DAR File No. 27795

Human Services, Services for People with Disabilities

R539-8

Community-Based Services

NOTICE OF PROPOSED RULE

DAR File No.: 27795
Filed: 04/01/2005, 12:55
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The repealing of this rule is proposed after a comprehensive revision and consolidation of the Division's rules.

Summary of the rule or change:

The change involves repealing the current rule and placing these service descriptions in the Provider's service contracts with the Division. The Division's internal processes are outlined in Internal Directives for staff. This rule is repealed in its entirety.

State statutory or constitutional authorization for this rule:

Sections 62A-5-102 and 62A-5-103

Anticipated cost or savings to:

the state budget:

None--The repeal of this rule does not alter the basic operations or functions of the Division and, therefore, does not result in either a cost or savings to the state.

local governments:

None--Local government funding is not used. Therefore, there is no cost to local governments.

other persons:

None--The repeal of this rule does not alter the basic operations or functions of the Division and, therefore, does not result in either a cost or savings to other persons.

Compliance costs for affected persons:

None--The repeal of this rule does not alter the basic operations or functions of the Division. Provider requirements now appear in their current service contracts. Division staff requirements appear in Internal Directives. This does not change the fiscal impact on service providers.

Comments by the department head on the fiscal impact the rule may have on businesses:

None--The repeal of this rule does not alter the basic operations or functions of the Division. Provider requirements now appear in their current service contracts. Lisa-Michele Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Suzie Totten at the above address, by phone at 801-538-4197, by FAX at 801-538-4279, or by Internet E-mail at stotten@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/16/2005

This rule may become effective on:

05/17/2005

Authorized by:

Lisa-Michele Church, Executive Director

RULE TEXT

R539. Human Services, Services for People with Disabilities.

[R539-8. Community-Based Services.

R539-8-1A. Day Training.

A. Policy.

The Division of Services for People with Disabilities shall provide habilitative services to Division eligible individuals who require training and support in the acquisition of independent living skills. Day Training services are designed to prevent institutional placement and should include opportunities to enhance self-esteem, maximize independent functioning, facilitate skill development, increase utilization of community resources, and relieve isolation.

B. Procedures.

1. Individuals are referred to the service provider by the region case manager. Individuals shall be presented with all available service options and personal preference and choice shall be honored within resource constraints. Unmet service needs are documented on the waiting list and the case manager prioritizes referrals to the day training program using the waiting list in accordance with R539-3-1, Waiting List.

2. The provider will comply with:

a. The Home and Community Based Waiver (if applicable),

b. Division policies which apply,

c. General Department standards, and

d. Office of Licensing standards if site-based or Division Certification standards if non-site based.

e. All services must be provided by staff who meet Division provider qualification, and

f. Other standards identified in the contract.

3. The Purchase of Service Provider will develop a plan of services based on the individual's needs as identified through the individual assessment and planning process and agreed to at the Individual Plan meeting (See R539- 3-2, The Individual Plan).

R539-8-1B. School Vacation Habilitation Services.

A. Policy.

School Vacation Habilitation services provides assistance with acquisition, retention, or improvement in self-direction, socialization, and adaptive skills which takes place during school vacation time and when no other education programs are available. Vacation services for children will focus on the individual attaining and maintaining his/her maximum functional level in self-direction, in addition may serve to reinforce acquisition of skills as defined in therapy or other settings.

B. Procedures.

1. Services may be furnished four to six hours per day.

2. Services must be provided in accordance with the recipient's plan of care.

3. The provider will comply with all standards and policies as outlined in the contract.

4. School Vacation Habilitation service is not available when programs funded by the Department of Education are available.

R539-8-2. Senior Habilitative Alternatives.

A. Policy.

DSPD shall provide Habilitative Alternatives to DSPD eligible individuals who are 55 years of age or older or who have chronic or acute medical conditions that significantly impede the individual's ability to participate in traditional day training programs. Services may also include transportation to enable an individual to attend a day training program. Habilitative Alternatives are designed to promote the ongoing development or skill maintenance for individuals who require alternatives to day training.

B. Procedures.

Individuals must be determined eligible for DSPD services. The need for Habilitative Alternatives is determined by the individual, and the Individual Support Plan/Individual Program Plan (ISP/IPP) team who develops a written plan of care. The case manager coordinates the services with the residential or day training provider. Placement is reviewed semi-annually.

R539-8-3. Supported Employment.

A. Policy.

The Division of Services for People with Disabilities will assist eligible individuals who want to work to obtain opportunities for supported employment.

B. Procedures.

1. Supported employment can be full or part time and is in a work setting where the Person works with others without disabilities, not including staff or contracted co-workers paid to support the Person. Supported employment may occur anytime during a 24 hour day. Supports assist the Person to achieve competitive employment. Competitive employment is defined as work compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by employees who are not disabled. Persons in supported employment are supported and employed consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the Person as indicated in the Person's individual service plan. A Person may be supported one-on-one or in a group. When appropriate, the provider may contract with a co-worker to provide additional support, under the direction of a job coach, as a natural extension of the workday.

2. Payment will only be made for adaptations, supervision and training required by a Person as a result of the Person's disability and will not include payment for the supervisory activities rendered as a normal part of the business setting. Documentation must be maintained, for all Persons whose supports are funded by the Waiver, showing that supported employment services rendered are not available under a program funded by either the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act. Federal financial participation will not be claimed for incentive payments, subsidies, or unrelated vocational training expenses such as incentive payments made to an employer or beneficiaries to encourage or subsidize an employer's participation in a supported employment program, payments that are passed through to a beneficiary of supported employment programs, or for payments for vocational training that is not directly related to a beneficiary's supported employment program.

3. Provider agency standards:

a. Persons shall be employed for a significant number of hours, at a level optimal for the Person and in accordance with the Person's capabilities and desires. This should be determined at the person centered plan meeting. The hours worked by Persons receiving supported employment should approximate the hours worked by other employees;

b. Persons shall be compensated at minimum wage or better. If minimum wage is not feasible, compensation shall be at a commensurate wage based on a Person's productivity. Persons shall be provided benefits by the employer, which are comparable to workers who are not disabled.

c. There shall be no more than eight Persons in any one workgroup.

d. Assistive technology shall be used to enhance productivity when appropriate in accordance with the Americans with Disabilities Act.

e. An individual assessment of work interests shall be conducted within 30 days of the Person's referral to the provider agency. To increase the Person's performance on the job, provider staff ensure that the job is appropriate for the Person, that the Person has had input into the decision of employment, and that the most effective training and support techniques are used. Techniques should foster the use of natural supports such as family, friends, and co-workers.

f. Supported employment direct service staff and their immediate superiors shall be trained in the support strategies required for each Person's particular supported employment placement or job.

R539-8-4. Transportation.

A. Policy.

Individuals receiving services shall be trained, assisted and provided opportunities to use generic transportation services available in their community. Whenever possible, public transportation, or transportation services without charge will be utilized. Whenever a Division Contracted Provider provides transportation as any part of a day or residential program, the Provider must comply with all State safety, licensure, inspection and training requirements.

B. Procedures.

1. All drivers shall have the appropriate license as specified in Utah Code Section 53-3-202 and any vehicle used must be insured, as required by Utah Code Sections 41-12a-401 through 41-12a-412.

2. All drivers shall have current First Aid training.

3. Written procedures for accidents and emergencies must be kept in the vehicle(s) at all times.

4. All drivers, staff, and volunteers shall be trained to implement specific techniques for safe transportation of individuals who have unique medical or physical considerations.

5. A signed consent form shall be obtained prior to transporting a child (ages 0 through 17). The consent form must be completed by the appropriate parent, guardian, or legal representative.

a. The signed form shall be maintained in the child's file.

b. Children three years of age and younger being transported shall be protected by using a child safety seat or an approved restraint device. Children over three years of age may be transported using only seat belts, unless their developmental disability has caused them to be less than the average size of a three year old.

c. Any vehicle used for the transportation of children shall be provided with door locks. Doors are to be locked at all times while the vehicle is moving.

6. Contractor must have current licenses, safety inspections and State Department of Transportation safety requirements on all vehicles used to transport people.

7. All vehicles shall be reasonably accessible if persons have physical disabilities. Special lifts and other equipment must be in safe working order.

8. The provider shall do the following when transporting individuals:

a. No individual shall be permitted to remain unattended in the vehicle;

b. Persons shall remain seated while the vehicle is in motion;

c. Keys will be removed from the vehicle at all times when the driver is not in the driver's seat; and

d. All persons shall use seat belts; vehicles serving individuals who use wheelchairs must have locking mechanisms to immobilize wheelchairs during travel.

R539-8-5. Residential Services.

A. Policy.

The Division of Services for People with Disabilities will provide training, support, and opportunities for individuals with disabilities to reside as independently as possible in community settings which are typical of those in which persons without disabilities reside. Each individual who resides in a community residential living setting funded through the Division must also be enrolled in a day service or education program.

B. Procedures.

1. Providers shall maintain compliance with all requirements of the Department of Human Services, Office of Licensing standards as defined in the Home and Community Based Services Waiver Provider Manual, the Division Policy Manual, and the Department Manual.

2. Division staff shall complete an on-site certification review of a proposed facility prior to final selection. The Office of Licensing must license the facility prior to individuals moving in, if required.

3. The array of community residential living settings include but are not limited to group homes, supervised apartment settings, Supported Living services, and Professional Parent services.

a. A group home means a single residence (home) where four or more individuals reside. No more than eight individuals are allowed to reside in a single residence.

b. A supervised apartment means an apartment setting in which individuals with disabilities reside either alone, or with one or two roommates who may or may not have a disability. No more than three individuals are allowed to reside in a single supervised apartment.

c. Supported Living services are individually tailored to meet the desires and needs of the individuals who are receiving services in their own home or apartment. Supported Living services shall be developed to integrate individuals into services that are available to individuals in their community, rather than to set up a duplicate system of services (see R539-8-8, Supported Living).

d. Professional Parent services shall be provided in a private residence, not the individual's own home or apartment, for one or two Division eligible individuals. Trained staff and trained professional parents provide opportunities for the individuals to be as independent and self-sufficient as possible in a home setting (see R539-8-7, Professional Parent Services).

4. The level and method of supervision required by each individual receiving services (as determined by the Individual Plan team) determines the level and method of supervision provided by the Contractor in each setting.

5. An individual receiving Residential services must have a source of income (such as Supplemental Security Income) which will allow the individual to contribute toward expected living expenses.

R539-8-6. Extended Residential Habilitation.

A. Policy.

Extended Residential Habilitation shall be provided by the residential provider and is in lieu of traditional out of home programs (day services or school) when the individual's age, chronic or acute medical condition significantly impedes the individual's ability to participate in an out-of-home program.

B. Procedures.

1. DSPD eligible individuals, who are recipients of residential services and who are not enrolled in full day programs may be considered for this specialized service.

2. Recommendation for an Extended Residential Habilitation services shall require the consensus of the IPP team. Long-term goals and objectives are written to document that the service offers a therapeutic alternative to the formal environment.

3. The service shall be time-limited and is to be reviewed by the IPP team at a minimum, semi- annually.

4. The service shall be subject to approval from the Division based on the identification of individual's need and the fiscal limitations of the Regional budget.

R539-8-7. Professional Parent Services.

A. Policy.

All children receiving residential services funded by the Division of Services for People with Disabilities will receive services in a family-like setting and in accordance with the professional parent service model. The Division will contract with service providers to locate and train professional parents and support staff to provide residential services in a private home to one to two individuals with disabilities. Professional parent homes shall assist and provide opportunities for individuals with disabilities to be as independent and self-sufficient as possible in a family-like setting.

B. Procedures.

1. The contractor, in conjunction with region staff, shall explain to all recipients of services and legal representatives the service offered, program objectives, basic policies and entrance criteria.

2. A person will be eligible for professional parent services as long as the Individual Service Plan team determines the placement is in the individual's best interest.

3. The purchase of service contractor will comply with:

a. The Home and Community Based Waiver.

b. Division Policy Manual and standards which apply.

c. Office of Licensing standards, as applicable.

d. Staff providing services must meet the qualifications specified in the Division contract, as well as all other standards identified by the contract.

4. The home shall be adequately maintained to meet the Facility Requirements (R539-6-11).

5. Professional parents must conform with the following:

a. Professional parents must be at least 21 years of age.

b. Professional parents must meet all personnel and training requirements.

c. Professional parents and persons 18 years or older living in the home where services are provided to children must comply with R539-6-1, Personnel Requirements, in regards to Bureau of Criminal Identification screening (Utah Code Annotated Section 62A-4-514), and child and adult abuse screening (in accordance with R501-6-7). This requirement also applies to support staff not living in the home who work with children. Professional parents and persons 18 years or older living in the home where services are provided to adults with disabilities must also comply with R539-6-1, in regards to child and adult abuse screening (in accordance with R501-6-7). This requirement also applies to support staff not living in the home who work with adults with disabilities.

6. Support staff are professionals who are responsible for giving technical support and assistance to the professional parents in the day to day operation of the home. Support staff provide consultation, and hands on training for the individual as well as relief to the professional parent. Support staff must who are 16-17 years of age must be accompanied and supervised by an adult during training.

R539-8-8. Supported Living.

A. Policy.

Supported Living services shall be provided for individuals who reside in their own home or apartment who require support to live independently. Individuals who receive Supported Living services may live alone, with roommates, a spouse, or children. Services may also be provided to individuals living in a family member's home if the individual is 18 years of age or older and Supported Living services are being used to assist the individual to transition into independent living. Services may include supportive assistance, habilitative training, support services that allow individuals to participate in community activities of their choice, and any other specialized, generic, or natural supports needed to promote independence. Individuals receiving residential services in other community residential living settings are not eligible for this service.

B. Procedures.

1. Services and supports provided shall fall within one of the following two categories:

a. Habilitative Training-includes any training in independent living skills or community access skills.

b. Supportive Assistance-includes any type of assistance needed to support the individual to live as independently as possible.

2. The level of services provided to each individual will be determined by the Individual Plan team, and is expected to be flexible to meet the needs of the individual. The level of services may be reduced, maintained, or increased based upon changes in the individual's skills or changes in natural and generic supports. Changes in the level of service shall be determined by the Individual Plan team and documented on the Individual Plan as they occur.

3. An individual receiving Supported Living services must have a source of income which will allow the individual to meet expected living expenses.

4. The Provider shall develop policy and procedures that recognize self-determination and choice for individuals receiving services, which shall include the following guidelines:

a. In the event the individual's behavior threatens employment, residence, physical or mental health, or safety, the Provider shall first meet with the individual to resolve any concerns. If concerns still are not resolved, the Provider shall convene a meeting of the Individual Plan team to discuss the issue with the individual.

b. The individual shall be offered additional services, support, or supervision (as appropriate) to assist the individual to remedy the threatening situation.

c. The decision as to whether to accept the additional services, support, or supervision rests entirely with the individual. The Individual Plan team must respect the decision of the individual.

d. The Provider shall maintain documentation of each situation in which additional services, support, or supervision is offered to an individual; and documentation of the individual's decision. The Individual Plan team may be convened as often as necessary to ensure that the individual has adequate opportunities to receive additional services.

R539-8-9. Assistive Technology/Environmental Modifications.

A. Policy.

When an individual who is eligible for Division services requires assistive technology/environmental modifications, region staff coordinating services shall assist the person in exploring possible alternatives and funding to obtain the needed assistive technology/environmental modifications. If the person is eligible for services from more than one agency or organization, region staff shall meet with and ensure service coordination across agencies.

B. Procedures.

1. An Assistive Technology Device is any item, piece of equipment, or product system whether commercially produced, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. Environmental modifications are any modifications needed to the individual's living and/or working environment to improve the person's functional capabilities.

2. Region staff shall assist the individual in contacting agencies/organizations which provide assistive technology devices/environmental modifications and arranging for an assessment of the individual's needs. Assistive technology/environmental modifications funded by regions shall adhere to the following expenditure guidelines. The need for assistive technology/environmental modifications shall be documented in the Individual Plan and the total amount expended annually shall receive the following prior approval as well as adhere to the State Purchasing Policy:

a. Under $500.00, shall be approved by the region case manager.

b. $500.00 to $1999.00, shall be approved by the region supervisor.

c. $2000.00 to $4999.00, shall be approved by the region director.

d. $5000.00 and above, shall be approved by the Division director.

R539-8-10. Personal Emergency Response Systems.

A. Policy.

A Personal Emergency Response System is an electronic device which enables individuals at high risk, to secure help in the event of an emergency. Individuals eligible for this service are those eligible for Division services and, who live alone, live with others who are not able to respond to an emergency, or are alone for significant parts of the day and have no regular caretaker for extended periods of time.

B. Procedures.

1. Services must be provided through an authorized vendor who is on contract with the Division and licensed either as a Home Health Agency or by the Federal Communications Commission as an alarm system network.

2. Services must be listed on and provided in accordance with the individual's plan of care.

KEY: disabled persons, social services

May 5, 2003

Notice of Continuation December 18, 2002

62A-5-103]

ADDITIONAL INFORMATION

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For questions regarding the content or application of this rule, please contact Suzie Totten at the above address, by phone at 801-538-4197, by FAX at 801-538-4279, or by Internet E-mail at stotten@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.