| (a) Day habilitation.
(1) Before including day habilitation on an individual's
IPC, a program provider must ensure and maintain documentation in
the individual's record that day habilitation is not available to
the individual under a program funded under §110 of the Rehabilitation
Act of 1973, as amended (29 U.S.C. §701 et seq.) or under a program
funded under the Individuals with Disabilities Education Act (20 U.S.C. §1401
et seq.).
(2) A program provider must ensure that day habilitation
includes:
(A) assistance in acquiring, retaining, or improving
the self-help, socialization, and adaptive skills necessary to live
successfully in the community and participate in home and community
life;
(B) providing the individual with individualized activities:
(i) in environments designed to foster the development
of skills and behavior supportive of greater independence and personal
choice consistent with achieving the outcomes identified in the individual's
IPP; and
(ii) designed to reinforce therapeutic outcomes targeted
by other DBMD Program services, CFC services, school, or other support
providers; and
(C) providing transportation necessary for the individual's
participation in day habilitation activities, such as shopping, swimming,
going to the park, or other community activities.
(3) A program provider must ensure day habilitation:
(A) is provided to an individual in a non-residential
setting separate from the individual's own or family home or the residence
in which the individual receives licensed assisted living or licensed
home health assisted living that:
(i) is accessible to and usable by the individual;
(ii) is maintained in good repair;
(iii) has at least two means of egress; and
(iv) is in continuous compliance with applicable local
building codes and ordinances and applicable state and federal laws,
rules, and regulations;
(B) reinforces:
(i) therapeutic outcomes identified by other DBMD Program
services and CFC services; and
(ii) for an individual eligible for public education
services, education goals in the Individualized Education Program
(IEP) and services provided by the school district;
(C) includes transportation necessary for the individual's
participation in day habilitation activities; and
(D) is not provided to an individual at the same time
that any of the following services are provided:
(i) employment assistance with the individual present;
(ii) supported employment with the individual present;
(iii) transportation provided as a residential habilitation
activity;
(iv) 24-hour licensed assisted living;
(v) 24-hour licensed home health assisted living;
(vi) respite; or
(vii) CFC PAS/HAB.
(4) A program provider must ensure a day habilitation
service provider works with one individual at a time unless the individual's
service planning team documents on the IPP that the individual's needs
can be met with a day habilitation service provider to individual
ratio of one-to-two or one-to-three.
(5) A program provider must ensure that for a service-provider-to-individual
ratio higher than one-to-three, that the IPP includes a recommendation
from the service planning team and supporting documentation of the
individual's ability to integrate and meaningfully participate in
an environment with a ratio higher than one-to-three.
(6) A program provider may bill for time spent by a
day habilitation service provider:
(A) in direct contact with an individual;
(B) participating as a member of an individual's service
planning team; or
(C) performing tasks delegated by a physician or RN.
(b) Residential habilitation.
(1) A program provider must ensure:
(A) residential habilitation:
(i) is not provided to an individual receiving licensed
assisted living or licensed home health assisted living;
(I) in the individual's own or family home; or
(II) in a setting outside the individual's own or family
home appropriate for the type of residential habilitation activities
described in the individual's IPP;
(ii) includes:
(I) transportation; or
(II) assistance in securing transportation;
(III) assistance with ambulation and mobility;
(IV) reinforcement of behavioral support or therapy
activities;
(V) assistance with medications and the performance
of tasks delegated by an RN in accordance with state law;
(VI) supervision of the individual's safety and security;
(VII) assistance with acquisition, retention, or improvement
in skills related to activities of daily living, including:
(-a-) personal grooming and cleanliness;
(-b-) bed making and household chores; and
(-c-) preparation and consumption of food;
(VIII) use of natural supports and typical community
services; and
(IX) social interaction and participation in leisure
activities; and
(iii) is not provided to the individual at the same
time that one of the following services are provided:
(I) employment assistance with the individual present;
(II) supported employment with the individual present;
(III) day habilitation;
(IV) respite; or
(V) CFC PAS/HAB; and
(B) a residential habilitation service provider works
with no more than one individual at a time.
(2) A program provider may bill for time spent by a
residential habilitation service provider transporting an individual.
(c) CFC PAS/HAB.
(1) A program provider must ensure CFC PAS/HAB is not
provided to an individual receiving licensed assisted living or licensed
home health assisted living.
(2) A program provider must ensure CFC PAS/HAB is not
provided to an individual at the same time that one of the following
services are provided:
(A) employment assistance with the individual present;
(B) supported employment with the individual present;
(C) day habilitation;
(D) respite; or
(E) transportation provided as a residential habilitation
activity.
(3) A program provider must ensure a CFC PAS/HAB service
provider works with no more than one individual at a time.
(4) If an individual's IPC includes CFC PAS/HAB, a
program provider must ensure compliance with §260.213 of this
chapter (relating to Service Backup Plans).
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