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To: Division of Disability and Rehabilitative Services Providers and Case Managers
From: Cathy Robinson, Director, Bureau of Developmental Disabilities Services
Re: Extended Services for Family Supports and Community Integration and Habilitation Waivers
Date: July 1, 2015
On June 26, 2015, the Division of Disability and Rehabilitative Services (DDRS) received approval from the Centers for Medicare and Medicaid Services (CMS) of the Family Supports Waiver (FSW) renewal. This followed the earlier approval of the division’s request to amend the Community Integration and Habilitation (CIH) Waiver. Both of the waiver documents are posted on the BDDS’ webpage.
For both waivers, as well as the Money Follows the Person-CIH grant (MFP-CIH), Extended Services has been added as a new service replacing Supported Employment Follow Along (SEFA), effective July 1, 2015. SEFA will no longer be offered on FSW, CIH or MFP-CIH effective June, 30, 2015.
At the bottom of this announcement is information from both of the approved waiver documents including the service definition as well as activities that are and are not allowed for Extended Services.
Providers who are currently approved for SEFA for the Family Supports and CIH Waivers and the MFPCIH grant will be automatically approved for Extended Services.
The new billing code for Extended Services is T2025 U7 U5 UA, and the new rate for this service will be $35.20 per 1.00 hourly unit. This is effective for dates of service on and after July 1, 2015.
The evening of Monday, June 29, an automated conversion will be completed to generate new Cost Comparison Budgets (CCB) for an individual who’s CCBs now include SEFA services for dates of July 1, 2015 and after. This conversion will change as followed:
On Tuesday, June 30, 2015, the Notice of Action (NOA) forms for any converted CCBs will be sent via secure email to service providers and case managers. Providers who have not received NOAs by Wednesday, July 1, 2015 should send a message to BDDS at Insite.Helpdesk@fssa.IN.gov with the name and RID number of the individuals.
Extended Services - Service Definition
Extended Services are ongoing employment support services which enable an individual to maintain integrated competitive employment in a community setting. Individuals must be employed in a community-based, competitive job that pays at or above minimum wage in order to access this service.
The initial job placement, training, stabilization may be provided through Indiana Vocational Rehabilitation Services. Extended Services provide the additional work related supports needed by the individual to continue to be as independent as possible in community employment. If an employed individual has obtained community based competitive employment and stabilization without Vocational Rehabilitation’s services, the participant is still eligible to receive Extended Services, as long as the participant meets the qualifications below.
Ongoing employment support services are identified in the participants’ Individualized Support Plan and must be related to the participants’ limitations in functional areas (i.e. self-care, understanding and use of language, learning, mobility, self-direction, capacity for independent living, economic self-sufficiency), as are necessary to maintain employment.
For Extended Services provided in a group setting, reimbursement equals the unit rate divided by the number of individuals served.
With the exception of 1:1 on the job coaching, support and observation, the potential exists for all components of the Extended Services’ definition to be applicable to either an individual waiver participant or to a group of participants. However, specific examples of activities that might be rendered in a group setting would include instructing a group of individuals on professional appearance requirements for various types of employment, reinforcement of work-related personal care or social skills, knowing how to get up in time to get ready for and commute to work. Groups could receive jobspecific or job-related safety training, self-advocacy training, or training on the use of public transportation. A group could receive training on computer skills or other job-specific tasks when group participants have similar training needs.
Only those waiver participants engaged in competitive community employment and actively utilizing a combination of Supported Employment Follow-Along (SEFA) and prevocational services as of June 30, 2015 (as reflected in their ISP, approved CCB and NOA) may utilize the combination of Extended Services and prevocational services on or after July 1, 2015.
Group services may only be rendered at the discretion of the IST and in group sizes no greater than four individuals to one staff. In addition, the provider must be able to provide appropriate documentation, as outlined in the DDRS Waiver Manual, demonstrating that the ratio for each claimed timeframe of services did not exceed the maximum allowable ratio determined by the IST for each group participant, and provide documentation identifying other group participants, by using the individuals’ HIPAA naming convention.
Activities Not Allowed
Reimbursement is not available under Extended Services for the following activities:
Supported employment services continue to be available under the Rehabilitation Act of 1973 through the Vocational Rehabilitation Services (VRS) program within FSSA/DDRS’s Bureau of Rehabilitation Services (BRS).
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