Eastern Los Angeles Regional Center. Respite, Out of Home Respite & Day Care

Transcription

1 Eastern Los Angeles Regional Center Respite, Out of Home Respite & Day Care

2 IN-HOME RESPITE In-home respite service means intermittent or regularly scheduled temporary non- medical care and supervision provided in the individual s s home. The individual must reside with a family member to be eligible for respite services. [WIC ]

3 The in-home respite services are intended to: Assist family members in maintaining the consumer at home Provide care and supervision to ensure the individual s s safety in the absence of family members. Relieve family members from the constantly demanding responsibility ity of caring for the individual. Respite worker to attend to the individual s s basic self-help needs and other activities of daily living including interaction, socialization, ation, and continuation of usual daily routines which would ordinarily be performed by family members.

4 Types of Respite IN HOME RESPITE SERVICES NURSING RESPITE GASTROSTOMY RESPITE DCFS FOSTER CARE VS. RESIDENTIAL FACILITIES

5 ELARC s s Criteria to Fund Respite: An individual s s needs are beyond the support of family, friends, natural supports and community resources Effective July 1, 2009, ELARC may only purchase respite services when the care and supervision needs of the individual exceed that of an individual of the same age without developmental disabilities [WIC Section ]. ELARC has revised its policies to incorporate that Respite Services shall be provided by use of a Fiscal Management System (FMS), conversion respite or respite agency.

6 Criteria to Fund Respite Cont. WIC4686.5(a)(2), ELARC shall not purchase more than 90 hours of in home respite services in a quarter per consumer. ELARC may grant an exemption to this requirement if it is demonstrated that the intensity of the consumer s s care and supervision needs are such that additional respite is necessary to maintain the individual in the family home or there is an extraordinary event that impacts the family member s s ability to meet the care and supervision needs of the individual. Family member(s) shall use existing authorized respite hours when he/she plans to attend a conference, training session or support group.

7 ALTERNATIVE FUNDING RESOURCES Social Security Private insurance Medi-Cal benefits Schools (may be considered a form of respite for a non-working parent) In Home Support Services (IHSS) can be considered a generic resource when the approved IHSS hours meet the respite needs as identified in the IFSP/IPP [WIC (a) (5) and 4659 (c)]. Natural Supports

8 Process for Purchase of Services In-home respite service must be identified on the IFSP/IPP If applicable, the service coordinator will assess the consumer for the Family Cost Participation Program as defined in WIC The Family Respite Guideline to determine the appropriate amount of respite hours.

9 Service Evaluation & Effectiveness The effectiveness of services will be determined by obtaining assessments and/or feedback from the family and/or consumer and tracking progress toward meeting IFSP/IPP objectives at intervals stated in the IFSP/IPP target dates, Service Provision Agreement and/or Schedule of Services. Annual Respite Record Reviews for all family member respite vendored services (See Attached Record Review Form). Respite hours over 30 hours a month (90 a quarter) may require a Behavioral Assessment, Clinical Review and or Medical Assessment. However, in all cases, the expanded planning team shall convene and approve the respite hours in excess of 30. These hours must be reviewed and re-authorized on a quarterly to semi-annual basis.

10 Out of Home Respite Services

11 Out-of-home Respite means intermittent or regularly scheduled temporary care provided outside the consumer s home by Occasional family and/or consumer needs are more than the support of friends, natural and community supports can provide. Additionally, out of home respite may be used as a support option should family members have planned activities which preclude the participation of the consumer such as vacations, hospitalizations and family emergencies.

12 Criteria to fund OHR Out-of-home respite is requested by the family, consumer and/or authorized representative, under the above criteria, and identified as a preferred objective on the IPP. When the care and supervision needs of the consumer exceed that of an individual of the same age without developmental disabilities WIC (a)(1)

13 Criteria to fund OHR A regional center shall not purchase more than 21 days of out of home respite services in a fiscal year. ELARC may grant an exemption to this requirement if it is demonstrated that the intensity of the consumer s care and supervision needs are such that additional respite is necessary to maintain the individual in the family home or there is an extraordinary event that impacts the family member s ability to meet the care and supervision needs of the individual (WIC (a) (2).

14 In Home Respite in lieu of OHR In home respite In lieu of out of home respite may be used only when there is no out of home respite arrangement available. The following information must be submitted to the service coordinator prior to implementation of the in home respite In lieu of out of home respite service: Proof of vacation plans (i.e. flight arrangements, receipts/hospitalization, emergency (i.e. detailed documentation from hospital or physician) Information on respite caretaker, if different from provider on original vendor application (Name, address, phone number and social security number) Written authorization for regional center to make unannounced visits to the home / school / day program to ensure the person s health and safety. The daily amount of hours (within the 21 or less days) will be calculated on individual need, not exceeding 16 hours per day. Hours are calculated by taking into account the amount of time that the consumer attends school/day program during the day, after school care, social/recreational program, hours of sleep, etc. Respite hours cannot be provided during these times.

15 PROCESS FOR SERVICE COORDINATION Out of home respite is included in the consumer s IPP. The Service Coordinator will consult with the Placement Coordinator to identify appropriate residential facilities with vacancies and refer Service Coordinator to the Facility Liaison. The Service Coordinator can make arrangements the family/consumer to visit the facility, if requested.

16 EVALUATION OF SERVICE EFFECTIVENESS The effectiveness of services will be determined by feedback from family and/or consumer and assessment of progress toward meeting IFSP/IPP objectives.

17 Day Care

18 Day Care is defined as: Care and supervision for a child who is residing at home and is unable to care for her or himself when both parents or a single parent (primary care-provider) is employed full/part time outside the home or for a parent(s) to attend an educational program directed toward gainful employment.

19 Types of Day Care After School Day Care Services Extended Day Care Services In-Home Day Care Services - Family Member

20 Criteria to fund Day care The regional center will only consider funding for day care when the planning team determines that specialized services are required. Specialized services are those that a consumer requires to meet his or her supervised needs that are beyond those of a non-disabled child WIC 4659 & WIC4685. In cases where specialized services are needed, ELARC will fund for the support/aide so that the child can participate in the day care setting within his/her community.

21 Criteria to fund Day Care cont. As a general practice, ELARC will not fund day care services for children under age 13. ELARC may only consider funding for day care for a child under age 13 when the IPP planning team has exhaust all generic resources identified in the Alternative Funding Resources If it is determined that the family meets a financial need or hardship (WIC 4685 subd. (c)(6). ELARC Uses the Federal Poverty Guideline (FPG) to determine financial hardship

22 Amount of Service The interdisciplinary team will determine the number of hours per day for day care based on the level of natural support resources available to the family, to the consumer, and on the family's and consumer s needs. For individuals who attend a full-day school program, after school day care will not exceed four hours per day. Standard day care hours are from 7:00 a.m. to 6:00 p.m.

23 ALTERNATIVE FUNDING RESOURCES ELARC in collaboration with the family shall explore the following resources After school programs provided by the public local school county resources such as Options, Head Start and preschools community agencies assisting parents while in work programs (Gain, MAOF, etc.), local social recreational programs IHSS, SSI, etc. Consumers receiving SSI at the board and care rate (consumers in residential facilities or in foster homes) will not be eligible for day care services.

24 EVALUATION OF SERVICE EFFECTIVENESS Age-appropriate activities and integration with non-disabled peers in a safe, wellsupervised environment are factors that service coordinator will assess in collaboration with parent, program, and if appropriate, clinical team.

25 Any Questions? Thank you