10 Colo. Code Regs. § 2505-10-8.7537

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

Section 10 CCR 2505-10-8.7537 - Peer Mentorship

8.7537.APeer Mentorship Eligibility

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

a. Brain Injury Waiver

b. Community Mental Health Supports Waiver

c. Complementary and Integrative Health Waiver

d. Developmental Disabilities Waiver

e. Elderly, Blind, and Disabled Waiver

f. Supported Living Services Waiver

8.7537.BPeer Mentorship Definition

1. Peer Mentorship means support provided by peers to promote self-advocacy and encourage community living among Members by instructing and advising on issues and topics related to community living, describing real-world experiences as examples, and modeling successful community living and problem-solving.

8.7537.CPeer Mentorship Inclusions

1. HCBS Elderly, Blind, and Disabled (EBD) Waiver; Community Mental Health Supports (CMHS) Waiver; Complementary and Integrative Health (CIH) Waiver; Brain Injury (BI) Waiver; Supported Living Services (SLS) Waiver, Developmental Disabilities (DD) Waiver:

2. Peer Mentorship means support provided by peers of the Member on matters of community living, including:

a. Problem-solving issues drawing from shared experience.

b. Goal Setting, self-advocacy, community acclimation and integration techniques.

c. Assisting with interviewing potential providers, understanding complicated health and safety issues, and participating on private and public boards, advisory groups and commissions.

d. Activities that promote interaction with friends and companions of choice.

e. Teaching and modeling of social skills, communication, group interaction, and collaboration.

f. Developing community-Member relationships with the intent of building social capital that results in the expansion of opportunities to explore personal interests.

g. Assisting the person in acquiring, retaining, and improving self-help, socialization, self- advocacy, and adaptive skills necessary for community living.

h. Support for integrated and meaningful engagement and awareness of opportunities for community involvement including volunteering, self-advocacy, education options, and other opportunities identified by the individual.

i. Assisting Members to be aware of and engage in community resources.

8.7537.DPeer Mentorship Service Access and Authorizations

1. To obtain approval for Peer Mentorship, a Member must demonstrate:

a. A need for soft skills, insight, or guidance from a peer;

b. That without this service he/she may experience a health, safety, or institutional risk; and

c. There are no other services or resources available to meet the need.

2. To establish eligibility for Peer Mentorship, the Member must satisfy general criteria for accessing 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.

8.7537.EPeer Mentorship Exclusions and Limitations

1. Members may utilize Peer Mentorship up to 24 units (six hours) per day, for no more than 160 units (40 hours) per week, for no more than 365 days.

2. Services covered under the State Plan, another waiver service, or by other resources are excluded.

a. Services or activities that are solely diversional or recreational in nature are excluded.

b. Peer Mentorship shall not be provided by a peer who receives programming from the same residential location, day program location, or employment location as the Member.

8.7537.FPeer Mentorship Provider Agency Requirements

1. The Provider Agency must ensure services are delivered by a peer mentor staff who:

a. Has lived experience transferable to support a Member with acclimating to community living through providing them Member advice, guidance, and encouragement on matters of community living, including through describing real-world experiences, encouraging the Member's self-advocacy and independent living goals, and modeling strategies, skills, and problem-solving.

b. Is qualified to furnish the services customized to meet the needs of the Member as described in their Person-Centered Support Plan or Provider Care P;

c. Has completed training from the Provider Agency consistent with core competencies. Core competencies include:

i. Understanding boundaries;

ii. Setting and pursuing goals;

iii. Advocacy for Independence Mindset;

iv. Understanding of Disabilities, both visible and non-visible, and how they intersect with identity; and

v. Person-centeredness.

8.7537.GPeer Mentorship Documentation

1. All documentation, including but not limited to, employee files, activity schedules, licenses, insurance policies, claim submission documents and program and financial records, shall be maintained according to Section 8.7405 and provided to supervisor(s), program monitor(s) and auditor(s), and CDPHE surveyor(s) upon request, including:

a. Start and end time/duration of services;

b. Nature and extent of services;

c. Mode of contact (face-to-face, telephone, other);

d. Description of peer mentorship activities such as accompanying Members to complicated medical appointments or to attend board, advisory and commissions meetings, and support provided interviewing potential providers;

e. Progress toward support and care plan goals and objectives; and

f. Provider's signature and date.

8.7537.HPeer Mentorship Provider Agency Reimbursement

1. Peer Mentorship services are reimbursed based on the number of units billed, with one (1) unit equal to 15 minutes of service.

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

3. Reimbursement is limited to services described in the care plan.

10 CCR 2505-10-8.7537

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

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