Current through Register Vol.. 38, No. 17, April 11, 2022
A. Service description. Individual and
family/caregiver training service provides training and counseling to
individuals, families, or caregivers of individuals enrolled in the waiver
including participation in educational opportunities designed to improve the
family's or caregiver's ability to care for and support the individual enrolled
in the waiver. This service shall also provide educational opportunities for
the individual to better understand his disability and increase his
self-determination and self-advocacy. Individual and family/caregiver training
service shall be covered in the FIS waiver.
Criteria and allowable activities.
1. Individuals who are enrolled in the FIS
waiver and their family/caregivers, as appropriate, may participate in this
service. DMAS shall cover this service as authorized by the individual's
For the purpose of this
service, "family" means the same as set forth in 12VAC30-122-20
Service units and limits.
1. Individual and family/caregiver training
service is only available in the FIS waiver.
2. Individual and family/caregiver training
service may be authorized for up to $4,000 per ISP year.
3. Travel expenses and room and board
expenses shall not be covered.
2. Providers shall have a signed, current
provider participation agreement with DMAS in order to be reimbursed for
providing individual and family/caregiver training.
3. Providers shall have the necessary
licensure or certification as required for their profession, that is, RNs shall
have a current license to practice nursing in the Commonwealth or shall hold a
multistate licensure privilege.
Individual and family/caregiver training service shall be provided by enrolled
provider entities with expertise in, experience in, or demonstrated knowledge
of the training topic set out in the plan for supports.
5. Individual and family/caregiver training
service may be provided through seminars and conferences organized by the
enrolled provider entities.
Individual and family/caregiver training service may also be provided by
individual practitioners who have experience in or demonstrated knowledge of
the training topics. Individual practitioners may include psychologists,
teachers or educators, social workers, medical personnel, personal care
providers, therapists, and providers of other services such as day and
residential support services.
Qualified provider types include:
a. Staff of
home health agencies, community developmental disabilities service agencies,
developmental disabilities residential providers, community mental health
centers, public health agencies, hospitals, clinics, or other agencies or
practitioners, including licensed or certified personnel such as RNs, LPNs,
psychologists, speech-language therapists, occupational therapists, physical
therapists, licensed clinical social workers, licensed behavior analysts, and
persons with other education, training, or experience directly related to the
specified needs of the individual as set out in the ISP.
Service documentation and
The support coordinator shall
maintain a plan for supports that includes:
a. Identifying information such as provider
name, provider number, responsible person and telephone number, effective dates
for the service, and if applicable, person-centered review dates;
b. Expected outcomes of the training;
c. Specific training or
activities showing frequency, location, dates and times, and to whom the
training was provided.
The provider shall maintain and relay to
the support coordinator contact notes or a summary documenting:
a. Date, location, hours, and summary of each
b. Plan for support
desired outcome that was addressed;
c. Specific details of the training
activities conducted, including person to whom activities were
d. Training delivered as
planned or modified; and
Effectiveness of strategies and satisfaction of the individual or family
Person-centered reviews by the provider (i) shall be required quarterly if the
training extends three months or longer, (ii) shall be forwarded to the support
coordinator, and (iii) shall include:
summary of the quarter's activities;
b. Training recipient's status and
satisfaction with the service; and
c. Training outcomes and
Provider and support coordinator 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.