10 Colo. Code Regs. § 2505-10-8.7550

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

Section 10 CCR 2505-10-8.7550 - Supported Living Program

8.7550.ASupported Living Program Eligibility

1. Supported Living Program is a covered benefit available to Members enrolled in the HCBS Brain Injury Waiver

8.7550.BSupported Living Program Definitions

1. The Supportive Living Program (SLP) means an Assisted Living Residence as defined at 6 C.C.R. 1011-1, Chapter VII, Section 2, which has been licensed by the Colorado Department of Public Health and Environment (CDPHE) and has been certified by the Department to provide Supportive Living Program services to Medicaid Members. The Supportive Living Program is a specialized assisted living service for Members with brain injuries. Settings are certified. Services include 24-hour oversight, Assessment, training and supervision of self-care, medication management, behavioral management, and cognitive supports. They also include interpersonal and social skills development.

8.7550.CSupported Living Program Inclusions

1. Supportive Living Program services consist of structured services designed to provide:

a. Assessment;

b. Protective Oversight and supervision as defined at Section 8.7506.B.2;

c. Behavioral Management and Education;

d. Independent Living Skills Training in a group or individualized setting to support:

i. Interpersonal and social skill development;

ii. Improved household management skills; and

iii. Other skills necessary to support maximum independence, such as financial management, household maintenance, recreational activities and outings, and other skills related to fostering independence.

e. Community Participation;

f. Transportation between therapeutic activities in the community;

g. Activities of Daily Living (ADLs);

h. Personal Care and Homemaker services; and

i. Health Maintenance Activities.

j. The Supportive Living Program provider shall ensure that each Member is furnished with their own personal hygiene and care items. These items are to be considered basic in meeting a Member's need for hygiene and remaining healthy. Any additional items may be selected and purchased by the Member at their discretion.

2. Servic Planning

a. Supportive Living Program Provider Agencies must comply with the Person-Centered Support Planning process. Providers must work with Case Management agencies to ensure coordination of a Member's Person-Centered Support Plan and Provider Care Plan. Additionally, Supportive Living Program providers must provide the following actionable plans for all Brain Injury (BI) waiver Members, updated every six (6) months:

i. Transition Planning; and

ii. Goal Planning.

b. These elements of a care plan are intended to ensure the Member actively engages in their care and activities and is able to transition to any other type of setting or service when desired.

8.7550.D Supported Living Program Exclusions and Limitations

1. The following are not included as components of the Supportive Living Program:

a. Room and board shall not be a benefit of Supportive Living Program services, as set forth at Section 8.7413.

b. Additional services which are available as a State Plan benefit or other Brain Injury waiver service. Examples include, but are not limited to physician visits, mental health counseling, substance abuse counseling, specialized medical equipment and supplies, physical therapy, occupational therapy, long-term home health, and private duty nursing.

8.7550.ESupported Living Program Provider Agency Requirements

1. Staffing

a. The Supportive Living Program Provider Agency shall ensure sufficient staffing levels to meet the needs of Members.

b. The operator, staff, and volunteers who provide direct Member care or Protective Oversight as defined at 8.7506.B.2 must be trained in precautions and emergency procedures, including first aid, to ensure the safety of the Member. Within one month of the date of hire, the Supportive Living Program Provider Agency shall provide adequate training for staff on each of the following topics:

i. Crisis prevention;

ii. Identifying and dealing with difficult situations;

iii. Cultural competency;

iv. Infection control; and

v. Grievance and Complaint procedures.

c. In addition to the requirements of 6 C.C.R. 1011-1 Ch. 7, the Department requires that the program director shall have an advanced degree in a health or human service-related profession plus two years of experience providing direct services to persons with a Brain Injury. A bachelor's or nursing degree with three years of similar experience, or a combination of education and experience shall be an acceptable substitute.

d. The Supportive Living Program shall ensure that provision of services is not dependent upon the use of Members to perform staff functions. Volunteers may be utilized in the home but shall not be included in the Provider Agency's staffing plan in lieu of employees.

2. Environmental and Maintenance Requirements

a. Supportive Living Program providers shall develop and implement procedures for the following:

i. Handling of soiled linen and clothing;

ii. Storing personal care items;

iii. General cleaning to minimize the spread of pathogenic organisms; and

iv. Keeping the home free from offensive odors and accumulations of dirt and garbage.

8.7550.FSupported Living Program Provider Reimbursement Requirements

1. Room and board shall not be a benefit of Supportive Living Program services.

2. Supportive Living Program services shall be reimbursed according to a tiered per diem rate based on Member acuity, using a methodology determined by the Department.

3. Supportive Living Program services are subject to Post Eligibility Treatment of Income (PETI), as described in 8.7202.BB.

10 CCR 2505-10-8.7550

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

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