A Report on Services and Reimbursement Rates for ID/DD Waivers in Selected States

Transcription

1 A Report on Services and Reimbursement Rates for ID/DD Waivers in Selected States Michelle Hull Edward T. Jennings, Jr. Martin School of Public Policy and Administration University of Kentucky Prepared for the Commonwealth Council on Developmental Disabilities November 1, 2012

2 ID/DD Medicaid Waivers All of the information in this report is taken from each state's 1915(c) HCBS Waiver application on Medicaid.gov except for some of the Kentucky information which came from as of October 31, Tennessee Payment rate Number of Units of Service Allowed HCBS Waiver for MR/DD October 2011 Support Coordination $231/month The Support Coordinator must have: 1. A Bachelor's degree from an accredited college or university in a human services field; or 2. A Bachelor's degree from an accredited college or university in a non-related field and one year of relevant experience; or 3. Associate degree plus two (2) years of relevant experience; or 4. Four (4) years of relevant experience. Relevant experience means experience in working directly with persons with intellectual, developmental, or other types of disabilities or mental illness. Support coordinators who do not have a Bachelor s degree in a human services field must be supervised by someone who does meet that qualification. Support Coordinators must successfully complete required pre-service training courses as well as periodic in-service training and any other any re-training required to maintain approval to be a Support Coordinator. Psychological Services Psychologist-Must be licensed to practice in Tennessee Nutrition Services Assessment and Plan Development $234.25/visit Other Service $ visits/year 1 assessment/year Dietician or Nutritionist-Must have a valid license to practice in Tennessee Behavior Specialist $6.69/15 min A Behavior Specialist must have a Bachelor's degree from an accredited college or university in one of the behavioral sciences or in an alternative discipline, and acceptable field work and experience equivalent to one (1) year of full-time behavioral therapy or behavioral modification. Behavior Analyst $18.69/15 min 5 hours for presentations at meetings per year 2 assessments per year; 8 hours per assessment for completion of the behavior assessment; 6 hours per assessment for behavior plan development and staff training during the first 30 days following its approval.

3 A Behavior Analyst must have a Master s degree in behavior analysis, psychology, special education, or related field; a minimum of 12 credit hours of undergraduate or graduate level course work in behavior analysis; and a minimum of six (6) months full-time, supervised employment (or internship/practicum) in behavior analysis under the supervision of a behavior analyst. Supervision minimally consists of face-to-face meeting for the purpose of providing feedback and technical consultation at least once per week. Community Access/Integration Residential Habilitation $110/day Special Needs Adjustment $30/day 1 day=24 hours Waiver service agency - Must be licensed by the Department of Mental Health and Developmental Disabilities (TCA Title 33 Chapter 2) as a Mental Retardation Residential Facility Day Services Facility-Based $46.35/day Community-Based $76.25/day 243 days/year 1 day=up to 10.5 hours during weekday daytime hours (7:30 am to 6:00 pm) Waiver service agency (Facility-based Day Services)- Must be licensed by the Department of Mental Health and Developmental Disabilities as a Mental Retardation Adult Habilitation Day Facility (TCA Title 33 Chapter 2) Respite Overnight $214/day Sitter $3.69/15 min 30 days/year 1 day=8-24 hours Medicaid-certified ICF/MR - Must be licensed by the Department of Mental Health and Developmental Disabilities (TCA Title 33 Chapter 2) as a Mental Retardation Institutional Habilitation Facility 2

4 Ohio SELF Waiver July 2012 Support Broker Payment rate 3 Number of Units of Service Allowed Can be unpaid(volunteer) Cost limit: $8,000/year $31.30/hour Must attend training established by DODD The following cannot be a Support Broker: County Boards; CB employees; SELF waiver providers (and their related entities); employees of SELF waiver providers In addition, legal guardians, as well as family members who reside with the individual, cannot be paid to provide this service Psychological Services Clinical/Therapeutic Intervention $54.74/hour Clinical/therapeutic intervention shall be provided by senior level specialized clinical/therapeutic interventionists, specialized clinical/therapeutic interventionists, and clinical/therapeutic interventionists. (a) A senior level specialized clinical/therapeutic interventionist shall have a doctoral degree in psychology, special education, medicine, or a related discipline; be licensed under the laws of the state to practice in his or her field; and have at least three months of experience and/or training in the implementation and oversight of comprehensive interventions for individuals with developmental disabilities who need significant behaviorally-focused interventions. (b) A specialized clinical/therapeutic interventionist shall: (i) Have a master s degree in psychology, special education, or a related discipline and be licensed under the laws of the state to practice in his or her field or be registered with the state board of psychology as an aide or a psychology aide working under psychological work supervision in accordance with rule of the Administrative Code; and (ii) Have at least three months of experience and/or training in the implementation and oversight of comprehensive interventions for individuals with developmental disabilities who need significant behaviorally-focused interventions. (c) A clinical/therapeutic interventionist shall work under the supervision of a senior level specialized clinical/therapeutic interventionist or a specialized clinical/therapeutic interventionist and shall either: (i) Have experience providing one-to-one care for an individual with developmental disabilities who needs significant behaviorally-focused interventions; or (ii) Have undergone two monitored sessions with an individual with developmental disabilities who needs significant behaviorally-focused interventions. Licensed Dietician or Nutritionist Behavior Specialist/Behavior Supports Functional Behavioral 1 assessment/year ($1500 limit) Assessment Must be licensed as one of the following: Licensed Professional Clinical Counselor per OAC ; Licensed Professional Counselor per OAC ; Licensed Independent Social

5 Worker per OAC ; or Licensed Social Worker (under the supervision of an LISW) per OAC Community Community Inclusion ($25,000 limit with respite) Access/Integration $15.97/hour Has a Medicaid provider agreement with the Ohio department of job and family services; and (c) Has completed and submitted an application and adheres to the requirements of rule 5123: of the Administrative Code. Day Habilitation $64/day 6,000 (15 minute) units/year 1 day=4 or more hours Adult day support shall be provided by an agency provider that meets the requirements of this rule and that has a Medicaid provider agreement with the Ohio department of job and family services. (2) Adult day support shall not be provided by an independent provider. (3) An applicant seeking approval to provide adult day support shall complete and submit an application and adhere to the requirements of rule 5123: of the Administrative Code. Respite Residential $191.61/day Community $7.32/hour Residential 90 day limit Community 60 day limit ($25,000 limit with community inclusion) An applicant seeking approval to provide residential respite or community respite shall meet the requirements of this rule and complete and submit an application and adhere to the requirements of either rule 5123: or5123: of the Administrative Code, as applicable. ( 4

6 Indiana Family Supports July 2012 Support Broker/Community Guide Payment rate Psychological Services Therapy Family $17.87/15 min Individual $15.99/15 min Group $4.98/15 min Number of Units of Service Allowed DDRS approved 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Provider Financial Status, 460 IAC (Psychological) Therapy Provider qualifications Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals. Licensed Dietician or Nutritionist Behavioral Supports $18.83/15 min Intensive Behavioral Intervention (IBI) Level I $104.69/hour Level II $25/hour DDRS Approved 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Provider Financial Status, 460 IAC Behavioral Support Services Provider Qualifications 460 IAC 6-18 Behavioral Support Services Standards Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals. For IBI Director: Psychologist licensed under IC 25-33, or Psychiatrist Licensed under IC For IBI Case Supervisor: IBI Case Supervisor must be BCBA or BCABA certified. DDRS Approved 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Provider Financial Status, 460 IAC Direct Care Staff qualifications, 5

7 460 IAC Staff Training Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals Community Community Based Access/Integration Habilitation Group 2:1 $13.48/hour 3:1 $8.99/hour 4:1 $6.75/hour Individual $25.87/hour DDRS-approved, 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Financial Status of Providers, 460 IAC Direct Care, 460 IAC Staff Training, 460 IAC Health Care Coordination Services provider qualifications, and Transportation Requirements Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals Day Services Basic $1.43/15 min $22.71/half day Enhanced $1.86/15 min $29.80/half day Intensive $2.21/15 min $35.48/half day 16 (15 minute) units/day 2 (half day) units/ day 1 half day=3-5 hours 1 day=5-8 hours DDRS-approved 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Financial Status of Providers, 460 IAC Qualification for ADS, 460 IAC Direct Care, 460 IAC Staff Training, and Transportation Requirements. Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals. Respite $25.87/hour Nursing Care RN $8.06/15 min Nursing Care LPN $6.12/15 min DDRS-approved 460 IAC Criminal Histories, 460 IAC 6-12 Insurance, 460 IAC 6-11 Financial Status of Providers, 460 IAC Respite Care Qualifications, 460 IAC Health Care Coordination Qualifications, 6

8 460 IAC Direct Care, 460 IAC Staff Training Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals. 7

9 Indiana Community Integration and Habilitation Waiver September 2012 Support Broker Payment rate Psychological Services Therapy Family $0.01/15 min Individual $15.99/15 min Group $4.98/15 min 8 Number of Units of Service Allowed Enrolled as an active Medicaid provider Must be DDRS-approved Must comply with Indiana Administrative Code, 460 IAC 6 Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals, including DDRS Waiver Manual and DDRS BDDS Policy Manual. Licensed Dietician or Nutritionist Behavioral Supports $18.56/15 min Intensive Behavioral Intervention (IBI) Level I $104.69/hour Level II $25/hour Enrolled as an active Medicaid provider Must be DDRS-approved Must comply with Indiana Administrative Code, 460 IAC 6 Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals, including DDRS Waiver Manual and DDRS BDDS Policy Manual. Community Access/Integration Community Based Habilitation Group 2:1 $13.49/hour 3:1 $8.99/hour 4:1 $6.75/hour Individual $25/hour Enrolled as an active Medicaid provider Must be DDRS-approved Must comply with Indiana Administrative Code, 460 IAC 6 Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals, including DDRS Waiver Manual and DDRS BDDS Policy Manual. Must be accredited by at least one (1) of the following organizations: (1) The Commission on Accreditation of Rehabilitation Facilities (CARF), or its successor.

10 (2) The Council on Quality and Leadership In Supports for People with Disabilities, or its successor. (3) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), or its successor. (4) The National Committee for Quality Assurance, or its successor. (5) The ISO-9001 human services QA system. (6) An independent national accreditation organization approved by the secretary Day Services Basic $1.43/15 min $22.72/half day Enhanced $1.86/15 min $29.81/half day Intensive $2.21/15 min $35.49/half day 16 (15 minute) units/day 2 (half day) units/ day 1 half day=3-5 hours 1 day=5-8 hours Enrolled as an active Medicaid provider Must be DDRS-approved Must comply with Indiana Administrative Code, 460 IAC 6 Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals, including DDRS Waiver Manual and DDRS BDDS Policy Manual. Must be accredited by at least one (1) of the following organizations: Application for 1915(c) HCBS Waiver: IN.0378.R Sep 01, 2012 (as of Sep 01,... Page 82 of /29/2012 (1) The Commission on Accreditation of Rehabilitation Facilities (CARF), or its successor. (2) The Council on Quality and Leadership In Supports for People with Disabilities, or its successor. (3) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), or its successor. (4) The National Committee for Quality Assurance, or its successor. (5) The ISO-9001 human services QA system. (6) An independent national accreditation organization approved by the secretary Respite $25.88/hour Nursing Care RN $8.06/15 min Nursing Care LPN $6.12/15 min Enrolled as an active Medicaid provider Must be DDRS-approved Must comply with Indiana Administrative Code, 460 IAC 6 Must comply with any applicable BDDS service standards, guidelines, policies and/or manuals, including DDRS Waiver Manual and DDRS BDDS Policy Manual. 9

11 Illinois Adults with DD July 2007 Support Broker/Community Guide Payment rate Individual Service and Support Advocate (ISSA) Qualified Mental Retardation Professional (QMRP) Psychological Services Psychotherapy Individual $37/hour Group $12/hour Counseling Individual $30/hour Group $10/hour Crisis Services $10/hour Number of Units of Service Allowed Combined 60 hours/year for psychotherapy and counseling. Crisis Services may not exceed $2,000 in any single month and may not be authorized for more than two consecutive months or 60 consecutive days. Clinical Psychologist, Clinical Social Worker, Marriage/Family Therapist, Clinical Professional Counselor Crisis Services Worker: Aged 18 or older, has a high school diploma or GED, and is deemed by the guardian or family to be qualified and competent to meet the participant s needs and carry out responsibilities assigned via the support plan. Licensed Dietician or Nutritionist Behavioral Services Behavior Intervention and 66 hours/year Treatment $65/hour Clinical psychologist Masters level professional who is certified as a Behavior Analyst by the Behavior Analyst Certification Board (bacb.com) Bachelor s level professional who is certified as an Associate Behavior Analyst by the Behavior Analyst Certification Board (bacb.com) Professional who is certified to provide Relationship Development Assessment. Information is at rdiconnect.com. Professional with a Bachelor s Degree in a human service field and who has completed at least 1,500 hours of training or supervised experience in the application of behaviorally-based therapy models consistent with best practice and research on individuals with Autism Spectrum Disorder. Community Integration Residential Habilitation $102/day 1 day=24 hours Day Habilitation $10/hour 115 hours/month Respite 10

12 West Virginia Payment rate Number of Units of Service Allowed MR/DD Waiver July 2010 Service Coordination $8.47/15 min 840 (15 minute) units/year Agency staff must one of the following: Four (4) year degree in a human service field and one or more years experience in the MR/DD field. Four (4) year degree in a human service field and less than one (1) year of experience in the MR/DD field. (Restrictions must be under the supervision of the Service Coordinator Supervisor. Clinical supervision involves review of clinical activities, review of case notes and review of treatment plans for six (6) months. This must be verified by supervisory documentation once per month). Four (4) year degree in a non-human service field and one (1) year experience in the MR/DD field. (Restrictions must be under the supervision of the Service Coordinator Supervisor. Clinical supervision involves review of clinical activities, review of case notes, and review of treatment plans for six (6) months. This must be verified by supervisory documentation once per month). No degree or two (2) year degree and is a Licensed Social Worker grandfathered in by the WV Board of Social Worker Examiners due to experience in the MR/DD field. (Restrictions none) A Registered Nurse who has one or more years of experience working in the MR/DD field (Restrictions must be under the supervision of the Service Coordination Supervisor. Clinical supervision involves review of clinical activities, review of case notes, and review of treatment plans for six (6) months. This must be verified by supervisory documentation once per month). Psychological Services Crisis Services Crisis Services 336 hours/year $40.08/hour Therapeutic Consultant 960 (15 minute) Therapeutic Consultant units/year (in combination with Positive $8.38/15 min Behavior Support Professional) Agency must be an approved WV Medicaid Provider. Agency staff must have current CPR and First Aid cards, an approved Criminal Investigation Background check, be over the age of 18, have the ability to perform the tasks and meet the training requirements as mandated by the Office of Health Facility Licensure and Certification. Therapeutic Consultant: Acceptable CIB. Agency staff must have minimum of bachelor s degree in human services field and minimum of two years experience working with MR/DD population. Licensed Dietician or Nutritionist Dietary Therapy $19.53/15 min 416 (15 minute) units/year (in combination with Occupational and Physical Therapy) Agency must be an approved WV Medicaid Provider. Agency staff must be a registered, licensed dietitian. Agency staff must be over the age of 18, have an acceptable Criminal Investigation Background check, be able to perform the tasks and meet the mandated requirements of the Office of Health Facility Licensure and Certification. Positive Behavior $11.25/15 min 960 (15 minute) units/year (in 11

13 Support Professional combination with therapeutic services) Agency must be an approved WV Medicaid Provider. Agency staff must meet at least one of the following: -Board Certified Assistant Behavior Analyst Certificate-BcaBA (Bachelor s degree) -Board Certified Behavior Analyst Certificate- BCBA(Master s degree) -BA/BS degree in human services field and 2 years experience in the MR/DD field and documented evidence of successful completion of APBS Standards of Practice coursework/training. -BA/BS degree in human services field and evidence of successful completion of all coursework required for the BcaBA exam and 1 year experience in the MR/DD field. Agency staff must be over the age of 18, have an approved Criminal Investigation Background check, be able to perform the tasks and meet the mandated requirements of the Office of Health Facility Licensure and Certification. Community Access/Integration Day Habilitation $2.93/15 min 6,240 (15 minute) units/year Agency must be an approved WV Medicaid Provider. Agency staff must have current CPR and First Aid cards, have an acceptable Criminal Investigation Background check, be over the age of 18, be able to perform and tasks and meet training requirements as mandated by Office of Health Facility Licensure and Certification. Respite Traditional-$3.38/15 min Participant Directed- $2.77/15 min 1,728 hours/year Participant-directed employee must have current CPR and First Aid cards, an acceptable Criminal Investigation Background check, be over the age of 18 and have the ability to perform the tasks. 12

14 Virginia ID Waiver July 2009 Support Broker/Community Guide Payment rate Psychological Services Crisis Stabilization $92.65/hour Therapeutic Consultant $57.20/hour Crisis Supervision $25.16/hour 13 Number of Units of Service Allowed Crisis Stabilization/Supervision 15 days at a time, not more than 60 days/year A crisis stabilization clinical or behavioral intervention services provider must be licensed by DBHDS as a provider of outpatient services, residential services, supportive in-home services or day support services. In addition to meeting the above licensing requirements, the clinical services provider must employ or utilize qualified mental retardation professionals (QMRPs), licensed mental health professionals, or other personnel competent to provide clinical or behavioral interventions. These might include crisis counseling, behavioral consultation, or related activities to individuals with ID/MR who are experiencing serious psychiatric or behavioral problems. The face-to-face assessment or reassessment required to initiate or continue this service must be conducted by a QMRP. The QMRP providing crisis stabilization clinical/behavioral intervention services must have: 1. At least one year of documented experience working directly with individuals who have ID or developmental disabilities; and 2. At least a bachelor s degree in a human services field including, but not limited to, sociology, social work, special education, rehabilitation counseling, or psychology. 3. The required Virginia or national license, registration, or certification, as is applicable, in accordance with his or her profession. To provide Medicaid-funded therapeutic consultation, the person must be: Psychology Consultation: a. A psychologist who is licensed by the Commonwealth of Virginia; or b. A licensed professional counselor who is licensed by the Commonwealth of Virginia; c. A licensed clinical social worker who is licensed by the Commonwealth of Virginia; d. A psychiatric clinical nurse specialist who is licensed by the Commonwealth of Virginia; or e. A psychiatrist who is licensed by the Commonwealth of Virginia. Licensed Dietician or Nutritionist Behavior Specialist/Behavior Supports Community

15 Access/Integration Day Habilitation $35.58/unit 780 units/year 1 unit=1 hour Day Support providers must be licensed by DBHDS as a provider of Day Support services. Day Support providers must have a signed Provider Participation agreement with DMAS in order to provide Day Support services. Providers must assure and document that persons providing Day Support services have received DBHDS-approved training in the characteristics of ID and appropriate interventions, training strategies and other methods of supporting individuals with functional limitations prior to providing ID Waiver services. Respite $13.48/hour 720 hours/year Consumer directed $9.51/hour Any of the following types of providers can provide Respite services: 1. A provider licensed by DBHDS as a provider of: a. Supportive residential services, which may provide respite services based in and from the individual s home; b. Center-based respite services, which may provide respite services based in and from the approved respite center (licensed facility); c. In-home respite services, which may provide respite services based in and from the individual s home; d. Out-of-home respite services, which may provide respite services based in and from the provider s home; or e. Residential services, which may provide respite services based in and from the currently licensed group home, as long as DBHDS Office of Licensing approves the residential respite services. 2. A provider approved by DSS as a foster care home for children, which may provide respite services based from the provider s home to children only; 3. A provider approved by DSS as an adult foster care home, which may provide respite services based from the provider s home to adults not currently residing in the home only; or 4. A personal assistance/respite provider currently enrolled with DMAS to provide respite services, which may provide ID Waiver respite services based in and from the home of the individual. Respite assistants do not need to be enrolled with DMAS (i.e., have a participation agreement). Respite assistant qualifications include the following requirements. The assistant must: Be 18 years of age or older; Have the required skills to perform services as specified in the individual s service plan; Possess basic math, reading, and writing skills; Possess a valid Social Security number; Be willing to attend training at the individual s or family/caregiver s request; Understand and agree to comply with the DMAS ID Waiver requirements; Agree to receive an annual tuberculosis (TB) screening; Submit to a criminal records check and, 14

16 If the individual, to whom the assistant will be providing services, is a minor, consent to a search of the DSS Child Protective Services Central Registry. The assistant will not be compensated for services provided to the individual subsequent to the receipt of a records check verifying that the assistant has been convicted of crimes described in the Code of Virginia, , Subsection B, or if the assistant has a founded complaint confirmed by the DSS Child Protective Services Central Registry. 15

17 Missouri Payment rate Number of Units of Service Allowed MR DD Comprehensive July 2011 Support Broker $3.99/15 min 8 hours/day Individual Support Broker who is Age 18: meets minimum training requirements; agreement with Division Regional Office; agreement with individual/designated representative, supervised by individual/designated representative; DMH Contract Psychological Services Counseling $14.92/15 min Crisis Intervention: 4-8 weeks maximum Crisis Intervention Professional $67.44/hour Technical $40.47/hour Psychologist, counselor or social worker licensed in accordance with RSMo. Chapter 337 Licensed Dietician $6.25/15 min Licensed to practice in Missouri Positive Behavior Supports $15.65/15 min 6 months or less DMH Contract; Bachelors degree with special training, approved by the Division, related to the theory and practice of Positive Behavior Supports for individuals with intellectual and developmental disabilities, or Applied Behavior Analysis and implementation of Person Centered Approaches. Community Integration Day Habilitation Community Specialist $8.76/15 min Residential Habilitation $156.25/day 16 On-Site: Individual-$5.27/15 min Group-$2.92/15 min Off-Site: Individual-$5.46/15 min Group-$3.28/15 min DMH Certification for ISL or day hab; or CARF/CQL/Joint Commission accredited for ISL or day hab DMH Contract; employs qualified support brokers Respite In-Home-$83.92/day Individual-$3.15/15 min Group-$3.36/15 min Out of Home-$135.77/day $4.58/15 min The only limitation on total hours provided is that they be necessary to avoid institutionalization and remain within the overall cost effectiveness of each individual's plan. Out of Home Respite: 60 days/year

18 1 day=24 hours Missouri State professional license such as RN or LPN DMH Contract; Shall not be the consumer s spouse; a parent of a minor child (under age 18); nor a legal guardian The agency-based provider of respite must be trained and supervised in accordance with the certification or program enrollment requirements that apply, but must include at least the minimum training specified for the individual provider; the planning team may specify additional qualifications and training necessary to carry out the service plan. 17

19 Kentucky SCL Waiver August 2011 Payment rate 18 Number of Units of Service Allowed Community Guide $8.00/15 min 576 units/year a. Minimum of bachelor s degree and one year of experience in the field of developmental disabilities. b. Relevant experience and/or credentialing will substitute for education on a year for year basis; AND c. Meets all applicable DDID personnel and training requirements. d. Hold a valid class C State of KY driver s license, and have no major traffic violations, and has current mandatory insurance. Psychological Services Consultative Clinical and Therapeutic Service $22.50/15 min 160 units/year This service is provided by licensed or certified professionals in psychology, nutrition or counseling; OR a positive behavior specialist. These service providers must also have at least two years of direct service experience with individuals with intellectual or developmental disabilities. Licensed Dietician or Nutritionist $22.50/15 min 160 units/year Positive Behavior $665/plan Supports Community Access Individual-$8.00/15 min 160 units/week Group-$4.00/15 min DDID standards for Community Access staff are: a. Minimum of bachelor s degree and one year of experience in the field of developmental disabilities. b. Relevant experience and/or credentialing will substitute for education on a year for year basis; AND c. Meets all applicable DDID personnel and training requirements. d. Driver must be at least 18 years of age, hold a valid, Class C State of Kentucky driver s license, have no major traffic violations and have current mandatory insurance; Day Training I $2.20/15 min 160 units/week II $3.00/15 min 1. Is eighteen (18) years or older; and Has a high school diploma or GED; is or is at least twenty-one (21) years old; and 2. Meets all applicable DDID personnel and training requirements; 3. Has a valid Social Security number or a valid work permit if not a citizen of the U.S.; and 4. Has the ability to: a) communicate effectively with the person/family; b) understand and carry out instructions; c) perform required documentation.

20 Respite $2.77/15 min 830 hours/year 1. Is eighteen (18) years or older; and Has a high school diploma or GED; or Is at least twenty-one (21) years old; and 2. Meets all applicable DDID personnel and training requirements; 3. Has a valid Social Security number or a valid work permit if not a citizen of the U.S.; 4. Has the ability to: a) communicate effectively with the person/family; b) understand and carry out instructions; c) perform required documentation. 19