12 VAC 30-120-710     GENERAL COVERAGE AND REQUIREMENTS

710 B.2.

Omit Aand medically necessary.@

710 C.2.a.

Omit “or the individual’s care manager.”

710 C.2.c.

Omit the last sentence “A waiting list of emergency cases will not be kept.”

12 VAC 30-120-720 RECIPIENT QUALIFICATION AND ELIGIBILITY REQUIREMENTS, INTAKE PROCESS

720 A.2.

The Regulation should reflect the personal maintenance increase.

720 B.2.

Reorganize this section to appropriately reflect the process an individual uses to request screening and the date used for placement on the waiting list.

720 B.7.

Clarify that the individual cannot be charged a fee, including the cost of assessment, as part of the eligibility/screening process.

720 B.8.

Modify the first sentence of this section by adding “if appropriate” after “family/caregiver.”

720 B.11.

Clarify that the MR case manager is responsible to notify entities when the transfer occurs.

720 D.1.

In the first sentence of this section replace “DMAS” with “the individual or their representative.”

Clarify that the Screening Team has 45 days to notify the individual they are eligible.

720 D.3.

Add “, place on a waiting list” between “Medicaid coverage” and “or deny for Medicaid coverage.”

720 D.5.c.

Omit this item.

720 D.7 and 8

Terminology is inconsistent in these sections and should be revised.

720 F.1.a.

Modify the first sentence of this section by adding “if appropriate” after “family/caregiver.”

720 F.1.d.

Add “DMAS shall provide their decision regarding services to the support coordinator within 14 days of receiving the request for review of the plan.”

12 VAC 30-120-750     IN-HOME RESIDENTIAL SUPPORT SERVICES

750 A.2.

Clarify that other services, not just the three listed in this item, can be used simultaneously with in-home residential support services.

12 VAC 30-120-752     DAY SUPPORT SERVICES

752 B.2.

The new description of Levels of day support@ is confusing.  Clarify the difference between Aprimarily at one location/building@ and Aprimarily in community settings.@

12 VAC 30-120-754     SUPPORTED EMPLOYMENT SERVICES

754 D.2.

The second sentence should read as follows: AIf the individual is eligible to receive services through the Individuals with Disabilities Education Act .....@

12 VAC 30-120-756     THERAPEUTIC CONSULTATION

Comment

Since this service does not include direct therapy, it is important to clarify which services can be used as positive behavioral support and applied behavioral analysis as outlined in the June 26, 2006 DMAS Medicaid Memo to providers.

12 VAC 30-120-758     ENVIRONMENTAL MODIFICATIONS

758 A.

Amend the current restriction on “primary home” and “primary vehicle” to allow two homes and two vehicles to be made accessible with environmental modifications.

758 A. and C.

Comport these two sections so that the term “prior authorized” is used consistently.

12 VAC 30-120-762     ASSISTIVE TECHNOLOGY

762 C.

Amend the service description to clarify that the service includes training on the use of assistive technology.

12 VAC 30-120-766     PERSONAL CARE AND RESPITE CARE SERVICES

766 A.

The last sentence of this section, add the Virginians with Disabilities Act.

766 B.2.

Omit “living in the home.”

766 C.6.

Replace “one other individual” with “three other individuals.”

12 VAC 30-120-770     CONSUMER-DIRECTED SERVICES

770 A.2.

In the second sentence, replace “a family caregiver” with another appropriate person.”

770 A.5.

In the last sentence of this section replace “service facilitation” with “consumer directed.”

770 B.5.

Replace “The CD services facilitator” with “The CD fiscal contractor.”

12 VAC 30-120-776     COMPANION SERVICES

776 A.

Add the following: AAssistance with activities of daily living may be an incidental part of CD companion services.@

776 B.1.

Modify the criteria so that the service can be used by individuals regardless of whether or not they can be left alone.  The criteria should focus on the fact that people need this service to assist with or support the individual with IADLs and socialization.

776 D.6.

In the second sentence of this section, add “potential” before “consumer-directed employees.”

Add a new section titled Procedural Safeguards.  The following items should be organized into this new section include appeal rights; choice of providers; complaints; consent; discharge; participation in meetings; informed choice; procedural safeguards statement; records and written notice.