be provided by Responsible (check each that Person applies): Provider Specifications Provider Individual. List types: Agency. List the types of agencies: Category(s) Residential Support Agencies Provider Qualifications Provider Type: License Certificate Other Standard (specify) (specify) (specify) Residential 115 CMR 7.00 (Department Residential Residential Support Agency Provider Support Agencies of Developmental Services Support employees must possess appropriate Standards for all Services Agency qualifications as evidenced by and Supports) and 115 CMR Provider interview(s), two personal or professional 8.00 (Department of employees references and a Criminal Offender Developmental Services must have a Records Inquiry (CORI), be age 18 years Certification, Licensing and High School or older, be knowledgeable about what to Enforcement Regulations) or diploma, do in an emergency; be knowledgeable 104 CMR Chapter 28 GED or about how to report abuse and neglect, (Department of Mental relevant have the ability to communicate Health regulations governing equivalencies effectively in the language and Licensing and Operational or communication style of the participant, Standards for Community competencies. maintain confidentiality and privacy of the Programs). consumer, respect and accept different values, nationalities, races, religions, cultures and standards of living. Verification of Provider Qualifications Provider Type: Entity Responsible for Verification: Frequency of Verification Residential Support Department of Developmental Services (DDS) Every two years Agencies Office of Quality Enhancement, Survey and Certification staff. C-1/C-3: Service Specification Service Type: Other Service Service: Specialized Medical Equipment Service Specification Service Definition (Scope): Specialized Medical Equipment includes: (a) devices, controls, or appliances, specified in the plan of care, that enable participants to increase their ability to perform activities of daily living; (b) devices, controls, or appliances that enable the participant to perceive, control, or communicate with the environment in which they live; (c) items necessary for life support or to address physical conditions along with ancillary supplies and equipment necessary to the proper functioning of such items; (d) such other durable and non-durable medical equipment not available under the State plan that is necessary to address participant functional limitations; and, (e) necessary medical supplies not available under the State plan. In addition to the acquisition of the Specialized Medical Equipment itself this service may include:
be provided by (check each that applies): Responsible Person Provider Specifications Provider Category(s) Individual. List types: Agency. List the types of agencies: Residential Support Agencies Provider Qualifications Provider Type: License (specify) Certificate (specify) Other Standard (specify) Residential Support Agencies 115 CMR 7.00 (Department of Developmental Services Standards for all Services and Supports) and 115 CMR 8.00 (Department of Developmental Services Certification, Licensing and Enforcement Regulations) or 104 CMR Chapter 28 (Department of Mental Health regulations governing Licensing and Operational Standards for Community Programs). Residential Support Agency Provider employees must have a High School diploma, GED or relevant equivalencies or competencies. Residential Support Agency Provider employees must possess appropriate qualifications as evidenced by interview(s), two personal or professional references and a Criminal Offender Records Inquiry (CORI), be age 18 years or older, be knowledgeable about what to do in an emergency; be knowledgeable about how to report abuse and neglect, have the ability to communicate effectively in the language and communication style of the participant, maintain confidentiality and privacy of the consumer, respect and accept different values, nationalities, races, religions, cultures and standards of living. Verification of Provider Qualifications Provider Type: Entity Responsible for Verification: Frequency of Verification Residential Support Agencies Department of Developmental Services (DDS) Office of Quality Enhancement, Survey and Certification staff. Every two years C-1/C-3: Service Specification Service Type: Other Service Service: Specialized Medical Equipment Service Specification Service Definition (Scope): Specialized Medical Equipment includes: (a) devices, controls, or appliances, specified in the plan of care, that enable participants to increase their ability to perform activities of daily living; (b) devices, controls, or appliances that enable the participant to perceive, control, or communicate with the environment in which they live; (c) items necessary for life support or to address physical conditions along with ancillary supplies and equipment necessary to the proper functioning of such items; (d) such other durable and non-durable medical equipment not available under the State plan that is necessary to address participant functional limitations; and, (e) necessary medical supplies not available under the State plan. In addition to the acquisition of the Specialized Medical Equipment itself this service may include:
ABI-RH%20Renewal%20Application-Clean%20draft-October%202017.docx