Current through Register Vol.. 38, No. 17, April 11, 2022
1. Community engagement service means a
service that supports and fosters an individual's abilities to acquire, retain
or improve skills necessary to build positive social behavior, interpersonal
competence, greater independence, employability, and personal choices necessary
to access typical activities and functions of community life such as those
chosen by the general population. The community engagement service may include
community education or training and volunteer activities.
2. The community engagement service shall
provide a wide variety of opportunities to facilitate and build relationships
and natural supports in the community, while utilizing the community as a
learning environment. These activities are conducted at naturally occurring
times and in a variety of natural settings in which the individual may actively
interact with persons without disabilities, other than those who are being paid
to support the individual. The activities shall enhance the individual's
involvement with the community and facilitate the development of relationships
and natural supports.
community engagement service shall be covered in the FIS, CL, and BI
1. The community
engagement service shall be provided in the least restrictive and most
integrated community settings possible according to the individual's plan for
supports and individual choice.
Allowable activities shall include, as appropriate for the individual as
documented in his plan for supports:
building, education, support, and monitoring that assists the individual with
the acquisition and retention of skills in the following areas:
(i) participation in activities and public
events in the community,
participation in community educational activities and events,
(iii) development of interests and activities
that encourage therapeutic use of leisure time,
(iv) participation in volunteer experiences,
(v) maintenance of contact with
family and friends, and
development of independence in activities of daily living.
Skill building and education in
self-direction designed to enable the individual to achieve one or more of the
following outcomes, particularly through community collaborations and social
connections developed by the provider (e.g., partnerships with community
entities such as senior centers, arts councils):
(i) development of self-advocacy skills;
(ii) exercise of civil rights;
(iii) acquisition of skills that
promote the ability to exercise self-control and responsibility over services
and supports received or needed;
(iv) acquisition of skills that enable the
individual to become more independent, integrated, or productive in the
(v) development of
communication skills and abilities;
(vi) furtherance of spiritual practices as
desired by the individual;
participation in cultural activities as desired by the individual;
(viii) development of skills that enhance
career planning goals in the community;
(ix) development of living skills;
(x) promotion of health and wellness,
including administration of medication;
(xi) development of orientation to the
community and mobility in the community;
(xii) access to and utilization of public
transportation so as to develop the ability to achieve the desired destination;
(xiii) interaction with
volunteers from the community in program activities.
c. Providing routine supports and safety
supports with transportation to and from community locations and
Service units and limitations.
engagement service shall be a tiered service for reimbursement
2. The unit of service
shall be one hour.
3. The community
engagement service alone or in combination with the group day service,
community coaching service, workplace assistance service, or supported
employment service shall not exceed 66 hours per week.
4. Other than time for planning community
activities, this service shall be delivered in the community and shall not take
place in a licensed residential or day setting or in the individual's
5. This service may be
provided in groups no larger than three individuals with a minimum of one
6. This service may include
planning community activities with the individuals present in a group of no
more than three individuals, although this shall be limited to no more than 10%
of the total number of authorized hours per month.
7. Providers shall only be reimbursed for the
tier to which the individual has been assigned based on the individual's
assessed and documented needs.
Provider qualifications and requirements.
2. Providers shall be licensed by DBHDS as
providers of the non-center-based day support service.
3. Providers shall have a current, signed
provider participation agreement with DMAS in order to provide this service.
The provider designated in the participation agreement shall directly provide
the service and bill DMAS for reimbursement.
Providers shall ensure that staff
providing community engagement service meet provider training and competency
requirements as specified in 12VAC30-122-180
5. The DSP providing community engagement
service shall not be an immediate family member of an individual receiving the
community engagement service. For an individual receiving sponsored residential
service, the DSP providing the community engagement service shall not be a
member of the sponsored family residing in the sponsored residential
documentation and requirements.
shall include signed and dated documentation of the following in each
A copy of the
completed, standard, age-appropriate assessment form as described in
plan for supports per requirements detailed in 12VAC30-122-120
Documentation as detailed in
. Data shall be collected as described in the ISP, analyzed to
determine if the strategies are effective, summarized, and then clearly
documented in the progress notes or supports checklist.
d. Documentation to support units of service
delivered, and the documentation shall correspond with billing. Providers shall
maintain separate documentation for each type of service rendered for an
e. A written review
supported by documentation in the individual's record, which is submitted to
the support coordinator at least quarterly with the plan for supports modified.
For the annual review and every time supporting documentation is updated, the
supporting documentation shall be reviewed with the individual or
family/caregiver, as appropriate, and such review shall be
f. An attendance log or
similar document that is maintained and indicates the date, type of service
rendered, and the number of hours and units provided, including the specific
g. All correspondence to
the individual and individual's family/caregiver, as appropriate, the support
coordinator, DMAS, and DBHDS.
Written documentation of all contacts with family/caregiver, physicians,
providers, and all professionals regarding the individual.
Supervision of DSP shall be provided
consistent with the requirements in 12VAC30-122-120
by a supervisor meeting the
Providers shall make available for inspection documentation of supervision, and
this documentation shall be completed and signed by the staff person designated
to perform the supervision and oversight. This documentation shall include, at
a minimum, the following:
(i) date of contact
contacted or observed,
summary about the direct support professional's performance and service
(iv) any action
planned or taken to correct problems identified during supervision and
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