applicable B-D-S service standards, guidelines, policies and/or manuals. We will also discuss the requirement for providers to obtain and maintain Indiana accreditation by at least one of the four organizations: The Commission on Accreditation of Rehabilitation Facilities (C-A-R-F-), the Council on Quality and Leadership in Supports for People with Disabilities, the Joint Commission on Accreditation of Healthcare Organizations (J-C-A-H-O), the National Commission on Quality Assurance, or an independent national accreditation organization approved by the secretary. To be eligible to perform this service, a provider must meet the standards as a community rehabilitation provider as outlined in Indiana Code 12-12-1-4.1 Section 10.10: Facility-Based Support for F-S-W and C-I-H Waiver. These services are structured, comprehensive, non-residential programs that provide health, social, recreational and therapeutic activities, as well as educational and life skill opportunities as described in the PCISP. Facility-Based Support services must be provided in a congregate setting in groups not to exceed 16:1..

[Audio] We recommend that you thoroughly review the DDRS HCBS Waivers and the Current D-D-R-S Policies for Group Services, which contain vital information such as the provider's name, the date range of services, the main type of service, and the notation of the ratio for service delivery. Additionally, these documents require a brief summary of the progress made towards P-C-I-S-P outcomes, any obstacles that may have hindered progress, and a positive event that occurred during the quarter that positively impacted the individual's life. It is essential to make all data elements available to auditors and quality monitors..

[Audio] We emphasize the importance of carefully examining the DDRS HCBS Waivers Section 10 for all eligible providers. This section outlines the service definitions and requirements for Facility Supported Waiver (F-S-W--) and Comprehensive Individualized Supportive Habilitation (C-I-H--) Waiver. It is crucial for providers to understand the restrictions on group sizes, the prohibited activities under Day Habilitation, and the qualifications necessary to be eligible for Facility Supported Waiver (F-S-W--) and Comprehensive Individualized Supportive Habilitation (C-I-H--) Waiver..

[Audio] We recommend that all stakeholders carefully review the DDRS HCBS Waivers Section 10 to ensure compliance with the service definitions and requirements for F-S-W and C-I-H Waivers. This document includes critical information such as the name of the provider, the date range of services, the primary type of service, and the notation of the ratio for service delivery. Additionally, it requires a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and a positive event that occurred during the quarter that contributed to the individual's good life. All data elements must be made available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, further guidance related to day habilitation, including group services, is available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Day Habilitation services reimbursement does not include reimbursement for the cost of the activities in which the individual is participating when they receive skills training, such as the cost to attend a community event or a camp. The document also lists activities that are not allowed under Day Habilitation, such as services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse..

[Audio] We would like to emphasize the importance of reviewing DDRS HCBS Waivers Section 10 to ensure compliance with the service definitions and requirements for Family Support and Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waivers. This document includes crucial information such as the provider's name, date range of services, primary type of service, and notation of the ratio for service delivery. It is essential that all data elements are made available to auditors, quality monitors, case managers, and any other government entity upon request. For Group Services, further guidance related to day habilitation, including group services, is available on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applies only to a facility setting). Day Habilitation services reimbursement does not include reimbursement for the cost of the activities in which the individual is participating when they receive skills training, such as the cost to attend a community event or a camp. The document also lists activities that are not allowed under Day Habilitation, such as services that are available under the Rehabilitation Act of 1973 or PL 94-142, skills training for any activity that is not identified as directly related to an individual's habilitation outcome, activities that do not foster the acquisition and retention of skills, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services furnished to a minor by parents, stepparents or legal guardian, and services furnished to an individual by the individual’s spouse. It's important to note that DDRS HCBS Waivers Section 10 includes specific activities that are not allowed under Family and Caregiver Training (F-S-T--) and Community Integration and Habilitation (C-I-H--) Waivers. These activities include educational materials or training programs, workshops, and conferences that are not related to the caregiver’s ability to support the individual, education and training provided to train providers, training provided to caregivers who receive training reimbursement within their Medicaid or state line item reimbursement rates, cost of travel, meals and overnight lodging while attending the training program, workshop or conference, service provided by the parent of a minor child participant or the spouse of a participant, and cost of travel, meals and overnight lodging while attending the training program, workshop or conference. Provider qualifications are crucial for F-S-W and C-I-H Waivers. Providers must meet the following criteria: be enrolled as an active Medicaid provider, be FSSA DDRS-approved, comply with Indiana Administrative Code 460 I-A-C 6, including but not limited to documentation of criminal histories, insurance, financial status of providers, family and caregiver training services provider qualifications, and requirements for provision of services. Additionally, providers must comply with any applicable B-D-S service standards, guidelines, policies and/or manuals, including FSSA DDRS policies and this module, accessible from the I-H-C-P Provider Reference Modules page at in.gov/medicaid/providers. DDRS HCBS Waivers Section 10.12 provides information and requirements for Home Modification Assessment services for the F-S-W and C-I-H Waiver. This service will be used to objectively determine the specifications for a home modification that is safe, appropriate and feasible to ensure accurate bids and workmanship. All participants must receive a Home Modification Assessment with a certified waiver provider selected by the participant prior to any subsequent home modifications as well as a home modification inspection upon completion of the work. In conclusion, it's essential to review DDRS HCBS Waivers Section 10 to ensure compliance with the service definitions and requirements for Family Support and Waiver (F-S-W--) and Community Integration.

[Audio] The importance of reviewing the DDRS HCBS Waivers Section 10 to ensure compliance with the service definitions and requirements for F-S-W and C-I-H Waivers will be discussed. This document contains essential information such as the provider's name, service date range, primary type of service, and the service delivery ratio. It also requires a summary of progress towards P-C-I-S-P outcomes, any challenges faced, and any positive occurrences contributing to the individual's well-being during the quarter. All data elements must be readily available to auditors, quality monitors, case managers, and other government entities upon request. For Group Services, additional guidance on day habilitation can be found on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and the direct link for Day Habilitation: Service Definition and Standards. This document outlines restrictions on group sizes, including a 1:1 individual ratio, 2:1 to 4:1 small group ratio, 5:1 to 10:1 medium group ratio, and 11:1 to 16:1 large group ratio (only applicable to facility settings). However, reimbursement for day habilitation services does not cover the cost of activities in which the individual receives skills training, such as attending a community event or a camp. Additionally, certain activities are not allowed under Day Habilitation, such as activities available under the Rehabilitation Act of 1973 or PL 94-142, skills training not directly related to the individual's habilitation outcome, activities that do not promote skill acquisition and retention, duplicating or replacing supports provided through residential habilitation and support (R-H-S--) services, services provided by parents, step-parents, or legal guardians to minors, and services provided by an individual's spouse. Section 10 of the DDRS HCBS Waivers ensures that F-S-W and C-I-H Waivers provide individualized and enabling services to promote independence and prevent institutionalization. The assessor's responsibilities include writing specifications, examining feasibility, and evaluating the post-project results..

[Audio] I am pleased to share the DDRS HCBS Waivers Section 10 with everyone. This section outlines the service definitions and requirements for F-S-W and C-I-H Waivers, which are crucial for compliance. The document includes important details such as the provider's name, service date range, primary type of service, and service delivery ratio. It also requires a brief summary of progress towards P-C-I-S-P outcomes, challenges faced, and a positive event that contributed to the individual's well-being during the quarter. All data elements must be readily accessible to auditors, quality monitors, case managers, and any other government entity upon request..

[Audio] We will now discuss the importance of reviewing Section 10 of the DDRS HCBS Waivers to ensure compliance with the service definitions and requirements for F-S-W and C-I-H waivers. This document includes crucial details such as the provider's name, date range of services, primary type of service, and service delivery ratio notation. All data elements must be made available to auditors, quality monitors, case managers, and government entities upon request. Moving on to group services, we would like to offer further guidance on day habilitation, including group services. This information can be found on the Current D-D-R-S Policies page at in.gov/fssa/ddrs, under the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, such as the 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applicable only to a facility setting). It is important to note that reimbursement for day habilitation services does not cover the expenses of activities in which the individual participates, such as attending a community event or a camp. The document also specifies the prohibited activities under day habilitation, including those already covered by the Rehabilitation Act of 1973 or PL 94-142, skills training for activities unrelated to an individual's habilitation outcome, activities that do not develop or maintain skills, and activities that duplicate or replace support provided through residential habilitation and support services. Furthermore, day habilitation services are not eligible for reimbursement if provided by family members or spouses. We encourage a thorough review of this information to ensure compliance with regulations and promote the individual's well-being. Thank you for your attention to this matter. This concludes our presentation on DDRS HCBS Waivers Section 10. We hope this information has been helpful in understanding the requirements and regulations for these waivers..

[Audio] It is recommended that a review of the DDRS HCBS Waivers Section 10 be conducted to ensure compliance with service definitions and requirements for F-S-W and C-I-H Waivers. This review is important as the document includes crucial information such as provider name, service date range, primary type of service, and service delivery ratio. Additionally, the review requires a brief summary of progress towards P-C-I-S-P outcomes, challenges hindering progress, and any positive events that have contributed to the individual's well-being. All data elements must be readily available to auditors, quality monitors, case managers, and other government entities upon request. For Group Services, further guidance on day habilitation can be found on the Current D-D-R-S Policies page at in.gov/fssa/ddrs and at the direct link for Day Habilitation: Service Definition and Standards. This document outlines limitations on group sizes, including 1:1 Individual, 2:1 to 4:1 Small Group, 5:1 to 10:1 Medium Group, and 11:1 to 16:1 Large Group (applicable only to facility settings). It is important to note that day habilitation services do not cover the cost of activities that the individual participates in while receiving skills training, such as attending a community event or camp. The document also specifies activities that are not allowed under day habilitation, such as those covered by the Rehabilitation Act of 1973 or PL 94-142, skills training for activities not directly related to an individual's habilitation outcome, activities that do not promote skill acquisition and retention, activities that duplicate or replace supports provided through residential habilitation and support (R-H-S--) services, services provided to minors by parents, stepparents, or legal guardians, and services provided to an individual by their spouse. The following service standards apply to Home Modifications: all equipment and supplies must directly benefit the individual's health or remediation, and all items must meet applicable manufacturing, design, and installation standards. Additionally, all participants must receive a Home Modification Assessment..