ic2pr009 attachment d dds guidelines for hiring family members form

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					             DDS Prior Approval Guidelines for Hiring Family Members,
            Relatives, or Significant Others Who Reside with an Individual
Prior Approval is required whenever a family member, relative or significant other who
resides with an individual can be considered for employment. The information found
below must be completed and attached to the prior approval form and submitted to the
regional Self Determination Director.

General Rules:

I.        Family Members, Relatives, or Significant Others Who Reside with an Individual cannot
          be hired to provide a waiver service when:
              The relative/significant other is the sole legal guardian of the individual
              The relative/significant other is the sole legally responsible relative of the
              The relative/significant other is the employer of record
              The relative/significant other is the parent of a child under 18 who is receiving
                 the service

II.       Family Members, relatives, or significant others can be hired to provide a waiver service
          when they are not living in the same home (excluding those listed above). Family
          members, relatives, or significant others can also be paid mile reimbursement for
          transportation that is related to an IP goal.

III.      Family members, relatives, or significant others who reside with an Individual who do
          not meet the exclusionary criteria in Section I listed above can be considered for hire
               The service would otherwise need to be provided by a qualified provider
               A qualified provider who is not a family member is not available to provide the
                 service or can only provide the service at an extraordinarily higher cost than the
                 fee or charge negotiated with the qualified family member; and
               The planning team determines the family member providing the support will best
                 meet the individual’s needs.

The information below will be used to determine whether prior approval for the hire of a family
member will be authorized:

Step 1: Identification of Needs, Goals and Objectives in the Individual Plan (IP5)

     What needs, goals, and objectives will the family member be helping to address?

Step 2: Identification of appropriate waiver service, # of hours of service and rate to be paid for
the service (IP6)

     What specific waiver services will the family member provide, at what # of hours, at what pay
I.C.2.PR.009 Attachment D
Step 3: The IP team assesses the appropriateness of the family member to provide the service:

Question                          Considerations                                  Comments
1. Is the use of a family         The team needs to consider the day from
                                  the person’s perspective. Sometime
   member age and                 having family around may be fine. Other
   developmentally                times may not be. Does a 30 year-old
   appropriate?                   generally have his mom accompany him
                                  to evenings out with friends? Not
                                  usually. Support teams must look at
                                  ways of using family as paid direct
                                  service workers in situationally
                                  appropriate times that are consistent with
                                  meeting the person’s support needs. If
                                  using family as a paid direct service
                                  worker for some times makes sense, then
                                  consider including non-family members
                                  for times involving planned socializing
                                  and peer interaction.
2. Will using a family            The support team must build in
                                  opportunities for the individual to meet
   member as paid direct          different people and form relationships,
   service workers enable the     including making choices about
   person to learn and to         selection of different direct support
   adapt to different people      The support team must discuss any
   and also to form new           barriers to increased community
   relationships?                 integration or friendship development
                                  presented by use of family as paid direct
                                  service workers and how to address
                                  these barriers.

3.    Is the person learning      The support team and IFS provider must
                                  reinforce with the family member that
     flexibility and skills for   he/she is not in a “caretaking” role, but
     increased independence?      rather in a supportive role that is
                                  intended to encourage autonomy and
                                  skills building for independence in
                                  community living. The support team
                                  must ensure that the family member
                                  providing direct support approaches the
                                  job as such and does not present barriers
                                  to individual goals and treatment
                                  objectives. Support teams should
                                  approach with considerable caution use
                                  of family as paid direct support for
                                  persons with significant behavioral
                                  challenges due to requirements of
                                  treatment plans and treatment objectives.
4. What happens when the          Is this in the best interest of the person in
                                  the long-term? Is this something that is
   family caregiver is gone?      sustainable for the long-term? Continuity
   Who else is prepared to        of care in provision of direct services is
   step in and provide            an important aspect of achieving
                                  personal outcomes, including goals,
   support?                       wellness, and progression of skills.

I.C.2.PR.009 Attachment D
5. Is this about the person’s    Support teams must consider the motive
                                 and level of commitment of a family
   wishes, desires, needs, or    member requesting to act as a paid direct
   about supplementing a         service worker. Protecting against
   family member’s income?       exploitation is key. In the end, if a
                                 family member is more focused on
                                 earning money, the quality of care may
                                 be low, and the person may be put at
6. Are there any other factors    Staff supports are required at             Other:
                                       difficult times of the day to get or
   that should be considered           schedule employees;
   in hiring this family          The participant lives in a rural or
   member?                             isolated area;
                                  The family member may work on a
                                       temporary basis while other staffing
                                       options are explored;
                                  Having a family member as staff
                                       truly reflects the person’s wishes
                                       and desires.

Individual Planning Signature Sheet:

IP team members have discussed whether the participant hiring a family member is interested in
hiring their own staff and agree that all the statements below are true and accurate:

 The person is not opposed to the family member providing the service;
 The service to be provided does not primarily benefit the family unit
 The service is not a household task family members expect to share or do for one another
  when they live in the same household
 The service provided is above and beyond typical activities family members provide for
  another adult family member without a disability.
 Only the hours of service determined necessary through the assessment and person centered
  planning process will be authorized and the authorized units of care may fluctuate based on
  the needs of the individual. Family members providing paid care shall not be guaranteed a set
  number of hours to ensure the family member a steady income.

________________________________________                                       __________________________
Signature                                                                      Date

________________________________________                                       __________________________
Signature                                                                      Date

________________________________________                                       __________________________
Signature                                                                      Date

I.C.2.PR.009 Attachment D

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