Participants in the Assisted Living Waiver Pilot Project will have access to seven waiver benefits:
- Assisted Living Services (these services are called the Assisted Living Bundle when they’re provided in an RCFE and Assisted Care when they’re provided by a licensed Home Health Agency and delivered to residents of publicly-funded housing)
- Care Coordination
- Nursing Facility Transition Care Coordination
- Translation and Interpretation Services
- Consumer Education
- Environmental Accessibility Adaptations
- Community Transition Services
These benefits are described below.
Assisted Living Services include:
- Developing a Service Plan for each resident that details, at a minimum, the frequency and timing of assistance. Residents must be a part of the development process and must sign the Service Plan;
- Providing personal care and assistance with ADLs sufficient to meet both the scheduled and unscheduled needs of the residents;
- Washing, drying and folding all laundry;
- Performing all necessary housekeeping tasks;
- Maintaining the facility;
- Providing three meals per day plus snacks. Food must meet minimum daily nutritional requirements;
- Providing intermittent skilled nursing services as required by residents;
- In accordance with State law, providing assistance with the self-administration of medications or, as necessary, administering medications;
- Providing or coordinating transportation;
- Providing daily recreational activities;
- Providing social services;
- Providing a response system that enables waiver beneficiaries to summon assistance from personal care providers.
Care Coordination includes identifying, organizing, coordinating and monitoring services needed by a participant. Care Coordinators enroll clients, conduct assessments, develop Individualized Service Plans, arrange for services, maintain contact with participants, and monitor service delivery.
Nursing Facility Transition Care Coordination helps transition clients from nursing facilities to the community.
Translation and Interpretation Services help facilitate the assessment and re-assessment process for limited and non English-speaking clients.
Consumer Education services are intended to promote clients’ independence, help them exercise their rights, and assist them to acquire the skills needed to exercise control and responsibility over the services they receive.
Environmental Accessibility Adaptations are physical adaptations to the home required by the client’s Individual Service Plan that are necessary to ensure the health, welfare and/or safety of the client, or enable the client to function with greater independence in the home. Without these services the client would require institutionalization. Such adaptations may include the installation of ramps and grab-bars, widening of doorways, modifications of bathroom facilities, or installation of specialized electric and plumbing systems. This service is only available to residents of publicly-funded housing.
The Community Transition Services benefit is available only to individuals who are transitioning from a nursing facility to an Assisted Living setting. The benefit provides assistance with one-time costs associated with establishing a residence.
Reimbursement Rates for Services
