All services HCI provides, including ID Waiver services, are individualized to meet the needs of each consumer/individual. However, decisions regarding what services are appropriate, the number of units, or the dollar amounts of the appropriate services are based on the individual’s needs as determined by the individual and their interdisciplinary team. Rules of acceptance and participation in all of the programs and services offered by Howard Center are the same for everyone, without regard to race, color, national origin, sex, age, disability, spiritual beliefs, political affiliation, or ability to pay.
The following is a brief description of services available at Howard Center. All services must be identified in the individual’s case plan. Services shall not be simultaneously reimbursed with other HCBS services. All services work on a “team approach” which may involve different agencies with different responsibilities and limitations to assist in meeting the individual’s needs.
Service coordination includes coordination of services received, as well as diagnostic and evaluation services. The following services are available to each individual according to his/her needs:
- Academic services
- Community living skills training
- Legal services
- Self-care training
- Treatment (medical and psychological)
- Vocational/Day services
A Service Coordinator is responsible for the coordination of services to each individual on their caseload.
HCBS SUPPORTED COMMUNITY LIVING (SCL):
SCL services are provided within the individual’s home & community. All supported community living services are designed to be available to the person on an as-needed basis, for up to 24 hours per day. These services must be provided in the least restrictive environment possible and reflect the individual’s choice of living arrangement & services. Activities do not include those associated with vocational services, academics, day care, medical services, Medicaid case management, or other case management. An individual chooses almost any living arrangement.
Service Components include:
Personal and home skill training services – activities which assist an individual to develop or maintain skills for self-care, self-directness, & care of immediate environment.
Individual advocacy services – the act or process of representing a person’s rights & interests in order to realize the rights to which the person is entitled & to remove barriers to meeting the person’s needs.
Community skills training services – activities which assist a person to develop/maintain skills which allow better participation in the community. Services must focus on the following areas as they are applicable to the person being served:
Personal management skills training services – activities which assist an individual to maintain or develop skills necessary to sustain oneself in the physical environment and are essential to the management of one’s personal business and property. This includes self-advocacy skills. Examples of personal management skills are the ability to maintain a household budget, plan and prepare nutritional meals, use community resources (such as public transportation and libraries), and select foods at the grocery store.
Socialization skills training services – activities which assist an individual to develop or maintain skills which include self-awareness and self-control, social responsiveness, community participation, social amenities, & interpersonal skills.
Communication skills training services – activities which assist an individual to develop or maintain skills including expressive and receptive skills in verbal and nonverbal language and the functional application of acquired reading and writing skills.
Personal and environmental support services – activities & expenditures provided to or on behalf of a person in the areas of personal needs in order to allow the person to function in the least restrictive environment.
Transportation services – activities & expenditures designed to assist the individual to travel from one place to another to obtain services or carry out life’s activities. The service excludes transportation to & from work or a day program.
Treatment services – activities designed to assist the individual to maintain or improve physiological, emotional & behavioral functioning, & to prevent conditions that would present barriers to an individual’s functioning. Treatment services include physical or physiological treatment & psychotherapeutic treatment:
• Physiological treatment means activities, including medication regimens, designed to prevent, halt, control, relieve, or reverse symptoms or conditions which interfere with the normal functioning of the human body. These activities shall be provided by or under the supervision of a health care professional certified or licensed to provide the activity specified.
• Psychotherapeutic treatment means activities provided to assist an individual in the identification or modification of beliefs, emotions, attitudes, or behaviors in order to maintain or improve the individual’s functioning in response to the physical, emotional, and social environment.
Respite care services are services provided to the individual that gives temporary relief to the usual caregiver and provides all the necessary care that the usual caregiver would provide during that time period. The purpose of respite care is to enable the individual to remain in his/her current living situation. There are various types of respite, including: specialized respite, group respite, and basic individual respite. Respite may be provided in the individual’s home, another family’s home, camps, organized community programs, ICF/MR, RCF/MR, hospital, nursing facility, skilled nursing facility, assisted living program, adult day care center, foster group care, foster family home, or DHS licensed daycare. Respite provided outside the consumer’s home or outside a facility in locations covered by the facility’s licensure, certification, accreditation, or contract must be approved by the parent, guardian, or primary caregiver and interdisciplinary team, and must be consistent with the way the location is used by the general public. Respite in these locations may not exceed seventy-two (72) continuous hours. Respite cannot be provided to individuals residing in the family, guardian or usual caregiver’s home during the hours in which the usual caregiver is employed unless it is in a camp setting.
CONSUMER DIRECTED ATTENDANT CARE (CDAC)
Assistance to the individual with self-care tasks, which the person would typically do independently if he/she was otherwise able. An individual or agency, depending on the individual’s needs may provide the service. The individual, parent, guardian, or attorney in fact under durable power of attorney for health care shall be responsible for selecting the individual provider or agency that will provide the components of the CDAC services to be provided. All consumer-directed attendant care services are supportive. They are conducted at home and/or in the community. The CDAC service may include assistance with non-skilled and skilled services. The skilled services must be done under the supervision of a professional registered nurse or licensed therapist working under the direction of a physician. The registered nurse or therapist shall retain accountability for actions that are delegated. HCI only provides non-skilled CDAC services.
Home-based habilitation consists of individualized services and supports that assist with the acquisition, retention, or improvement in skills related to living in the community. These services are provided in the member’s home or community and assist the member to reside in the most integrated setting appropriate to the member’s needs. Services are intended to provide for the daily living needs of the member and can be provided at any time of day or night that is necessary to meet the member’s needs. This includes the following supports:
- Adaptive skill development
- Assistance with activities of daily living
- Community inclusion
- Transportation (except to and from a day program)
- Adult educational supports
- Social and leisure skill development
- Personal care
- Protective oversight and supervision
DAY HABILITATION SERVICES
Day habilitation services are services that assist or support the individual in developing or maintaining life skills (self-help, socialization, & adaptive skills) and community integration. Services must enable or enhance the person’s intellectual functioning, physical & emotional health and development, language & communication development, behavior management, responsibility & self-direction, daily living activities, self-advocacy skills, or mobility. The goal is to assist the individual with attaining and/or maintaining their maximum functional level. Assistance & support will include, but not be limited to: eating & drinking, toileting & dressing, self-help, mobility, socialization, communication, sensor motor, independent functioning, basic academics, recreation & leisure, money management, interpersonal skills, self-advocacy skills, training & education in self-determination, accessing one’s community, participation in events & activities, volunteerism activities, anger management; skilled services such as occupational therapy, speech & language therapy, & physical therapy; nursing services, range of motion, behavior supports, use of adaptive equipment, hobbies, & companionship with friends and peers.
HOME AND VEHICLE MODIFICATIONS (HVM)
Physical modifications to the home and/or vehicle that directly address the individual’s medical health or must be necessary to provide for the medical needs, welfare, and safety of the individual and to increase or maintain independence. All modification requests are reviewed individually and a determination is made regarding the appropriateness of the modification request. Does NOT Include: modifications, which increase the square footage of the home, items for replacement which are the responsibility of the homeowner/landlord, vehicle purchase, fences, furnaces or any modifications or adaptations available through regular Medicaid. Modifications that are necessary or desirable without regard to the individual’s medical or remedial need and that would be expected to increase the fair market value of the home or vehicle are excluded, with a few exceptions. Repairs are also excluded.
Individualized services associated with obtaining & maintaining competitive paid employment in the least restrictive environment possible, provided to individuals for whom competitive employment at or above minimum wage is unlikely and who, because of their disability, need intense and on-going support to perform in a work setting. Individual placements are the preferred service model. Job placements shall be made in integrated settings with the majority of co-workers being persons without disabilities. Services address the disability-related challenges to securing and keeping a job. The two components to this service are: activities to obtain a job and supports to maintain employment.
Transportation services are for individuals to conduct business errands, essential shopping, to receive medical services, to travel to & from work or day programs, and to reduce social isolation. Transportation is provided in the community, as identified in the service plan. The service does NOT include: transportation simultaneously reimbursed with transportation costs that may be included in an SCL rate or Medical Transportation that is reimbursable through medical transportation funding.