10.09.52.04-1

.04-1 Covered Services — Autism Waiver Service Coordination — General Requirements.

A. Autism Waiver Service Coordination is intended to:

(1) Assist a waiver participant in gaining access to the Autism Waiver services approved in the waiver participant's waiver plan of care;

(2) Assure coordination of the waiver participant's Autism Waiver services with other services received by the waiver participant; and

(3) Assure that the waiver participant's full range of needs are adequately met, so as to assure the individual's:

(a) Appropriate placement in the community;

(b) Health and safety;

(c) Quality of care; and

(d) Access to authorized, necessary services.

B. Service Coordinator. A service coordinator employed by a provider shall assist with meeting the provider's responsibilities specified in this regulation and Regulation .04-2 of this chapter.

C. Waiver Multidisciplinary Team. A waiver multidisciplinary team:

(1) Shall be convened by the local lead agency or local school system to:

(a) Assess or reassess a waiver applicant's or waiver participant's need and eligibility for Autism Waiver services; and

(b) Develop or review the waiver participant's waiver plan of care; and

(2) Shall include:

(a) The waiver participant's service coordinator;

(b) The waiver applicant's or waiver participant's parent or parents;

(c) A chairman who is the official representative of the local lead agency or local school system;

(d) Other appropriate professionals representing the local lead agency or local school system, as necessary and consistent with the Individuals with Disabilities Education Act (IDEA); and

(e) Other service providers and individuals, as appropriate.

D. Waiver Plan of Care.

(1) A waiver participant's waiver plan of care is:

(a) Initially developed on admission to the Autism Waiver;

(b) Reviewed at least every 12 months; and

(c) Revised as necessary by a waiver multidisciplinary team convened by the waiver participant's service coordinator.

(2) A waiver participant's waiver plan of care shall be approved by MSDE before implementation.

(3) Any revisions or additions to a waiver participant's waiver plan of care shall be approved by MSDE before implementation.

(4) A waiver participant's service coordinator may make minor changes to the waiver participant's waiver plan of care without reconvening the waiver multidisciplinary team, if the change is approved by the chair of the multidisciplinary team and the waiver participant's parent or parents, and MSDE is notified.

(5) A waiver participantís initial or revised waiver plan of care shall be documented on the waiver plan of care form that includes the:

(a) Description of each specific preauthorized service to be delivered;

(b) Service start date;

(c) Estimated duration;

(d) Approved frequency and units of services to be delivered; and

(e) Provider.

E. Three types of Autism Waiver Service Coordination shall be provided, at times concurrently;

(1) Waiver initial assessment;

(2) Waiver ongoing service coordination; and

(3) Waiver reassessment.