Home and Community Based Services Manual
4.00 Home and Community Based Services Process Introduction
Introduction
The Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS), has the oversight responsibility for the provision of Home and Community Based Services (HCBS), (i.e., (re)assessment, person-centered care planning, and care plan maintenance). HCBS is designed to support and meet the unmet needs of seniors and individuals with disabilities who meet Nursing Facility Level of Care (NFLOC), by providing necessary assistance to remain in their homes.
Purpose
The primary goal of HCBS is to enable a current or potential participant to remain in the least restrictive environment.
Process
DSDS staff, or its designee, shall create, through the HCBS process, a person-centered care plan (PCCP) that is designed around the participant’s current level of supports and unmet needs, taking into consideration the participant’s health and safety needs. Unmet needs are those routine tasks which are allowable by the HCBS program but cannot be reasonably met by the members of the participant’s household or other support systems. The participant’s right to self-determination and state/ federal regulation shall guide the PCCP process.
The management of HCBS processes is controlled through an electronic case system. The intake, (re)assessment, PCCP authorization, and care plan maintenance activities are all completed in the participant's electronic case record. The electronic case system provides HCBS partners ‘real-time’ access to the participant’s PCCP information, which facilitates improved communication among agencies involved in service delivery.