operational standards for host...

DBHDD Policy 02-704: Attachment A Version6/27/2016Page1

OperationalStandardsforHostHome/Life-Sharing

For

DevelopmentalDisabilityCommunityServicesProviders

GeorgiaDepartmentofBehavioralHealthandDevelopmentalDisabilities


OperationalStandardsforHostHome/Life-Sharing

IndexGeneralProvisions

IntroductionPurposeApplicabilityExemptionsDefinitions

GeneralRequirements

WaiversMaximumcapacityResponsibilityforComplianceSelf-AssessmentsofHomesHomeStudyRequirementsInspectionofHomesM.A.N.E.ReportingandInvestigationofDeathsandCriticalIncidentsCriminalHistoryRecordCheck/ClearanceCharacterReferencesIndividualFundsandPropertyDriver’sLicenseandotherAccesstoTransportation

EnrollingHostHomes

ProceduresforMatchingIndividualsandHostHomeProvider

ProceduresforMonitoringHostHomesTerminationofContractbetweentheHostHomeandtheCommunityResidentialAlternative(CRA)ProviderAgencyTransferenceofaHostHome/s

IndividualRights

InformingandEncouragingExerciseofRightsRightsRightsofIndividualCivilRights


StaffingStaffQualificationsandResponsibilitiesDirectCareand/orProfessionalStaffingSupervisionTraining

PhysicalHomeSafety

SpecialAccommodationsPoisonsHeatSourceSanitationVentilationLightingSurfacesRunningWaterHeatandAirConditioningSystemsTelephoneEmergencyTelephoneNumbersScreens,WindowsandDoorsHandrailsFirstAidMaterialsExteriorConditionsIndividualBedroomsBathroomsKitchensLaundrySwimmingPoolsFirearmsYard

FireSafety

UnobstructedStairways,Halls,DoorwaysandExitsFlammableandCombustibleMaterialsFurnacesPortableSpaceHeatersWoodandCoalBurningStovesFireplacesSmokeDetectorsFireExtinguishersDisaster/SevereWeatherandFireDrills

Program

ImplementationofIndividualServicePlanRecordManagement


HealthIndividualHealthCareExaminationsRefusalofHealthCareHostHome/Life-SharingFamilyHealthCareExaminationsCommunicableDiseases

Medications

StorageofMedicationsLabelingofMedicationsMedicationTraining

Nutrition

ProtectionofFoodThreeMealsaDayQuantityofFoodFoodGroups

BehaviorManagementGuidelines

BehaviorManagementGuidelinesSeclusionandMechanicalRestraint

AlternateCare

ProvisionsforHost/Life-SharingHomesVacation


GENERALPROVISIONS

IntroductionHostHome/Life-Sharingmeanslivingwithandsharinglifeexperienceswithsupportivepersonswhoformacaringhousehold. AHostHome/Life-Sharingresidentialsettingisrecognizedasbeingbothaclosepersonalrelationshipandaplacetolive.

HostHome/Life-Sharingisbasedontheimportanceofenduringandpermanentrelationshipsasthefoundationforlearninglifeskills,developingself-esteemandlearningtoexistininterdependencewithothers. TheHostHome/Life-Sharingexperienceprovidesanopportunityforeachindividualwithintellectual/developmentaldisabilitytogrowanddeveloptohisorhergreatestpotentialandtoparticipateineverydaycommunitylife. ThisisanimportantfeatureofaHostHome/Life-Sharingarrangement. HostHome/Life-Sharingalsoprovidesindividualizedattentionbasedontheneedsoftheindividualwithintellectual/developmentaldisabilities.

Life-Sharingisaprocess. AkeytosuccessfulLife-Sharingisfindingafamilyorpersonwhoiswillingtosharetheirliveswithanindividualwithintellectual/developmentaldisabilities. ThematchingprocessbetweenpeoplewhowanttoLife-Shareiscriticaltopredictingfuturesuccessoftherelationship.

Purpose

ThepurposeoftheseStandardsisfortheprotection,health,safetyandwellbeingofindividualswithintellectual/developmentaldisabilities,throughtheformation,implementationandenforcementofminimumrequirementsforHostHome/Life-Sharingasaresidentialserviceoption.

Applicability

TheseStandardsapplytoHostHome/Life-Sharingforadultswithdevelopmentaldisabilities.

TheseStandardscontaintheminimumrequirementsthataretobemettoreceivefundingforindividualsapprovedtoreceivecommunityresidentialservicesbytheDivisionofDevelopmentalDisabilities(DD),oftheDepartmentofBehavioralHealthandDevelopmentalDisabilities(DBHDD).

TheseStandardsapplytoprofit,nonprofitandpubliclyfundedagenciesapprovedasdevelopmentaldisabilityresidentialprovidersofferingHostHome/Life-Sharingserviceoption.

TheDepartmentofBehavioralHealthandDevelopmentalDisabilities(DBHDD)istoenrollandapproveeachCommunityResidentialAlternative(CRA)agencyadministeringoneor


moreHostHome/Life-sharingresidentialsettingaspartofthewaiverproviderenrollmentprocess. TheSupportCoordinationAgencyorDBHDDdesigneeforanyindividualchoosingthisresidentialoptionistoinspectthehomeusingtheDivisionofDevelopmentalDisabilitiesApprovedSiteInspectiontoolpriortoanindividualwithintellectual/developmentaldisabilitylivingorreceivingHostHome/Life-Sharingcareinthissetting.

Exemptions

Theserulesdonotapplytothefollowingfacilities:

1. Privatehomesofpersonsprovidingcaretoarelativewithdevelopmentaldisability.

2. AcommunityhomelicensedbyGeorgiaHealthcareFacilityRegulations(HFR)asa

CommunityLivingArrangement.

3. ApprovedFosterHomesforChildrenoperatingunderaChildPlacementAgencylicensedbyGeorgiaOfficeofResidentialChildCare.

4. AhomeoperatingunderpermitbytheGeorgiaHealthcareFacilityRegulations

(HFR)asaPersonalCarehomeexclusivelyservingpeoplewithmentalillness,addictivediseases,ordomiciliarycareresidents.

5. Residencesinwhichapersonliveswithhisorherfamily.

6. Boardinghomesorroominghomesthatprovidepersonalservicesotherthan

lodgingandmeals.

7. Facilitiesofferingtemporaryoremergencyshelter,suchasthoseforthehomelessorvictimsoffamilyviolence.

8. Respitehomes

9. Emergencyreceiving,evaluation,andtreatmentfacilitiesthatprovidemedicaland

nursingservicesthatareapprovedbythestateandregulatesunderthemorespecificauthorities.

10. Facilitiesprovidingresidentialservicesforfederal,stateorlocalcorrectional

institutionsunderthejurisdictionforthecriminaljusticesystem.

11. Hospicethatserveterminallyillpersons.

12. Therapeuticsubstanceabusetreatmentfacilitiesandresidencethatarenotintendedtobeanindividual’spermanentresidence.


13. Groupresidencesorganizedbyorforpersonswhochoosetoliveindependentlyandmanagetheirowncareandwhosharethecostofserviceincludingbutnotlimitedtoattendantcare,transportation,rentutilitiesandfoodpreparation.

14. Charitableorganizationsprovidingshelterandotherserviceswithoutchargingany

feetotheresidentandwithoutbillingotheragenciesforserviceprovided.

15. Asinglepersonresidenceownedandoperatedbyanagency.

16. Residencesinwhichapersonlivesunderhisorherownleaseorwarrantydeed,inwhichtheagencyprovidingservicesdonotmanagetheperson’sresidenceandtheresident,isnotrequiredtomovewhentheagencyprovidingserviceschanges.

17. Apartmentsorotherclusteredresidentialarrangementswherestaffisavailablethat

aredevelopedaspermanenthousingforadultwithmentalillness,inwhichanindividualliveswithinhisorherresidentialarrangementwithimmediatesupportofstaff.

Definitions

Thefollowingwordsandterms,whenusedintheseStandards,havethefollowingmeanings,unlessthecontentclearlyindicatesotherwise:

Agency–AlegallyconstitutedorganizationadministeringoneormoreHostHome/Life-Sharingresidentialsettings.

Alternatecare–TemporaryHostHome/Life-Sharercarenottoexceed30daysforanindividualintheirIndividualplanyear.

CommunityResidentialAlternative(CRA)–Serviceswhicharetargetedforindividualswhorequireintenselevelsofresidentialsupportsinsmallgroupsettingoffourorless,fosterhomes,orHostHomesandincluderangeofinterventionswithparticularfocusontrainingandsupportinoneormoreofthefollowingareas:eating,drinking,toileting,personalgroomingandhealthcare,dressing,communication,interpersonalrelationships,mobility,homemanagementanduseofleisuretime.

DBHDD–TheDepartmentofBehavioralHealthandDevelopmentalDisabilities

DCH–TheDepartmentofCommunityHealth

DevelopmentalDisability–Adisabilitythatispresentinearlylifeandpriortoage22withrelatedconditionssimilartothelimitationsineverydaylifefunctionspresentforsomeonewithdevelopmentaldisabilities.

HostHome–Theprivatehomeofanindividualorafamily,whetherownedorleased,inwhichresidentialsupportsareprovidedtooneortwoadultindividuals,definedas19


yearsofageandabovewithdevelopmentaldisability. ThehomeownerorlesseeisnottobeanemployeeofthesameDBHDDapprovedprovideragency,whichprovidestheHostHomeservices. Individualsarenottoberelatedtotheoccupantownerorlesseebybloodormarriage. Theoccupantownerorlesseeisnottobetheguardianofanypersonservedontheirpropertynortheagentinsuchperson’sadvancedirectiveforhealthcare.

Thetermdoesnotincludeahomeiftherearemorethantwoindividuals,includingindividualsreceivingalternatecareorrespitecare,livinginthehomeatanyonetime,whoarenotfamilymembers,relativesornon-relativesofthefamilymember. Thetotalnumberoffamilymembers,relativesandnon-relativeslivinginthehomeatanygiventimemaynotexceedsix. Thisnumberdoesnotincludetheindividual(s)beingserved.

Individual–Apersonwithdevelopmentaldisabilitywhoresides,orreceivesresidentialcare,inaHostHome/Life-Sharingresidentialsettingandwhoisnotarelativeoftheownerorthefamilymembers. Thetermdoesnotincludefamilymembers.

ISP–IndividualServicePlan

Life-Sharing–Livingwithandsharinglifeexperienceswithsupportivepersonswhoformacaringhousehold. AHostHome/Life-Sharingresidentialsettingisrecognizedasbeingbothaclosepersonalrelationshipandaplacetolive.

RegionalOffice–RegionalofficesarethefieldoperationsofficesoftheDepartmentofBehavioralHealthandDevelopmentalDisabilities.

Relative–Aparent,child,stepparent,stepchild,grandparent,grandchild,brother,sister,half-brother,half-sister,aunt,uncle,nieceornephew


GENERALREQUIRMENTS

WaiversAwaiverofaspecificsection,subsectionorparagraphofthesesubsectionsmayberequestedbywritingtotheRegionalOfficeofBehavioralHealthandDevelopmentalDisabilitiesinaccordancewithRequestforWaiveroftheStandards,04-107.

Awaiverwillbeconsideredifallofthefollowingcriteriaaremet:

1. Thewaiverdoesnotjeopardizethehealth,safetyorwell-beingofanyoftheindividualsinthehome.

2. Thewaiverisbasedonthebestinterestsandneedsoftheindividuals.3. Noncompliancewiththeguidelineisofgreaterbenefittotheindividualthan

compliancewiththeOperationalProcedures.4. ThereisnotanalternativemethodtomeettheintentoftheOperational

Procedures.5. Therearespecialcircumstancesthatmakethehomedifferentfromotherhomes

complyingwiththeOperationalProcedures.6. ThewaiverdoesnotviolateanyotherStateregulationorstatute.7. ThereisonlyoneproviderperHostHome/Life-Sharingenvironment.

Maximumcapacity

Nomorethantwo(2)individualswithintellectual/developmentaldisabilitiesservedmayliveinthehousehold.

ResponsibilityforCompliance

IftheagencyisthelegalentityapprovedasaDevelopmentalDisabilityProviderto provideHostHome/Life-Sharing,theagencyisresponsibleforcompliancetothefollowing:

1. HostHome/Life-sharingStandards2. COMPSupportsWaiverProgram,PartIIand PartIII, and PartIPolicies

andProceduresforMedicaidPeachCareforKids,ThecurrentProviderManual,PartII,SectionI,StandardsforallProviders

Self-AssessmentoftheHostHome/Life-SharingResidentialSettingTheagencyistocompleteaself-assessmentofeachHostHomesiteannually,tomeasureandrecordcompliancewiththeHostHome/Life-SharingStandards.

Tomeasureandrecordcompliance,theagencyistoutilizetheseOperationalStandards.Acopyoftheagencyself-assessmentresultsandawrittensummaryofcorrectionsmadearetobekeptintheHostHome/Life–Sharingresidentialsettingforatleastone(1)calendaryear.

DBHDD Policy 02-704: Attachment A Page10

Version6-27-2016

HomeStudyRequirementsTheagencyistomakeathoroughevaluationofeachprospectiveHostHomefamily(orcurrentHostHome/Life-SharingResidentialSetting). Theevaluationistobedocumentedinthestudyreport,whichistobeupdatedaschangesintherequiredhomestudyinformationoccur,andincludeatleastthefollowing:

1. Fulllegalnameofapplicant,dateofassessment,thefamilyaddressand

telephonenumber.

2. Descriptionofthehomeandcommunity,including,butarenotlimitedto:• Typeofhome(i.e.ranch,2stories)• Roomsinthehome(Includebasementandattic)• Numberofstepstothefrontandbackdoorifapplicable• HandicapAccessibilityFeaturesifany• Sleepingarrangementsforthepotentialplacement(s)• Descriptionoftheneighborhood. Listaccessiblecommunityservicesand

activities(Includeaccesstohospitals/urgentcarefacilities,churches,schools,Physicians,YMCAetc.)

• PublicTransportation(Documentdistancefromhometopublictransportation)

• PhysicalStandardsofthehome,including:a. Fireextinguishers(Notetype,numberandlocation)b. Smokeand/orcarbonmonoxidedetectors(Notefunctionality,number

andlocation)c. Isthereaswimmingpool?Isitsecuredbyfenceorgate?d. Istherealockedbox/space(notewheremedicationswillbelockedand

hazardouschemicalswillbekept)e. Doyouhavepets?Typeandhowmany?

3. Adescriptionoffamilymembers/individualslivinginthehome,including:

• DateandPlaceofbirth• Physicaldescription• Familybackgroundandhistory• Currentrelationshipswithimmediateandextendedfamilymembersorother

personsresidinginthehome• Educationalbackground• Relationshiptoapplicant(s)

4. Astatementastowhetherornottherearefirearmskeptinthehomeandifso,

allfirearmsownedandinthehomeareunloaded,securedandlockedinacabinetwithammunitionstoredinaseparatelockedcabinet. Iffirearmsarestoredinanofficialguncabinet,ammunitionmayalsobestoredinthesamegun


Version6-27-2016

cabinet;however,theammunitionmustbekeptinalockedcontainerorlockedinaseparatecompartmentoftheguncabinet.

5. AvailabilityofSupervision:

• Describetheworkscheduleofallmembersofthehousehold

• Currentrelationshipwithextendedfamilymembers• SupportnetworkinplacefortheLife-Sharingfamily• WillingnesstocooperatewiththeDBHDDapprovedagency

6. FamilyDynamics:

• InterestandHobbies(includeclubs,groups,associationsetc.)• Personalityofeachmemberofthehousehold• Interactionandrelationshipwithneighbors• Examplesofwayseachpersoninhouseholdtendtointeractwithothersin

thehome• Examplesofwayseachfamilymemberreacttostressandcopingstrategies

used• Familymeal-timeinteraction(includewhatmealsfamilyeattogetherif

applicable)• Familyactivitiesafterwork/schooltobedtime• DescriptionofatypicalSaturday,Sunday,Holidayandvacations• Churchorotherreligiousrelationship• Acceptanceofanindividual(s)ofanotherculture/ethnicity. (Include

responsetovariousculturalissuesi.e.religiouspractices,eatinghabits,holidaytraditions)

• Attitudesonpotentialplacement(s)dating• Alcoholordruguseinthefamily(Includehistoryandwherealcoholis

stored)• AnticipatedadjustmentofeachLife-Sharingmembertoapotential

placement

7. ExperienceandExpectations:• ThemotivationforLife-Sharingincludingbutnotlimitedtoattitudes

towardsanindividualwithdevelopmentaldisability• Documentthefollowing:

a. WhetherornotthepotentialLife-Sharingfamilyworkedforanotherprovider(inoroutofstate)

b. WhetherornotthepotentialLife-Sharingfamilyeverbeendeniedc. WhetherornotthepotentialLife-Sharingfamilybeeninvestigatedfor

anyseriousreportableincident• Knowledgeofintellectual/developmentaldisabilities,attitudesandskills• Methodsofdisciplineusedbyapplicantifapplicable


Version6-27-2016

• Discusstrainingandcompliancerequirements(IncludeHostHome/Life-SharingOperating Procedures,DBHDDProviderManual,DCHWaiverManualandAgencyPolicyandProcedures)

• Attitudestowardsfamilyinvolvementofthepotentialplacement• DescriptionofexperiencewithworkingwithindividualswithMRDD,if

applicable

8. AdescriptionofthetypeofindividualdesiredbytheprospectiveLife-Sharer

9. AgeneralhealthexaminationofeachmemberlivingintheprospectiveHostHome/Life-Sharingresidentialsetting

10. Screeningfortuberculosisandcommunicabledisease,andageneralstatement

fromalicensedpractitioneridentifyinganycommunicablediseases,foreachmemberlivingintheprospectiveHostHome/Life-Sharingresidentialsetting

11. CriminalRecordsCheck/Clearance

12. Whowillbetransportingtheindividual(s)andhowwouldtransportationbe

provided

13. Aminimumofthree(3)characterreferences;

AtleastonereferenceistobefromanextendedfamilymembernotresidingwiththeprospectiveHostHome/Life-Sharingfamily,

And

IfanymemberofthepotentialHostHome/Life-Sharingfamilyhaseitherservedpreviouslyasaproviderforanotheragency,and/orbeenemployedwithinthepastfive(5)yearsinajobinvolvingthecareofindividualswithDD,atleastonereferencemustbefromtheformeragencyoremployer. Inaddition,documentationmustbeprovidedifanymemberofthepotentialHostHome/Life-Sharingfamilyhasbeenterminatedasaprovider/agencyandanyadverseactionstakenbyDBHDDoranotherstateentity.

14. Proofofhomeowner’s,renter’sinsuranceorpersonalpropertyinsurance

Note: Insurancemustbekeptcurrent.

15. ProofofpotentialLife-Sharer’shomeownership(ex.mortgagestatement)orcurrentlease.

16. SignedstatementfromthepotentialLife-Sharer(s)indicatingthereceiptand

reviewoftheHostHome/Life-SharingStandardsandProcessfor


Version6-27-2016

Enrolling,Matching,andMonitoringHostHome/Life-SharingSitesforDBHDDDevelopmentalDisabilityCommunityServiceProviders,02-704.

17. Thehomestudyistobecompleted,reviewed,signedwithdesignatedtitle,anddatedbyadesignatedemployeeoftheagencyorprofessionalundercontractwiththeagencyandreviewed,signedanddatedbytheAgencyDirector/ProgramDirectororDevelopmentalDisabilityProfessional(DDP).

18. Documentationofanyrecommendationregardingapprovalasaprospective

Life-Sharer,includingdescriptionofidentifiedtrainingorresourcesneeded,andthattheprospectiveLifesharerspossessthecapacitytoprovideroom,boardandwatchfuloversight.

19. NotificationofApproval. ProspectiveHostHome/Life-Sharer(s)willbenotified

inwritingastowhetherornottheyhavebeenapprovedbytheagency.INSPECTIONOFHOMES

Theagencywillcompleteasiteinspectionofeachhometheagencyhasapprovedtooperate.

AllinspectionsandinvestigationsbyDBHDDmaybeunannouncedandwithoutpriornotice.TheHostHome/Life-Sharingprovideroranyadultlivinginthehome(excludingtheindividual(s)served)mustbepresentduringanyinspectionofthehome. Theinspectormusthaveaccessandauthoritytoexaminequalityofcareandservicesdelivery,theindividual’srecords,physicalpremises,includingtheconditionofthehome,groundsandequipment,food,watersupply,sanitation,maintenance,housekeepingpracticesandanyotherareasnecessarytodeterminecompliancewiththeseStandards.

Theinspectorhastheauthoritytointerviewthehosthomeprovider,anyadultslivinginthehome,theindividualandtheindividual’sfamily. Interviewswiththeindividualwillbeconfidentialandconductedprivatelyunlessotherwisespecifiedbytheindividual.

M.A.N.E.

ItisexpresslyprohibitedtoMistreat,Abuse,andNeglectorExploitanyperson(s)receivinghosthome/life-sharingservice.Mistreatment,abuse,neglectandexploitationisdefinedas,butnotlimitedto:

PhysicalAbuse-includesbutisnotlimitedtosuchactionsasstriking,pulling,pushing,twistingbodyparts,orinflictinganyphysicalinjurytoanindividualbyanymeans.Physicalabuseincludesdirectingoneindividualtophysicallyabuseanotherindividual.

SexualAbuse-includesbutisnotlimitedtosexualassault,rape,fondling,sexualexploitationoranysexualinteraction.


Version6-27-2016

MentalAbuse-includesbutisnotlimitedtoanyaction,whichcreatesmentalanguishfortheindividual.Theseactionsincludebutarenotlimitedtodiscriminatoryremarks,belittlement,derogatorynamecalling,teasing,unreasonableexclusionfromconversationoractivities,andverbalabuse.

Neglect-includesbutisnotlimitedtothedenialofmeals,medication,habilitationandothernecessities.

Exploitation-includesbutisnotlimitedtoanyillegalorimproperactionaffectingapersonoruseoftheperson’sresourcesforanotherperson’sprofitoradvantage.

ReportingandInvestigationofDeathsandCriticalIncidents

DBHDDrequiresastandardizedprocessforreportingandinvestigatingdeathsandothersentinel/criticalincidentsinvolvingindividualsreceivingallcommunity-basedservices.ProvidersshallbefamiliarandcomplywithpolicyasdefinedinReportingandInvestigatingDeathsandCriticalIncidentsinCommunityServices,04-106.

CriminalHistoryCheck/ClearanceProvidersshallbeinaccordancewithCriminalHistoryRecordsCheckforContractors,04-104isfollowedandfingerprintsareobtainedbyelectronicfingerprint submissionthroughCogentSystemswww.ga.cogentid.com.

Acopyofthefinalcriminalhistoryreportsistobekeptintheprovideragencyrecord. Theagencymusthaveapolicyandprocedureforongoingcriminalhistorymonitoring.RefertotheProviderManualforCommunityDevelopmentalDisabilityProviders,PartII,SectionI,StandardsforAllCommunityDevelopmentalDisabilityProviders,02-1201.

IndividualFundsandProperty

Theprovideragencyistohaveawrittenpolicythatestablishesproceduresfortheprotectionandadequateaccountingofindividualfundsandproperty,andforadvisingtheindividualconcerningtheuseofthefundsandproperty.

Thepolicymaynotprohibitorinterferewiththeindividual’srighttomanageherorhisownfinances.

Anindividual’spersonalfundsincludebutarenotlimitedtosavings/checkingaccountandotherinvestmentaccounts,earnedincomeandtheremainingportionfromSSIpaymentforday-to-daylivingexpenses.Anindividual’sfundsandpropertyaretobeusedfortheindividual’sbenefit.

Anup-to-datefinancialandpropertyrecordistobekeptforeachindividual. Thisrecordistoincludethefollowing:


Version6-27-2016

1. Personalpossessionsandfundsreceivedbyordepositedwiththefamilyoragency.2. Disbursementsmadetoandfortheindividual.

IftheagencyorHostHome/Life-Sharingfamilyassumestheresponsibilityforanindividual’sfinancialresources,thefollowingistobemaintainedforeachindividual:

1. Aseparaterecordoffinancialresourcesincludingthedatesandamountsof

depositsandwithdrawals.2. Forawithdrawalwhentheindividualisgiventhemoneydirectly,therecordwill

indicatethatthefundsweregivendirectlytotheindividual.3. Documentation,bytheactualreceiptorexpenserecord,ofeachsinglepurchase

madeonbehalfoftheindividualcarriedoutbythefamilymemberoragencystaff.Theremaynotbecomminglingoftheindividual’spersonalfundswithagencyorhouseholdfunds.

Theremaynotbeborrowingoftheindividual’spersonalfundsbyfamilymembersoragencystaff.

DriverLicenseandotherAccesstoTransportation

Forproviderstransportingindividualsintheirpersonalvehicles,atleastoneadultmemberoftheHostHome/Life-SharinghouseholdwillhaveavalidGeorgiaDriver’sLicenseandaccesstoaproperlyoperatingvehiclecoveredunderGeorgiaVehicleInsurancerequirements.

ADrivingHistoryReport(MVR)isrequiredforanymemberofthehouseholdresponsiblefortransportingtheindividual.Theremustbenomorethantwochargeableaccidents,movingviolationsorDUI’sinathree(3)yearperiod,withinthelastfive(5)yearsoftheseven(7)yearMotorVehicle(MVR)period.

Providersresidingnearpublictransportationandwhoarecurrentlyusingthismodeoftransportationarerequiredtosubmitdocumentationverifyingthatthehomehasaccesstopublictransportationwithinaone-fourth(¼)milewalkingdistancefromtheHostHome/Life-Sharingresidence.

EnrollingHostHomes

CurrentandNewDBHDDprovidersmustmeetthefollowingrequirementspriortoenrollingaHostHomeasaCRAserviceoption:

DBHDDprovidermustbeaproviderofDDCommunityResidentialAlternative(CRA)services

AND


Version6-27-2016

DBHDDprovidermustbeinbusinessfortwelve(12)monthsdeliveringDevelopmentalDisability(DD)CommunityResidentialAlternativeservices

AND

DBHDDproviderscannotenrollanyHostHome/Life-SharingresidenceuntiltheCRAservice/siteintheinitialproviderapplicationhavesuccessfullyachievedfullaccreditationand/orcompletecompliancewiththeStandardsComplianceReview,foraminimumofsix(6) months.Provisionalstatusofanytypewillnotbeaccepted.

DBHDDprovideragenciesarerequiredtomakeathoroughevaluationofeachprospectiveHostHomefamily/individual,anddocumentthisevaluationinaHostHomestudyreport.Thiswillbecompletedand/orupdatedaschangesintherequiredhomestudyinformationoccurorwhenthereisavacancytobefilled.

Note:

1. Onlyone(1)DBHDDapprovedCRAprovideragencymayenrollandprovideCRAservicesatanyHostHomesite.

2. HostHomeproviderscannotbetheownerofaPersonalCareHome(PCH)or

CommunityLivingArrangement(CLA),eitherofwhichprovideservicestoCOMPwaiverparticipants.

BasedontheHostHomestudyreportandanysupportingdocuments,theDBHDDprovideragencywillnotifythepotentialHostHomeproviderinwritingastowhetherornottheHostHomeproviderhasbeendeemedappropriatetoworkwiththeirorganization.

EachHostHomemusthaveasitespecificMedicaidProvider(CRA)numberassignedbytheDepartmentofCommunityHealth(DCH)beforeplacementofanypersonintothatparticularHostHome.

DBHDDprovideragenciesmustsubmittheHostHomestudy,allsupportingdocumentation,andHostHomeprovider’sevidenceofrequiredcompetency-basedtraining,alongwiththeDBHDDandDCHapplicationforasitespecificnumbertoDBHDDOfficeofProviderNetworkManagementforreview.

SupportingdocumentsfortheHostHomestudyincludethefollowing:

1. AgeneralhealthexaminationofeachmemberlivinginthepotentialHostHome2. Evidenceofscreeningfortuberculosisandcommunicabledisease,andageneral

statementfromalicensedpractitioneridentifyinganycommunicablediseases,foreachmemberlivinginthepotentialHostHome

3. NationalCriminalrecordscheck/clearance4. Aminimumofthree(3)characterreferences5. Proofofhomeowner’s,rentersinsuranceorpersonalpropertyinsurance6. Statementastowhetherornottherearefirearmsinthehome


Version6-27-2016

7. Documentationofhomeownership(ex.currentmortgagestatement)orrenter’slease. Document(s)mustbeinthenameofthepotentialHostHomeprovider.

8. Thehomestudywillbecompleted,signedanddatedbyadesignatedemployeeoftheagencyorprofessionalundercontractwiththeagencyandreviewed,signedanddatedbytheAgencyDirectororDevelopmentalDisabilityProfessional(DDP).

9. SignedstatementfrompotentialHostHomeproviderindicatingthereceiptandreviewoftheHostHome/Life-SharingStandards.

TheadultfamilymemberwhowillhaveprimaryresponsibilitytotheindividualandforprovidingservicestotheindividualwillhaveatleastthefollowingtrainingpriortotheDBHDDprovideragencysubmissionofanapplicationforasitespecificMedicaidprovidernumber:

1. Person-CenteredValues,PrinciplesAndApproaches2. HumanRightsandResponsibilities3. RecognizingandReportingCriticalIncident4. IndividualServicePlan5. ConfidentialityOfIndividualInformation,BothWrittenAndSpoken6. FireSafety7. EmergencyandDisasterPlansandProcedures8. TechniquesOfStandardPrecautions9. BasicCardiacLifeSupport(BCLS)10. FirstAidandSafety11. MedicationAdministrationandManagement/SupervisionOfSelf-Medication12. AgencyPolicyAndProcedures

TheDBHDDprovideragencymustsubmitevidenceofthetypeoftraining,content,dates,lengthoftraining,and/orcopiesofcertificates. Asignedattestationbetweentheagencyandthepotentialhosthomeprovider,whichindicatesthereceiptoftrainings,mustalsobesubmitted.

HostHomeapplicationsmustnotbesubmittedforanylocationthatiscurrentlylicensedasaPCHorCLA. LicensedPCHorCLAprovidersmustrelinquishtheirlicensepriortomakingapplicationtobecomeaHostHome. AHostHomestudymustbesubmitted,alongwithdocumentationofthesurrenderoftheperspectivelicenseandtherequiredtrainings(byevidenceoftrainingcertificateorsignedattestationindicatingreceiptoftraining),toDBHDDOfficeofProviderNetworkManagement.

ProcedureforMatchingIndividualandHostHomeProvider

WhenanindividualisidentifiedforpotentialplacementinaHostHome,provideragenciesmustforwardasummaryoftheHostHomestudyreporttoSupportCoordinationorthePlanningListAdministrator. AsummaryoftheHostHomestudymayinclude,butisnotlimitedto:theaddressandaccesstolocalservices’ thecurrentlivingarrangement;namesandagesofthefamily/individualsresidinginthehome;family/individuals’previouswork


Version6-27-2016

history,educationandreligiousaffiliation,membershiporparticipationincommunityorganizations;theDBHDDproviderrecommendations.

DBHDDprovideragencieswilldiscusstheprospectiveplacementwiththeHostHomefamily/individual,andpreparethefamily/individualfortheplacementofaparticularpersonwithdevelopmentaldisabilitiesbyanticipatingtheadjustmentsandproblemsthatmayariseduringplacement,andprovidinganyspecializedtrainingandsupport.

TheHostHomestudyreportmustbereviewedbyallstakeholdersinvolvedinplacementplanningtoensureanappropriatematchbetweentheindividualandtheHostHomeprovider.

SubmissionofInformationtotheDivisionofDevelopmentalDisabilities

TheDBHDDprovideragencymustsubmitspecifiedinformationtotheDivisionofDevelopmentalDisabilitiespertainingtoadministrativecostandpaymenttotheHostHome/Life-SharingProvider

TherequirementsforadministrativecostsoftheCRAprovideragencyandtheagency’spaymenttotheHostHome/Life-Sharingproviderareasfollows:

1. ThebudgetandpaymenttotheHostHome/Life-SharingproviderforeachindividualineachHostHome/Life-SharingservicesenrolledbytheDBHDDprovideragencymustsupporttheamountofpaymenttotheHostHome/Life-SharingproviderthatallowsfortheprovisionoftheCRAservicesspecifiedintheISPoftheindividual,andensuresthehealthandsafetyoftheindividualintheHostHome/Life-Sharingarrangement.

2. ThebudgetandagreedpaymentoftheHostHome/Life-SharingprovidermustbesubmittedtotheDivisionofDDpriortoanyindividualmovingintoaHostHome/Life-Sharingresidentialsetting,wheneverthereisanenhancementordecreaseintheindividual’sresidentialallocation,andonanannualbasis(byJune30). HostHome/Life-SharingprovidersofindividualswithexceptionalratesreceiveahigherpaymentbasedonenhancedservicesprovidedbytheHostHome/Life-Sharingprovider.

3. Eachindividual’sbudgetsubmittedtotheDivisionofDDmustinclude,butisnotlimitedtotheindividual’snameandMedicaidnumber,addressandcontactinformationoftheHostHome/Life-Sharing.

ProvideragenciesmustcomplywithDivisionofDevelopmentalDisabilities’Management/Supervision/SafeguardingofPossessions,Valuables,PersonalFundsandDay-To-DayLivingExpensesinDevelopmentalDisabilityResidentialServices,02-702policy.

1. TheCRAProvideristomakeavailabletoindividuals,whoresideinagencyoperatedHostHomes/Life-Sharingresidenceaday-to-daylivingexpensesagreementuponadmission,annually,orasneeded.Theday-to-daylivingexpensesagreementisreviewedattheannualISP.Theday-to-daylivingexpensesagreementincludesastatementofallassociatedhousingandfoodcosts;andanyestimatedmedical,


Version6-27-2016

dental,andclothingfeesorchargesassessedtotheindividual,totheextentthatthosefundsareavailable.Anychangesinchargesforday-to-daylivingexpensesareprovidedtotheindividualservedandtheagencyoperatedHostHome/Life-SharingProvider,inwriting,60dayspriortochangesincharges.Copiesofeachday-to-daylivingexpensesagreementaremaintainedintherecordofthepersonserved.

2. Day-to-daylivingexpensesagreementmustbesignedbytheCRAProvideragency

andHostHome/Life-Sharing ProviderandsubmittedtotheDivisionofDevelopmentalDisabilitiesannually(byJune30th)orwheneverthereisachangeoftheHostHome/Life-SharingProviderservingtheindividual,orpriortoanyindividualmovingintothehome.

3. Day-to-daylivingagreementsaretobemailedto:

DivisionofDevelopmentalDisabilitiesAttn:AdministrativeOperationalManager2PeachtreeStreet,Suite22-413Atlanta,GA30303

ProcedureforMonitoringHostHomes

DBHDDprovideragencieswillensurecompliancewiththeHostHome/Life-SharingStandards,DCHCOMPWaiverandcurrentFiscalYear(FY)DBHDDProviderManual.

DBHDDprovideragencywillcompleteaninitialSiteInspectionofeachHostHome/Life-sharingresidentialsettingtheagencyhasapprovedtooperate. TheSupportCoordinatororDBHDDRegionalOfficedesigneewillconductafollow-upsiteinspection.

SupportCoordinatorand/orthePlanningListAdministratorwillconducthomevisits,atleastonamonthlybasis,tomonitortheperson’sprogressinthespecificHostHome/Life-Sharingsetting,andtoensurethatHostHome/Life-Sharingservicesisdeliveringthesupportsinaccordancewiththeindividual’sISP.

DBHDDprovideragencywillconducthomevisitsatleastmonthly,inordertoverifythattheHostHomeisdeliveringcare,roomandwatchfuloversightinasafeandhealthyenvironment. TheDBHDDprovideragencyistoevaluateanddocumentthefollowingduringeachvisit:

1. Availableservices,supports,careandtreatment. Thisincludes,butisnotlimitedtotheserviceneedsaddressedintheISP.

2. HumanandCivilRightsaremaintained.3. OversightofSelf-AdministeringofMedicationAdministration(ifapplicable)orthat

theadministeringofmedicationfollowsfederalandstatelaws,rulesandregulations.

4. PersonCenteredFocusisEvidentinDocumentation.5. Informationanddocumentationmanagementisprotected,secure,organizedand

confidential.


Version6-27-2016

6. Thehosthomeenvironmentdemonstratesrespectfortheindividual(s)servedandisappropriatetothesupportsprovided. Thisincludes,butisnotlimitedto,thephysicalenvironment,reviewofdisasterandfiresafetyplan,requiredtraining,communityinclusion,personalfunds,andvehicletransportationrequirement.

ThisevaluationistobesharedwiththeHostHomefamily/individualandmadeavailableforreviewbytheSupportCoordinatororDBHDDstaffasevidencedbythesignatureoftheHostHomefamily/individualandtheDBHDDprovideragency. AcopyofeachmonthlyvisitandwrittensummaryofcorrectionsaretobekeptintheHostHome.

TheDBHDDprovideragencywillcompleteanannualsummaryofeachmonthlyhomevisit.Thesummaryistoinclude,butisnotlimitedtoallitemsidentifiedintheabovesections1-6. Acopyoftheannualsummaryandawrittensummaryofcorrectionsaretobekeptinthehomeforeachfiscalyear(FY).

DBHDDRegionalOfficesanddesignatedstafffromtheDivisionofDDaretoprovidetechnicalassistancetoDBHDDprovideragenciesenrollinghosthomes,asneeded.

TheDivisionofDDwillconductquarterlyQualityAssurancereviewsofprovideragenciessomeofwhichwillbecontractinghosthomes. Reviewsmayinclude,butarenotlimitedto,SupportCoordinatorratingsof3’sand4’s,externalqualityreviews,andcriticalincidents.Basedonthesereviews,theDivisionofDDwillrecommendand/orimplementthefollowing,whichincludes,butisnotlimitedto,provisionoftechnicalassistancetotheproviderand/orhosthome,themovementoftheindividualsfromthehosthome,fullstandardscompliancereview,and/ormoratoriumontheenrollmentofhosthomesforaspecificDBHDDprovideragency.

TerminationofcontractbetweentheHostHomeandCRAProviderAgency

WhenaHostHomeprovidernolongerwantstoprovideservicestotheindividualand/orwantstoenditssubcontractwiththeDBHDDprovideragency,theymustgiveatleastthirty(30)dayswrittennoticeto:

1. Theindividual(s)served2. TheDBHDDprovideragencyundercontract

WhenaDBHDDprovideragencyinitiatesterminationofacontractwithaHostHomeproviderforgoodcausethefollowingapplies:

a) DBHDDprovideragencymustgiveatleastthirty(30)dayswrittennoticeto:i) Theindividual(s)servedii) TheHostHomeprovider


Version6/27/2016

b) TheHostHomeprovidermustrelinquishCRAserviceprovisionfortheindividual(s)supportedtothecontractedDBHDDprovideragencyandassisttheDBHDDprovideragencywiththemovementoftheindividual(s),unlesstheindividualindicatesadesiretoterminatefromtheDBHDDprovideragencyandremainwiththehosthome,inwhichtheprovisionsofSectionFofProcessforEnrolling,Matching,andMonitoringHostHome/Life-SharingSite,02-704,shallapply.

3. TheHostHomeproviderisexpectedtocontinueworkingforthirty(30)daysunlessotherwisedeterminedbytheDBHDDprovideragencyorDBHDD.

4. Ifanemergencyoccursandservicesmustbeterminatedimmediately,theHostHomeprovidermustgiveimmediatenoticetoallpartieslistedinthesectionabove.

5. TheDBHDDprovidermustsubmitbothDBHDDandDCHChangeofInformationformstoDBHDDOfficeofProviderNetworkManagementtodeactivatetheHostHomeprovidernumber.

IndividualChoicetoTerminateRelationship

Whenawaiverparticipant/individualindicatesadesiretoterminateservicesfromeitheraHostHomeprovideroraDHBDDprovideragency,theindividualwillbeinterviewedbyaneutralpartytodeterminethattheindividual'schoiceisindependentofcoercionfromanyparty. Theindividual'sSupportCoordinatorandaDHBDDstaff(RegionalorStateOffice)willinterviewtheindividual,theindividual'slegalguardian(ifany)and/oranyrepresentativewhohasbeenformallyorinformallydesignatedbytheindividual.Theindividual'sSupportCoordinatorandDBHDDstaffmayalso,attheirdiscretion,interviewotherpersons,includingbutnotlimitedtofriendsandrelativesoftheindividual,toensurethedecisiontoterminateserviceswithaHostHomeprovideroraDBHDDproviderisfreefromcoercion.

TransferenceofaHostHome

TheDBHDDprovideragencyandHostHomeprovidermustcooperateasrequestedbyDBHDDtoeffectuatethesmoothandreasonabletransitionofthecareandservicesforindividualsasdirectedbyDBHDD. Thisincludes,butisnotlimitedto,thetransferoftheindividualrecords,personalbelongings,andfundsofallindividualsasdirectedbyDBHDD.

DBHDDreservestherightunderallHostHomeagreementstotransferaHostHometoanotherDBHDDprovideragencyonthefollowinggrounds:

1. DBHDDterminationofthecontract/letterofagreement,oragreementwiththe

DBHDDprovideragency.2. DBHDDprovideragencyterminationofthecontract/letterofagreement.

TheIndividualorFamily/Representative’sterminationoftherelationshipwithanidentifiedcontractingprovideragency,(whichrequirestheterminationofthesitespecificMedicaidProviderNumberbythecontractingprovideragency).

Ineithercaseabove,theHostHomeprovidermustbeinagreementtocontractwithanotherDBHDDprovideragencyiftheywanttoservethesameindividual(s).


Version6/27/2016

PriorapprovalforthetransferoftheHostHometoanalternativeDBHDDprovideragencymustbegivenbythedesignatedDBHDD,RegionalServicesAdministratorforDD.

IndividualRights

InformingandEncouragingExerciseofRights

Eachindividual,ortheindividual’sparent,guardianoradvocate(ifappropriate)istobeinformedoftheindividual’srightsuponadmissionandannuallythereafter.Individualsaretoreceivethisinformationthroughtheirprimaryformofcommunication.

Astatementsignedanddatedbytheindividual,ortheindividual’sparent,guardianoradvocateifappropriate,acknowledgingreceiptoftheinformationonindividualrightsuponadmissionandannuallythereafter,willbekept.

Eachindividualistobeencouragedtoexercisehisorherindividualrights.

Rights

Anindividualmaynotbedeprivedofrights.

RightsoftheIndividual

1. Anindividualmaynotbeneglected,abused,mistreatedorsubjectedtocorporalpunishment.

2. Anindividualmaynotberequiredtoparticipateinresearchprojects.

3. Anindividualhastherighttomanagehisorherpersonalfinancialaffairs.

4. Anindividualhastherighttoparticipateinprogramplanningthataffectshimor

her.

5. Anindividualhastherighttoprivacyinbedrooms,bathroomsandduringpersonalcare.

6. Anindividualhastherighttoreceive,purchase,haveandusepersonalproperty.

7. Anindividualhastherighttoreceivescheduledandunscheduledvisitors,

communicate,associateandmeetprivatelywiththeirfamilyandpersonsoftheindividual’schoice.

8. Anindividualhastherighttoreasonableaccesstoatelephoneandtheopportunity

toreceiveandmakeprivatecalls,withassistancewhennecessary.


Version6/27/2016

9. Anindividualhastherighttounrestrictedmailprivileges.

10. Anindividualwhoisofvotingagewillbeinformedoftherighttovoteandwillbeassistedtoregisterandvoteinelections.

11. Anindividualhastherighttopracticethereligionorfaithoftheindividual’schoice.

12. Anindividualhastherighttobefreefromexcessivemedication.

13. Anindividualmaynotberequiredtoworkatthehomeexceptforthetypical

upkeepoftheindividual’sbedroomandintheupkeepoffamilyareasandyard.Forexample:Repairofacloggeddrain,seedingoflawns,etc.,wouldnotbeconsideredtypicalupkeep.

CivilRightsAnindividualmaynotbediscriminatedagainstbecauseofrace,color,religiouscreed,disability,handicap,ancestry,nationalorigin,ageorsex.

CivilRightspoliciesandproceduresaretobedevelopedandimplementedinaccordancetoallStateandFederallegislation.Civilrightspoliciesandproceduresaretoincludethefollowing:

1. Nondiscriminationintheprovisionofservices,admissions,placement,referralsandcommunicationwithnon-Englishspeakingandnonverbalindividuals.

2. Physicalaccessibilityandaccommodationforindividualswithphysicaldisabilities.3. Theopportunitytolodgecivilrightscomplaints.4. Informingindividualsoftheirrightstoregistercivilrightscomplaints.

StaffingQualificationsandResponsibilities

ProvideragenciesrenderingCommunityResidentialAlternativeServices(CRA)musthavestaffingthatmeetsthefollowingrequirements,inadditiontoanyapplicablelicensurerequirements:

1. Adesignatedagencydirectorwhomust:

• Haveeitherabachelor’sdegreeinahumanservicefield(suchassocialwork,

psychology,education,nursing,orcloselyrelatedfield)orbusinessmanagementandtwoyearsofexperienceinservicedeliverytopersonswithdevelopmentaldisabilities,withatleastoneyearinasupervisorycapacity;or


Version6/27/2016

• Haveanassociatedegreeinnursing,educationorarelatedfieldandfour(4)yearsofexperienceinservicedeliverytopersonswithdevelopmentaldisabilities,withatleastoneyearinsupervisorycapacity

DutiesoftheAgencyDirectorinclude,butarenotlimitedto:

• Overseeingtheday-to-dayoperationoftheagency;

• Managingtheuseofagencyfunds;

• Ensuring thedevelopmentandupdatingofrequiredpoliciesoftheagency;

• Managingtheemploymentofstaffandprofessionalcontractsfortheagency;

• Designatinganotheragencystaffmembertooverseetheagency,inhisorher

absence.

2 Atleastoneagencyemployeeorprofessionalundercontractwiththeagency,whomust:• HavetheresponsibilityforoverseeingthedeliveryofCommunityResidential

AlternativeServicestoparticipants.

3. Atleastoneagencyemployeeorprofessionalundercontractwiththeagencywhomust:

BeaDevelopmentalDisabilityProfessional(DDP)(fordefinition,seetheCOMPManual.DutiesoftheDDPinclude,butarenotlimitedto:

• Overseeingtheservicesandsupportsprovidedtoparticipants;

• Supervisingtheformulationoftheparticipant’splanfordeliveryofCommunity

ResidentialAlternativeServices;

• Conductingfunctionalassessments;and

• Supervisinghighintensityservices.

Note: ThesameindividualmayserveasboththeagencydirectorandtheDevelopmentalDisabilityProfessional.

4. DirectCareStaffmust:

• Be18yearsorolder


Version6/27/2016

• Iftransportinganindividualservedorfamily,haveavalidClassClicenseasdefinedbytheGeorgiaDepartmentofDriver’sServicesandnomajorormultipletrafficviolationsiftransportingparticipants(s);

• Beprovidedwithabasicorientationpriortodirectcontactwithindividualsand

showcompetencein:

a. ThepurposeandscopeofCRAservices,includingrelatedHostHome/Life-SharingStandards;

b. Confidentialityofindividualinformation,bothwrittenandspoken;c. Rightsandresponsibilitiesofindividuals;d. Requirementsforrecognizingandreportingsuspectedabuse,neglect,or

exploitationofanyindividual:i. ToDBHDDii. Withintheorganizationiii. Toappropriateregulatoryorlicensingagencies;andiv. Tolawenforcementagencies

5. Foranyadditionalrequirementsreferto:

COMPSupportsWaiverProgram,PartIIandPartIII,andPartIPoliciesandProceduresforMedicaidPeachCareforKids.

And

ThecurrentProviderManualforCommunityDevelopmentalDisabilityProviders,PartII,SectionI,CommunityServiceStandardsforDDProviders.

DirectCareand/orProfessionalStaffingTheadultfamilymemberintheHostHome/Life-Sharingisresponsibleforthe24-hourcareoftheindividual(s)served.

Directcareand/orprofessionalstaffmaybeutilizedtoprovideintermittentorbriefsupporttotheHost/Life-Sharingfamily.IntermittentorbriefstaffingshouldbewithinthemaximumCommunityResidentialAlternative(CRA)rateandwouldnotqualifyforanExceptionalRate.

TheprovideristosubmitExceptionalRateRequeststotheRegionalServiceAdministratorforDevelopmentalDisabilitiesunderthefollowingcircumstances:

1) Theindividualhassignificantmedicaland/orbehaviorproblems,whichareassessedasbarriers,andthreatenstheindividual’sstabilityinaHostHome/Life-Sharingcommunitysetting;

And


Version6/27/2016

2) Thesignificantmedicaland/orbehaviorproblemsdemandtheavailabilityofcontinuedenhanceddirectcareand/orprofessionalstaffing,tosupporttheindividual’sstabilityinacommunitysetting.

TheExceptionalRateRequestsforenhanceddirectcareand/orprofessionalstaffing,mustdocumentacleardemonstrationofenhancedintensityandthetypeofservicebeyondwhataHostHome/Life-Sharingfamilycouldprovidewithtraining.

Note:AWaiverofStandardsRequestisnottobesubmittedforExceptionalRateRequestspertainingtotheneedforcontinuedenhanceddirectcareand/orprofessionalstaffing,whichaddresstheaboveparameters.

Pre-Service/AnnualTraining

Training

PriortotheDBHDDprovideragency’ssubmissionofanapplicationforasitespecificMedicaidprovidernumber,theadultfamilymemberwhowillhaveprimaryresponsibilitytotheindividualandforprovidingservicestotheindividualistohaveatleastthefollowingtraining:

1. Person-CenteredValues,PrinciplesAndApproaches2. HumanRightsandResponsibilities3. RecognizingandReportingCriticalIncidents4. IndividualServicePlan5. ConfidentialityOfIndividualInformation,BothWrittenAndSpoken6. FireSafety7. EmergencyandDisasterPlansAndProcedures8. TechniquesOfStandardPrecautions9. BasisCardiacLifeSupport(BCLS)10. FirstAidandSafety11. MedicationAdministrationandManagement/SupervisionOfSelf-Medication12. AgencyPoliciesAndProcedures

Priortodirectcontactwiththeindividual,theadultfamilymemberwhowillhavetheprimaryresponsibilitytotheindividualandforprovidingservicestotheindividualistoreceiveatleastthefollowingtraining:

1. ThePurpose,ScopeOfServices,Supports,CareAndTreatmentOffered,Including

RelatedPoliciesAndProcedures2. HolisticCareOfTheIndividual3. PromotingPositive,AppropriateAndResponsiveRelationshipsWithPersons

ServedAndTheirFamilies4. Medical,Physical,BehavioralAndSocialNeeds,AsWellAsCharacteristicsOf

PersonsServed


Version6/27/2016

5. TheUtilizationOfPositiveCommunication,PositiveBehavioralSupportsAndCrisisInterventionTechniques

6. Ethics,CulturalPreferenceAndAwareness7. Service,Support,CareandTreatmentSpecificAppropriateTotheCareofPerson

ServedAlltrainingsspecifiedabovemustalsobeprovidedtotheHostHome/Life-Sharingadultfamilymemberonanannualbasis.

RecordofTrainingRecordsofpre-serviceandannualtraining,includingnameofpersontrained,thetrainingsource,content,dates,lengthoftraining,andcopiesofcertificatesreceivedandpersonsattendingwillbekeptandbereadilyavailable.

PhysicalHomeSafetyAlllivingquarterswillbemaintainedandnotthreatenthehealthorsafetyofoccupants.

SpecialAccommodations

Ahomeservinganindividualwithaphysicaldisability,blindness,avisualimpairment,deafnessorahearingimpairmentwill haveaccommodationstoensurethesafetyandreasonableaccessibilityforentranceto,movementwithinandexitfromthehomebaseduponeachindividual’sneeds.

Adaptiveequipmentwillbeprovidedifneededfortheindividualtomoveaboutandfunctioninthehome(i.e.wheelchairs,walkers,lowshelves,cabinets,countertops,specialdoorbellsandtelephonedevicesforindividualswhohaveahearingimpairment,andtactileguidesforindividualswhohavevisualimpairment).

Poisons

Poisonousmaterialswillbekeptlockedormadeinaccessibletoindividualsifallindividualslivinginthehomeareunabletosafelyuseoravoidpoisonousmaterials

Poisonousmaterialsmayalsobekeptunlockedandaccessibletoindividualsifallindividualslivinginthehomeareabletosafelyuseoravoidpoisonousmaterials.

Documentationofeachindividual’sabilitytosafelyuseoravoidpoisonousmaterialswillbeineachindividual’sISP.

Poisonousmaterialswillbestoredintheiroriginal,labeledcontainers.


Version6/27/2016

Poisonousmaterialswillbekeptseparatefromfood,foodpreparationsurfacesanddiningsurfaces.

HEATSOURCES

Heatsources,suchashotwaterpipes,fixedspaceheaters,hotwaterheaters,radiators,woodandcoalburningstovesandfireplaces,exceeding120°Fthatareaccessibletoindividuals,willbeequippedwithprotectiveguardsorinsulationtopreventindividualsfromcomingincontactwiththeheatsource.

Heatsourcesdonotrequireguardsorinsulationifallindividualslivinginthehomeunderstandthedangerofheatsourcesandhavetheabilitytosenseandmoveawayfromtheheatsourcequickly.Documentationofeachindividualunderstandsandabilitywillbeineachindividual’sISP.

Sanitation

Cleanconditionswillbemaintainedinallareasofthehome.

Theremaynotbeevidenceofinfestationofinsectsorrodentsinthehome. Chemicalsusedinthecontrolprogrammustbeselected,storedandusedsafely. Thechemicalmustbeselectedonthebasisofthepestinvolvedandusedonlyinthemannerprescribedbythemanufacturer.

Trashwillberemovedfromthepremisesonaroutinebasis.

Ventilation

Livingareas,diningareas,individualbedrooms,kitchensandbathroomswillbeventilatedbyatleastoneoperablewindoworbymechanicalventilation. Exceptionsarehometheaterrooms.

Lighting

Rooms,hallways,interiorstairways,outsidesteps,outsidedoorways,porches,rampsandfireescapes,thatareusedbyindividualswillbelightedtoassuresafetyandtoavoidaccidents.

Surfaces

Floors,walls,ceilingsandothersurfaceswillbefreeofhazards,asdeterminedbytheneedsoftheindividualresident.


Version6/27/2016

RunningWaterAhomewillhavehotandcoldrunningwaterunderpressure.

Hotwatertemperaturesinbathtubsandshowersthatareaccessibletoindividualsmustbewithin10-120degreeFahrenheit.

Waterandsewagesystemswillmeetfederal,state,andlocalstandardsandregulations.

HeatingandAirConditioningSystemsHeatingandAirConditioningSystemswillbeoperationalandmaintainedtoprovideadequateheatandairconditioningthroughoutthehome.

Telephone

Ahomewillhaveanoperabletelephonethatiseasilyaccessible. Theindividualmusthaveadequateprivacywhileusingthetelephone.

EmergencyTelephoneNumbers

Thetelephonemustbeimmediatelyavailableincaseofemergency. Telephonenumbersofthenearesthospital,policedepartment,firedepartment,ambulanceandpoisoncontrolcenterwillbereadilyaccessibleinthehome.

Screens,WindowsandDoors

Windows,includingwindowsindoors,willbesecurelyscreenedwhenwindowsordoorsareopen. Screens,windowsanddoorswillbeingoodrepair.

Handrails

Aninteriorstairwayexceedingtwostepsthatisaccessibletoindividuals,rampandoutsidestepsexceedingtwosteps,willhaveawell-securedhandrail.

FirstAidMaterials

Eachhomewillhaveantiseptic,anassortmentofadhesivebandages,sterilegauzepads,tweezers,tape,andscissors.

ExteriorConditions

Anoutsidewalkwaythatisusedbyindividualswillbefreefromice,snow,obstructionsandotherhazards.


Version6/27/2016

Theyardandoutsideofthehomewillbewellmaintainedandfreefromunsafeconditions.

IndividualBedroomsAnindividual’sbedroommaynotbelocatedinbasements,attics,stairway,halloranyroomcommonlyusedforotherthanbedroompurposes.Abedroomwillhaveatleastoneexteriorwindowthatpermitsaviewoftheoutside.

Bedroomwindowswillhavecleanand/oroperabledrapes,curtains,shades,blindsorshutters.Bedroomswillhavedoorsatallentrancesforprivacy.

Inbedrooms,eachindividualwillhavethefollowing:

1. Abedofsizeappropriatetotheneedsoftheindividual.Cotsandportablebedsarenotpermitted.Bunkbedsarenotpermittedforindividuals18yearsofageorolder.

2. Aclean,comfortablemattressandsolidfoundation.

Cleanbedding;includingapillow,linensandblanketsappropriatefortheseason.

1. Achestofdrawers.

2. Closetorwardrobespacewithclothingracksandshelvesaccessible.

Anindividualmaynotshareabedroomwithanyoneofanoppositesexinthehome.

Bathrooms

Therewillbeatleastonetoiletandonebathtuborshowerinthehome.

Privacywillbeprovidedfortoilets,showersandbathtubsbypartitionsordoors.

Atleastonebathroomareawillhaveasink,wallmirror,soap,toiletpaper,individualcleanpaperorclothtowelsandtrashreceptacle.

Acleanwashcloth,bathtowelandoperabletoothbrushwillbeprovidedforeachindividual.

Kitchens

Eachhomewillhaveakitchenareawithacleanandoperablerefrigerator,sink,cookingequipmentandcabinetsforstorage.


Version6/27/2016

Utensilsusedforeating,drinkingandpreparationoffoodordrinkwillbewashedandrinsedaftereachuse.

Laundry

Individualbedlinens,towels,washclothsandclothingwillbekeptclean.

SwimmingPools

Anin-groundswimmingpoolwillbefencedwithagatethatislockedwhenthepoolisnotinuse.

Anabovegroundswimmingpoolwillbemadeinaccessibletoindividualswhenthepoolisnotinuse.

Firearms

Allfirearmsownedandinthehomeareunloaded,securedandlockedinacabinetwithammunitionstoredinaseparatelockedcabinet. Iffirearmsarestoredinanofficialguncabinet,ammunitionmayalsobestoredinthesameofficialguncabinet. However,theammunitionmustbekeptinalockedcontainerorlockedinaseparatecompartmentoftheguncabinet.

Yard

Theyardsurroundingthehomemustbesafeandmaintained.

FIRESAFETYUnobstructedStairways,Halls,DoorwaysandExits

Stairways,halls,doorwaysandexitsfromroomsandfromthehomewillbeunobstructed.

Nointeriorlocks,keyedlocksordeadboltsintheHostHome/Life-Sharingresidencewillprohibitfreeaccesstoexitfromthehome.

FlammableandCombustibleMaterials

Flammableandcombustiblesuppliesandequipmentwillbeutilizedsafelyandstoredawayfromheatsources.

Furnaces

Furnacesfilterswillbecleanedorreplacedatleastannually.Writtendocumentationofthecleaningorchangingoffilterswillbekept.


Version6/27/2016

PortableSpaceHeatersPortablespaceheatersdefinedasheatersthatarenotpermanentlymountedorinstalled,maynotbeusedwhileindividualsareintheHostHome.

WoodandCoalBurningStovesTheuseofwoodandcoalburningstovesispermittedonlyifthestoveisinspectedandapprovedforsafeinstallationbyalicensedand/orbondedcontractorspecializedinthisarea.Writtendocumentationoftheinspectionandapprovalistobekept.Woodandcoalburningstoves,includingchimneysandflues,willbecleanedatleasteveryyear. Writtendocumentationofthecleaningwillbekept.

Ifnaturalgasorheatingoilisusedtoheattheresidence,orifawood-burningfireplaceisintheresidence,theresidencewillbeprotectedwithsufficientcarbonmonoxidedetectorslistedbyUnderwritersLaboratories,Inc. InformationonUnderwritersLaboratories,Inc.maybefoundathttp://www.ul.com/consumers/monoxide.html

FireplacesFireplaceswillbesecurelyscreenedand/orequippedwithprotectiveguardswhileinuse.

Smoking

Smokingisafirehazard.TheHostHome/Life-Sharingresidencemaychoosetoallowor notallowsmoking. IftheHostHome/Life-Sharingchoosestoallowsmokingitmustreducetheriskoffireby:

1.Prohibitingsmokinginanyareawhereflammableliquid,gasesoroxidizersarein

useorstored;

2. Prohibitingresidentsfromsmokinginbed;and

3. ProhibitingunsupervisedsmokingofindividualsunlessunsupervisedsmokingisdocumentedintheISP.

SmokeDetectorsEachHostHomewillbeprotectedwithsufficientsmokedetectorslistedbyUnderwritersLaboratories,Inc.,whichwhenactivatedwillinitiateanalarm,thatisaudibleinsleepingrooms.InformationonUnderwritersLaboratories,Inc.maybefoundathttp://www.ul.com/fallsafety/smoke_alarms.html.


Version6/27/2016

AnoperablesmokedetectorAnoperablesmokedetectormustalsobelocatedintheattic.(Anareawithpulldownstepsisconsideredanattic).

Eachsmokedetectorwillbetestedeachmonthtodetermineifthedetectorisoperable.

FIREEXTINGUISHERS

Theremustbeatleastoneoperablefirefivepound(5lb.)multipurposeABCfireextinguisheroneachfloor;includingbasements. Allfireextinguishersmustbelocatedinaccessiblelocations.

Allfireextinguishersmustbeexaminedmonthlytodeterminethat:

1. Fireextinguishersareaccessibleandinadesignatedlocation;2. Sealsortamperindicatorarenotbroken;3. Theextinguishershavenotbeenphysicallydamaged;and4. Theextinguishersdonothaveanyobviousdefects.

Disaster/SevereWeatherEmergencyandFireDrills

TheagencywillhavethatsupporttheHostHome/Life-Sharingresidentialsetting’semergencynotificationandpreparednessprocesses. Thisincludes,butisnotlimitedtoathree-daysupplyofnon-perishablefoodsandwaterforemergencyneedsandsuppliesforanemergencypreparednesskitforthehousehold.

Forinformationoncreatinganemergencypreparednesskitvisitthefollowingwebsite:http://www.gema.ga.gov orhttp://ready.ga.gov

Awrittendisaster/severeweatherandfiresafetyplanwillbedevelopedforeachhousehold.Theplanwillbereviewedandupdatedannuallyorasneeded.Theplanwillincludegeneralfiresafety,evacuationprocedures,responsibilitiesduringdrillsoractualevents,thedesignatedmeetingplaceoutsidethehome,theuseoffireextinguishers,notificationoflocalfireandemergencyresponseteamsandifapplicable,smokingsafetyproceduresifanindividualofhousehold membersmokes.Awrittenrecordofthetrainingwillbekeptreadilyavailable.

Firedrillswillbeconductedeverymonthatalternatetimes. Atleasttwodrillspercalendaryearwillbeduringsleepinghours. Allfiredrillswillbedocumentedandkeptreadilyavailable.

Theplanshouldalsoaddressmedicalemergencies,naturaldisasters(i.e.tornado),powerfailures,lossofheatorairconditioning,continuityincriticalmedicalcareneedsofindividualssupported,andnotificationofindividuals’naturalsupportsassoonasthe


Version6/27/2016

situationrendersthispossible. Componentsoftheplanwillbemaintained,tested,inspected,drilledandreviewedforriskreductiononaquarterlybasis.Disasterandsevereweatheremergencydrillsareconductedatleastonceperquarteratvarioustimesthroughouttheyear,includingonedrillduringtypicalsleephoursofthehousehold.

Program

ImplementationofIndividualServicePlan

TheHostHome/Life-Sharingfamilywillcooperativelyparticipatewiththeindividual’ssupportteaminthedevelopmentandimplementationoftheindividual’sserviceplan.

TheHostHome/Life-Sharingdynamicsisenduring,offeringdependability,consistency,trustworthinessandsecurity. TheHostHome/Life-Sharingfamilyjoinstogetherincelebrationofanniversaries,birthdaysandinsimpleday-to-dayinteractions,joysandaccomplishments. Theyalsomourntogetherintheirlossesattimesofillnessanddeath.TheHostHome/Life-Sharingfamilyshouldencompassextendedfamiliesandpromotetheindividual’smaturingrelationshipwithhisorherownnaturalbirthfamily.

TheHostHome/Life-Sharingindividual(s)shouldbeactiveparticipantsintheircommunity. Communityintegrationcouldbefacilitatedbythecontractingfamily’sownfriends,civicinterests,neighbors,recreationalandhobbyactivities,andreligiousaffiliations. Thisexpandsandincludestheindividual’sfamily,friendsandspecialinterests.

RecordManagement

AllrecordswillbekeptinaccordancewithrequirementsoftheDepartmentofBehavioralHealthandDevelopmentalDisabilitiescurrentProviderManualfoundatthewebsite:http://dbhdd.georgia.gov/portal/site/DBHDD/(clickProviderInformationandProviderToolKit).

AcopyoftheIndividualServicePlanwillbeintheHostHome/Life-SharingresidencealongwithcasenotesperdirectionintheIndividualServicePlanalongwithDCHdocumentationrequirements.

ProvidersmustdocumentthefollowingintherecordofeachparticipantreceivingCommunityResidentialAlternativeServices:

1. Specificactivity,training,orassistanceprovided;2. Dateandthebeginningandendingtimewhentheservicewasprovided;3. Locationwheretheservicewasdelivered;4. Verificationofservicedelivery,includingfirstandlastnameandtitle(ifapplicable)

ofthepersonprovidingtheserviceandhisorhersignature;5. Progresstowardsmovingtheparticipanttowardsindependencebymeetingthe

participant’sISP,whichincludesperson-centeredgoals,desiredoutcomesinthe


Version6/27/2016

participant’sactionplan,andtheamount/typeofassistance/supportintheCurrentServiceSummaryandtheHealthandSafetysectionsoftheISP.

EachHostHome/Life-Sharingresidenceprovideristoretainacopyofthehomestudy,includinganyupdates,annualself-assessmentofthehomeandrequiredmonthlymeeting/qualityassuranceminutesforreviewbythestate.

Health

IndividualHealthCareExaminations

Theindividualservedwillhaveahealthcareexaminationwithin12monthspriortolivingintheHost/Life-SharingHomeandannuallythereafter.

ThehealthexamwillbecompletedanddocumentedontheAnnualHealthFormfoundintheProviderManualfoundatthewebsite:http://dbhdd.georgia.gov/portal/site/DBHDD/(clickonProviderinformationandtheProviderManualforthecurrentyear).

RefusalofHealthCare

Ifanindividualrefusesroutinehealthcareexaminationsortreatment,therefusalandcontinuedattemptstotraintheindividualabouttheneedsofhealthcarewillbedocumentedintheindividual’srecord.

Ifanindividualhasaseriousmedicalcondition,reasonableeffortswillbemadetoobtainconsentfromtheindividualorsubstituteconsentinaccordancewithapplicablelaw.

HostHome/Life-SharingFamilyHealthCareExaminations

FamilymembersandpersonslivingintheHostHome/Life-Sharingresidencewillhaveahealthcareexaminationwithin12monthspriortoanyindividualinservicelivinginthehomeandannuallythereafter.

Thehealthcareexaminationdocumentationwillbecompleted,signedanddatedbyalicensedphysician,certifiednursepractitionerorlicensedphysicianassistant.

Thegeneralhealthcareexaminationwillinclude:

1. Ageneralhealthcareexamination2. Tuberculinskintestingwithnegativeresultsevery2yearsfor familymembers1

yearofageorolder;or,ifatuberculinskintestispositive,an initialchestX-raywithresultsnoted.Tuberculinskintestingmaybecompletedand certifiedinwritingbyaregisterednurseorlicensedpracticalnurseinsteadofa licensedphysician.

3. Asignedstatementthatthepersonisfreeofcommunicablediseasesorotherhealthconditionswhichmightinterferewiththehealthoftheindividual,orspecific precautionstobetakeninthepresenceofsuchconditions.


Version6/27/2016

StorageofMedications

Medications

Prescriptionsandnonprescriptionmedicationsofindividualswillbekeptintheiroriginalcontainers,exceptformedicationsofindividualswhoself-administermedicationsandkeeptheirmedicationsinpersonaldailyorweeklydispensingcontainers.

Prescriptionandpotentiallytoxicnonprescriptionmedicationsstoredinarefrigeratorwillbekeptinaseparatelockedcontainerormadeinaccessibletotheindividuals,unlessitisdocumentedineachindividual’sassessmentthateachindividualinthehomecansafelyuseoravoidtoxicmaterials.

Prescriptionsandnonprescriptionmedicationsofindividualswillbelockedandstoredunderproperconditionsofsanitation,temperature,moistureandlight.

Discontinuedprescriptionmedicationsofindividualswillbedisposedofinasafemanner.Documentationofthedateandmannerdisposedwillberecorded.

LabelingofMedications

Theoriginalcontainerforprescriptionmedicationofindividualswillbelabeledwithapharmaceuticallabelthatincludestheindividual’sname,thenameofthemedication,thedatetheprescriptionwasissued,theprescribeddoseandthenameoftheprescribingphysician.

MedicationTraining

HostHome/Life-SharingFamilymemberswhoassistwithorsuperviseself-medicationforindividual(s)willreceivetrainingabouttheadministration,sideeffectsandcontraindicationsofthespecificmedicationinaccordancewithstatelawsandregulations


Version6/27/2016

Nutrition

ProtectionofFoodFoodreceivedorusedinthehomewillbeclean,wholesome,freefromspoilage,adulteration,andmisbranding,andsafeforhumanconsumption.

Allfoods,whilebeingstored,prepared,orserved,willbeprotectedagainstcontaminationandbesafeforhumanconsumptioninaccordancewithacceptedstandardsforfoodsafety.

ThreeMealsaDay

Atleastthreemealsadaywillbeavailabletotheindividualsandinaccordancewithanyspecificdietaryneedsidentifiedintheindividual’sIndividualServicePlan.

QuantityofFood

ThequantityoffoodservedforeachindividualwillmeetminimumdailyrequirementsasrecommendedbytheUnitedStatesDepartmentofAgriculture,unlessotherwiserecommendedinwritingbyalicensedphysician.

FoodGroups

Atleastonemealeachdaywillcontainatleastoneitemfromthedairy,protein,fruitsandvegetablesandgrainfoodgroups,unlessotherwiserecommendedinwritingbyalicensedphysicianforindividuals.

BehavioralManagementGuidelines

PositiveBehaviorSupportsareintendedtoprovideguidelinesformanagingchallengingbehavior(s)ofindividualswithDevelopmentalDisabilitiesresidinginHostHome.

PoliciesdevelopedwithinHostHomeregardingpositivebehaviorsupportsareexpectedtocomplywithguidelinessetforthintheGuidelinesforSupportingAdultswithChallengingBehaviorsinCommunitySettingsapplicabletoallprovidersundercontractorLetterofAgreement(LOA)withtheDepartmentofBehavioralHealthandDevelopmentalDisabilities.

Theseguidelinesareavailableatthewebsite:http://dbhdd.georgia.gov/portal/site/DBHDD/ (clickonProviderInformation,thenProviderToolKit).

Documentationofannualpolicyreviewforappropriateupdateandrevisionswillbereadilyavailabletoallreviewers.


Version6/27/2016

BehaviorSupportPlansshouldbeincorporatedintheIndividualServicePlan(ISP)andeveryattemptwillbemadetoanticipateandde-escalatethebehaviorusingmethodsofinterventionlessintrusivethanrestrictiveprocedures.

Plansshouldbedevelopedbyappropriatelyqualifiedindividualswithexpertiseinbehavioralsupportsevaluationandservicesforpeoplewithdevelopmentaldisabilities.Theindividual,HostHome/Life-Sharingfamilyandothervestedstakeholderswillbeinvolvedinthedevelopmentofthebehaviorsupportplan.

Replacementbehavioracquisitiontrainingand/orfamilyeducationtrainingonPositiveBehaviorSupportsarerequiredtoshowtheeffectivenessoftheplan.

Writtendocumentationofperson/stafftrainedwillbekeptandreadilyavailable. Thisdocumentationmustincludethedateandsignatureofthetrainerevidencingthattheindividualhascompetentlycompletedthetraining.

SeclusionandMechanicalRestraint

Seclusion,definedasplacinganindividualinalockedroom,isprohibited.Alockedroomincludesaroomwithanytypeofdoorlockingdevice,suchasakeylock,springlock,boltlock,footpressurelockorphysicallyholdingthedoorshut.

Physicalrestraints(i.e.mechanicalrestraints)arenotusedaspunishment,forstaffconvenience,orthroughabehavioralsupportplanorbehavioralmanagementinterventionforpurposesofrestrictingaparticipant’smovement.Thosedeviceswhichrestrainmovement,butareappliedforprotectionofaccidentalinjury(suchasahelmetforprotectionoffallduetofrequent,severeseizuresbutnotforpurposefulheadbangingorotherself-injuriousbehavior)orrequiredformedicaltreatmentofthephysicalconditionoftheparticipant(suchasprotectionforhealingofanopenwound)orforsupportiveorcorrectiveneedsoftheparticipant(suchasphysicaltherapydevices)arenotconsideredphysicalrestraints.

AlternateCare

ProvisionforHostHome/Life-SharingSetting

AlternatecaremustbeofferedtotheHostHome/Life-SharingfamilythroughotherHostHomesmanagedbytheSAMEagency.AlternatecareistobeofferedtoeachHostHome/Life-Sharingfamilyannually,nottoexceed30unitsofCRAservices.

ThealternatecareHostHome/Life-SharingsettingwillmeetallandtheStandardsforHostHome/Life-Sharing. EachCRAagencyadministeringoneormoreHostHome/Life-Sharingresidentialsettingsmusthave,atminimum,ofone(1)vacancyavailableatalltimesforalternatecare.


Version6/27/2016

Onlyone(1)AlternateCarehomemaybeusedandidentifiedforeachindividualaccessingthisprovision.

TheISPmustidentifythefollowing:

1. TheneedforAlternateCare.

2. TheAlternateCarehomephysicallocationandcontactinformation. TheAlternate

Carehomemustbesitespecific.

3. TheallottednumberofdaysfortheuseoftheAlternateCarehome(nottoexceed30unitsofCRAservicesannually).

IfAlternateCareprovisionsareutilized,theindividual’sPriorAuthorization(PA)mustindicate:

1. TheprimaryHostHome/Life-Sharingsite2. The amountofCRAunits3. AlternateCaresiteand4. TheamountofCRAunits

Forexample,theremightbe294unitsatHostHomesite,and30unitsatAlternateCareSite. Incaseswherethemaximumof30unitsofAlternateCarewillnotbeutilized,aPAchangeisrequiredtoaddtheunitsbacktothemainHostHome/Life-Sharingsite.

TheannualmaximumnumberofunitsforCRAservicesperyearmustNOTbeexceeded.

Vacation

Vacationbillingmustnotexceedthirty(30)daysinacalendaryearforindividual(s)choosingtogoonavacationwiththeHostHome/Life-Sharingfamily.

operational standards for host...

Documents