Habilitation Services is a program to provide Home- and Community-Based Services (HCBS) for Iowans with the functional impairments typically associated with chronic mental illnesses. The federal Deficit Reduction Act of 2005 permitted states to offer HCBS as a state plan option effective January 1, 2007. Using this option, the Department worked with the Centers for Medicare and Medicaid Services (CMS) to design a program to meet the service needs of Iowans with the functional limitations typically associated with chronic mental illness. Habilitation Services are designed to assist participants in acquiring, retaining and improving the self-help, socialization and adaptive skills necessary to reside successfully in home- and community-based settings. Services available through the program include:
- Case Management
Provides service coordination and monitoring. Available as a Habilitation service when the individual does not otherwise qualify for targeted case management (Iowa Plan or IME funded).
- Home-Based Habilitation
Services provided in the person's home and community. Typical examples would be assistance with medication management, budgeting, grocery shopping, personal hygiene skills, etc.
- Day Habilitation
Services that are usually provided in a day program setting outside the home. Focuses on areas such as social skills, communication skills, behavior management, etc.
- Prevocational Services
Can be provided in a variety of settings, and focus on developing generalized skills that prepare a person for employment. Typical examples include attendance, safety skills, following directions, and staying on task.
- Supported Employment
Assists in obtaining and keeping a job in the community. Assists in placing the individual in a job in a regular work setting with persons without disabilities at minimum wage or higher, and provides support to maintain the job. Typical examples would include: skills assessments, consultation with the employer, job coaching, and behavior management.
Resources:
HCBS Habilitation Program Changes Training Sessions | ||
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Postponed. See Informational Letter No. 2289-MC-FFS for more details.
Frequently Asked QuestionsAdministrative RulesQ: Where can I find the Adminitrative Rules for the program? A: The rules are all available on the DHS website.
Member EnrollmentQ: How do consumers enroll for Habilitation Services? A: The enrollment process begins with a case manager. In general the process will follow these steps:
Q: I tried to enter my consumer in ISIS and it gave me an error message saying the % of federal poverty level is missing, or is 000 or 999. What does this mean and what should I do about it? A: The message you received means that the calculation of federal poverty level that the Income Maintenance worker enters is either 000 or 999. These are both generic codes that don't give the real poverty level. When you get that message, ISIS sends a message to the IM worker asking them to enter the correct poverty level calculation. It may take up to a week for this to be entered and carried over to ISIS, so when you get this message, wait a week and try again. Knowing the poverty level is necessary for ISIS to start the case because the federal law that authorizes the Habilitation program limits eligibility to persons at or below 150% of the federal poverty level (FPL). See the eligibility FAQs below for more intformation on this requirement.
Needs Based AssessmentQ: What assessment form is used? A: The Case Management Comprehensive Assessment (Form 470-4694). The case manager can also send a social history as an attachment if it is felt that additional information is needed.
Q: Where should the assessment be sent? A: Submit it to the IME Medical Services Unit by FAX at (515)725-0931. Please be sure it is clearly marked as being for Habilitation Services. Do not batch requests under one fax cover sheet; send each request with a separate cover sheet. Response to requests will be completed by fax only. It is necessary to provide your fax number to us on your cover sheet.
Questions regarding assessments can be sent by email to: habilitationservices@dhs.state.ia.us. Do NOT submit assessments to this address. Use the above FAX number only.
Q: How soon will the assessment be processed? A: Initial assessments will be responded to within 2 business days. Annual reviews will be responded to within 5 business days. In some cases, the reviewer may ask for additional information to be sent.
Provider EnrollmentQ: Do current Medicaid providers need to re-enroll to provide Habilitation Services? A: Yes. All current providers will need to enroll separately as a Habilitation Services provider because some qualifications may be different than for other programs a provider is currently enrolled for. Targeted case management providers who wish to provide case management as a service under this program must also enroll in order to establish a provider number that is different from their TCM provider number.
Q: What is the enrollment process? A: Providers must complete the Organizational Provider application form, a provider agreement form, and an IRS W-9 form. These forms can all be found at the IME Provider enrollment webpage. Alternately, you can contact the IME Provider Enrollment Unit by e-mail at imeproviderservices@dhs.state.ia.us or call 1-800-338-7909 (Option 2) or 515-725-1004 from Des Moines.
Q: What are the qualifications needed to become a provider for Habilitation Services? A: Requirements shown in the chart below reflect the requirements in effect as of 4/1/07:
Case Management Accredited under 441 IAC Chapter 24
Home-Based Habilitation Meet any of the following:
Day Habilitation Meet any of the following:
Prevocational Habilitation Meet any of the following:
Supported Employment Habilitation
Meet any of the following:
EligibilityQ: Who is eligible to receive these services? A: The federal law that the program will operate under prohibits targeting a specific population group to be served. However, the program provides the type of services typically needed by adults with a chronic mental illness. Anyone seeking services through this program must be eligible for Medicaid and have a need for such services which will be demonstrated by meeting the following Needs-Based Criteria:
The individual meets at least one of the following risk factors:
In addition, the person has a need for assistance typically demonstrated by meeting at least two of the following criteria on a continuing or intermittent basis for at least two years:
Q: Can children receive Habilitation Services? A: There is no age restriction on the receipt of Habilitation Services; anyone who meets all eligibility requirements for the program can receive the service. However, the needs-based criteria are functional criteria that most likely would not be applicible to most younger children regardless of disability. Adolescents who are transitioning from children's services to adult services would likely benefit from the program without the need to make an abrupt transition at the age of eighteen.
Q: What are the financial eligibility requirements? A: Federal law restricts eligibility to individuals whose household income does not exceed 150% of the federal poverty level.
Q: Are there slots for this program? A: No, as of January 1, 2011 there are no slots or waiting lists for the program.
Q: Can a person receive services through this program and through an HCBS Waiver program? A: As of June 1, 2008 there is no longer a rule that prohibits a person from receiving Habilitation Services and Waiver services. A person must still meet all eligibility criteria for both programs, and services may not be duplicitive between the two programs. |