2. Overview Residential Services Housing Inspections Supports Intensity Scale Questions

3. Residential Services

4. Residential Habilitation Agency owns or rents home on behalf of person(s) Room and board charges (no more than 80% of the current year’s maximum SSI amount) Home licensed by DIDD Agency chooses housemates and staff No more than 4 people per home unless licensed on June 23, 2000 (TCA 33-2-418)

5. Supported Living Person(s) own or rent home Person(s) pay own bills Agency licensed by DIDD to provide this service DIDD housing inspection required No more than 3 people per SL home Person(s) have a voice in choosing housemates and staff (control) Models of supported living include shift, Companion, 7-On/7-Off, etc.

6. Medical Residential Requires additional licensing by the Department of Health (Professional Support Services License) Can be either Res Hab or SL (licensed as above) Room and board is as described for Res Hab Inclusive of day services Requires RN oversight and supervision of LPN staff Requires delivery of LPN or RN skilled nursing services as per doctor’s orders in the home, however the nurse can perform non-skilled service or SL

7. Family Model Residential Support (FMRS) Adult foster care model Live in home of caregiver (other than family of origin) Room and board charges (no more than 70% of the current year’s maximum SSI amount) Longevity Good model for some (only model for children under 18) Screened yearly by provider agency Agency licensed by DIDD to provide this service No more than 3 person’s supported per home regardless of funding source

8. Semi-Independent Living Services (SILS) Persons lives alone or with 1 or 2 housemates Staff make home visits at least two times per week and provide intermittent supports for routine activities as described in the ISP Agency licensed by DIDD to provide this service Most independent residential service Does NOT require 24-hour on-site staff supports

9. Semi-Independent Living Services (SILS) cont’d As of 3/27/15, now available in the CAC and Statewide Waivers There will be incentives to providers that support people that transition from a 24-hour residential service to SILS

10. Intensive Behavioral Residential Services (IBRS) Clinical service with enhanced Provider Qualifications Home licensed as Residential Habilitation by DIDD No more than 4 persons (TCA 33-2-418) Room and board charges (no more than 80% of the current year’s maximum SSI amount) Not intended to be long term Inclusive of other services as needed(i.e. day and behavior analyst services) Referrals are reviewed by DIDD Clinical Review Team Periodic re-evaluation for continued stay is required Comprehensive discharge planning and transition requirements

11. Other Waiver Services

12. Personal Assistance Provided only in the community home of the person or the person’s family Limited to 215 hours per month Family members can be paid to support the person except for a spouse or minor child, but at a maximum of 40-hours per week per family member Agency licensed by DIDD to provide this service If the agency provides Personal Assistance through the Choices Waiver (TennCare) they would also need to have a PSL license from Department of Mental Health and Substance Abuse

13. Respite Not available to anyone receiving a residential service (DOES apply to personal assistance) Agency licensed by DIDD to provide this service Limited to 30-days per year Available as a quarter hour up to a maximum of 8 hours/day or daily service Can be provided in the person’s home or another residential setting

14. Behavioral Respite Clinical service available to persons who are experiencing a behavioral crisis Agency licensed by DIDD to provide this service Inclusive of all other services (i.e. day and behavior analyst services) Limited to 60-days per calendar year This respite service is available to persons receiving a residential service and can be provided in a home operated by a licensed residential provider Admission determined by Regional Director in the region in which the Behavior Respite home is located

15. Housing Inspections

16. Requesting an Inspection All Supported Living and Semi-independent Living homes must be inspected by a DIDD housing inspector and must pass prior to persons supported moving in to the home. This is the only way to get a site code that will allow you to bill for these services. Once requested, the housing inspector has 7 business days to complete the inspection. The request for inspection form can be found on the DIDD website.

17. Preparing for an Inspection It is best to prepare before you have the inspector come to the home. To do so, find the Housing Inspection Checklist on the DIDD website. It contains the minimum requirements you will need in order to pass an inspection.

18. Supports Intensity Scale (SIS®) DIDD is required to have a uniform assessment tool to assist in planning the lives of persons served. Persons receiving residential, day, or PA services must have a SIS® DIDD contracts with an outside organization (Ascend) so that an independent party is the one conducting the assessments.

19. Supports Intensity Scale (SIS ® ) The SIS ® measures the support that is needed to help the person with a disability:  Engage in activities like other same-aged adults  Participate as fully in the activity as possible  Participate as often as other adults in the community

20. Supports Intensity Scale (SIS ® ) The role of the provider agency  Work with assessors to schedule assessments  Possibly act as respondents or help identify potential respondents who can speak to the persons support needs  Ensure that the person is present for the assessment.

21. Questions