F. Scheduling of Waiver Services
Part of the work to develop an ISP is the scheduling of anticipated services that the applicant will receive. The Projected Weekly Schedule of All Services is a one (1) week schedule for twenty four (24) hours-a-day indicating the type of the service being provided (e.g. ILST, CIC, informal supports, etc) and the day(s), time(s) and frequency of each service in the Service Plan. The name of each provider agency must be documented in the Waiver Service and Cost Projection chart in the ISP. The name of Informal Supports and specific assistance provided are documented in the Current Supports and Services section of the ISP. The schedule should be flexible to allow for preferences and limitations of the applicant such as a limited attention span or reduced stamina, balanced with the availability of formal and informal supports. It should be designed to meet the goals and needs of the applicant, support the waiver's philosophy of choice, and provide for the health and welfare of the participant.
Once the ISP is approved by the RRDS and the applicant becomes a participant, the established frequency and duration of waiver services must be adhered to unless prior approval is given by the SC following a request to increase or decrease services.
Negotiations for changes in time will include the waiver participant, SC, and impacted providers of waiver and non-waiver services.
The Service Plan must document any situations where two services will be provided at the same time to ensure consistent and effective service provision; situations must be clinically justified and time limited. Example: When an Independent Living Skills Training (ILST) provider is training Home and Community Support Services (HCSS) provider to assist a participant in a specific task or when the Director of the Positive Behavioral Interventions and Supports (PBIS) in the process of developing the PBIS Detailed Plan must observe a participant's behavior at the Structured Day Program (SDP). The overlap of services must be justified and documented in the Service Plan in order for both services to be reimbursed.
Services may be rescheduled if the participant is unable to participate or the provider is not available. When the participant requests that a service be suspended for a day or more, it is the responsibility of that participant and/or informal support to notify the SC who, in turn notifies the providers. If the participant notifies the provider(s), he/she must also notify the SC.
A provider should notify the SC when a participant repeatedly refuses a service. The SC should review the Service Plan with the participant and provider to determine if it needs to be revised to more accurately reflect the goals and abilities of the participant. Revisions to the schedule should allow enough time for the provider to make the necessary arrangements. When a participant refuses significant services, it may be necessary to discontinue the individual from the waiver.