Service Goals and Objectives
- To provide training and supervision for the member to increase or maintain his/her socialization and adaptive skills to reside and participate successfully in his/her own community when beneficial to the child in addition to their primary school program.
- To develop positive relationships and support for members and their families.
- To provide opportunities for members to interact socially with family, friends, and the community at large, including providing information regarding and facilitating access to community resources.
- To assist the member in developing skills to achieve and maintain a quality of life that promotes the member’s and his/her family’s vision of the future.
- To provide opportunities for members to participate in meaningful activities and experience new activities.
The Qualified Vendor shall ensure the following are met:
1. In accordance with the member’s Individual Support Plan (ISP) processes, assist in developing an individualized support plan, including:
- Establishing individualized, time-limited training functional outcomes that are based on assessment data and input from the member and the member’s representative that will allow the member to achieve his/her long-term vision.
- Developing strategies for habilitative functional outcomes within ten (10) business days after initiating service. The specific training strategy for each functional outcome shall identify the schedule for implementation, the frequency of services, data collection methods, and teaching strategies.
- Based on the presence or absence of measurable progress, make changes to specific training functional outcome(s) and/or strategies, as agreed upon by the ISP team.
2. As identified in the member’s ISP, provide training and/or assistance such as:
- Assistance and training related to personal and physical needs and routine daily living skills;
- Implementing strategies to address behavioral concerns, developing behavior intervention programs, and coordinating with behavioral health programs to ensure proper review of medication treatment plans;
- Ensuring that the health needs of the member are being met, including providing follow up as requested by the member’s primary care physician or medical specialist;
- Implementing all therapeutic recommendations including speech, occupational, and physical therapy and assisting members in following special diets, exercise routines, or other therapeutic regimes;
- Mobility training, alternative or adaptive communication training;
- Providing general supervision to the member;
- Opportunities for training and/or practice in basic member skills such as shopping, banking, money management, access and use of community resources, and community survival skills; and
- Assisting members in utilizing community transportation resources to support the member in all daily living activities, e.g., day treatment and training, employment situation, medical appointments, visits with family and friends and other community activities, etc., as identified within the member’s ISP.
3. Develop, maintain, or enhance independent functioning skills in sensory-motor areas, cognition, personal grooming, hygiene, dressing, eating, toileting, self-medication, and first aid, recognizing symptoms of illness, and preventing accidents and illnesses.
4. Assist each member in developing methods of starting and maintaining friendships of his/her choice, as well as appropriate assertiveness, social skills, and problem-solving abilities for use in daily interactions.
5. Provide opportunities for members to participate in community activities and facilitate member utilization of community resources.
6. Provide transportation necessary to support program activities.
7. Develop, at a minimum, monthly on-site/community integrated schedule of daily activities and document the member’s direct input into the schedule. Daily activities and schedules are based on the member’s choice, developmental level, ISP goals, and enrichment of life experiences. Allow for reasonable choice in activity participation and offer alternative activities. This schedule shall be available to the member, member’s representative, or others upon request.
8. Play an active role in ensuring that services with other involved entities, including family members, group homes, health care providers, and schools, are coordinated to meet the needs of the members served.
9. Partner with the Division to conduct program reviews to assess performance in meeting all identified tasks, promote quality improvement, and encourage best practices. Such reviews shall include the participation of members served, families, and all other interested parties. The frequency of the reviews shall be determined by the Division.
Service Utilization Information
1. Utilization may be up to four (4) units per day, with an average of 2-3 (two to three) hours per participant; direct service time associated with providing transportation to/ from the program is included in the “Flat Trip Rate for Regularly Scheduled Daily Transportation” rate. Typical programs operate during the weekdays, Monday through Friday, and program sites are generally open during typical school days. Exceptions may be approved by the District Program Manager/designee based on the needs of the member.
2. Since this service is typically provided in a planned and structured manner, if the member does not intend to consistently and fully participate on a daily basis as the program is scheduled, the service may no appropriate. The Qualified Vendor should confirm the actual intended use of this service. This would include the start and end date for each member as well as their anticipated daily schedule. Inconsistent participation is not conducive to achieving habilitative goals.
3. This service is typically provided at the 1:2.5 to 1:4.5 staff to member ratio. Higher ratios may be used based on the collective needs of the members. Lower ratios must be specifically authorized by the District’s Program Manager/ designee.
Published. The published ratio rate is based on the ratio of total direct service staff hours with members present at the program to total member hours.
Throughout the term of the contract, the appropriate billing codes, billing units, and associated billing rules are subject to change. All billing codes and billing units, and associated billing rules will be included in the Division’s Policies and Procedures Manual, Billing Manual, RateBook, and/or other provider resources made available by the Division.
Direct Service Staff Qualifications
The direct service staff shall:
1. Have at least three (3) months experience in conducting group or individual activities related to specific developmental, habilitative, or recreational programs, or be supervised by an individual with such experience; and
2. Have completed training, approved by the Division, in early childhood development when working with children who are under age six (6).
Recordkeeping and Reporting Requirements
1. The Qualified Vendor shall maintain a copy of each member’s ISP on file and make it available to the member/family/member’s representative and/or Division upon request.
2. The Qualified Vendor shall submit quarterly progress reports, including a written summary describing the specific service activities and the performance data that identifies the member’s progress toward achievement of the established functional outcomes, within thirty (30) days after the close of the quarter to the member’s support coordinator and the member/family/member’s representative.
3. The Qualified Vendor must keep a record of each member’s attendance, including time of arrival and departure. The time begins when the Qualified Vendor assumes responsibility for the member and the ends when the Qualified Vendor ends this responsibility.
4. For direct service staff, the Qualified Vendor must keep daily records of the number of hours each direct service staff spends providing direct services to members in the program. Only the time when members are present at the program shall be counted as direct service.
5. The Qualified Vendor shall have a monthly schedule of planned activities posted at all times.
6. Best Practices will require providing advance notice of the schedule to member participants.
7. The Qualified Vendor shall maintain data that documents full compliance with all programmatic and contractual requirements of the Department and Division.