Current through Register Vol. 50, No. 9, September 20, 2024
A.
Skilled maintenance therapy is therapy services that may be received by
participants in the home or rehabilitation center.
B. Skilled maintenance therapy services
include physical therapy, occupational therapy, and speech and language
therapy.
C. Therapy services
provided to participants are not necessarily tied to an episode of illness or
injury and instead focus primarily on the participant's functional need for
maintenance of, or reducing the decline in, the participant's ability to carry
out activities of daily living.
D.
Skilled maintenance therapies may also be used to assess a participant's need
for assistive devices or home modifications, training the participant and
family members in the use of the purchased devices, performance of in-home fall
prevention assessments, and participation on the POC planning team.
E. Services may be provided in a variety of
locations including the participant's home or as approved by the POC planning
team.
F. Skilled maintenance
therapy services specifically include:
1.
physical therapy services which promote the maintenance of, or the reduction
in, the loss of gross/fine motor skills, and facilitate independent functioning
and/or prevent progressive disabilities including:
a. professional assessment(s), evaluation(s)
and monitoring for therapeutic purposes;
b. physical therapy treatments and
interventions;
c. training
regarding physical therapy activities, use of equipment and
technologies;
d. designing,
modifying or monitoring the use of related environmental
modifications;
e. designing,
modifying, and monitoring the use of related activities supportive to the POC
goals and objectives; or
f.
consulting or collaborating with other service providers or family members, as
specified in the POC;
2.
occupational therapy (OT) services which promote the maintenance of, or
reduction in, the loss of fine motor skills, coordination, sensory integration,
and/or facilitate the use of adaptive equipment or other assistive technology
including:
a. teaching of daily living
skills;
b. development of
perceptual motor skills and sensory integrative functioning;
c. design, fabrication, or modification of
assistive technology or adaptive devices;
d. provision of assistive technology
services;
e. design, fabrication,
or applying selected orthotic or prosthetic devices or selecting adaptive
equipment;
f. use of specifically
designed crafts and exercise to enhance function;
g. training regarding OT activities;
and
h. consulting or collaborating
with other service providers or family members, as specified in the
POC;
3. speech language
therapy (SLT) services which preserve abilities for independent function in
communication, facilitate oral motor and swallowing function, facilitate use of
assistive technology, and/or prevent progressive disabilities including:
a. identification of communicative or
oropharyngeal disorders;
b.
prevention of communicative or oropharyngeal disorders;
c. development of eating or swallowing plans
and monitoring their effectiveness;
d. use of specifically designed equipment,
tools, and exercises to enhance function;
e. design, fabrication, or modification of
assistive technology or adaptive devices;
f. provision of assistive technology
services;
g. adaptation of the
participant's environment to meet his/her needs;
h. training regarding SLT activities;
and
i. consulting or collaborating
with other service providers or family members, as specified in the
POC.
G. Where
applicable, the participant must use Medicaid State Plan, Medicare, or other
available payers first. The participant's preference for a certain therapist or
agency is not grounds for declining another payer in order to access waiver
services.
H. All services must be
based on a verified need of the participant and the service must have a direct
or remedial benefit to the participant with specific goals and outcomes. The
authorized service will be reviewed/monitored by the support coordinator to
verify the continued need for the service and that the service meets the
participant's needs in the most cost effective manner.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
