10 Colo. Code Regs. § 2505-10-8.7528

Current through Register Vol. 47, No. 7, April 10, 2024

Section 10 CCR 2505-10-8.7528 - Independent Living Skills Training

8.7528.AIndependent Living Skills Training Eligibility

1. Independent Living Skills Training is a covered benefit available to Members enrolled in the HCBS Brain Injury Waiver.

8.7528.BIndependent Living Skills Training Descriptions and Definitions

1. Independent Living Skills Training (ILST) means services designed and developed based on the Member's ability to independently sustain themselves physically, emotionally, and economically in the community. ILST may be provided in the Member's residence or in the community.

2. ILST Person-Centered Support Plans are plans that describe the ILST services necessary to enable the Member to independently sustain themselves physically, emotionally, and economically in the community. This plan is developed with the Member and the provider.

3. ILST Trainers are individuals trained in accordance with guidelines listed below and tasked with providing the service to the Member.

4. The Person-Centered Support Plan is a plan of care created by a process that is driven by the individual and may also include people chosen by the individual, as well as the appropriate health care professional and the designated ILST trainer(s). It provides necessary information and support to the Member to ensure that they direct the process to the maximum extent possible. It documents Member choice, establishes goals, identifies potential risks, assures health and safety, and identifies the services and supports the Member needs to function safely in the community. This plan is developed by the Member, provider, and Case Manager.

8.7528.CIndependent Living Skills Training Inclusions

1. Reimbursable services are limited to the Assessment, training, maintenance, supervision, assistance, or continued supports of the following skills:

a. Self-care, including but not limited to basic personal hygiene;

b. Medication supervision and reminders;

c. Household management;

d. Time management skills training;

e. Safety awareness skill development and training;

f. Task completion skill development and training;

g. Communication skill building;

h. Interpersonal skill development;

i. Socialization, including but not limited to acquiring and developing appropriate social norms, values, and skills;

j. Recreation, including leisure and community integration activities;

k. Sensory motor skill development;

l. Benefits coordination, including activities related to the coordination of Medicaid services;

m. Resource coordination, including activities related to coordination of community transportation, community meetings, neighborhood resources, and other available public and private resources;

n. Financial management, including activities related to the coordination of financial management tasks such as paying bills, balancing accounts, and basic budgeting.

2. All Independent Living Skills Training shall be documented in the Person-Centered Support Plan. Reimbursement is limited to services described in the Person-Centered Support Plan.

8.7528.DIndependent Living Skills Exclusions and Limitations

1. Benefit is not provided for Members who reside in a Supportive Living Program (SLP) as defined in Section 8.7547.

2. Travel to and from the Member's home is not reimbursable.

8.7528.EIndependent Living Skills Training Provider Agency Requirements

1. Provider Agencies must have valid licensure and Certification as well as appropriate professional oversight.

a. Agencies seeking to provide ILST services must have a valid Home Care Agency Class A or B license or an Assisted Living Residency license and Transitional Living Program Certification from the Department of Public Health and Environment.

b. Agencies must employ an ILST coordinator with at least 5 years of experience working with individuals with disabilities on issues relating to life skills training, Brain Injury, and a degree within a relevant field.

i. This coordinator must review ILST Person-Centered Support Plans to ensure Member plans are designed and directed at the development and maintenance of the Member's ability to independently sustain himself/herself physically, emotionally, and economically in the community.

c. Any component of the ILST plan that may contain activities outside the scope of the ILST trainer must be created by the appropriate licensed professional within their scope of practice to meet the needs of the Member. These professionals must hold licenses with no limitations in one of the following professions:

i. Occupational Therapist;

ii. Physical Therapist;

iii. Registered Nurse;

iv. Speech Language Pathologist;

v. Psychologist;

vi. Neuropsychologist;

vii. Medical Doctor;

viii. Licensed Clinical Social Worker;

ix. Licensed Professional Counselor.

d. Professionals providing components of the ILST plan may include individuals who are Members of Agency staff, contracted staff, or external licensed and certified professionals who are fully aware of duties conducted by ILST trainers.

e. All ILST Person-Centered Support Plans containing any professional activity must be reviewed and authorized at least every 6 months, or as needed, by professionals responsible for oversight as referenced in 8.7528.E.1.c.i-iii

2. ILST trainers must meet one of the following education, experience, or Certification requirements:

a. Licensed health care professionals with experience in providing functionally based Assessments and skills training for individuals with disabilities; or

b. Individuals with a bachelor's degree and one (1) year of experience working with individuals with disabilities; or

c. Individuals with an associate degree in a social service or human relations area and two (2) years of experience working with individuals with disabilities; or

d. Individuals currently enrolled in a degree program directly related to but not limited to special education, occupational therapy, therapeutic recreation, and/or teaching with at least three (3) years of experience providing services similar to ILST services; or

e. Individuals with four (4) years direct care experience teaching or working with individuals with a Brain Injury or other cognitive disability either in a home setting, hospital setting, or rehabilitation setting.

3. The Agency shall administer a series of training programs to all ILST trainers.

a. Prior to delivery of and reimbursement for services, ILST trainers must complete the following trainings:

i. Person-centered care approaches;

ii. HIPAA and Member confidentiality;

iii. Basics of Brain Injury including at a minimum:

1) Basic neurophysiology;

2) Impact of a Brain Injury on an individual;

3) Epidemiology of Brain Injury;

4) Common physical, behavioral, and cognitive impairments and interactions strategies;

5) Best practices in Brain Injury recovery; and

6) Screening for a history of Brain Injury.

iv. On-the-job coaching by an incumbent ILST trainer;

v. Basic safety and de-escalation techniques;

vi. Training on community and public resource availability;

vii. Understanding of current brain injury recovery guidelines; and

viii. First aid.

b. ILST trainers must also receive ongoing training, required annually, in the following areas:

i. Cultural awareness;

ii. Updates on Brain Injury recovery guidelines; and

iii. Updates on resource availability.

8.7528.FIndependent Living Skills Training Provider Reimbursement

1. ILST shall be reimbursed according to the number of units billed, with one (1) unit equal to fifteen (15) minutes of service. Payment and billing may not include travel time to and from the Member's residence.

10 CCR 2505-10-8.7528

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