Definition

a) Supportive home care (SHC) is available to waiver consumers who live with their birth or adoptive parents. This service provides necessary assistance for eligible consumers in order to meet their daily living situation needs.

b) Supportive home care provides direct assistance to waiver consumers in daily living and personal adjustment, attendant care, assistance with medications that are ordinarily self-administered and accessing medical care, supervision, reporting changes in the consumer’s condition and needs, extension of therapy services, ambulation and exercise, household services essential to health care at home or performed in conjunction with assistance in daily living (e.g., shopping, meal preparation, clean up after meals, bathing, using appliances, dressing, feeding, bed making, laundry and cleaning the bathroom and kitchen) and household maintenance related to the consumer. The supportive home care worker can accompany or transport the consumer to accomplish any of the tasks listed above or to provide supervision or support for community activities.

c) A description of expectations for supportive home care workers must be maintained and available for review. The descriptions are subject to audit.

d) If services are being provided to children in school as separate description of expectations for supportive home care workers (one for when in school and one for when not in school) may be appropriate and must also be available for review. These descriptions are also subject to audit.

e) A self–direct option may be chosen for respite care by the individual or, if the person is incapable of providing self-direction, by the consumer’s guardian or parent acting on his/her behalf.

Limitations and Restrictions

a) HCBS MR/DD Supportive Home Care is available to Medicaid Program consumers who:
- are 5 years of age or older, and
- are mentally retarded or otherwise developmentally disabled, and
- Meet the criteria for ICF/MR level of care as determined by ICF/MR (HCBSMR/DD) screening, and
- Choose to receive HCBS MR/DD rather than ICF/MR services.

b) HCBS MR/DD is available to minor children, ages 5-18, who are determined eligible for the Medicaid Program through a waiver of requirements relating to the deeming of parental income and who meet the criteria above.

c) Supportive home care may not be provided by a consumer’s spouse or by a parent of a consumer who is a minor child under eighteen years of age.

d) Supportive home care consumers may not also receive residential services or family/individual supports.

e) Supportive home care may not be provided in a school setting and may not be used for education or as a substitute for educationally related services or for transition services as outlined in the consumer’s IEP.

f) Supportive home care services are limited to a maximum of 8 hours on any given date, and to only the activities described above unless sufficient rationale is provided for hours in excess of 8 a day. The absolute maximum allowable billing is 12 hours on any given date.

g) Supportive home care hours are provided only when the primary care givers are present or regularly scheduled to be absent; otherwise, respite hours should be utilized.

h) A consumer can receive supportive home care services from more than one worker, but no more than one worker can be paid for services at any given time of the day (unless the case manager approves with rationale).

i) Supportive home care services can not be provided to a consumer who is an inpatient of a hospital, a nursing facility, or an ICF/MR when the inpatient facility is billing medicaid, medicare, and/or private insurance.