Tenn. Comp. R. & Regs. 0465-01-02-.07 - SPECIAL NEEDS ADJUSTMENTS

(1) An adjustment up to an additional thirty-five dollars ($35.00) per day is available to Residential Habilitation and Supported Living Levels 1-4 for homes with 1-4 persons.
(2) An adjustment of twenty dollars ($20.00) per day is available to Residential Habilitation homes with 5 or more people except for reasons of a vacancy in the home.
(3) This adjustment may be used for additional staff coverage or higher wages for staff.
(4) A special needs adjustment does not change the rate level designated for the waiver participant, but adjusts the rate level as a result of one or more of the following circumstances:
(a) The waiver participant has a history of significant behavioral or psychiatric problems such as DSM-V diagnosis, violent acting out, serious self-injury or danger to others that are now not apparent due to the design or intensity of services being received or the person has a situation that is unique and results in the need for additional resources.
(b) Less intensive services will likely result in recurrence of previous problems. The Regional Office must review the special adjustment at least annually.
(c) The waiver participant is in circumstances that are time limited but that require support(s) at a higher level than described by the Level. (For example, the person has had a serious illness, injury, or surgery that requires more support while he/she is recovering than the Level describes.) A special adjustment may be approved for up to ninety (90) days and may be extended for an additional ninety (90) days.

Notes

Tenn. Comp. R. & Regs. 0465-01-02-.07
Original rule filed December 12, 2013; effective March 12, 2014. Amendments filed October 7, 2019; effective 1/5/2020.

Authority: T.C.A. ยงยง 4-3-2701, 4-3-2707, 4-4-103, 4-5-201, et seq., 4-5-208, et seq. and its applicable regulations concerning emergency rules, 33-1-201, 33-1-202, 33-1-203(1) and (6), 33-1-204, 33-1-301, 33-1-302, 33-1-302(a)(3) and (a)(4), 33-1-303, 33-1-303(3) and (11), 33-1-304, 33-1-305(1), and 33-1-309(d); Executive Order of the State of Tennessee No. 23, dated October 19, 1999; State of Tennessee Delegated Purchase Authority DP 10-28649-00 Reg. 515; and the "Reimbursement Rate" for Medical Services under DIDD federal waiver(s) for provision of services as administered by TennCare.

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