Home and Community Based Services Waiver
(Adults and Children)

The Department of Mental Health and the Division of Medicaid have implemented a Home and Community-Based Services (HCBS) Waiver for individuals with mental retardation/developmental disabilities. The purpose of the HCBS Waiver is to provide services at home and in the community to people who would be eligible for services in an Intermediate Care Facility for persons with mental retardation (ICF/MR), if Waiver services were not available. The provision of Support Coordination by the five regional centers is a pivotal component of the MR/DD Waiver. Support Coordinators are responsible for arranging for the assessment of individuals by the Diagnostic Services Department at each regional center. They are also responsible for developing the written plan of care for each eligible individual, assisting him/her in locating and gaining access to all services on the plan of care.

Services available through the MR/DD Waiver Program include:

Attendant Care Services

Attendant care services are provided to meet daily living needs and to ensure adequate support for optimal functioning at home or in the community. Services include activities such as: support for community participation and integration; assistance with shopping and meal preparation; assistance with housekeeping; and, assistance with grooming and personal hygiene.

Respite Care

Respite care is provided for people who are unable to care for themselves, on a short-term basis, and because of the absence or need for relief of those persons normally providing the care. Respite care can be provided in a person's home or in a facility approved by the state which is not a private residence or a licensed ICF/MR. Respite care provided in the recipient's home may by provided by a registered nurse (RN) or licensed practical nurse (LPN) (in-home nursing respite) or a certified nurse assistant (CNA) (in-home companion respite), depending on the needs of the individual served. Respite care provided in the community is designed to provide families/care givers with an avenue of receiving respite while their family member is in a setting other than their home. Community respite is not provided overnight and cannot be provided in a private residence.

Residential Habilitation

Residential habilitation is defined as assistance with acquisition, retention or improvement in skills related to activities of daily living, such as personal grooming and cleanliness, bed making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a community living arrangement.

Supervised Residential Habilitation has staff available on-site 24 hours per day. No more than three individuals live together in an apartment or house, regardless of whether all three are eligible for MR/DD Waiver services. The staff:recipient ratio is 1:6, depending on the people served and their individual requirements. Staff must be able to respond to requests for assistance within five minutes.

Supported Residential Habilitation provides staff as needed to support individuals living independently in the community. Staff are on call 24 hours per day but need not be on-site 24 hours per day. The maximum number of hours that can be provided is seven (7) hours per week, depending on the needs of the individual. The support coordinator can authorize more hours per week as may be needed to meet unforeseen circumstances or needs. The staff:recipient ratio is 1:10.

Day Habilitation

Day habilitation services provide individual training and support in the acquisition, retention, or improvement of daily living, social, communication, self-help and other adaptive skills. Individual interaction with community resources is required. Intended outcomes of day habilitation include increased competency in activities of daily living, development of a positive self-image, and enhanced social interactions. Services are normally furnished four to six hours per day. Day habilitation cannot be used to supplant mandated educational services for school-aged persons.

Prevocational Services

Prevocational services, which consist of a range of activities, are directed at specific habilitation goals leading to vocational skill development, but are not job task oriented. They include teaching concepts such as compliance, attending, task completion, problem-solving and safety. These services can be either center-based or community-based. Community-based services are provided in sites typically used by others in the community which promote individual inclusion and independence in the community; center-based services are provided in work activity settings. Services are normally provided four hours per day unless provided as an adjunct to other day activities included on the plan of care, and depending on the needs of the individual.

If the individual engages in any form of compensable work as a necessary but subordinate part of habilitation services, the program must be a certified work activity center in accordance with Section 14(c) of the Fair Labor Standards Act.

Activities included in this service are not primarily directed at teaching specific job skills, but at underlying habilitative goals, such as attention span and motor skills. All prevocational services are to be reflected in the individual's plan of care as directed to habilitative, rather than explicit employment objectives.

Supported Employment Services

Supported employment services consist of paid employment for persons for whom competitive employment at or above the minimum wage is unlikely, and who, because of their disabilities, need intensive on-going support to perform in a work setting. Supported employment is conducted in a variety of settings, particularly work sites in which persons without disabilities are employed. Supported employment includes activities needed to sustain paid work by Waiver participants, including supervision and training. When supported employment services are provided at a work site in which persons without disabilities are employed, payment is made only for the adaptations, supervision and training required by waiver recipients as a result of their disabilities, and does include payment for the supervisory activities rendered as a normal part of the business setting.

Physical Therapy, Occupational Therapy, Speech/Language/Hearing Therapy

Physical and occupational therapy evaluations must be ordered by a physician. Therapies may only be provided by therapists licensed to practice in the State of Mississippi. Services may be provided in the home or habilitation setting.

Specialized Medical Supplies

Supplies covered through the MR-DD Waiver are diapers, underpads, and catheters. This service is available to those individuals who are not covered under the regular Medicaid State Plan or any other Medicaid program. Items reimbursed with waiver funds are in addition to any supplies furnished under the State Plan.

Behavior Support/Intervention

Behavior support/intervention provides support services for individuals who exhibit behavior problems that cause them not to benefit from other services being provided or cause them to be so disruptive in their environment(s) that there is imminent danger of institutionalization. The provider works directly with the individual and also trains staff and family members to assist them in implementing specific behavior support/intervention programs.

 

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