Resource: Waiver service options to consider as additional supports

Page posted: 1/26/24

This page is part of CBSM – Guide to support a person with a residential service termination notice from a 245D-licened provider, a toolkit to support a person on a disability waiver or in an ICF/DD with a residential service termination notice. To access other parts of this toolkit, refer to:

· Overview of the process for residential service termination.

· Case manager responsibilities and legal rights of the person or their legal representative.

· Non-waiver service support options to consider as additional supports.

· Mental health service options to consider as additional supports.

When a person receives a residential service termination notice, the lead agency can consider authorizing the waiver service options on this page.

Intervention services for adults and children

Intervention services through a disability waiver provide support:

· Before a person experiences a crisis.

· When a person experiences a crisis.

· When caregivers need specialized training.

· When a person wants to improve their quality of life through person-centered positive supports.

Waiver intervention services include the following options.

Positive support services

Positive support services include the following activities for adults and children:

· Develop a positive behavior support plan to teach an alternative, positive behavior that will result in an increase in the person’s quality of life and decrease of the challenging behavior.

· Use person-centered approaches to incorporate a comprehensive, functional behavior assessment of both positive and challenging behavior.

· Teach the person skills to manage their specific needs.

· Teach caregivers (paid and unpaid) additional skills to support the person’s specific needs.

· Ensure active supports are in place and identify outcomes to increase the person’s quality of life.

For more information, refer to CBSM – Positive support services.

Crisis respite services

Crisis respite services include the following activities for adults and children:

· Support the person to cope with immediate stressors.

· Identify additional support resources.

· Develop intervention support plans.

· Avoid unnecessary institutional level of care.

· Return the person’s functional level to pre-crisis.

· Facilitate the person’s successful transition to other service providers.

· Train caregivers to support the person to avoid future crises.

Crisis respite providers are licensed to provide services in a person’s own home, family home, 245D-licensed community residential setting, adult foster care setting, child foster care setting, community setting and workplace. Providers can delivery crisis respite as:

· In-home daily.

· Out-of-home daily.

· 15-minute units.

The lead agency can authorize crisis respite to keep the person in their primary community-based home (licensed setting or own home). Crisis respite helps the person avoid institutional levels of care.

The person can receive crisis respite in their community. They do not have to relocate to a licensed setting.

For more information, refer to CBSM – Crisis respite services.

Specialist services

Specialist services include services provided by an expert or professional that are designed to promote, support and augment staff and caregiver competency to meet a person’s needs in eligible areas. Adults and children can receive this service. For more information, refer to CBSM – Specialist services.

Waiver services for adults and children in their own home

For the definition of “own home,” refer to CBSM – Requirements for a person’s own home.

Chore services

Chore services provide assistance to a person or their primary caregiver to help maintain a clean, sanitary and safe environment. For more information, refer to CBSM – Chore services.

Consumer directed community supports (CDCS)

CDCS is a service option available through all waivers that allows a person to buy non-traditional supports, such as special therapies, assistive technology and home and vehicle modifications. For more information, refer to the CDCS Policy Manual.

Homemaker

Homemaker helps a person manage general cleaning and household activities. For more information, refer to CBSM – Homemaker.

Independent living skills (ILS) therapies

ILS therapies include art, music or recreational therapies with specific therapeutic goals and outcomes. For more information, refer to CBSM – ILS therapies.

Individualized home supports (IHS)

IHS includes options without training, with training and with family training. It provides services for people who live in their own home or family home that provide support and/or training in community living service categories. IHS covers community living services in four categories:

· Community participation.

· Health, safety and wellness.

· Household management.

· Adaptive skills.

For more information, refer to CBSM – IHS.

Night supervision services

Night supervision services include an awake staff person who provides overnight assistance and supervision in a person’s own home. For more information, refer to CBSM – Night supervision services.

Other service options

24-hour emergency assistance

24-hour emergency assistance provides on-call counseling, problem solving and/or immediate response for assistance at a person’s home due to a health or personal emergency. For more information, refer to CBSM – 24-hour emergency assistance.

Life-sharing arrangement

Life sharing is a relationship-based living arrangement that carefully matches an adult age 18 or older who has a disability with an individual or family who will share their life and experiences and support the person using person-centered practices. In this arrangement, the individual/family owns or rents the home, and the county/tribal nation licenses the physical home. For more information, refer to CBSM – Resource: Life-sharing matching process and ongoing supports.

Caregiver living expenses

Caregiver living expenses cover certain expenses incurred by an unrelated caregiver who lives in the same household as a person age 18 or older who receives waiver services when the caregiver also provides an approved service. For more information, refer to CBSM – Caregiver living expenses.

Respite

Respite provides short-term care services to a person when their primary caregiver is absent or needs relief. There are two types:

· In-home respite: Respite provided to a person in their home. This can include time spent in community locations used by the general public (e.g., malls, parks, libraries) while the person continues to stay in their home.

· Out-of-home respite: Respite provided to a person in a licensed setting or unlicensed setting that is not the person’s home. This can include time spent in community locations used by the general public (e.g., malls, parks, libraries) while the person stays in a licensed or unlicensed setting that is not their home.

For more information, refer to CBSM – Respite.