Current through Register Vol. 41, No. 3, September 23, 2024
A. Service description. Electronic home-based
support service shall provide devices, equipment, or supplies, based on current
technology to enable the individual to more safely live and participate in his
community while decreasing the need for other services such as staff supports.
The equipment or devices shall be purchased for the individual and typically
shall be installed in the individual's home. Portable hand-held devices may be
used by the individual at home or in the community. These devices and this
service shall support the individual's greater independence and self-reliance
in the community. This service may also include ongoing electronic monitoring,
which is the provision of oversight and monitoring within the home through
off-site monitoring. The electronic home-based service shall be covered in the
FIS, CL, and BI waivers.
B.
Criteria and allowable activities.
1. In
order to qualify for the electronic home-based support (EHBS) service, the
individual shall be at least 18 years of age and capable of using the equipment
provided via EHBS service.
2. A
preliminary needs assessment shall be completed by an independent professional
consultant to determine the best type and use of technology and overall cost
effectiveness of various options. This assessment shall be submitted to the
DMAS designee for service authorization prior to the delivery of any goods and
services and prior to the submission of any claims for Medicaid reimbursement.
The independent professional consultant conducting the preliminary assessment
may be an occupational therapist, or other similarly credentialed specialist,
who is licensed or certified by the Commonwealth and specializes in assistive
technologies, mobile technologies, and current accommodations for individuals
with developmental disabilities.
3.
EHBS service shall support training in the use of these goods and services,
ongoing maintenance, and monitoring to address an identified need in the
individual's ISP, including improving and maintaining the individual's
opportunities for full participation in the community.
4. Items or services purchased through EHBS
service shall be designed to decrease the need for other Medicaid services,
such as reliance on staff supports, promote inclusion in the community, and
increase the individual's safety in the home environment.
C. Service units and limits.
1. The ISP year limit for this service shall
be $5,000. No unspent funds from one plan year shall be accumulated and carried
over to subsequent plan years.
2.
Receipt of EHBS service shall not be tied to the receipt of any other covered
waiver or Medicaid service. Equipment or supplies already covered by any other
Medicaid covered service shall be excluded from coverage by this waiver
service.
3. EHBS service shall be
provided in the least expensive manner possible that will meet the identified
need of the individual enrolled in the waiver and shall be completed within the
ISP year.
4. EHBS service shall not
be covered for individuals who are receiving residential supports that are
reimbursed on a daily basis, such as group home, or sponsored or supported
living residential service.
D. Provider requirements.
1. Providers shall meet all of the
requirements of 12VAC30-122-110 through 12VAC30-122-140.
2. An EHBS service provider shall be one of
the following:
a. A Medicaid-enrolled licensed
personal care agency;
b. A
Medicaid-enrolled durable medical equipment provider;
c. A CSB or BHA;
d. A center for independent living;
e. A licensed and Medicaid-enrolled home
health provider;
f. An EHBS
manufacturer or a company that has the ability to provide electronic home-based
equipment, direct services (i.e., installation, equipment maintenance, and
service calls), and monitoring; or
g. A PERS manufacturer or a company that is
Medicaid-enrolled and has the ability to provide electronic home-based
equipment, direct services (i.e., installation, equipment maintenance, and
service calls), and monitoring services.
3. Providers of this service shall have a
current, signed participation agreement with DMAS. Providers as designated on
this agreement shall render this service directly and shall bill DMAS for
Medicaid reimbursement.
4. The
provider of ongoing monitoring systems shall provide an emergency response
center with fully trained operators who are capable of (i) receiving signals
for help from an individual's equipment 24 hours a day, 365 or 366 days per
year as appropriate; (ii) determining whether an emergency exists; and (iii)
notifying the appropriate responding organization or an emergency responder
that the individual needs help.
5.
The EHBS service provider shall have the primary responsibility to furnish,
install, maintain, test, and service the equipment, as required, to keep it
fully operational. The provider shall replace or repair the device within 24
hours of the individual's notification of a malfunction of the unit or
device.
6. The EHBS service
provider shall properly install all equipment and shall furnish all supplies
necessary to ensure that the system is installed and working
properly.
7. The EHBS service
provider shall install, test, and demonstrate to the individual and
family/caregiver, as appropriate, the unit or device before submitting a claim
to DMAS. The provider responsible for installation of devices shall document
the date of installation and training in use of the devices.
8. The provider of off-site monitoring shall
document each instance of action being taken on behalf of the individual. This
documentation shall be maintained in this provider's record for the individual
and shall be provided to either DMAS or DBHDS upon demand. The record shall
document all of the following:
a. Delivery
date and installation date of the EHBS;
b. The signature of the individual or his
family/caregiver, as appropriate, verifying receipt of the EHBS
device;
c. Verification by a test
that the EHBS device is operational, monthly or more frequently as
needed;
d. Updated and current
individual responder and contact information, as provided by the individual or
the individual's care provider or support coordinator/case manager;
and
e. A case log documenting the
individual's utilization of the system and contacts and communications with the
individual or his family/caregiver, as appropriate, support coordinator, or
responder.
E.
Service documentation and requirements.
1.
Providers shall include signed and dated documentation of the following in each
individual's record:
a. The appropriate
service authorization to be completed by the support coordinator may serve as
the plan for supports for the provision of EHBS service. A rehabilitation
engineer may be involved for EHBS service if disability expertise is required
that a general contractor may not have. The service authorization request
documentation shall include justification and explanation if a rehabilitation
engineer is needed. The service authorization request shall be submitted to the
state-designated agency or its designee in order for service authorization to
occur;
b. Written documentation
regarding the process and results of ensuring that the item is not covered by
the State Plan for Medical Assistance as durable medical equipment (DME) and
supplies, and that the item is not available from a DME provider;
c. Documentation of the recommendation for
the item by an independent professional consultant;
d. Documentation of the date service is
rendered and the amount of service that is needed;
e. Any other relevant information regarding
the device or modification;
f.
Documentation in the support coordination record of notification by the
designated individual or individual's representative family/caregiver of
satisfactory completion or receipt of the service or item; and
g. Instructions regarding any warranty,
repairs, complaints, or servicing that may be needed.
2. Provider documentation shall support all
claims submitted for DMAS reimbursement. Claims for payment that are not
supported by supporting documentation shall be subject to recovery by DMAS or
its designee as a result of utilization reviews or audits.
Statutory Authority: §
32.1-325
of the Code of Virginia;
42 USC §
1396 et
seq.