Current through Register Vol. 35, No. 18, September 24, 2024
A. Adult day
health: adult day health services provide structured therapeutic, social and
rehabilitative services designed to meet the specific needs and interests of a
member that are incorporated into the member's care plan.
(1) Adult day health services are provided by
a licensed community-based adult day-care facility that offers health and
social services to assist a member to achieve his or her optimal
functioning.
(2) Private duty
nursing services and skilled maintenance therapies (physical, occupational and
speech) may be provided within the adult day health setting and in conjunction
with adult day health services but are reimbursed separately from adult day
health services.
(3) Adult day
health settings must be integrated and support full access of individuals
receiving medicaid home and community-based services (HCBS) to the greater
community, engage in community life, control personal resources, and receive
services in the community, to the same degree of access as individuals not
receiving medicaid HCBS.
B. Assisted living is a residential service
that provides a homelike environment, which may be in a group setting, with
individualized services designed to respond to the member's needs as identified
and incorporated in the care plan.
(1) Core
services are a broad range of activities of daily living (ADL) including:
personal support services (homemaker, chore, attendant services, meal
preparation); companion services; medication oversight (to the extent permitted
under state law); 24-hour on-site response capability:
(a) to meet scheduled or unpredictable
member's needs; and
(b) to provide
supervision, safety, and security.
(2) Services include social and recreational
programming. Coverage does not include 24-hour skilled care or supervision or
the cost of room or board. Nursing and skilled therapy services are incidental,
rather than integral to, the provision of assisted living services. Services
provided by third parties must be coordinated with the assisted living
provider.
(3) Assisted living
settings must be integrated and support full access of individuals receiving
Medicaid home and community-based services (HCBS) to the greater community,
engage in community life, control personal resources, and receive services in
the community, to the same degree of access as individuals not receiving
medicaid HCBS.
(4) Assisted living
settings must meet CMS requirements for residential settings as outlined in the
MAD MCO policy manual.
C.
Behavior support consultation is the provision of assessment, treatment,
evaluation and follow-up services to assist the member, his or her parents,
family, and primary caregivers with coping skills which promote maintaining the
member in a home environment.
(1) Behavior
support consultation:
(a) informs and guides
the member's paid and unpaid caregivers about the services and supports that
relate to the member's medical and behavioral health condition;
(b) identifies support strategies for a
member that ameliorate contributing factors with the intention of enhancing
functional capacities, adding to the provider's competency to predict, prevent
and respond to interfering behavior and potentially reducing interfering
behavior;
(c) supports effective
implementation based on a member's functional assessment;
(d) collaborates with medical and ancillary
therapists to promote coherent and coordinated services addressing behavioral
issues and to limit the need for psychotherapeutic medications; and
(e) monitors and adapts support strategies
based on the response of the member and his or her services and supports
providers.
(2) Based on
the member's care plan, services are delivered in an integrated, natural
setting or in a clinical setting.
D. Community transition services are
non-recurring set-up expenses for a member who is transitioning from an
institutional or another provider-operated living arrangement (excluding
assisted living) to a living arrangement in a private residence where the
member is directly responsible for his or her own living expenses.
(1) Allowable expenses are those necessary to
enable the member to establish a basic household that does not constitute room
and board and may include:
(a) security
deposits that are required to obtain a lease on an apartment or home;
(b) essential household furnishings required
to occupy and use a community domicile, including furniture, window coverings,
food preparation items, and bed and bath linens;
(c) set-up fees or deposits for utility or
service access, including telephone, electricity, heating and water;
(d) services necessary for the member's
health and safety, such as, but not limited to, pest eradication and one-time
cleaning prior to occupancy;
(e)
moving expenses; and
(f) security
deposit for an assisted living facility placement up to five hundred dollars
($500).
(2) Community
transition services do not include monthly rental or mortgage expenses, food,
regular utility charges, household appliances, or items that are intended for
purely diversional or recreational purposes.
(3) Community transition services are limited
to three thousand five hundred dollars ($3500) per member every five years. In
order to be eligible for this service, the member must have a NF stay of at
least 90-consecutive days prior to transition to the community.
E. Emergency response services
provide an electronic device that enables a member to secure help in an
emergency at his or her home, avoiding institutionalization. The member may
also wear a portable "help" button to allow for mobility. The system is
connected to the member's phone and programmed to signal a response center when
the "help" button is activated. The response center is staffed by trained
professionals. Emergency response services include: testing and maintaining
equipment; training the member, his or her caregivers and first responders on
use of the equipment; 24-hour monitoring for alarms; checking systems monthly
or more frequently (if warranted by electrical outages, severe weather, etc.);
and reporting member emergencies and changes in the member's condition that may
affect service delivery.
F.
Employment supports include job development, job seeking and job coaching
supports after available vocational rehabilitation supports have been
exhausted.
(1) The job coach provides:
(a) training, skill development;
(b) employer consultation that a member may
require while learning to perform specific work tasks on the job;
(c) co-worker training;
(d) job site analysis;
(e) situational and vocational assessments
and profiles;
(f) education of the
member and co-workers on rights and responsibilities; and
(g) benefits counseling. The service must be
tied to a specific goal in the member's care plan.
(2) Job development is a service provided to
a member by skilled staff. The service has five components:
(a) job identification and development
activities;
(b) employer
negotiations;
(c) job
restructuring;
(d) job sampling;
and
(e) job placement.
(3) Employment supports are
provided by staff at current or potential work sites. When supported employment
services are provided at a work site where persons without disabilities are
employed, payment is made only for the adaptations, supervision and training
required by the member receiving services as a result of his or her
disabilities, and does not include payment for the supervisory activities
rendered as a normal part of the business setting.
(4) Payment shall not be made for incentive
payments, subsidies, or unrelated vocational training expenses such as the
following:
(a) incentive payments made to an
employer to encourage or subsidize the employer's participation in a supported
employment program;
(b) payments
that are passed through to users of supported employment programs; or
(c) payments for training that is not
directly related to a member's supported employment program.
(5) Federal financial
participation cannot be claimed to defray expenses associated with starting up
or operating a business.
(6)
Employment supports settings must be integrated and support full access of
individuals receiving medicaid HCBS to the greater community, engage in
community life, control personal resources, and receive services in the
community, to the same degree of access as individuals not receiving medicaid
HCBS.
G. Environmental
modification services include: the purchase of, the installation of equipment
for the physical adaptations to a member's residence that are necessary to
ensure the health, welfare, and safety of the member or enhance the member's
level of independence.
(1) Adaptations include
the installation of:
(a) ramps and
grab-bars;
(b) widening of doorways
and hallways;
(c) installation of
specialized electric and plumbing systems to accommodate medical equipment and
supplies;
(d) lifts and
elevators;
(e) modification of
bathroom facilities (roll-in showers, sink, bathtub, and toilet modifications,
water faucet controls, floor urinals and bidet adaptations and
plumbing);
(f) turnaround space
adaptations;
(g) specialized
accessibility/safety adaptations/additions;
(h) trapeze and mobility tracks for home
ceilings;
(i) automatic door
openers/doorbells;
(j)
voice-activated, light-activated, motion-activated and electronic
devices;
(k) fire safety
adaptations; air filtering devices;
(l) heating and cooling
adaptations;
(m) glass substitute
for windows and doors; modified switches, outlets or environmental controls for
home devices; and
(n) alarm and
alert systems, including signaling devices.
(2) All services shall be provided in
accordance with applicable federal and state statutes, regulations and rules
and local building codes.
(3)
Non-covered adaptations or improvements to the member's home include:
(a) adaptations for general utility which are
not for direct medical or remedial benefit to the member; and
(b) adaptations that add to the total square
footage of the member's resident except when necessary to complete an approved
adaptation.
(4) The
environmental modification provider must:
(a)
ensure proper design criteria is addressed in planning and design of the
adaptation;
(b) provide or secure
the appropriate licensed contractor or approved vendor to provide construction
and remodeling services;
(c)
provide administrative and technical oversight of construction
projects;
(d) provide consultation
to members, family members, providers and contractors concerning environmental
modification projects to the member's residence; and
(e) inspect the final environmental
modification project to ensure that the adaptations meet the approved plan
submitted for environmental adaptation.
(5) Environmental modification services to a
member are limited to five-thousand dollars ($5,000) every five years.
Additional services may be requested if the member's health and safety needs
exceed the specified limit.
H. Home health aide services provide total
care or assist the member in all ADLs.
(1)
Total care includes: the provision of bathing (bed, sponge, tub, or shower);
shampoo (sink, tub, or bed); care of nails and skin; oral hygiene; toileting
and elimination; safe transfer techniques and ambulation; normal range of
motion and positioning; and adequate oral nutrition and fluid intake.
(2) The home health aide services assist the
member in a manner that promotes an improved quality of life and a safe
environment for him or her. Home health aide services can be provided outside
the member's home.
(3) Home health
aides may provide basic non-invasive nursing assistant skills within the scope
of their practice. Home health aides perform an extension of therapy services
including:
(a) bowel and bladder
care;
(b) ostomy site
care;
(c) personal care;
(d) ambulation and exercise;
(e) household services essential to health
care at home;
(f) assisting with
medications that are normally self-administered;
(g) reporting changes in patient conditions
and needs; and
(h) completing
appropriate records.
(4)
Home health aide services must be provided under the supervision of a
registered nurse (RN) licensed by the New Mexico board of nursing, or other
appropriate professional staff. Such staff must make a supervisory visit to the
member's residence at least every two weeks to observe and determine whether
the member's goals are being met.
I. Nutritional counseling services include
assessment of the member's nutritional needs, development and revision of the
member's nutritional plan, counseling and nutritional intervention, and
observation and technical assistance related to implementation of the
nutritional plan.
J. Personal care
services (PCS) are provided to a member unable to perform a range of ADLs and
instrumental activities of daily living (IADL). PCS shall not replace natural
supports such as the member's family, friends, individuals in the community,
clubs, and organizations that are able and consistently available to provide
support and service to the member. Use of the Electronic Visit Verification
(EVV) system is required for payment of PCS. The managed care organizations
shall collaborate to offer a single EVV vendor for PCS and monitor compliance
with the federal 21st Century Cures Act.
(1)
PCS is a benefit for a member 21 years of age or older who meets the
eligibility for CB services. A member under 21 years of age must access PCS
through the EPSDT program.
(2) PCS
delivery models: A member may select either the consumer-delegated or the
consumer-directed delivery of his or her PCS. The PCS consumer-delegated or
consumer-directed agency must be certified as such by MAD or it designee to
perform such duties and to be reimbursed for the delivery model of those
services. The MCO's care coordinator is responsible for explaining both models
to each member, initially, and annually thereafter.
(a) The consumer delegated (PCS/CDelegated)
model allows the member to select his or her PCS agency to perform all PCS
employer-related tasks. This agency is responsible for ensuring all PCS are
delivered to the member.
(b) The
consumer-directed (PCS/CDirected) model allows the member to oversee his or her
own PCS delivery, and requires that the member work with his or her PCS agency
who then acts as a fiscal intermediary agency to process all financial
paperwork to be submitted to the MCO.
(c) If a member is unable to select or unable
to communicate which PCS delivery model he or she selects, then his or her
authorized representative will select on behalf of the member. The member's
authorized representative status must be properly documented with the member's
PCS agency.
(d) For both models,
the member may select his or her family member, with the exception of the
member's spouse. A friend; neighbor; or other person may also be selected as
his or her PCS attendant. A family member shall not be reimbursed for a service
he or she would have otherwise provided as a natural support. A PCS attendant,
regardless of family relationship, who resides with the member shall not be
paid to deliver household services, or supports such as shopping, errands, or
meal preparation that are routinely provided as part of the household division
of chores, unless those services are specific to the member.
(e) A member may have a relative, friend, or
other spokesperson assisting him or her with communicating information or
instructions to the member's attendant, providing information concerning the
member's natural services or supports needs during the member's assessment, or
fulfilling additional roles as designated by the member or the member's
authorized representative in writing. A spokesperson may not make decisions on
behalf of a member, which is the member or member's authorized representative's
sole responsibility, unless the member's authorized representative is also the
member's spokesperson.
(3) Eligible PCS agencies: PCS agencies
electing to provide PCS must obtain agency certification. A PCS agency
provider, must comply with the requirements as listed in the MAD MCO policy
manual PCS agencies must be an enrolled MAD provider.
(4) Bladder and bowel care: PCS must be
related to the member's functional level to perform ADLs and IADLs as indicated
in the members CNA. PCS will not include those services, or supports the member
does not need or is already receiving from other sources including tasks
provided by natural supports.
(a) A member who
has a signed statement by his or her primary care provider (PCP) stating he or
she is medically stable and able to communicate and assess his or her bladder
and bowel care needs may access this service when included in his or her
individual care plan.
(i) bowel care includes
the evacuation and ostomy care, changing and cleaning of such bags and ostomy
site skin care;
(ii) bladder care
includes the attendant cueing the member to empty his or her bladder at timed
intervals to prevent incontinence; and
(iii) catheter care, including the changing
and cleaning of such bag.
(b) A member who is determined by his or her
PCP in a signed statement to not be medically stable and not able to
communicate and assess his or her bladder and bowel care needs may access these
services:
(i) perineal care including
cleansing of the perineal area and changing of feminine sanitary
products;
(ii) toileting including
assisting with bedside commode or bedpan;
(iii) cleaning perineal area,
(iv) changing adult briefs or pads;
(v) cleaning changing of wet or soiled
clothing; and
(vi) assisting with
adjustment of clothing before and after toileting.
(5) Meal preparation and
assistance: Meal preparation includes cutting ingredients to be cooked, cooking
meals, placing and presenting the meal in front the member to eat, cutting up
food into bite-sized portions for the member, or assisting the member as stated
in his or her individual plan of care (IPoC). This includes provision of snacks
and fluids and may include mobility assistance and prompting or cueing the
member to prepare meals.
(6)
Eating: Feeding or assisting the member with eating a prepared meal using a
utensil or specialized utensils is a covered service. Eating assistance may
include mobility assistance and prompting or cueing a member to ensure
appropriate nutritional intake and monitor for choking. If the member has
special needs in this area, the PCS agency will include specific instruction in
the member's IPoC on how to meet those needs. Gastrostomy feeding and tube
feeding are not covered services.
(7) Household support services: This service
is for assisting and performing interior household activities and other support
services that provide additional assistance to the member. Interior household
activities are limited to the upkeep of the member's personal living areas to
maintain a safe and clean environment for the member, particularly a member who
may not have adequate support in his or her residence. Assistance may include
mobility assistance and prompting and cueing a member to ensure appropriate
household support services.
(a) An attendant
who resides in the same household as the member may not be paid for household
support services routinely provided as part of the household division of
chores, unless those services are specific to the member such as, changing the
member's linens, and cleaning the member's personal living areas.
(b) Services include:
(i) sweeping, mopping, or
vacuuming;
(ii) dusting
furniture;
(iii) changing
linens;
(iv) washing
laundry;
(v) cleaning bathrooms
includes tubs, showers, sinks, and toilets;
(vi) cleaning the kitchen and dining area
including washing dishes, putting them away; cleaning counter tops, and eating
areas, etc.; household services do not include cleaning up after other
household members or pets;
(vii)
minor cleaning of an assistive device, wheelchair and durable medical equipment
(DME) is a covered service. A member must have an assistive device requiring
regular cleaning that cannot be performed by the member and is not cleaned
regularly by the supplier of the assistive device to be eligible to receive
services under this category;
(viii) shopping or completing errands
specific to the member with or without the member;
(ix) cueing a member to feed and hydrate his
or her documented personal assistance animal or feed and hydrate such an animal
when the member is unable;
(x)
assistance with battery replacement and minor, routine wheelchair and DME
maintenance is a covered service. A member must have an assistive device that
requires regular maintenance, that is not already provided by the supplier of
the assistive device, and that the member cannot maintain in order to be
eligible to receive services under this category;
(xi) assisting a member self-administering:
assistance with self-administering physician ordered (prescription) medications
is limited to prompting and reminding only. The use of over the counter
medications does not qualify for this service. A member must meet the
definition of "ability to self-administer" defined in this section, to be
eligible to receive time for this task. A member who does not meet the
definition of ability to self-administer is not eligible for this service. This
assistance does not include administration of injections, which is a
skilled/nursing task; splitting or crushing medications or filling medication
boxes. Assistance includes: getting a glass of water or other liquid as
requested by the member for the purpose of taking medications; at the direction
of the member, handing the member his or her daily medication box or medication
bottle; and at the direction of the member, helping a member with placement of
oxygen tubes for members who can communicate to the caregiver the dosage or
route of oxygen; and
(xii)
transportation of the member: transportation shall only be for non-medically
necessary events and may include assistance with transfers in and out of
vehicles. Medically necessary transportation services may be a covered PCS
service when the MCO has assessed and determined that other medically necessary
transportation services are not available through other state plan
services.
(8)
Hygiene and grooming: The attendant may perform for the member or the attendant
may cue and prompt the member to perform the following services:
(a) bathing to include giving a sponge bath
in the member's bed, bathtub or shower; transferring in and out of the bathtub
or shower, turning water on and off; selecting a comfortable water temperature;
bringing in water from outside or heating water for the member;
(b) dressing to include putting on,
fastening, and removing clothing including shoes;
(c) grooming to include combing or brushing
hair, applying make-up, trimming beard or mustache, braiding hair, shaving
under arms, legs or face;
(d) oral
care for a member with intact swallowing reflex to include brushing teeth,
cleaning dentures or partials including the use of floss, swabs, or
mouthwash;
(e) nail care to include
cleaning, filing to trim, or cuticle care for member's without a medical
condition. For a documented medically at-risk member; nail care is not covered
under PCS; it is a skilled nurse service. Medically at risk conditions include,
but are not limited to venous insufficiency, diabetes, peripheral
neuropathy;
(f) applying lotion or
moisturizer to intact skin for routine skin care;
(g) physician ordered skin care is limited to
the application of skin cream when a member has a documented chronic skin
condition and is determined by his or her PCP unable to self-administer the
medication. The member's PCP must order a prescription or over-the-counter
medication to treat the condition.
(i) When
the PCP determines the member is able to self-administer the prescribed or
over-the-counter medication the attendant is limited to prompting and reminding
the member.
(ii) PCS does not
include the care of a member's wounds, open sores, debridement or dressing of
open wounds.
(h)
prompting or cueing to ensure appropriate bathing, dressing, grooming, oral
care, nail care and application of lotion for routine skin care; and
(i) mobility assistance to ensure appropriate
bathing, dressing, grooming, oral care and skin care.
(9) Supportive mobility assistance: Physical
or verbal prompting and cueing mobility assistance provided by the attendant
that is not already included as part of other PCS includes assistance with:
(a) ambulation to include moving around
inside or outside the member's residence or living area with or without an
assistive device such as a walker, cane or wheelchair;
(b) transferring to include moving to and
from one location or position to another with or without an assistive device
such as in and out of a vehicle;
(c) toileting to include transferring on or
off a toilet; and
(d) repositioning
to include turning or changing a bed-bound member's position to prevent skin
breakdown.
(10)
Non-covered services: The following services are not covered as PCS:
(a) services to an inpatient or resident of a
hospital, NF, ICF-IID, mental health facility, correctional facility, or other
institutional settings, with the exception when a member is transitioning from
a NF;
(b) services that are already
provided by other sources, including natural supports;
(c) household services, support services such
as shopping, errands, or meal preparation that are routinely provided as part
of the household division of chores;
(d) services provided by a person not meeting
the requirements and qualifications of a personal care attendant; including but
not limited to, training and criminal background checks;
(e) services not approved in the member's
IPoC;
(f) childcare, pet care, or
personal care for other household members. This does not include the member's
documented assistant service animal;
(g) retroactive services;
(h) services provided to an individual who is
not a MCO member or does not meet the eligibility criteria for CB
services;
(i) member assistance
with finances and budgeting;
(j)
member appointment scheduling;
(k)
member range of motion exercises;
(l) wound care of open sores and debridement
or dressing of open wounds;
(m)
filling of medication boxes, cutting or grinding pills, administration of
injections, assistance with over-the-counter medication or medication that the
member cannot self-administer;
(n)
skilled nail care for a member documented as medically at-risk;
(o) medically necessary transportation when
available through the member's MCO general benefit services;
(p) bowel and bladder services that include
insertion or extraction of a catheter or digital stimulation; and
(q) gastrostomy feeding and tube
feeding.
K.
Private duty nursing services include activities, procedures, and treatment for
a physical condition, physical illness, or chronic disability for a member who
is 21 years of age and older with intermittent or extended direct nursing care
in his or her home.
(1) Services include:
(a) medication management;
(b) administration and teaching;
(c) aspiration precautions;
(d) feeding tube management;
(e) gastrostomy and jejunostomy;
(f) skin care;
(g) weight management;
(h) urinary catheter management;
(i) bowel and bladder care;
(j) wound care;
(k) health education;
(l) health screening;
(m) infection control;
(n) environmental management for
safety;
(o) nutrition
management;
(p) oxygen
management;
(q) seizure management
and precautions;
(r) anxiety
reduction;
(s) staff supervision;
and
(t) behavior and self-care
assistance.
(2) All
services are provided under a written physician's order and must be rendered by
a New Mexico board of nursing licensed RN or a licensed practical nurse (LPN)
who provides services within his or her scope of practice.
L. Respite services are provided to a member
unable to care for him or herself and are furnished on a short-term basis to
allow the member's primary caregiver a limited leave of absence in order to
reduce stress, accommodate a caregiver illness, or meet a sudden family crisis
or emergency. Respite provides a temporary relief to the primary caregiver of a
CB member during times when he/she would normally provide unpaid care.
(1) Respite care is furnished at home, in a
private residence of a respite care provider, in a specialized foster care
home, in a hospital or NF, that meet the qualifications for MAD provider
enrollment requirements. For purposes of ABCB eligibility, when respite
services are delivered through an institutional provider, the member is not
considered a resident of the institution.
(2) Respite care services include:
(a) medical and non-medical health
care;
(b) personal care;
bathing;
(c) showering; skin
care;
(d) grooming;
(e) oral hygiene;
(f) bowel and bladder care;
(g) catheter and supra-pubic catheter
care;
(h) preparing or assisting in
preparation of meals and eating;
(i) administering enteral feedings;
(j) providing home management
skills;
(k) changing
linens;
(l) making beds;
(m) washing dishes;
(n) shopping; errands;
(o) calls for maintenance;
(p) assisting with enhancing self-help
skills, such as promoting use of appropriate interpersonal communication skills
and language, working independently without constant supervision or
observation;
(q) providing body
positioning, ambulation and transfer skills;
(r) arranging for transportation to medical
or therapy services;
(s) assisting
in arranging health care needs and follow-up as directed by primary care giver,
physician, and care coordinator; and
(t) ensuring the health and safety of the
member at all times.
(3)
Respite may be provided on either a planned or an unplanned basis and may be
provided in a variety of settings. If unplanned respite is needed, the
appropriate agency personnel will assess the situation, and with the caregiver,
recommend the appropriate setting for respite services to the member. Services
must only be provided on an intermittent or short-term basis because of the
absence or need for relief of those persons normally providing care to the
member.
(4) Respite services are
limited to a maximum of 300 hours annually per care plan year. Additional hours
may be requested if a member's health and safety needs exceed the specified
limit.
M. Skilled
maintenance therapy services for a member 21 years and older are provided when
his or her MCO's general physical health benefit skilled therapy services are
exhausted or are not a MCO covered benefit. The community benefit skilled
maintenance therapy services include physical therapy, occupational therapy or
speech language therapy. Therapy services focus on improving functional
independence, health maintenance, community integration, socialization, and
exercise, and enhance the support and normalization of the member's family
relationships.
(1) Physical therapy services
promote gross and fine motor skills, facilitate independent functioning and
prevent progressive disabilities. Specific services may include but are not
limited to:
(a) professional assessment,
evaluation and monitoring for therapeutic purposes;
(b) physical therapy treatments and
interventions;
(c) training
regarding PT activities;
(d) use of
equipment and technologies or any other aspect of the member's physical therapy
services;
(e) designing, modifying
or monitoring use of related environmental modifications;
(f) designing, modifying, and monitoring use
of related activities supportive to the care plan goals and objectives;
and
(g) consulting or collaborating
with other service providers or family enrollees, as directed by the
member.
(2) Occupational
therapy (OT) services promote fine motor skills, coordination, sensory
integration, and facilitate the use of adaptive equipment or other assistive
technology. Specific services may include but are not limited to:
(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; training regarding OT
activities; and
(g) consulting or
collaborating with other service providers or family enrollees, as directed by
the member.
(3) Speech
and language therapy (SLT) services preserve abilities for independent function
in communication; facilitate oral motor and swallowing function; facilitate use
of assistive technology; and prevent progressive disabilities. Specific
services may include but are not limited to:
(a) identification of communicative or
oropharyngeal disorders and delays in the development of communication
skills;
(b) prevention of
communicative or oropharyngeal disorders and delays in the development of
communication skills;
(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
member's environment to meet his or her needs;
(h) training regarding SLT activities;
and
(i) consulting or collaborating
with other service providers or family enrollees as directed by the
member.
(4) A signed
therapy referral for treatment must be obtained from the member's PCP. The
referral will include frequency, estimated duration of therapy and treatment,
and procedures to be provided.