Zan L Liccione, Mdiv, MSRC, CRC, QP CEO Clinical Services

Professional Rehabilitation Consultants

Program Descriptions

Zan L Liccione, MDiv, MSRC, CRC, QP CEO clinical services

Guilford Center and Alamance-Caswell LME

Mashunda F Famble, MSRC, CRC, QP CEO clinical services

Centerpoint Human Services

2007 Yanceyville Road Suite 3311, Box 40

Greensboro, NC 27405

Main Telephone 336-543-6970

CAP MR/DD Medicaid Waiver Program

Endorsed Services

Home Supports (Levels 1-5)

Service Definition:

These services must be delivered by a worker employed by a MH/DD/SA provider organization which meets the standards established by the Division of MH/DD-SAS. These standards set for the administrative, financial, clinical, quality improvement, and information services infrastructure necessary to provide services. The agency must fulfill the requirements of 10A NCAC 27G. The organization must be established as a legally recognized entity in the US and registered to do business as a corporate entity in NC. Providers are to achieve national accreditation within 1 year of the implementation of the waiver or within 1 year of enrollment as a provider, whichever comes last. PRC is presently nationally accredited by Council on Quality and Leadership (CQL).

The intent of this service is to meet the habilitation and personal care needs of adult (18

years or older) participants who choose to live with their family and receive supports

from their family and whose family wishes to provide services to the participant in the

family home. Home Supports is designed to provide flexibility and reflect the natural

flow of the participant’s day.

Home Supports provide assistance with acquisition, retention, or improvement in skills

related to activities of daily living, such as personal grooming and cleanliness, bed

making and household chores, eating and the preparation of food, and the social and

adaptive skills necessary to enable the participant to reside in a non-institutional setting as independently as possible in the community. Habilitation, training and instruction are coupled with elements of support, supervision and engaging participation to reflect the natural flow of training, practice of skills, and other activities as they occur during the course of the participant’s day.

This service is distinctive in that it includes habilitation and training activities, as well as care and assistance with activities of daily living when the participant is dependent on others to ensure health and safety. Interactions with the participant are designed to achieve

outcomes identified in the Person Centered Plan. Support and supervision of the

participant’s activities to sustain skills gained through habilitation and training are also

acceptable goals of Home Supports. This service provides assistance; support, supervision, and monitoring that allow participants to participate in home or community activities. Home suppers is used to provide habilitation and support in community living activities such as shopping and leisure activities in the community.

Service Location/Limitation:

Ø Home Supports is provided in the participant’s natural home with biological or

step-parents, guardian of the person or other family member who resides in the

natural home with the participant. Home Supports is not provided in out of

home placements.

Ø Payments for Home Supports are not made for room and board.

Ø Payments will not be made for the routine care and supervision that would be

expected to be provided by a family for activities or supervision for which a

payment is made by a source other than Medicaid.

Ø Participants receiving Home Supports may not receive State Plan Adult Care Personal Care Services, Residential Supports or waiver Personal Care Service. Participants who receive Home Supports may receive Respite Services.

Ø Home Supports is provided for adults and can be provided only by parents, stepparents, or adoptive parents living with the adult participant, family members living with the adult participant or guardians of the person who live with the adult participant. No service other than Home Supports will be provided by individuals who live with the participant in their home.

Staff Qualifications:

Staff must meet the requirements for paraprofessionals in 10A NCAC 27G.0100.0200 Home Support staff must have a high school diploma or GED. Staff who do not have a GED or a High School Diploma but were providing CAP-MR/DD personal care services prior to the implementation of this waiver will have a transition period of 18 months to meet the minimum education requirement. 18 months after the implementation of this waiver all staff who provide personal care services will meet the minimum education requirement of a GED or High School Diploma.

Staff must meet client specific competencies as identified by the participant’s person-centered planning team and documented in the Person Centered Plan. Staff must successfully complete First Aid, CPR and DMH/DD/SAS Core Competencies and required refresher training. Paraprofessionals providing this service must be supervised by a Qualified Professional. Supervision must be provided according to supervision requirements specified in 10A NCAC 27G.0204 and according to licensure or certification requirements of the appropriate discipline. Staff must complete a fingerprint criminal record check. Healthcare registries check as required in accordance with 10A NCAC 27G. 0200. Blood Borne Pathogen and Medication Administration training is required, along with North Carolina Interventions training (NCI). If providing transportation, have a North Carolina or valid driver’s license, a safe driving record and an acceptable level of automobile liability insurance.

Documentation Requirements: Grid to include full date the service is being provided, goals that are being addressed, a number or letter as specified in the key which reflects the intervention/activity; a number or letter as specified in the key which reflects the assessment of the consumer’s progress toward goals; duration, and initial of the individual providing the service, with initials corresponding to a signature on the log section of the grid.

Home and Community Supports (ind. H2015 and group H2015HQ)

Service Definition:

The intent of this service is to meet the habilitation and support needs of individuals living in their own home or their family’s home. Home and community supports services provide instruction and assistance to enable the individual to acquire and maintain skills that will allow him/her to function with greater independence in the community. Home and community supports provides habilitation, training and instruction coupled with elements of support, supervision and engaging participation to reflect the natural flow of training, practice of skills, and other activities as they occur during the course of the participant’s day. Interactions with the person are designed to achieve outcomes identified in the Plan of Care. Support and supervision of the person’s activities to sustain skills gained through habilitation and training is also an acceptable goal of home and community Supports. Home and community supports are provided in the home, family home, or community of the participant.

Home and community supports consist of an integrated array of individually designed services and supports that are described in the Plan of Care. This service is distinctive from personal care services by the presence of training activities in addition to support, supervision, and monitoring as described in the Plan of Care. The community component may be utilized by an individual residing in a residential facility but must not include training and habilitation activities that are expected of the residential provider.

Home and Community Supports include:

Ø Training and/or support with socialization that includes development or maintenance of self-awareness and self-control, social responsiveness, social amenities, and interpersonal skills, and the development and maintenance of personal relationships.

Ø Training and/or support with personal skill development that includes activities designated to improve the participants’ own ability to accomplish every day activities of community living, including eating, bathing, dressing, personal hygiene, and mobility.

Ø Training and support with community participation, recreation, or leisure that includes the development or maintenance of skills to use community resources, facilities or businesses and support in accessing such opportunities for community integration.

Staff must meet the requirements for paraprofessionals in 10A NCAC 27G.0100.0200 Home Support staff must have a high school diploma or GED. Staff must meet client specific competencies as identified by the participant’s person-centered planning team and documented in the Person Centered Plan. Staff must successfully complete First Aid, CPR and DMH/DD/SAS Core Competencies and required refresher training. Paraprofessionals providing this service must be supervised by a Qualified Professional. Supervision must be provided according to supervision requirements specified in 10A NCAC 27G.0204 and according to licensure or certification requirements of the appropriate discipline. Staff must complete a fingerprint criminal record check. Healthcare registries check as required in accordance with 10A NCAC 27G. 0200. Blood Borne Pathogen and Medication Administration training is required, along with North Carolina Interventions training (NCI). If providing transportation, have a North Carolina or valid driver’s license, a safe driving record and an acceptable level of automobile liability insurance.

Limitation: This service may not be provided at the same time of day as: Adult Day Health, Day Supports, Home and Community Supports, Personal Care, Residential Supports, Respite Care, Transportation, Home Supports or Long Term Vocational Supports.

Individual/Caregiver Training and Education (S5110)

Service Definitions:

Individual/caregiver training and education includes training and counseling services for the individual and or family members of the individual. The purpose of this service is to enhance the decision making capacity of the family unit, provide orientation regarding the nature and impact of the developmental disability upon the individual and his/her family, provide information about community integration options and strategies, provide education and training on intervention strategies, and provide education and training on the use of specialized equipment and supplies. Updates are included to maintain the person safely at home. Outcomes related to conferences and classes must be clearly outlined in the plan of care. Individual/caregiver training excludes training furnished to family members through Specialized Consultation Services.

For purpose of this service “family” is defined as the people who live with or provide care to the person receiving waiver services, and may include a parent, spouse, children, relatives, foster family, guardians or in-laws. “Family” does not include individuals who are employed to care for the person. All family training will include outcomes that are documented in the person’s Plan of Care. The service includes conference registration, and enrollment fees for classes. Travel to conferences will be reimbursed for waiver participants only.

Service is limited to a maximum of $1500 per waiver year which includes a maximum of $1000 for conference registration, travel to conference for the waiver participant, and enrollment fees for classes. Conference registration and enrollment for classes must be billed through the LME using LME business procedures (contact the LME for specific details for consumer area). Individuals who are paid service providers are excluded from this service.

This may be provided by persons having appropriate expertise in the field in which the training is being provided. Driving record must be checked if providing transportation.

Documentation Requirements: Grid to include full date the service is being provided, purpose of the contact as it relates to a goal, description of the intervention/activity; assessment of consumer’s progress; duration, and initial of the individual providing the service, with initials corresponding to a signature on the log section of the grid.

Long Term Vocational Supports (Ind. H2023 and Group H2023HQ)

Service Definition:

Long Term Vocational Supports provide assistance with maintaining a job for participants

who no longer need the intense level of Supported Employment Services. Long Term