10 Colo. Code Regs. § 2505-10-8.7507

Current through Register Vol. 47, No. 24, December 25, 2024

Section 10 CCR 2505-10-8.7507 - Assistive Technology

8.7507.AAssistive Technology Eligibility

1. Assistive Technology is a covered service available to Members enrolled in one of the following HCBS waivers:

a. Brain Injury Waiver

b. Children's Extensive Supports Waiver

c. Supported Living Services Waiver

8.7507.BAssistive Technology Definitions

1. Assistive Technology Device means an item, piece of equipment, or product system, including tablets, software, and phone applications, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of Members.

2. Assistive Technology Service means a service that directly assists a Member in the selection, acquisition, or use of an assistive technology device.

8.7507.CAssistive Technology Inclusions

1. Assistive Technology is authorized for Organized Health Care Delivery System (OHCDS).

2. HCBS Supported Living Services (SLS) Waiver, Children's Extensive (CES) Waiver:

a. The evaluation of the assistive technology needs of a Member, including a functional evaluation of the impact of the provision of appropriate assistive technology and appropriate services to the Member in the customary environment of the Member.

b. Assistive technology recommendations shall be based on an Assessment provided by a qualified provider within the provider's scope of practice.

c. Training and technical assistance shall be time limited, goal specific and outcome focused.

d. Services consisting of selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices.

e. Training or technical assistance for the Member, or where appropriate, the Family Members, Guardians, caregivers, advocates, or Legally Authorized Representatives of the Member.

f. Warranties, repairs, or maintenance on assistive technology devices purchased through the waiver.

g. Adaptations to computers, or computer software related to the Member's identified needs in their Person-Centered Support Plan.

3. HCBS Brain Injury (BI) Waiver

a. For Members enrolled in the HCBS-BI Waiver, the following are covered Assistive Technology benefits:

i. Specialized medical equipment and supplies including devices controls, or appliances specified in the plan of care, which enable recipients to increase their abilities to perform Activities of Daily Living, or to perceive, control, or communicate with the environment in which they live.

ii. Assistive devices that augment an individual's ability to function at a higher level of independence.

iii. Assistive devices that enable the individual to secure help in the event of an emergency or are used to provide reminders to the individual of medical appointments, treatments, or medication schedules.

iv. Assistive devices to augment cognitive processes, "cognitive-orthotics" or memory prostheses. Examples of cognitive orthotic devices include informational databases, spell checkers, text outlining programs, timing devices, security systems, car finders, sounding devices, cueing watches, electronic medication monitors, and memory communication devices.

v. Training or technical assistance for the Member, or where appropriate, the Family Members, Guardians, caregivers, advocates, or Legally Authorized Representatives of the Member.

vi. Warranties, repairs, or maintenance on assistive technology devices purchased through the waiver.

b. All items shall meet applicable standards of manufacture, design, and installation.

8.7507.DAssistive Technology Exclusions and Limitations

1. Assistive technology devices and services are only available to meet needs identified through the Person-Centered Support Plan. They shall be the most cost effective and efficient means to meet the identified need and cannot be available through the Medicaid state plan, other HCBS Waiver Services, or third-party resources.

2. Items which are not of direct medical or remedial benefit to the Member are excluded

3. HCBS Supported Living Services (SLS) Waiver, Children's Extensive (CES) Waiver:

a. When the expected cost exceeds $2,500 per device, the Case Manager shall obtain and maintain three estimates in the case record and the most cost-effective option shall be selected. When it is not possible to obtain three estimates, documentation shall be maintained in the case record the reason for less than three estimates.

b. The following devices and services are specifically excluded under HCBS waivers and not eligible for reimbursement:

i. Purchase, training, or maintenance of service animals,

ii. Computers or cell phones unless prior authorized according to procedure.

iii. Training or adaptation directly related to a school or home educational goal or curriculum for members under 21 years of age.

iv. Internet or broadband access.

v. In-home installed video monitoring equipment.

vi. Medication reminders.

vii. Items considered as typical toys for children.

viii. Items or devices that are experimental.

ix. Items or devices that are used for typical daily activities and are not used to increase, maintain, or improve the functional capabilities of Members.

8.7507.EAssistive Technology Reimbursement Requirements

1. HCBS Supported Living Services (SLS) Waiver, Children's Extensive (CES) Waiver:

a. The total cost of home accessibility adaptations, vehicle modifications, and assistive technology shall not exceed $10,000 over the five-year life of the waiver without an exception granted by the Department.

b. Costs that exceed this limitation may be approved by the Department for devices to ensure the health and safety of the Member or that enable the Member to function with greater independence in the home or if it decreases the need for paid assistance in another waiver service on a long-term basis.

c. Requests for an exception shall be prior authorized within 30 days of the request in accordance with the Department's procedures.

2. HCBS Brain Injury (BI) Waiver:

a. Reimbursement for assistive devices will be on a per unit basis. If assistive devices are to be used primarily in a vocational application, devices should be funded through the Division of Vocational Rehabilitation with secondary funding from Medicaid.

10 CCR 2505-10-8.7507

47 CR 03, February 10, 2024, effective 3/16/2024

47 CR 21, November 10, 2024, effective 11/30/2024