10 Colo. Code Regs. § 2505-10-8.7541

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

Section 10 CCR 2505-10-8.7541 - Residential Habilitation Service and Supports

8.7541.AResidential Habilitation Service and Supports Eligibility

1. Residential Habilitation Service and Supports is a covered benefit available to Members enrolled in the HCBS Developmental Disabilities Waiver.

8.7541.BResidential Habilitation Service and Supports Definition

1. Residential Habilitation Service and Supports (RHSS) provide service, supports, and supervision up to 24 hours per day.

8.7541.CResidential Habilitation Service and Supports Inclusions

1. Services are provided to ensure the health, safety and welfare of the Member, and to provide training and habilitation services or a combination of training (i.e., instruction, skill acquisition) and supports in the areas of personal, physical, mental and social development and to promote independence, self-sufficiency and community inclusion. Services and supports are designed to meet the unique needs of each Member determined by the assessed needs, personal goals, and other input provided by the Member Identified Team and to provide access to and participation in typical activities and functions of community life.

2. Members receiving Residential Habilitation Service and Supports must have up to 24-hour supervision. Supervision may be on-site (direct service provider or caregiver is present) or accessible (direct service provider or caregiver is not on site but available to respond when needed). Staffing arrangements must be adequate to meet the health, safety and welfare of the Member and the needs of the Member as determined by the Person-Centered Support Plan. The Provider Agency is responsible for verifying that any direct care provider they employ or contract with has the capacity to serve the Members in their care, as described in the care plan.

3. Members are presumed able to manage their own funds and possessions unless otherwise documented in the Person-Centered Support Plan and Provider Care Plan.

4. Residential Habilitation Service and Supports includes medical and health care services that are integral to meeting the daily needs of the Member.

a. Individual Residential Support Services (IRSS)

i. IRSS includes skilled care that may be performed by a Certified Nursing Assistant (CNA) or lower.

b. Group Residential Services and Supports (GRSS)

ii. GRSS includes nursing services set forth at 6 C.C.R. 1011-1 Chapter 8, Part 16.

8.7541.D Residential Habilitation Service and Supports Provider Agency Requirements

1. The Provider Agency must send documented notification to the Member, Guardians, other Legally Authorized Representatives, and the Case Manager at least 30 days prior to proposed changes in setting placements.

a. If an immediate move is required for the protection of the Member, the Provider Agency must send documented notification to the Member, Guardians, other Legally Authorized Representatives, and the Case Manager as soon as possible before the move or no later than three days after the move.

b. The Provider Agency must include the Member, Guardians, and other Legally Authorized Representatives, as appropriate, in planning subsequent placements. Any Member of the Member Identified Team may request a meeting to discuss the change in placement.

c. When a Member moves settings or providers, all residential providers involved must be present for the move, or designate a Legally Authorized Representative to be present, and must ensure all possessions, medications, money and pertinent records are transferred to the Member within 24 hours.

d. A Member, Guardians, or other Legally Authorized Representative, as appropriate, wishes to contest a change in setting shall follow the Grievance procedure of the Agency.

2. The Provider Agency is responsible for monitoring conditions at the setting to ensure compliance and must provide oversight and guidance to safeguard the health, safety, and welfare of the Member.

3. The Provider Agency must provide for and document the regular on-site monitoring of Residential Habilitation Service and Supports. Provider's must conduct an on-site visit of each IRSS or GRSS setting before a Member moves in, and at a minimum once every quarter, with at least one visit annually that is unscheduled. On-site monitoring of IRSS and GRSS settings must include, but not be limited to:

a. Inspection of all smoke alarms and carbon monoxide detectors;

b. Ensuring all exits are free from blockages to egress;

c. Review of each Member's emergency and disaster Assessment; and

d. Medication administration records and physician orders.

10 CCR 2505-10-8.7541

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

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