Section 20: Definitions

• Challenging Behavior – in the last sentence, after “may include” add "but not be limited to". There are many other types of behaviors that place individuals and others at risk.
• Family - remove Legal Guardian from list and have a separate and distinct definition for said, including legal guardian’s role, responsibilities and limitations as it relates to these regulations.
• Positive Behavior Supports - use A.A.P.B.S. definition
• Progress Note - use of this definition should be consistent throughout entirety of the regulations.
• Supported living residential – remove “in an apartment setting” and replace with “in the individual’s home”
• Add a definition for Independent Living

Section 60: Financial eligibility standards

• B3a1 and B3b1 - Remove “for an individual employed at least eight” hours.

Section 80: Waiver approval process

• C4 - Extend timeframe for initiating service from 30 days to 60 or 90 days. It takes more than a few weeks to provide and obtain completed service applications (and related materials), arrange for tours, schedule and conduct intake meetings and hire/train/assign staff, etc.

Section 90: Waiting List

• C1a – Add (reinstitute) age (65 or 70) of primary care giver as criteria for Priority One eligibility in an effort to allow for a modicum of individual and family service planning before the individual is in crisis, dealing with the death or serious health issue of a aging parent and potential life-changing move to an unfamiliar setting.
• E3 – All waiver slots should be for Priority One individuals. Further, if there is a lack of interest in the BI waiver, the slots should be reassigned to Priority One CL and FIS waivers with no need for WSAC session to review re-assignment to Priority Two and Three.

Section 120: Provider requirements

• A4 – Extend timeframe for initiating service from 30 days to 60 or 90 days (see note in section 80 above)
• A6 – Remove “supplies” and replace with “supports”

Section 190: Individual Support Plan

• A8 – Specify that the ISP is to be provided by the Support Coordinator

Section 200: Supports Intensity Scale

• A1 – Clarify what assessment and rate reimbursement determinant structure is to be used for individuals older than 72.
• A2a – Remove “three” and replace with “four” years for consistency with the state waiver application to CMS.
• A2d – Remove “six” months and replace with “two” months. Providers regularly support individuals following surgeries and other medical events/conditions wherein it is immediately known and/or highly predictable that the individual’s supports needs have, or will have, changed significantly for an extended time period but also likely to last less than six months before returning to baseline.
• A4 -   Remove scoring protocols from regulations and communicate to providers via some other means.

Section 390: Group Home residential

• E1C – Change “daily note” to “progress note”