Supports Program Policies & Procedures Manual

1 1 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 New Jersey Department of Human Services Division of Developmental Disabilities Supports Program Policies & Procedures Manual 2 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 Supports Program Policies & Procedures Manual , Version March 2019 Section Description of Changes Overall Manual General grammatical, typo, etc. corrections, changed Molina to DXC Technology to reflect name change 3 Added the DSP Service budget component with an explanation Added info regarding emergencies and CCP eligibility 6 Provided clarification that an approved ISP must be completed within 30 days any time a new ISP is generated in order for the SCA to claim for services 7 Added other services requiring DDD approval Added guidance for circumstances in which ISP signatures have not been able to be obtained 8 Provided clarification regarding hiring family members as Self-Directed Employees (SDE)

2 11 Provided additional information about topics to cover in the provider s Policies & Procedures Manual 14 Removed the requirement for a Rate Component Report and changed date for submitting Fiscal Sustainability Criteria 17 Added indication that the DSP Service component applies to Career Planning, Community Based Supports , Community Inclusion Services, Day Habilitation, Prevocational Training, Respite, and Supported Employment Added a statement under relevant services to explain that providers must follow medication standards described under Day Habilitation and Prevocational Training if they are distributing medication while delivering these other services such as Community Inclusion Services Added a statement related to volunteering and the need to ensure there isn t an Employment Relationship with the entity for which the individual is volunteering per Provided additional information regarding the daily rate for support Coordination when it is used, deliverables, etc.

3 Provided clarification that an approved ISP must be completed within 30 days any time a new ISP is generated in order for the SCA to claim for services Updated transportation documentation to note that start and end times are not necessary Rephrase exceptions under Transportation to clarify that transportation can be provided to community activities as part of Day Habilitation Appendix Updated help desk information Updated links to documentation Adjusted rates in Appendix H to reflect DSP wage increase Provided additional clarification to Appendix K regarding services that can be provided when an individual is receiving Individual support services using the daily rate Added Appendix M regarding the extension to come into compliance with Behavioral support service qualifications Added Appendix N - interagency agreement with Wage & Hour in order to provide non paid experiences for individuals when criteria outlined in this appendix are met.

4 3 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 Table of Contents 1 INTRODUCTION .. 13 Supports Program Policy Manual .. 13 Overview of the Division of Developmental Disabilities .. 13 Mission and Goals .. 13 Key Themes .. 14 Division of Developmental Disabilities Responsibilities .. 14 2 VISIONING A LIFE COURSE TRANSITIONING TO ADULTHOOD .. 16 3 DIVISION OF DEVELOPMENTAL DISABILITIES ELIGIBILITY .. 17 Requirements for Division Eligibility .. 17 Intake/Application Process .. 17 Application .. 17 Additional Documents .. 18 Eligibility Determination Process .. 18 Tiering & Acuity Factor.

5 19 Acuity Factor Requirements .. 19 Individual Budgets .. 20 Requesting the Supported Employment Component of the Individual Budget .. 21 Bump-Up .. 21 Requesting NJ CAT Reassessment .. 21 Redetermination of Eligibility .. 22 Eligibility Appeal Rights .. 22 Discharge from the Division .. 22 Moving from the Supports Program to the Community Care Program .. 22 4 OVERVIEW OF THE Supports Program .. 23 Supports Program + Private Duty Nursing (PDN) .. 23 5 Supports Program ELIGIBILITY AND INDIVIDUAL ENROLLMENT .. 24 Eligibility for the Supports Program .. 24 Allowable Types of Medicaid for the Supports Program .. 24 Individual Enrollment into the Supports Program .

6 24 Enrollment into the Supports Program + Private Duty Nursing (PDN) .. 25 Individual Responsibilities .. 26 4 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 Individual Disenrollment from the Supports Program .. 27 Individual Disenrollment Process .. 27 6 CARE MANAGEMENT .. 29 Selection and Assignment of a support Coordination Agency .. 29 Choosing a support Coordination Agency .. 29 Process for Assigning a support Coordination Agency .. 29 Changing support Coordination Agencies .. 30 Role of the support Coordinator .. 30 Responsibilities of the support Coordinator .. 30 support Coordinator Deliverables.

7 32 Community Transitions & support Coordination .. 32 Transitions to Institutions from Community Settings .. 32 Transitions from Institutional to Community Settings .. 33 Transitions from Hospitalization to Community Settings .. 33 7 SERVICE PLAN .. 35 Operating Principles .. 35 Planning Team Membership .. 36 Responsibilities of Each Team Member .. 36 Responsibilities of the Plan Coordinator ( support Coordinator) .. 36 Responsibilities of the Individual (and guardian, where applicable) as a Planning Team 37 Responsibilities of the Service Provider as a Planning Team Member (when included) .. 37 Responsibilities of Other Planning Team Members .. 37 Development of the Individualized Service Plan.

8 38 Assessments/Evaluations .. 38 Planning Meetings .. 41 Components of the Individualized Service Plan (ISP) .. 42 Participant Information .. 43 Outcomes and Services .. 43 Employment First Implementation .. 44 Voting Plan .. 44 Health & Nutrition Needs .. 45 Safety & Supports Needs .. 45 5 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 Emergency Contacts .. 45 Medication .. 45 Authorizations & Signatures .. 45 Resolving Differences of Opinion among Planning Team Members .. 46 Service Plan Approval .. 46 Service Approvals by the Division .. 47 Changes to the Service Plan.

9 47 8 ACCESSING SERVICES .. 48 Identification of Needed Services .. 48 Use of Community Resources and Non-Division-Funded Services .. 48 Community Resources .. 48 Coordination with Other State programs and Agencies .. 48 Accessing Division-Funded Services .. 49 Utilizing a Service Provider .. 49 Hiring a Self-Directed Employee (SDE) Self-Hires .. 51 Accessing/Continuing Needed Services upon 21st Birthday .. 56 Prior Authorization of Services .. 56 Rounding of Service Units .. 56 Unit Accumulation .. 57 Back-Up SDEs .. 57 Delivery of 57 Duplicative Services .. 57 Retirement .. 58 Retirement from Employment .. 58 Retirement from Employment/Day Services.

10 58 9 PROVIDER ENROLLMENT .. 59 Prior to Submitting an Application .. 59 Submitting an Application to Become a Medicaid/DDD Approved Provider .. 59 Application Process .. 59 Adding Services .. 60 Adding Service Locations .. 60 Business Entity/Individual Practitioner .. 60 6 NJ Division of Developmental Disabilities Supports Program Policies & Procedures Manual (Version ) March 2019 10 FISCAL INTERMEDIARY (FI) .. 61 11 ADDITIONAL PROVIDER REQUIREMENTS .. 62 Policies & Procedures Manual .. 62 Organizational Governance Policy .. 63 Documentation of Qualifications .. 63 Staff Orientation, Training, and Professional Development .. 63 Accessing Training through the College of Direct support (CDS).