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Developmental Disabilities Waiver Service Standards

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Developmental Disabilities Waiver Service Standards Developmental Disabilities Waiver Service Standards Original Issue February 26, 2018 Reissue Date: December 28, 2018 Effective Date: January 1, 2019 . Page left blank DD Waiver Service Standards Reissue December 28, 2018; Effective Date January 1, 2019 Page 2 of 285 Acknowledgements The Developmental Disabilities Supports Division (DDSD) would like to acknowledge the assistance, time, and expertise of many people who contributed to the development of these DD Waiver Service Standards. DDSD received input over many months from people receiving services, family members, providers, organizations, and subject matter experts within both the Department of Health (DOH) and the Human Services Department (HSD). Many stakeholders participated in five full day feedback forums and /or provided written comments. Their time and input were invaluable to the completion of the final DD Waiver Service Standards. DDSD is grateful for the commitment, time, energy, and creativity of all who worked so hard on this project to improve the lives of people with intellectual and developmental disabilities (I/DD) in New Mexico. We share a common goal and core values to establish a system that provides person centered services in support of people with I/DD to achieve quality outcomes, to have choice, to live meaningful lives, and to engage in meaningful relationships in the community of their choice. These service standards are the framework for providers to operate a quality system of services and supports for people with I/DD. DD Waiver Service Standards Reissue December 28, 2018; Effective Date January 1, 2019 Page 3 of 285 Statement from Advocates DDSD invited advocates representing people receiving services and their families to introduce these DD Waiver Service Standards. Here is what they wrote: Foremost in creating the New Mexico developmental disability service system is alignment with the needs and desires of those receiving the services. That alignment is ultimately the measure of success for any service system. The DD Waiver system is a way to provide community based alternatives to individuals with developmental disabilities. The 2014 final HCBS settings rule (The Final Rule) created new requirements for all DD Waiver residential and non-residential settings/facilities, including that they provide opportunities for participants to engage in community life, have access to the community, control their personal resources, seek employment and work in competitive settings. These new rules will enhance the quality and definition of waiver services and provide additional protections to individuals that receive services. The person-centered planning process is a key part of the new rule. Team meetings afford the opportunity for the person receiving services to communicate in whatever manner they are able, their wishes and desires, the goals they have for their life, and the supports and services they need to achieve these. The collaboration between the person receiving services, Provider Agencies, friends, and natural supports determine an individualized plan that meets the person’s wishes and needs. Ultimately it is the person’s quality of life that is the measure of the success of a program. All members of the person’s team, particularly the CM, set the tone for creating a comfortable atmosphere in the IDT planning meetings so that the individuals with their voices (or the individual with his/her voice) or other advocates in the planning meeting can support the concerns of the individuals. The person we are serving is why these systems exist, and therefore why it is so important that we listen and support the person to achieve his/her goals. DD Waiver Service Standards Reissue December 28, 2018; Effective Date January 1, 2019 Page 4 of 285 Table of Contents Acknowledgements ............................................................................................................................................... 3 Statement from Advocates .................................................................................................................................... 4 TABLE OF CONTENTS ....................................................................................................................... 5 Introduction ......................................................................................................................................................... 10 I.1. Developmental Disabilities Supports Division (DDSD) Mission ..................................................................... 10 I.2. General Purpose and Description of Developmental Disabilities Waiver ..................................................... 10 I.3. General Authority .......................................................................................................................................... 10 I.4. Federal Oversight of States Quality Improvement Strategy (QIS) ................................................................. 10 I.5. Quality Improvement Strategy(QIS) at the State Level: Developmental Disabilities System Quality Improvement Committee (DDSQI) ......................................................................................................................... 11 I.6. Purpose of Standards .................................................................................................................................... 11 I.7. Updates and Enhancements ......................................................................................................................... 12 I.8. Organization of the DD Waiver Service Standards ........................................................................................ 12 I.9. Common References ..................................................................................................................................... 13 I.10. Using the DD Waiver Service Standards ................................................................................................... 13 SECTION I: PLANNING .................................................................................................................... 14 Chapter 1: Initial Allocation and Ongoing Eligibility ........................................................................................ 14 1.1 Definition of Developmental Disability ......................................................................................................... 14 1.2 Central Registry ............................................................................................................................................. 15 1.3 Allocation Process ......................................................................................................................................... 15 1.4 Primary Freedom of Choice (PFOC) ............................................................................................................... 16 1.5 Refusal Form.................................................................................................................................................. 16 1.6 Expedited Allocation ..................................................................................................................................... 16 1.7 Letter of Allocation ........................................................................................................................................ 17 1.8 Medical and Financial Eligibility .................................................................................................................... 17 Chapter 2: Human Rights................................................................................................................................ 20 2.1 CMS Final Rule: Home and Community-Based Services (HCBS) Settings Requirements .............................. 20 2.2 Home and Community Based Services (HCBS): Consumer Rights and Freedoms ......................................... 21 2.3 Dignity of Risk and Duty of Care .................................................................................................................... 21 Chapter 3: Safeguards .................................................................................................................................... 22 3.1 Decisions about Health Care or Other Treatment: Decision Consultation and Team Justification Process . 22 3.2 Financial Rights and Responsibilities of the Person in Services .................................................................... 23 3.3 Human Rights Committee ............................................................................................................................. 23 3.4 Emergency Physical Restraint (EPR) .............................................................................................................. 27 Chapter 4: Person-Centered Planning (PCP) ................................................................................................... 35 4.1 Essential Elements of Person-Centered Planning (PCP) ................................................................................ 35 4.2 Person-Centered Thinking ............................................................................................................................. 35 4.3 Person-Centered Planning ............................................................................................................................. 36 4.4 Person-Centered Practice .............................................................................................................................
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