Validation Review Checklist Physical Location 3 2 1 Recommendations/Comments Acceptable evidence of support may include: notes/minutes where there is The evidence provided clearly supports that the location where services are being agreement between various provided are in the community among other private residences or retail businesses; stakeholders that this is true have the same access to goods/services as persons not receiving HCBS; and do NOT A copy of licenses inclusive of lack of have the following characteristics: license for private ICF/DD Located in a building that is also publically or privately operated facility that If the agency does own/operate provides inpatient institutional treatment housing is it done under a separate Located on the grounds of or immediately adjacent to a public or private board and/or budget? If so, this could institution owned by the service provider support it as a separate entity and be considered in compliance. Own or operate multiple homes located on the same street (excluding duplexes and multiplexes, unless there is more than one on the same street. Specifically, for site visits-LGE staff would be able to verify location in Located in a for people with disabilities gated/secured “community” person and could visit some Designed specifically for people with developmental disabilities participant homes to assure compliance. Choice of Setting/Person-Centered 3 2 1 Recommendations/Comments Acceptable evidence of support may include: Review a sample plans of individual’s Evidence provided supports that individuals have been given choice as to where they care for agency will live and receive services. This includes: Review applicable policy/procedures Choice of provider, services, and settings for the agency Opportunity to visit/understand options available Review a sample of individual’s Individual has opportunity to regularly update or change preferences schedules Opportunity to participate in both work/non-work activities in the most Interview some of the individual’s integrated setting supported by the agency Opportunity and support to develop and update plans of care that reflect If the agency completes satisfaction individual needs and preferences with the they survey’s individual’s, Individual understands how/when to request planning meetings support could review a sample of those
Validation Review Checklist Physical Location 3 2 1 Recommendations/Comments Acceptable evidence of support may include: notes/minutes where there is agreement between various stakeholders that this is true A copy of licenses inclusive of lack of license for private ICF/DD If the agency does own/operate housing is it done under a separate board and/or budget? If so, this could support it as a separate entity and be considered in compliance. Specifically, for site visits-LGE staff would be able to verify location in person and could visit some participant homes to assure compliance. The evidence provided clearly supports that the location where services are being provided are in the community among other private residences or retail businesses; have the same access to goods/services as persons not receiving HCBS; and do NOT have the following characteristics: Located in a building that is also publically or privately operated facility that provides inpatient institutional treatment Located on the grounds of or immediately adjacent to a public or private institution owned by the service provider Own or operate multiple homes located on the same street (excluding duplexes and multiplexes, unless there is more than one on the same street. Located in a gated/secured “community” for people with disabilities Designed specifically for people with developmental disabilities Choice of Setting/Person-Centered 3 2 1 Recommendations/Comments Acceptable evidence of support may include: Review a sample individual’s plans of care for agency Review applicable policy/procedures for the agency Review a sample of individual’s schedules Interview some of the individual’s supported by the agency If the agency completes satisfaction survey’s with the individual’s, they support could review a sample of those Evidence provided supports that individuals have been given choice as to where they will live and receive services. This includes: Choice of provider, services, and settings Opportunity to visit/understand options available Individual has opportunity to regularly update or change preferences Opportunity to participate in both work/non-work activities in the most integrated setting Opportunity and support to develop and update plans of care that reflect individual needs and preferences Individual understands how/when to request planning meetings
STP091316CG.docx