APPENDIX B – COVERED SERVICES DEFINTIONS Exhibit 4: New Community-based Services Day Services that provide for on-site structured day activity typically for Enrollees with pervasive and extensive support needs who are not ready to join the general workforce. Such day services are individually designed around Consumer choice and preferences with a focus on improvement or maintenance of the person’s skills and their ability to live as independently as possible in the community; Such services often include assistance to learn activities of daily living and functional skills; language and communication training; compensatory, cognitive, and other strategies; interpersonal skills; prevocational skills; and recreational/socialization skills. Home Care Services provided within the Enrollee’s home or in the community. Such services include several types of home supports, including: Providing a worker or support person to perform general household tasks such as preparing meals, doing laundry and routine housekeeping, and/or to provide companionship to the member; Providing a range of personal support and assistance to enable an Enrollee to accomplish tasks that they would normally do for themselves if they could, including such things as help with bathing, dressing, personal hygiene and other activities of daily living. Such assistance may take the form of hands-on assistance or cueing and supervision to prompt the Enrollee to perform a task; Providing a variety of activities to help the Enrollee acquire, retain, or improve his/her skills related to personal finance, health, shopping, use of community resources, community safety, and other social and adaptive skills to live in the community. This may include skills training and education in self-determination and self-advocacy to enable the Enrollee to acquire skills to exercise control and responsibility over the services and supports they receive, and to become more independent, integrated, and productive in their communities; and Requires all such home care services/supports to be appropriate when the Enrollee needs them and/or when the person who is regularly responsible for the activities, such as a family caregiver, is absent or unable to manage the tasks. Respite Care services provided within the Enrollee’s home or in locations such as hospitals, rest homes, nursing facilities, assisted living residences, adult day health or adult foster care. Such services include services provided to an Enrollee to support his/her caregiver (family member, friend); and
APPENDIX B – COVERED SERVICES DEFINTIONS Exhibit 4: New Community-based Services Day Services that provide for on-site structured day activity typically for Enrollees with pervasive and extensive support needs who are not ready to join the general workforce. Such day services are individually designed around Consumer choice and preferences with a focus on improvement or maintenance of the person’s skills and their ability to live as independently as possible in the community; Such services often include assistance to learn activities of daily living and functional skills; language and communication training; compensatory, cognitive, and other strategies; interpersonal skills; prevocational skills; and recreational/socialization skills. Home Care Services provided within the Enrollee’s home or in the community. Such services include several types of home supports, including: Providing a worker or support person to perform general household tasks such as preparing meals, doing laundry and routine housekeeping, and/or to provide companionship to the member; Providing a range of personal support and assistance to enable an Enrollee to accomplish tasks that they would normally do for themselves if they could, including such things as help with bathing, dressing, personal hygiene and other activities of daily living. Such assistance may take the form of hands-on assistance or cueing and supervision to prompt the Enrollee to perform a task; Providing a variety of activities to help the Enrollee acquire, retain, or improve his/her skills related to personal finance, health, shopping, use of community resources, community safety, and other social and adaptive skills to live in the community. This may include skills training and education in self-determination and self-advocacy to enable the Enrollee to acquire skills to exercise control and responsibility over the services and supports they receive, and to become more independent, integrated, and productive in their communities; and Requires all such home care services/supports to be appropriate when the Enrollee needs them and/or when the person who is regularly responsible for the activities, such as a family caregiver, is absent or unable to manage the tasks. Respite Care services provided within the Enrollee’s home or in locations such as hospitals, rest homes, nursing facilities, assisted living residences, adult day health or adult foster care. Such services include services provided to an Enrollee to support his/her caregiver (family member, friend); and