(a) IHSS are Medicaid state plan services that are
authorized by HHSC prior to delivery.
(b) IHSS listed in this subsection are selected for
inclusion in a designated resident's plan of care to help the designated
resident partially or fully attain, maintain, improve, or slow or
prevent a decline in skills that were not fully acquired because of
a congenital, genetic, or early acquired health condition.
(1) Behavioral support:
(A) is assistance provided for a designated resident
to increase adaptive behaviors and to replace or modify maladaptive
behaviors that prevent or interfere with the designated resident's
interpersonal relationships across all service and social settings;
(B) is delivered in the NF or in a community setting;
and
(C) consists of:
(i) assessing the behaviors to be targeted in an appropriate
behavior support plan and analyzing those assessment findings;
(ii) developing and getting the designated resident's
or LAR's written consent to an individualized behavior support plan
that reduces or eliminates the target behaviors, assisting the designated
resident in achieving the outcomes identified in the HSP;
(iii) training and consulting with the LAR, family
members, NF staff, other support providers, and the designated resident
about the purpose, objectives, and methods of the behavior support
plan;
(iv) documenting and implementing the behavior support
plan or revisions to the behavior support plan;
(v) monitoring and evaluating the success of the behavior
support plan implementation;
(vi) revising the behavior support plan as necessary;
and
(vii) participating in SPT and IDT meetings.
(2) Day habilitation:
(A) is assistance provided for a designated resident
to acquire, retain, or improve self-help, socialization, and adaptive
skills necessary to successfully and actively participate in all service
and social settings;
(B) is delivered in a setting other than the designated
resident's NF;
(C) does not include services provided under the Day
Activity and Health Services program;
(D) includes expanded interactions, skills training
activities, and programs of greater intensity or frequency beyond
those a NF is required to provide by 42 CFR §483.24; and
(E) consists of:
(i) individualized activities consistent with achieving
the outcomes identified in a designated resident's HSP to attain,
learn, maintain, or improve skills;
(ii) activities necessary to reinforce therapeutic
outcomes targeted by other support providers and other specialized
services;
(iii) services in a group setting at a location other
than a designated resident's NF for up to five days per week, six
hours per day, on a regularly scheduled basis;
(iv) personal assistance for a designated resident
who cannot manage personal care needs during the day habilitation
activity;
(v) transportation between the NF and the day habilitation
site, as well as during the day habilitation activity necessary for
a designated resident's participation in day habilitation activities;
and
(vi) participating in SPT and IDT meetings.
(3) Employment assistance:
(A) is assistance provided for a designated resident
who requires intensive help locating competitive employment in the
community; and
(B) consists of:
(i) identifying a designated resident's employment
preferences, job skills, and requirements for a work setting and work
conditions;
(ii) locating prospective employers offering employment
compatible with a designated resident's identified preferences, skills,
and requirements;
(iii) contacting prospective employers on a designated
resident's behalf and negotiating the designated resident's employment;
(iv) transporting a designated resident between the
NF and the site where employment assistance services are provided
and as necessary to help the designated resident locate competitive
employment in the community; and
(v) participating in SPT and IDT meetings.
(4) Independent living skills training:
(A) is assistance provided for a designated resident
that is consistent with the designated resident's HSP;
(B) is provided in the designated resident's NF or
in a community setting;
(C) includes expanded interactions, skills training
activities, and programs of greater intensity or frequency beyond
those a NF is required to provide by 42 CFR §483.24; and
(D) consists of:
(i) habilitation and support activities that foster
improvement of or facilitate a designated resident's ability to attain,
learn, maintain, or improve functional living skills and other daily
living activities;
(ii) activities that help preserve the designated resident's
bond with family members;
(iii) activities that foster inclusion in community
activities generally attended by people without disabilities;
(iv) transportation to facilitate a designated resident's
employment opportunities and participation in community activities,
and between the designated resident's NF and a community setting;
and
(v) participating in SPT and IDT meetings.
(5) Supported employment:
(A) is assistance provided for a designated resident:
(i) who requires intensive, ongoing support to be self-employed,
work from the designated resident's residence, or work in an integrated
community setting at which people without disabilities are employed;
and
(ii) to sustain competitive employment in an integrated
community setting; and
(B) consists of:
(i) making employment adaptations, supervising, and
providing training related to the designated resident's assessed needs;
(ii) transporting the designated resident between the
NF and the site where the supported employment services are provided
and as necessary to support the designated resident to be self-employed,
work from the designated resident's residence, or work in an integrated
community setting; and
(iii) participating in SPT and IDT meetings.
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