10 Colo. Code Regs. § 2505-10-8.7529

Current through Register Vol. 47, No. 8, April 25, 2024

Section 10 CCR 2505-10-8.7529 - Life Skills Training

8.7529.ALife Skills Training Eligibility

1. Life Skills Training is a covered benefit available to Members enrolled in one of the following HCBS waivers:

a. Community Mental Health Supports Waiver

b. Complementary and Integrative Health Waiver

c. Elderly, Blind, and Disabled Waiver

d. Supported Living Services Waiver

8.7529.BLife Skills Training Descriptions

1. Individualized training designed and directed with the Member to develop and maintain their ability to independently sustain themselves physically, emotionally, socially and economically in the community. Life Skills Training (LST) may be provided in the Member's residence or in the community.

2. Life Skills Training trainers directly support the Member by designing with the Member an individualized LST support plan. Trainers implement the plan to develop and maintain the Members' ability to independently sustain themselves physically, emotionally, socially and economically in the community.

3. The LST coordinator reviews the Member's LST support plan to ensure it is designed to meet the needs of the Member in order to enable them to independently sustain themselves physically, emotionally, and economically in the community.

8.7529.CLife Skills Training Inclusions

1. HCBS Elderly, Blind, and Disabled (EBD) Waiver; Community Mental Health Supports (CMHS) Waiver; Complementary and Integrative Health (CIH) Waiver; Supported Living Services (SLS) Waiver

2. Life Skills Training includes Assessment, training, maintenance, supervision, assistance, or continued supports of the following skills:

a. Problem-solving;

b. Identifying and accessing mental and behavioral health services;

c. Self-care and Activities of Daily Living;

d. Medication reminders and supervision, not including medication administration;

e. Household management;

f. Time management;

g. Safety awareness;

h. Task completion;

i. Communication skill building;

j. Interpersonal skill development;

k. Socialization, including, but not limited to: acquiring and developing skills that promote healthy relationships, assistance with understanding social norms and values, and support with acclimating to the community;

l. Recreation, including leisure and community engagement;

m. Assistance with understanding and following plans for occupational or sensory skill development;

n. Accessing resources and benefit coordination, including activities related to coordination of community transportation, community meetings, community resources, housing resources, Medicaid services, and other available public and private resources;

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

p. Acquiring and utilizing assistive technology when appropriate and not duplicative of training covered under other services.

8.7529.DLife Skills Training Service Access and Authorization

1. To obtain approval for Life Skills Training, the Member must demonstrate a need for the service as follows:

a. The Member demonstrates a need for training designed and directed to develop and maintain their ability to sustain themselves physically, emotionally, socially and economically in the community;

b. The Member identifies skills for which training is needed and demonstrates that without the skills, the Member risks their health, safety, or ability to live in the community;

c. The Member demonstrates that without training they could not develop the skills needed; and

d. The Member demonstrates that with training they have the ability to acquire these skills or services necessary within 365 days.

2. To establish eligibility for Life Skills Training, the Member must satisfy general criteria for accessing the service:

a. The Member is transitioning from an institutional setting to a Home and Community-Based setting, or is experiencing a qualifying change in life circumstance that affects a Member's stability and endangers their ability to remain in the community;

b. The Member demonstrates a need to develop or sustain independence to live or remain in the community upon their transitioning; and

c. The Member demonstrates that they need the service to establish community support or resources where they may not otherwise exist.

8.7529.ELife Skills Training Service Requirements

1. The Member's Case Manager must not authorize Life Skills Training for more than 365 days. The Department, in its sole discretion, may grant an exception based on extraordinary circumstances.

2. The LST coordinator must share the LST support plan with the Member' providers of other HCBS services that support or implement any LST services The LST coordinator will seek permission from the Member prior to sharing the LST program Person-Centered Support Plan, or any portion of it, with other providers; and

3. Any component of the LST support plan that may contain activities outside the scope of the LST trainer's scope of expertise or licensure must be created by the appropriately licensed professional within his/her scope of practice.

4. All LST support plans containing any professional activity must be reviewed and authorized monthly during the service period, or as needed, by professionals responsible for oversight.

5. All LST providers must maintain a LST support plan that includes:

a. Monthly skills training plans to be developed and documented;

b. Skills training plans that include goals, goals achieved or failed, and progress made toward accomplishment of continuing goals;

c. The start and end time/duration of service provision;

d. The nature and extent of service;

e. A description of LST activities;

f. Progress toward support plan goals and objectives; and

g. The provider's signature and date.

6. The LST support plan shall be sent to the Case Management Agency responsible for the support plan on a quarterly basis, or as requested by the Case Management Agency.

7. The LST support plan shall be shared, with the Member's permission, with the Member's providers of other HCBS services.

8.7529.FLife Skills Training Service Exclusions and Limitations

1. Members may utilize LST up to 24 units (six hours) per day, for no more than 160 units (40 hours) per week, for up to 365 days following the first day the service is provided.

2. LST is not to be delivered simultaneously during the direct provision of Adult Day Services, Group Behavioral Counseling, Consumer Directed Attendant Support Services (CDASS), Health Maintenance Activities, Homemaker, In-Home Support Services (IHSS), Mentorship, Peer Mentorship, Personal Care, Prevocational Services, Respite, Specialized Habilitation, Supported Community Connections, or Supported Employment.

a. LST services may be provided in conjunction with Non-Medical Transportation if it is described in the Member's LST support plan. Services are billable only when provided by an enrolled NMT provider, who is not the LST provider.

3. LST does not include services offered through State Plan or other Waiver Services, except those that are incidental to the LST training activities or purposes or are incidentally provided to ensure the Member's health and safety during the provision of LST.

8.7529.GLife Skills Training Service Provider Agency Requirements

1. The Provider Agency must employ an LST coordinator with at least 5 years of experience working with individuals with disabilities on issues relating to life skills training, or a degree within a relevant field; and

2. The Provider Agency must ensure any component of the LST plan that may contain activities outside the scope of the LST trainer's expertise or licensure must be created by an appropriately licensed professional acting within his/her scope of practice.

a. The professional must hold a license with no limitations in the scope of practice appropriate to meet the Member's LST needs. The following licensed professionals are authorized to furnish LST training:

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; or

x. Board Certified Behavior Analyst (BCBA).

b. An appropriately licensed professional providing a component(s) of the LST plan may be an Agency staff Member, contract staff Member, or external licensed and certified professionals who are fully aware of duties conducted by LST trainers.

3. A Provider Agency must maintain a Class A or B Home Care Agency License issued by the Colorado Department of Public Health and Environment if that Agency chooses to provide training on Personal Care as defined at Section 8.7536

4. The Agency must employ one or more LST Trainers to directly support Members, one-on-one, by designing with the Member their LST support plan and implementing the plan for the Member's training.

a. An individual is qualified to be an LST trainer only if they are:

i. A licensed healthcare professional with experience in providing functionally based Assessments and skills training for individuals with disabilities;

ii. An individual with a bachelor's degree and one (1) year of experience working with individuals with disabilities;

iii. An individual with an associate's degree in a social service or human relations area and two (2) years of experience working with individuals with disabilities;

iv. An individual currently enrolled in a degree program directly related to special education, occupational therapy, therapeutic recreation, and/or teaching with at least three (3) years of experience providing services similar to LST services;

v. An individual with four (4) years direct care experience teaching or working with needs of individuals with disabilities; or

vi. An individual with four (4) years of lived experience transferable to training designed and directed with the Member to develop and maintain his/her ability to sustain himself/herself physically, emotionally, socially and economically in the community. The provider must ensure that this individual receives Member-specific training sufficient to enable the individual to competently provide LST to the Member consistent with the LST support plan.

b. Prior to delivery of and reimbursement for any services, LST trainers must complete the following trainings:

i. Person-centered support approaches;

ii. HIPAA and Member's confidentiality;

iii. Basics of working with the population to be served;

iv. On-the-job coaching by the provider or an incumbent LST trainer on the provision of LST training;

v. Basic safety and de-escalation techniques;

vi. Community and public resource availability; and

vii. Recognizing emergencies and knowledge of emergency procedures including basic first aid, home and fire safety.

c. The Provider Agency must ensure that staff acting as LST trainers receive ongoing training within 90 days of unsupervised contact with a Member, and no less than once annually, in the following areas:

i. Cultural awareness;

ii. Updates on working with the population to be served; and

iii. Updates on resource availability.

8.7529.HLife Skills Training Service Provider Agency Reimbursement:

1. LST may be billed in 15-minute units. Members may utilize LST up to 24 units (six hours) per day, no more than 160 units (40 hours) per week, for up to 365 days following the first day the service is provided.

2. Payment for LST shall be the lower of the billed charges or the maximum rate of reimbursement.

3. LST may include escorting Members if doing so is incidental to performing an authorized LST service. However, costs for transportation in addition to those for accompaniment may not be billed LST services. If accompaniment and transportation are provided through the same Agency, the person providing transportation may not be the same person who provided accompaniment as a LST benefit to the Member.

10 CCR 2505-10-8.7529

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