"Understanding and Improving Home Care: Top 10 Concerns for Individuals with Brain Injury" It's not always easy having someone else take care of you, especially when you've experienced a brain injury. Home care agency providers play an essential role in helping people with brain injuries recover and maintain their independence. However, there are some common issues that individuals with brain injuries may face with their home care providers. In this article, we'll explore the top 10 concerns and how to address them. Lack of Understanding: Do you feel that your home care provider truly understands your needs? It's crucial to have a provider who is knowledgeable about brain injuries and can adapt their care accordingly. Solution: Choose an agency with experience and training in brain injury care. Inconsistency: Does your care provider change frequently, making it hard to build trust? Consistency is essential for individuals with brain injuries. Solution: Speak with your agency about ensuring consistent care providers for your needs. Poor Communication: Are your needs and preferences being heard and respected? Effective communication is crucial to ensure proper care. Solution: Establish clear lines of communication with your provider and agency, and don't be afraid to speak up. Lack of Empathy: Do you feel like your provider truly cares about you? Empathy is a vital component of quality care. Solution: Find a provider who demonstrates genuine concern and empathy for your situation. Overprotection: Are you being given the independence and autonomy you desire? It's essential for providers to strike the right balance between assistance and independence. Solution: Discuss your preferences with your provider and set clear boundaries. Lack of Flexibility: Does your care plan feel rigid and unresponsive to your changing needs? A flexible approach is necessary for effective care. Solution: Collaborate with your provider to create a more adaptable care plan. Unreliable Support: Are your providers consistently late or canceling appointments? Reliability is crucial for your recovery and well-being. Solution: Address the issue with your agency and consider switching providers if necessary. Invasion of Privacy: Do you feel that your privacy is being respected by your care provider? Everyone deserves to maintain their dignity and privacy. Solution: Establish boundaries and voice your concerns if your privacy is not being respected. Inadequate Training: Does your provider have the necessary skills and training to support you? Proper training is essential for effective care. Solution: Ensure your provider has the appropriate training and experience for your needs. High Costs: Are you struggling with the financial burden of home care? Affordability is an essential factor in long-term care. Solution: Explore various funding options and discuss your financial concerns with your agency. By addressing these concerns, individuals with brain injuries and their home care providers can work together to create a more positive and supportive environment. Living with a brain injury can be challenging, but with the right support, recovery and maintaining independence are achievable goals. While there are some concerns individuals with brain injuries may have about their home care providers, it's important to remember that these concerns can be addressed and overcome. Effective communication, empathy, consistency, flexibility, and respect for privacy form the bedrock of quality care. By expressing your needs and preferences, setting clear boundaries, and ensuring your care providers are well-trained and reliable, you can transform your home care experience. Always remember that your voice matters and you have the ability to advocate for your needs. Together, we can create a more supportive and understanding environment for individuals with brain injuries. Let's turn these challenges into opportunities for improvement and forge a path towards better home care. ____________________________ Discover the top 10 concerns for individuals with brain injuries about their home care providers, and learn how to address these issues to improve the quality of care. https://www.ctbraininjury.com/post/understanding-improving-home-care-top-10-concerns brain injury, home care, agency, provider, understanding, inconsistency, communication, empathy, overprotection, flexibility, unreliable support, privacy, training, cost, solution, concerns, improvement, care plan, recovery, well-being, independence, trust, boundaries, preferences, consistency, adaptability, experience, knowledge, genuine concern, late, canceling, appointments, dignity, respect, financial burden, funding options, positive environment, supportive, addressing, proper training, collaboration, relationship, affordable care, quality care, essential, respect, patient rights, respect, care provider, personal boundaries, home care services, brain injury recovery, brain injury support, care consistency, professional care, experienced care, empathetic care, adaptive care, reliable care, respectful care, trained care, cost-effective care, personalized care, healthcare, health services, patient-provider communication, patient autonomy, home care solutions, brain injury needs, home care agency, understanding brain injury, brain injury concerns, care provider issues, home care improvements, patient voice, speaking up, caregiver empathy, caregiver consistency, caregiver reliability, caregiver training, healthcare affordability, healthcare reliability, individual needs, individual preferences, care provider respect, care provider reliability, flexible care plans, brain injury care plans. brain injury, home care, agency, provider, understanding, communication, empathy, flexibility, privacy, training, cost, concerns, recovery, independence, consistency, adaptability, experience, reliability, respect, boundaries, preferences, overprotection, inconsistency, affordability, care plan. "Brain Injury and Home Care: Addressing Top Concerns" "Improving Home Care for Individuals with Brain Injury" "Understanding and Overcoming Brain Injury Home Care Challenges" "Top 10 Concerns for Brain Injury Individuals and Their Home Care" "Navigating Home Care: A Guide for Individuals with Brain Injury" "Brain Injury: How to Improve Your Home Care Experience" "Addressing Home Care Issues for Individuals with Brain Injury" "Ensuring Quality Home Care for Individuals with Brain Injury" "Brain Injury and Home Care: Ensuring Quality and Understanding" "Overcoming Home Care Challenges for Individuals with Brain Injury"

Balancing Individual Needs and Group Care in the ABI Waiver Program Imagine your life as an exciting, interesting story. Just like any other story, you'd want yours to be focused on you, with your needs and wishes taking center stage. That's the kind of care brain injury survivors should receive, but some people are worried that's not always the case. Connecticut's ABI Waiver program was designed to help brain injury survivors move away from institutionalized care and into environments that better support their unique needs and recovery journey. The idea was to create a more personalized approach, respecting each person's preferences, capabilities, and aspirations. However, recent concerns suggest that the reality might not be living up to the promise. Some participants, and their families, are worried that they're being directed towards group care settings, also known as supported day groups. These settings can feel a lot like the institutionalized care the ABI Waiver program was meant to replace. The concern grows when people start wondering: "Who benefits more from this situation? Us, or the service providers?" After all, it could be more financially advantageous for service providers to operate group settings than to provide individualized, person-centered care. But that shift may not always be in the best interest of the brain injury survivors who need tailored support to recover and regain their independence. So, what can we do to ensure brain injury survivors get the care they deserve? First, let's ask ourselves some reflective questions: Are we advocating for the needs and wishes of brain injury survivors? Are we ensuring that their care environments are supportive rather than restrictive? Are we allowing financial interests to compromise the quality of care and recovery opportunities? Once we have considered these questions, it's easier to imagine some possible solutions. For one, the implementation of the ABI Waiver program should be carefully monitored to make sure it stays true to its person-centered philosophy. There should also be increased transparency and accountability to prevent potential financial manipulations. Finally, brain injury survivors and their families should be empowered to voice their needs, preferences, and concerns. In conclusion, while group care settings can provide valuable social interaction and routine, the shift towards this type of care within Connecticut brain injury supported living groups should not overshadow the fundamental principles of the ABI Waiver program: individualized care, personal growth, and the potential for recovery. Let's ensure that the story of each brain injury survivor's recovery remains person-centered, respectful, and empowering. ___________________________ Explore the ABI Waiver program in Connecticut and concerns about group care's potential institutionalization and financial bias over individualized care. https://www.ctbraininjury.com/post/supported-groups Connecticut, ABI Waiver program, brain injury survivors, institutionalized care, individualized care, person-centered care, group care settings, supported day groups, financial interests, service providers, transparency, accountability, potential manipulations, personal growth, recovery potential, care environments, supportive care, restrictive care, family concerns, participant preferences, participant needs, participant capabilities, participant aspirations, care quality, financial advantages, financial manipulations, care monitoring, program philosophy, voice of survivors, empowerment, social interaction, routine, respect, living groups, participant story, participant recovery, individual needs, group benefits, financial benefits, service benefits, program implementation, care balance, personal story, reflective questions, advocacy, needs assessment, wishes assessment, solution imagining, care shift, care philosophy, program accountability, survivor voice, potential harm, care services, care steering, long-term harm, financial steering, group operation, tailored support, independence, recovery journey, participant concerns, participant benefits, program benefits, transparency increase, accountability increase, recovery opportunities, participant advocacy, survivor advocacy, service advocacy, recovery environment, personal needs, financial compromise, quality compromise, recovery compromise, service quality, program quality, survivor needs, survivor wishes, survivor capabilities, survivor aspirations, survivor concerns, survivor benefits, program concerns, family advocacy, recovery support, What are the monitoring mechanisms in place in Connecticut brain injury supported living groups to prevent financial manipulation of the ABI Waiver and Money Follows the Person (MFP) programs' participants? How does Connecticut community care ensure that the principles of person-centered care are being upheld within their Connecticut brain injury supported living groups? Are there any safeguards in place within Connecticut brain injury supported living groups to prevent service providers from potentially exploiting these programs for financial gain? How does Connecticut community care ensure that the environments they provide within Connecticut brain injury supported living groups align with the desires and needs of program participants? Are there reports of participants in Connecticut brain injury supported living groups being placed into more institutional type environments contrary to their needs or wishes? How is the transition from individual care to group care settings being managed in Connecticut brain injury supported living groups, and are participants' desires being considered in this shift? How is Connecticut community care validating their belief in brain injury recovery and promoting the independence of the people they serve within Connecticut brain injury supported living groups? Are there any instances within Connecticut brain injury supported living groups where the person-centered care principle has been compromised for financial benefits? Are participants within Connecticut brain injury supported living groups being given a choice in the type of care they receive, whether it be person-centered care or group care settings? How can one identify and report potential financial manipulations in the ABI Waiver and MFP programs within Connecticut brain injury supported living groups?

Art Therapy: Are ABI Waiver Program supported living agencies Repackaging Institutional Care? Imagine attending a class that's meant to be fun and therapeutic. You're expecting to engage in activities that promote healing and recovery, but instead, you find yourself in a group setting that feels less like therapy and more like an institution. This is the fear some people have about certain day groups for brain injury survivors in ABI Waiver Program supported living agencies . The ABI Waiver program was developed with the intention to move away from institutionalized care towards a more personalized care setting. The goal is to ensure every individual gets the support they need to recover and regain their independence. However, some families and survivors are worried that the situation isn't living up to its promise. They're concerned that what is being called 'therapeutic art programs' might just be a disguise for group settings similar to institutionalized care. This worry intensifies when they think about who could be benefiting more from this situation: the service providers or the brain injury survivors. Group care, disguised as therapeutic art programs, could potentially be more lucrative for the service providers. But this could risk causing more harm than good to the survivors, as they might not be receiving the individualized, person-centered care they need for their recovery. So, what can we do? Let's consider some reflective questions: Are we providing genuine therapeutic art programs or repackaging institutional care? Are we allowing the allure of financial gain to compromise the quality of care we provide? By pondering these questions, we can identify potential challenges and solutions. We should ensure that the implementation of the ABI Waiver program aligns with its person-centered care philosophy. This involves holding service providers accountable and demanding transparency. Most importantly, brain injury survivors and their families need to feel empowered to voice their needs and concerns. If you or a loved one are a brain injury survivor and feel that you're experiencing the concerns outlined in the article, here are some steps you can take: Acknowledge Your Concerns: First, recognize that your worries are valid. Being aware of the situation is the first step towards making a change. Document Your Observations: Start keeping a record of your experiences and concerns. This can be useful for both your personal reflection and for any discussions you may have with service providers or relevant authorities. Research Your Rights: Understand the principles of the ABI Waiver program, especially its emphasis on person-centered care. This will help you to articulate your concerns effectively. Speak Up: Voice your concerns to the service providers directly. Constructive, open dialogue could lead to improvements in the care you're receiving. Reach Out to Support Networks: Talk to other participants and families who might be experiencing similar situations. Shared experiences can often lead to mutual support and collective advocacy. Seek External Assistance: If your concerns persist, consider reaching out to external organizations such as advocacy groups, legal aid services, or regulatory bodies. Consider Alternatives: If your situation doesn't improve, you may need to consider other care options that better align with your needs and the ABI Waiver program's person-centered philosophy. Remember, you are the center of your care and recovery journey. You deserve to receive care that respects your individual needs, preferences, and potential for recovery. In conclusion, while therapeutic art programs can indeed be beneficial, it's crucial to ensure that these programs do not become disguised institutionalized care. ABI Waiver Program supported living agencies should stay true to personalized care, supporting each survivor's unique recovery journey to independence. Public advocacy and the act of asking questions play a pivotal role in supporting individuals who may face challenges in advocating for themselves. In today's complex and diverse society, it is essential to recognize that not everyone possesses the ability, resources, or platforms to effectively voice their needs and concerns. Public advocacy serves as a powerful tool to bridge this gap, empowering marginalized and underrepresented communities by amplifying their voices and fighting for their rights. By asking pertinent questions, we can shed light on issues that may have otherwise remained unnoticed or ignored. This active engagement enables us to uncover the underlying complexities and nuances of different perspectives, leading to more informed decision-making and the development of inclusive policies and practices. Public advocacy and questioning serve as catalysts for social progress, fostering empathy, understanding, and the promotion of equity. Through these efforts, we can create a more just and inclusive society that uplifts and supports those who need it most. ______________________________ Concerns rise about ABI Waiver Program art groups: Are therapeutic art programs disguising daily institutionalized group care? https://www.ctbraininjury.com/post/tbi-art-groups ABI Waiver Program supported living agencies , ABI Waiver program, brain injury survivors, institutionalized care, person-centered care, group care, therapeutic art programs, financial interests, service providers, transparency, accountability, quality of care, recovery, independence, family concerns, survivor concerns, individualized care, personal growth, recovery journey, care environments, care quality, financial advantages, program implementation, voice of survivors, empowerment, advocacy, survivor needs, survivor preferences, participant needs, participant preferences, tailored support, art therapy, therapeutic disguise, potential harm, financial manipulations, long-term harm, care balance, program philosophy, care philosophy, survivor benefits, participant benefits, program accountability, service accountability, service quality, program quality, service benefits, survivor advocacy, participant advocacy, recovery support, recovery environment, recovery opportunities, participant voice, care services, care steering, financial steering, group operation, participant story, reflective questions, needs assessment, wishes assessment, solution imaging, service transparency, program transparency, financial compromise, recovery compromise, survivor wishes, survivor capabilities, survivor aspirations, survivor voice, family advocacy, institutional disguise, program disguise, service disguise, program concerns, service concerns, family worries, participant worries, therapeutic benefits, therapeutic concerns, therapeutic quality, artistic therapy, artistic benefits, artistic concerns, artistic quality, therapeutic potential, artistic potential, care disguise, care compromise, artistic compromise. ABI Waiver Program supported living agencies , ABI Waiver program, brain injury survivors, institutionalized care, person-centered care, group care, therapeutic art programs, financial interests, service providers, transparency, accountability, recovery, independence, family concerns, survivor concerns, individualized care, personal growth, recovery journey, tailored support, art therapy, therapeutic disguise, potential harm, financial manipulations, long-term harm, empowerment. What are your primary concerns about your current care setting in the context of Connecticut brain injury sup ported living groups? Do you believe your rights are being upheld in the Connecticut brain injury supported living groups you are participating in? How well do you feel the ABI Waiver program's principles are being applied in your experience with Connecticut brain injury supported living groups? Are you comfortable voicing your concerns within your Connecticut brain injury supported living group? Have you noticed any changes in your Connecticut brain injury supported living group that suggest a shift towards institutionalized care? Do you feel your individual needs are being met in your Connecticut brain injury supported living group? Are the service providers in your Connecticut brain injury supported living group receptive to feedback and concerns? Do you believe there is a bias towards group care over individualized care within your Connecticut brain injury supported living group? What steps have you taken to voice your concerns about your Connecticut brain injury supported living group? Have you sought external assistance to address your concerns about Connecticut brain injury supported living groups? How has your experience with Connecticut brain injury supported living groups impacted your recovery journey?

Understanding the ABI Waiver in Connecticut Have you heard about the ABI Waiver in Connecticut? If you haven't, don't worry. We are here to help you understand it in a simple way! The ABI Waiver stands for Acquired Brain Injury Waiver. But what does it really mean? Let's break it down! Acquired Brain Injury (ABI): This refers to any injury to the brain that happens after birth. It can happen due to a fall, a car accident, a sports injury, or even a stroke. Waiver: In this context, a waiver is a special kind of permission. It's a way for people with an Acquired Brain Injury to get special help they might not normally qualify for. So, putting it all together, the ABI Waiver in Connecticut is a special program that helps people with brain injuries get the support and services they need. Now you might wonder, how can this ABI Waiver help? Well, it can provide several services like help with daily living activities, modifications to make homes safer, job coaching, and even help with getting back to community activities. Isn't it great? The ABI Waiver is there to ensure that people with brain injuries can have a good quality of life, get the care they need, and become a part of their communities again. Remember, if you or someone you know could benefit from this program, be sure to ask about the ABI Waiver in Connecticut! Question: What is the ABI Waiver program in Connecticut? Answer: The Acquired Brain Injury (ABI) Waiver program in Connecticut is a special initiative that provides a range of services to people who have suffered a brain injury after birth. These services aim to support individuals in their daily activities, provide job coaching, make home modifications for safety, and help with community integration. Question: Who is eligible for the ABI Waiver program? Answer: To be eligible for the ABI Waiver program, an individual must have an Acquired Brain Injury, be a Connecticut resident, be at least 18 years old, and meet certain financial and care need criteria. Additionally, they must require at least one waiver service and be able to safely live in a community setting with the supports provided by the waiver. Question: What types of services are covered under the ABI Waiver? Answer: The ABI Waiver covers a wide variety of services aimed at helping individuals live independently. These can include, but are not limited to, case management, personal care assistance, vocational supports, residential habilitation, day services, respite care, and environmental modifications. Question: How can I apply for the ABI Waiver program? Answer: The application process involves submitting an application to the Department of Social Services in Connecticut. It's a good idea to work with a healthcare provider or social worker who can guide you through the process and ensure you have all the necessary documentation. Question: How long does it take to get approved for the ABI Waiver program? Answer: The approval time can vary. It depends on the completion of the application, the availability of funding, and the individual's needs and eligibility. If there's a waiting list, it might take some time before the services can start. Question: What happens if I don't qualify for the ABI Waiver program? Answer: If you don't qualify for the ABI Waiver program, there may be other resources and services available to you. This could include other state programs, community resources, and non-profit organizations that provide support to individuals with brain injuries. Question: Can the ABI Waiver program help me find a job? Answer: Yes, the ABI Waiver program includes vocational supports, which may involve job coaching and assistance in finding and maintaining employment. Question: Does the ABI Waiver cover the cost of medical treatment for my brain injury? Answer: The primary goal of the ABI Waiver program is to provide services that support daily living and community integration. While it might not directly cover the cost of medical treatment for the brain injury, it can provide support services that can aid in recovery and rehabilitation. Question: What if my needs change after I start receiving services through the ABI Waiver program? Answer: If your needs change, your case manager or healthcare provider can reassess your situation and adjust your services as needed. It's important to communicate any changes in your condition or needs to your support team. Question: Can family members provide care under the ABI Waiver program? Answer: In some cases, family members might be eligible to provide care and receive compensation through the ABI Waiver program. The specifics depend on the rules of the program and the individual circumstances. It's best to consult with a program representative for detailed information. Question: Does the ABI Waiver Program affect eligibility for other state benefits? Answer: Participation in the ABI Waiver program shouldn't affect eligibility for other state benefits. However, it's always a good idea to discuss this with a social worker or benefits coordinator to be sure. Question: What is the role of a case manager in the ABI Waiver program? Answer: The case manager plays a crucial role in the ABI Waiver program. They assist with the development, implementation, and monitoring of the service plan. They coordinate with various service providers and ensure that the individual's needs are being met. Question: What kind of home modifications can be made under the ABI Waiver program? Answer: Home modifications under the ABI Waiver program can include various adaptations to make the home safer and more accessible. This could include installing grab bars in bathrooms, ramps for wheelchair accessibility, or modifying kitchen facilities for easier use. Question: Can ABI Waiver services be provided in a residential facility or only at home? Answer: ABI Waiver services aim to support individuals in community settings. This can include their own home, a family home, or a residential facility that provides a homelike environment. Question: How often are services provided under the ABI Waiver program? Answer: The frequency of services provided under the ABI Waiver program varies depending on the individual's specific needs. The service plan, developed with the assistance of a case manager, outlines the type and frequency of services. Question: Can ABI Waiver services be combined with other services I'm already receiving? Answer: Yes, the goal of the ABI Waiver program is to supplement existing supports and services. The program is designed to work in conjunction with other services you're already receiving. Question: What happens if my application for the ABI Waiver program is denied? Answer: If your application is denied, you have the right to appeal the decision. The denial notice will include information on the appeals process and timelines. Question: How does the ABI Waiver program support community integration? Answer: The ABI Waiver program supports community integration by providing services like vocational supports, social supports, and transportation to community activities. The goal is to help individuals participate in their community as much as possible. Question: Can I choose my service providers under the ABI Waiver program? Answer: Yes, you generally have the ability to choose your service providers under the ABI Waiver program, as long as they meet the program's requirements and standards. Question: Who can I contact for more information about the ABI Waiver program? Answer: For more information about the ABI Waiver program, you can contact the Department of Social Services in Connecticut or a local social service agency. Question: What kind of vocational supports does the ABI Waiver program provide? Answer: Vocational supports under the ABI Waiver program may include job coaching, job development, and supported employment services. These services aim to help individuals with brain injuries find and maintain employment. Question: Is there a waiting list for the ABI Waiver program? Answer: There can be a waiting list for the ABI Waiver program depending on the current demand for services and the availability of funding. It's best to inquire about this during the application process. Question: How is the ABI Waiver program funded? Answer: The ABI Waiver program is funded through a combination of state and federal Medicaid funds. Question: Can the ABI Waiver program assist with transportation needs? Answer: Yes, one of the services offered under the ABI Waiver program is non-medical transportation. This can assist with travel to community activities, job sites, and other necessary locations. Question: Do I have to reapply for the ABI Waiver program every year? Answer: While you don't need to reapply for the ABI Waiver program every year, your eligibility and needs will be reassessed on a regular basis to ensure you're receiving the appropriate services. Question: Is there a cost to participate in the ABI Waiver program? Answer: There is no cost to apply for or participate in the ABI Waiver program. However, there may be some cost sharing depending on your income level and the specific services you receive. Question: What is the role of a caregiver in the ABI Waiver program? Answer: A caregiver in the ABI Waiver program provides support to the individual with the brain injury. This can include assistance with daily activities, medical care, transportation, and emotional support. Question: Can I receive services from the ABI Waiver program if I'm living with a family member? Answer: Yes, you can receive services from the ABI Waiver program regardless of whether you're living in your own home, with family members, or in a residential facility. Question: Does the ABI Waiver program provide any mental health services? Answer: While the primary focus of the ABI Waiver program is on providing supports for daily living and community integration, it may also include some behavioral and mental health services as part of a comprehensive care plan. Question: Can I change my service providers under the ABI Waiver program? Answer: Yes, you generally have the flexibility to change your service providers under the ABI Waiver program if you're not satisfied with the care you're receiving or if your needs change. Question: Can I get help filling out the application for the ABI Waiver program? Answer: Yes, you can get help with your application. Social workers, case managers, or representatives from the Department of Social Services can provide assistance with the application process. Question: How often does the case manager check-in once I start receiving services from the ABI Waiver program? Answer: The frequency of check-ins can vary but generally, case managers maintain regular contact to ensure services are meeting your needs. The specific frequency might be outlined in your service plan. Question: Does the ABI Waiver program cover the cost of medications? Answer: While the ABI Waiver program primarily focuses on services to support daily living and community integration, the costs of certain medications may be covered under your standard Medicaid benefits. It's important to consult with your healthcare provider or a program representative for specific details. Question: Is there a limit to the number of services I can receive under the ABI Waiver program? Answer: The number and type of services you receive under the ABI Waiver program are based on your individual needs and the service plan developed by you and your case manager. There may be limits based on program regulations and available resources. Question: If I move, can I still receive services from the ABI Waiver program? Answer: If you move within Connecticut, you should still be able to receive services from the ABI Waiver program. However, if you move out of state, you would need to apply for services in your new state of residence. Question: How can the ABI Waiver program assist with my social life? Answer: The ABI Waiver program can provide social supports and assist with transportation to community activities, helping you maintain social connections and integrate into your community. Question: Is personal care assistance part of the ABI Waiver program? Answer: Yes, personal care assistance is part of the services that can be provided under the ABI Waiver program. This can include help with tasks like bathing, dressing, and meal preparation. Question: What should I do if I have a problem with my service provider in the ABI Waiver program? Answer: If you have a problem with a service provider, you should report the issue to your case manager. They can help you resolve the problem and, if necessary, find a new service provider. Question: Does the ABI Waiver program provide emergency medical services? Answer: The ABI Waiver program does not directly provide emergency medical services. If you have a medical emergency, you should call 911. However, the program can help coordinate medical care and services for routine and ongoing medical needs related to the brain injury. Question: Can ABI Waiver services be provided on weekends or holidays? Answer: The scheduling of ABI Waiver services depends on the specific service and provider. Some services may be available seven days a week, while others may operate on a more traditional business schedule. Your case manager can provide more information based on your specific service plan. Question: Are there language translation services available for the ABI Waiver program? Answer: Yes, the Department of Social Services in Connecticut provides language translation services to ensure that non-English speaking residents can access the services and supports they need. Question: Can the ABI Waiver program help with educational goals? Answer: The ABI Waiver program primarily focuses on daily living support, community integration, and vocational supports. While it may not directly support educational goals, the program can facilitate activities and services that indirectly contribute to achieving these goals. Question: How is the success of the ABI Waiver program measured? Answer: Success in the ABI Waiver program is measured by various factors, including an individual's improved ability to live independently, their satisfaction with the services provided, progress towards their personal goals, and overall quality of life improvements. Question: Is there a limit to the amount of time I can participate in the ABI Waiver program? Answer: There is no specific time limit for participating in the ABI Waiver program. As long as you continue to meet the eligibility criteria and require at least one waiver service, you can remain in the program. Question: What type of job coaching does the ABI Waiver program provide? Answer: The job coaching provided by the ABI Waiver program can include guidance on finding suitable employment, support in developing job skills, assistance with resume writing and interview techniques, and ongoing support once employment has been secured. Question: Can the ABI Waiver program help me find suitable housing? Answer: While the ABI Waiver program does not directly provide housing, it can assist with services like residential habilitation and home modifications to make your current home more accessible and safe. Question: What is the role of a healthcare provider in the ABI Waiver program? Answer: A healthcare provider's role in the ABI Waiver program can include diagnosing and treating medical conditions related to the acquired brain injury, providing necessary medical documentation for the program, and collaborating with the case manager to ensure the individual's medical needs are being met. Question: Can I have a say in the services I receive from the ABI Waiver program? Answer: Yes, you have an important role in deciding which services you receive from the ABI Waiver program. Your input will be taken into account when your service plan is developed, and you can discuss any changes in your needs or preferences with your case manager. Question: Does the ABI Waiver program cover long-term care services? Answer: The ABI Waiver program is designed to provide a range of long-term services and supports to help individuals with acquired brain injuries live as independently as possible. This includes personal care assistance, vocational support, and community integration services. Question: Who do I contact if I have concerns about the quality of services I'm receiving from the ABI Waiver program? Answer: If you have concerns about the quality of services you're receiving, you should first discuss this with your case manager. If the issue is not resolved, you can contact the Department of Social Services in Connecticut or the agency responsible for quality assurance in the ABI Waiver program. Question: What is the process for reassessing eligibility for the ABI Waiver program? Answer: Reassessment of eligibility for the ABI Waiver program is typically conducted on a periodic basis to ensure that services are still necessary and appropriate. The specific process may involve submitting updated documentation, participating in interviews or assessments, and providing information about any changes in the individual's condition or circumstances. Question: Can I receive services from the ABI Waiver program if I have private health insurance? Answer: Yes, individuals can receive services from the ABI Waiver program even if they have private health insurance. The ABI Waiver program is designed to provide additional supports and services that may not be covered by private insurance. Question: What happens if I no longer require services from the ABI Waiver program? Answer: If an individual no longer requires services from the ABI Waiver program, their case manager will work with them to develop a transition plan. This may involve gradually reducing services and connecting the individual with other appropriate resources or programs. Question: Can I appeal a decision if my application for the ABI Waiver program is denied? Answer: Yes, individuals have the right to appeal a decision if their application for the ABI Waiver program is denied. The denial notice will provide information about the appeals process, including the timeframe for filing an appeal and the steps to follow. Question: How long can I continue to receive services from the ABI Waiver program? Answer: The duration of services provided by the ABI Waiver program can vary based on individual needs. As long as an individual continues to meet the eligibility criteria and requires the specified services, they can continue to receive support through the program. Question: Can the ABI Waiver program cover the cost of therapy services? Answer: Yes, therapy services such as physical therapy, occupational therapy, and speech therapy may be covered under the ABI Waiver program if they are deemed necessary to support the individual's functional abilities and independence. Question: Can the ABI Waiver program help with accessing community resources and support networks? Answer: Yes, one of the goals of the ABI Waiver program is to assist individuals in accessing community resources and building support networks. Case managers can provide information and referrals to relevant community organizations and services. Question: Can I receive respite care services through the ABI Waiver program? Answer: Yes, respite care services, which provide temporary relief to caregivers, can be included as part of the supports offered by the ABI Waiver program. Question: Is there a limit to the number of individuals who can be enrolled in the ABI Waiver program? Answer: The number of individuals who can be enrolled in the ABI Waiver program may be subject to funding availability and program capacity. If there are limitations, a waiting list may be implemented. Question: Can the ABI Waiver program assist with finding and securing affordable housing options? Answer: While the ABI Waiver program does not directly provide housing assistance, case managers can help individuals explore available housing resources and connect them with relevant agencies or programs that offer support in finding affordable housing options. Question: Can the ABI Waiver program cover the cost of specialized equipment or assistive technology? Answer: Yes, the ABI Waiver program may cover the cost of specialized equipment or assistive technology that is necessary to support the individual's functional abilities and independence. This can include items like wheelchairs, communication devices, or adaptive tools. Question: Can the ABI Waiver program assist with accessing transportation services? Answer: The ABI Waiver program may provide non-medical transportation services to help individuals with brain injuries access community activities, employment, or necessary appointments. This can include transportation vouchers, coordination of accessible transportation, or reimbursement for mileage. Question: Can I change my service plan or request additional services once enrolled in the ABI Waiver program? Answer: Yes, individuals can request changes to their service plan or request additional services if their needs change or if they require additional supports. Case managers can work with the individual to evaluate the request and make necessary adjustments to the service plan. Question: Can the ABI Waiver program assist with medication management? Answer: While the ABI Waiver program primarily focuses on non-medical supports, case managers can provide information and referrals to resources that can assist with medication management, such as medication reminders or medication administration training. Question: Can the ABI Waiver program provide assistance with financial planning or budgeting? Answer: The ABI Waiver program does not typically provide direct financial planning or budgeting assistance. However, case managers can offer guidance and referrals to resources that specialize in financial planning for individuals with disabilities. Question: Can the ABI Waiver program help with accessing educational or training programs? Answer: While the primary focus of the ABI Waiver program is on supports related to daily living, employment, and community integration, case managers can provide information and referrals to educational or training programs that may be available to individuals with brain injuries. Question: Can the ABI Waiver program cover the cost of counseling or mental health services? Answer: The ABI Waiver program may cover the cost of counseling or mental health services that are directly related to the acquired brain injury and necessary to support the individual's overall well-being and adjustment. Question: Can the ABI Waiver program assist with navigating the healthcare system or coordinating medical appointments? Answer: While the primary focus of the ABI Waiver program is on non-medical supports, case managers can provide guidance and assistance with navigating the healthcare system, understanding medical recommendations, and coordinating medical appointments. Question: Can I receive services from the ABI Waiver program if I live in a rural area? Answer: Yes, the ABI Waiver program aims to provide services to eligible individuals regardless of their geographic location. Efforts will be made to ensure that necessary supports are delivered, even in rural areas, through coordination with local service providers and resources. Question: Can the ABI Waiver program help with accessing legal assistance or advocacy services? Answer: While the ABI Waiver program does not directly provide legal assistance or advocacy services, case managers can offer information and referrals to organizations or programs that specialize in legal assistance and advocacy for individuals with disabilities. __________________________________ ABI resources are the beacon of hope and guidance for individuals and families navigating the complex world of brain injury, TBI, stroke, and the ABI Waiver program. They serve as the most updated and comprehensive source of information, offering valuable insights, support, and resources. From understanding the intricacies of the ABI Waiver program to exploring the possibilities under the Money Follows the Person initiative, these resources provide a roadmap towards recovery, independence, and a fulfilling life. They empower individuals to access the services and supports they need, ensuring that no one walks this journey alone. With ABI resources at hand, individuals can find solace, knowledge, and a network of professionals dedicated to improving lives and fostering resilience in the face of adversity. Together, we can overcome the challenges of brain injury and pave the way towards a brighter future. https://www.ctbraininjury.com/post/what-is-the-abi-waiver ABI Waiver, Connecticut, Acquired Brain Injury, ABI, waiver, injury, brain, support, services, program, quality of life, care, community, daily living activities, home modifications, job coaching, birth, fall, car accident, sports injury, stroke, permission, special help, qualify, life, safety, jobs, activities, benefit, ask, understand, lifeline, recover, rehabilitation, reintegration, assistance, daily tasks, independence, living, sports, accidents, brain damage, health, medical, recovery, funding, state program, trauma, traumatic brain injury, brain health, brain recovery, health services, daily care, job support, community reintegration, health assistance, medical support, safety modifications, home safety, job training, training, services, therapies, physical therapy, occupational therapy, speech therapy, cognitive therapy, community services, support programs, state waivers, Connecticut services, brain injury support, recovery program, health programs, brain injury rehabilitation, adaptive equipment, special needs, support networks, financial aid, medical aid, community aid, community resources, recovery services, rehabilitation services, medical services, therapy services, support services. ABI Waiver, Connecticut, Acquired Brain Injury, brain, waiver, support, services, program, care, community, daily living, home modifications, job coaching, injury, stroke, safety, rehabilitation, recovery, health, trauma, state program, therapies, adaptive equipment, financial aid, community resources. The ABI Waiver in Connecticut: A Comprehensive Guide Understanding Connecticut's ABI Waiver: A Lifeline for Brain Injury Survivors ABI Waiver in CT: Empowering Lives Post Brain Injury Connecticut's ABI Waiver: Supporting Brain Injury Recovery ABI Waiver: A Ray of Hope for Brain Injury Survivors in Connecticut How the ABI Waiver in Connecticut is Changing Lives Unpacking the ABI Waiver: A Special Program for Brain Injury in Connecticut The ABCs of the ABI Waiver in Connecticut: A Guide for Families From Injury to Independence: The Role of ABI Waiver in Connecticut Navigating Life After Brain Injury: The Importance of ABI Waiver in Connecticut.

Know Your Rights as a Disabled Person #KnowYourRights Every person in the world has rights - rights that are like superpowers. It doesn't matter who you are, where you're from, or whether you have a disability or not. So, let's embark on a journey together to understand these superpowers better. Knowing Your Rights As a person with a disability, it's essential to know your rights under the law. In many places, laws like the Americans with Disabilities Act (ADA) in the United States protect you. They ensure that you have equal access to public places, employment, and services, just like everyone else. Equal Opportunity: This right means that whether it's school, work, or any other activity, you should have the same opportunities as everyone else. Non-Discrimination: This right protects you from being treated unfairly because of your disability. Reasonable Accommodation: This right ensures that you get necessary adjustments to help you participate fully in life's activities. Taking Action When Rights are Violated It's unfortunate, but sometimes, people might not respect these rights. If you ever feel that your rights are violated, you don't need to feel powerless. Here are simple steps you can take: Record the Incident: Note down what happened, when, and who was involved. Talk About It: Speak up about the incident to a trusted adult. This can be a teacher, parent, or counselor. Contact an Advocate or Organization: Reach out to disability advocacy groups. They can guide you and provide necessary support. File a Complaint Online Here: If needed, file a formal complaint. You can reach the ADA Information Line at 1-800-514-0301 (voice) or 1-833-610-1264 (TTY). Now, take a moment and ask yourself these self-reflective questions: Do I fully understand my rights as a person with a disability? Have I ever felt that my rights were violated? Did I take action when I felt my rights were violated? Do I have supportive people around me who understand my rights? Am I taking steps to ensure that I am treated with respect and equality? Even if your answers indicate that you're facing challenges, don't worry. Remember that you are not alone and there are resources available to support you. Each challenge is an opportunity for growth and change. As a person with a disability, you have rights that protect you from discrimination and ensure equal opportunities. If these rights are violated, don't hesitate to take action - record the incident, talk about it, seek help from advocacy groups, and file a complaint if needed. Never forget that your voice matters and you deserve respect and equality. ________________________ Explore your rights as a disabled person and learn the steps to take if they are violated. Empower yourself and ensure equality for all. https://www.ctbraininjury.com/post/disability-rights-file-a-complaint Disabled rights, disability, empowerment, non-discrimination, equality, ADA, reasonable accommodation, equal opportunity, discrimination, advocacy, rights violation, incident record, formal complaint, self-reflection, self-advocacy, respect, support groups, person with disability, understanding rights, disability law, disability rights, personal growth, taking action, knowing your rights, stand tall, disability awareness, fairness, inclusion, accessible, disability support, human rights, equality act, legal rights, disability legislation, rights education, legal assistance, social justice, accessible services, individual rights, disabled community, disability justice, disability equality, legal protection, advocacy groups, disabled individuals, disability representation, disabled advocacy, disability resources, empowerment strategies, respect for all, human dignity, disability respect, social equality, accessible environments, disability rights movement, disability legislation, global disability rights, disability inclusion, disability pride, disability discrimination, disability rights advocate, disability empowerment, disability services, disability rights education, civil rights, inclusive society, equal rights, rights awareness, disability activism, disability community, equal access, disability rights violation, special needs rights, respect for disabilities, disability justice movement, right to participation, universal accessibility, legal rights of disabled, discrimination against disabled, support for disabled, legal recourse, self-respect, disability acceptance, disability self-advocacy, ableism, inclusion and diversity, disability rights activists, disability rights and advocacy, dignity and respect. 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ABI WAIVER | What is a care plan? Do you have one? Have you seen it? Building Effective Person-Centered Care Plans in the Acquired Brain Injury (ABI) Waiver Program: A Comprehensive Approach Abstract: The following article explores the process of creating person-centered care plans within the framework of the Acquired Brain Injury (ABI) Waiver Program. It provides insights into the fundamental elements required for these plans and outlines how care managers drive the development of these plans and effectively communicate them to the care team. Introduction The Acquired Brain Injury (ABI) Waiver Program is an essential initiative aimed at helping individuals with brain injuries live independently within their community. A cornerstone of this program is the Person-Centered Care Plan, a strategic approach to care that focuses on the unique needs, goals, and preferences of each individual. This comprehensive, tailored plan is developed by care managers and communicated to the wider care team. Key Elements of a Person-Centered Care Plan Person-centered care planning within the ABI Waiver Program incorporates several core components, including: Individual Assessment: A detailed and accurate assessment of the individual's current health status, abilities, and needs forms the basis of any person-centered care plan. This assessment should also identify their personal goals and objectives, which guide the care plan development process. Personal Goals and Preferences: The individual's personal goals, lifestyle preferences, and values should be at the heart of the care plan. This may include their aspirations for living arrangements, social activities, or vocational pursuits. Interdisciplinary Input: Collaboration with different professional disciplines, such as physical therapists, occupational therapists, neurologists, social workers, and others, helps to ensure a holistic approach to the individual's care plan. Family and Community Involvement: Where possible, the care plan should incorporate input from family members and relevant community resources, ensuring a supportive and integrated approach to care. Role of Care Managers in Care Plan Development The role of care managers in creating a person-centered care plan is multifaceted and vital. Care managers are responsible for coordinating the comprehensive assessment, facilitating discussions about personal goals, gathering interdisciplinary input, and connecting with family and community resources. These professionals act as the central hub for all information, ensuring that the care plan addresses all aspects of an individual's health, well-being, and goals. They employ their expertise to address potential challenges, create innovative solutions, and ensure the person's voice is central throughout the planning process. Communication with the Care Team Once the care plan is developed, care managers take the lead in communicating the plan to the broader care team. This communication ensures that every member of the team - from physicians and therapists to direct support professionals - understand their role in the individual's care and the overall goals of the care plan. Effective communication strategies may include team meetings, written care plan summaries, training sessions, and ongoing check-ins. It's essential that all team members have opportunities to ask questions, clarify responsibilities, and provide input. The ABI Waiver Program's person-centered care plans are more than just strategic documents; they are blueprints for empowering individuals with brain injuries to live their lives to the fullest. Care managers play a pivotal role in these plans, creating a tailored approach that aligns with each person's unique needs and goals and effectively communicating this plan to the wider team. Through such comprehensive and person-centered planning, we can enhance the quality of care and enrich the lives of those within the ABI community. How have I contributed to the development and execution of a person-centered care plan for a client within the ABI Waiver Program? Reflect on your role in this process, your level of interaction with the client, the family, and other team members. Even if you aren't a care manager, your actions and insights can significantly impact the overall care plan. What steps have I taken to truly understand a client's personal goals and preferences? Every interaction with a client offers opportunities to learn about their life, goals, and preferences. Remember, an effective care plan goes beyond medical needs—it considers the individual as a whole person. How do I ensure interdisciplinary collaboration in care plan development? Reflection on how you actively seek and integrate input from different disciplines can highlight areas of strength or identify opportunities for improvement. How have I involved family members and community resources in the care planning process? The family and community play crucial roles in the care plan. Think about how you have engaged these resources and consider ways to enhance their involvement. How effectively have I communicated the care plan to the wider team? Communication is critical for successful execution of the care plan. Reflect on how you share information, how you create opportunities for feedback, and how you ensure everyone understands their role. Person-centered care plans are fundamental components of the ABI Waiver Program, designed to ensure individuals with brain injuries can live as independently as possible within their community. Care managers play a pivotal role in creating these plans, which are designed based on the individual's needs, goals, and preferences, and incorporate interdisciplinary input, family and community involvement. The care plan is then communicated effectively across the wider team, ensuring a holistic approach to care. ______________________________ What is a Care Plan? Do you have one? Have you seen it? "Explore the development and execution of person-centered care plans within the ABI Waiver Program, emphasizing the central role of care managers." https://www.ctbraininjury.com/post/care-plans ABI Waiver Program, person-centered care, care plan, care managers, team communication, brain injuries, individual assessment, personal goals, preferences, interdisciplinary input, family involvement, community resources, holistic approach, care team, physicians, therapists, direct support professionals, written care plan summaries, training sessions, check-ins, health, well-being, living arrangements, social activities, vocational pursuits, professional disciplines, physical therapists, occupational therapists, neurologists, social workers, strategic documents, empowering, quality of care, enrich lives, ABI community, collaboration, strategic approach, unique needs, supportive approach, integrated approach, assessment, challenges, innovative solutions, team meetings, health status, abilities, neurorehabilitation, independent living, supported living, community care, stroke, TBI, lifestyle, neurology, ABI, family, community, collaboration, communication, goals, patient advocacy, patient rights, personal objectives, care coordination, health plan, post-stroke, traumatic brain injury, rehabilitation, medical needs, neurologic care, health professionals, family care, physical recovery, cognitive recovery, medical professionals, interdisciplinary care, healthcare, healthcare providers, social care, case manager, individual care, rehabilitation services, healthcare team, patient-centered care, patient involvement, healthcare management, medical services, brain injury recovery, life enrichment, care planning process, team roles, care plan goals, community integration, vocational rehabilitation. ABI Waiver Program, person-centered care, care management, traumatic brain injury, stroke recovery, community-based care, neurorehabilitation, interdisciplinary care, care coordination, family involvement in healthcare, personal goal setting in healthcare, healthcare communication, ABI resources, supported living, patient advocacy, healthcare team collaboration, independent living post-ABI, occupational therapy, physical therapy, cognitive therapy, patient-centered planning, community resources in healthcare, health plan development, vocational rehabilitation, neurologic care. Person-Centered Care Planning in the ABI Waiver Program: A Comprehensive Guide The Role of Care Managers in ABI Waiver Program Navigating Person-Centered Care Planning for ABI Patients Unveiling the ABI Waiver Program: A Focus on Person-Centered Care Integrated Approach to Care: A Deep Dive into ABI Care Planning Building Bridges: The Intersection of Care Management and ABI Strategies for Successful Care Planning in ABI Waiver Program The Power of Communication in ABI Care Planning ABI Care Plans: From Development to Execution The ABI Waiver Program: Pioneering Person-Centered Care in Brain Injury What is a care plan? How do I create a care plan? Key components of a care plan? Importance of care plans in healthcare. How often should care plans be updated? Challenges in implementing care plans. Involving patients in care plan development. Care plan vs. treatment plan. Benefits of having a care plan. Effective communication of care plans. Technology and care plan support. Nursing process and care plan development. Incorporating preferences into care plans. Legal and ethical considerations in care plans. Risks of not following care plans. Collaboration among healthcare team. Addressing psychosocial needs in care plans. Evaluating care plan effectiveness. Modifying care plans for changing conditions. Resources for care plan implementation. Patient empowerment in care plans. Developing care plans for specific conditions. Role of patient education in care plans. Medication management in care plans. Interdisciplinary collaboration in care plans. What community care resources are beneficial for people recovering from a stroke or TBI in the ABI Waiver Program? ABI resources are crucial in providing supported living for consumers with brain injuries. How can interdisciplinary collaboration enhance the care plan for a person recovering from a stroke in the ABI Waiver Program? Supported living is a significant component in the care plan for people living with a TBI in the ABI Waiver Program. ABI resources can empower consumers and their families to make informed decisions post brain injury. How can ABI resources support individuals with a TBI or stroke in navigating community care? The care plan for people who have experienced a stroke within the ABI Waiver Program emphasizes the importance of supported living and community care. How can the care team effectively communicate the care plan to a person with a TBI in the ABI Waiver Program? Care managers in the ABI Waiver Program work closely with individuals who have had a stroke to develop a comprehensive, person-centered care plan. The ABI Waiver Program offers extensive community care and supported living options for people with brain injuries. How can the ABI Waiver Program enable a person with TBI to live independently in their community? ABI resources play a critical role in facilitating community integration for people recovering from brain injuries. The ABI Waiver Program's person-centered care plan aligns with the unique needs of people who have had a stroke or TBI. Care managers in the ABI Waiver Program collaborate with various healthcare professionals to develop a comprehensive care plan for people living with a TBI. How can ABI resources contribute to an enriched life for a person with a brain injury in a supported living environment? The role of care managers in the ABI Waiver Program is crucial to effectively tailor the care plan to meet the needs of people with brain injuries. The person-centered care plan of the ABI Waiver Program is a roadmap to independence and fulfillment for people living with a TBI or stroke. How can effective communication between care team members contribute to the success of the ABI Waiver Program for people with brain injuries? ABI resources are dedicated to promoting the well-being and independence of people who have experienced a stroke or TBI. Care managers work closely with people who have experienced a stroke to understand their lifestyle preferences and personal goals within the ABI Waiver Program. The ABI Waiver Program creates an environment of supported living for people with TBI, focusing on their unique needs and aspirations. How does the ABI Waiver Program incorporate the personal goals and preferences of people recovering from a stroke in the care plan? ABI resources, when effectively utilized, can significantly enhance the quality of life for people living with a brain injury. How can family and community involvement be better integrated into the care plan within the ABI Waiver Program for a person with a TBI? The interdisciplinary approach of the ABI Waiver Program allows for comprehensive care planning for people who have experienced a stroke. Supported living within the ABI Waiver Program encourages community participation and independence for people living with a TBI. How does the ABI Waiver Program assist people with brain injuries in reaching their vocational pursuits? ABI resources provide people who have experienced a stroke with the necessary support to live independently and participate fully in their community. The person-centered care plan of the ABI Waiver Program is instrumental in helping people with TBI regain control of their lives. How do care managers in the ABI Waiver Program ensure that the unique needs and preferences of people with brain injuries are met? Community care within the ABI Waiver Program fosters a sense of belonging and independence for people recovering from a stroke. ABI resources are focused on enhancing the well-being and independence of people living with a TBI. How can care teams effectively work with people who have experienced a stroke to develop and implement their care plan in the ABI Waiver Program? Care managers play a pivotal role in the ABI Waiver Program by ensuring that the care plan meets the specific needs of people with TBI. The ABI Waiver Program offers a person-centered approach, prioritizing the personal goals and lifestyle preferences of people recovering from brain injuries. How do ABI resources contribute to creating a supportive and inclusive community for people living with a TBI? The care team within the ABI Waiver Program works collaboratively to ensure the successful implementation of the care plan for people who have had a stroke. Supported living and community care are key components of the ABI Waiver Program, fostering independence for people with brain injuries. How can the person-centered care plan within the ABI Waiver Program be tailored to meet the vocational aspirations of a person with a TBI? ABI resources are dedicated to empowering people who have experienced a stroke, promoting their independence and integration into the community. Care managers in the ABI Waiver Program collaborate with people with TBI to develop a care plan that resonates with their personal goals and preferences. How does the ABI Waiver Program ensure a holistic approach in the care of people recovering from a stroke? ABI resources provide invaluable support for people with TBI, facilitating their transition to independent living within their community. The ABI Waiver Program, through its person-centered care plan, empowers people who have experienced a stroke to live a fulfilling life. How does the ABI Waiver Program work with care teams to ensure the successful implementation of the care plan for people with brain injuries? ABI resources play a significant role in providing a supportive living environment for people living with a TBI. The ABI Waiver Program encourages the active involvement of people who have had a stroke in the development of their care plan. How can care managers within the ABI Waiver Program ensure effective communication of the care plan to people with brain injuries and their care team? The ABI Waiver Program supports people with TBI in their journey towards independent living and community participation. How can ABI resources be effectively utilized to enhance the quality of life for a person recovering from a stroke in a supported living environment?

Exploiting Vulnerabilities: How Scammers are using Photos from Home Healthcare Agencies! How Fraudsters Leverage Home Healthcare Photos. Facial Recognition Apps and Software. Amid an increasingly interconnected digital landscape, scammers are turning to home healthcare agencies' media assets for malign activities, causing concern for the safety of vulnerable populations worldwide. These malefactors utilize seemingly benign photographs from these agencies to target susceptible individuals and their families, leading to numerous troubling consequences. The most prevalent issues include establishing fake relationships, identity theft, and even sexual predation. Home healthcare agencies typically share photos of their clients and employees on their websites and social media platforms to promote their services, celebrate achievements, and build community engagement. However, scam artists have manipulated these images, employing sophisticated facial recognition tools and artificial intelligence (AI) algorithms to identify and target individuals. This innovative misuse of technology is an escalating issue that threatens the privacy and security of countless individuals. Victims are often older adults, people with disabilities, and those dealing with chronic illnesses--populations that home healthcare agencies are intended to protect and serve. Unfortunately, the offenders often masquerade behind a veneer of normalcy. They may pose as potential romantic interests, healthcare workers, or friends, utilizing photos and information from home healthcare agencies to cultivate a sense of trust and authenticity. Subsequently, they exploit this established relationship to manipulate victims into sharing personal information, sending money, or engaging in compromising activities. As a result, home healthcare agencies worldwide have started reevaluating their online practices, including ceasing the posting of client and employee photos. While this strategy minimizes risk, it also means these organizations lose a valuable tool for communication, community-building, and public relations. Simultaneously, these agencies are working to educate their clients, employees, and the public about these scams. They're focusing on teaching how to recognize potential scams, the importance of safeguarding personal information, and the steps to take if targeted. Additionally, they're advocating for more robust privacy laws and stricter regulation of facial recognition technology and AI. Still, the challenges are immense. The fraudulent activities are often difficult to trace and the perpetrators hard to catch. Moreover, the victims may be reluctant to come forward due to embarrassment, fear, or lack of awareness. Even when they do, the damage--financial loss, emotional trauma, and privacy invasion--may be irreparable. This situation underscores the need for continued vigilance in the face of evolving cyber threats. As technological advancements facilitate new methods of exploitation, all sectors, including healthcare, must adapt their practices and prioritize the safety and privacy of the vulnerable populations they serve. Agencies, families, and communities must work together to fight against these cyber threats. The evolving landscape of digital security may be daunting, but only through collective awareness and action can the most vulnerable be protected from such exploitation. Remember, knowledge and awareness are powerful tools in combating these malicious practices. While the digital landscape continues to evolve, creating new threats, we must evolve with it, taking every necessary measure to protect the most vulnerable among us from these predatory tactics. Do you know how to spot a potential scam, particularly one leveraging personal photographs? Recognizing potential scams can involve a critical examination of the situation: unfamiliar contacts reaching out for personal details, unsolicited requests for financial aid, or communications that demand urgency or secrecy are often indicative of scam attempts. Are you aware of the privacy settings on your social media profiles? Awareness and usage of privacy settings are key to protecting your online presence. Ensure that your personal details and photos are only accessible to trusted individuals. Have you spoken to your loved ones about the importance of online privacy and the risk of scams? Regular conversations about the threats posed by online scams can equip your loved ones, especially those from vulnerable populations, with the knowledge to protect themselves better. Do you think enough about the implications of sharing photos of yourself or your family online? As innocent as it may seem, sharing personal photos can lead to unintended consequences, like identity theft and scams. Before posting, consider potential risks and implications. Do you understand the power and potential misuse of facial recognition technologies and AI in our digital age? These technologies, while beneficial, can be exploited for malicious activities, like scams. It's important to stay informed about such developments and adapt our online behaviors accordingly. In a concerning trend, fraudsters are leveraging photos and information from home healthcare agencies to target vulnerable populations worldwide. They use sophisticated facial recognition tools and AI algorithms to create scams ranging from fake relationships to identity theft. As a result, many home healthcare agencies have ceased posting client and employee photos and are educating their constituencies about scam recognition and privacy protection. The situation calls for vigilance, regulation, and collective action to protect the most vulnerable. ___________________________ "Scammers use Home healthcare photos and AI for sinister scams, targeting the vulnerable. Awareness, privacy, and regulation are needed." https://www.ctbraininjury.com/post/faces-of-fraud-scammers-are-using-photos-from-home-healthcare-agencies Online Privacy, Cybersecurity, Elderly Scams, Identity Theft, Home Healthcare, Digital Safety, Facial Recognition Technology, AI Misuse, Social Media Scams, Fake Relationships, Online Predation, Personal Data Protection, Cyber Threats, Healthcare Industry Scams, Tech-enabled Exploitation, Vulnerable Populations, Digital Literacy, Internet Fraud, Online Vulnerability, Regulation of AI, Privacy Laws, Health Information Privacy, Photo-sharing Risks, Internet Safety Education, Impact of Cybercrime Digital Deception: A Dark Side of Home Healthcare Faces of Fraud: Misuse of Home Healthcare Photos Cyber Predators: Leveraging AI and Photos for Scams Unveiling Online Scams: A Focus on Home Healthcare A New Face of Cybercrime: Exploiting the Vulnerable Against the Digital Threat: Protecting Home Healthcare Online Scams: Targeting the Vulnerable via Healthcare Photos Privacy and Protection: Guarding Against Healthcare Scams AI and Photos: Tools for Modern Scammers Protecting Vulnerable Populations in the Digital Age "Do Not Post My Photos": (Note: TBI stands for Traumatic Brain Injury) What precautions should TBI survivors take to prevent their photos from being used maliciously? How can individuals with a brain injury (TBI) protect their online photos from misuse? "As a TBI survivor, I request that you do not post my photos." What can caregivers of TBI patients do to protect their loved ones' photos from online scams? Have you informed your healthcare provider of your TBI and your wish not to have your photos posted online? "I'm a TBI survivor, and I ask that my privacy is respected – please, do not post my photos." How can TBI patients advocate for their digital privacy? What are the risks of posting photos of TBI survivors online? Understanding the importance of not posting photos of TBI patients without consent. What precautions should TBI survivors take to prevent their photos from being used maliciously? How can individuals with a brain injury (TBI) protect their online photos from misuse? "As a TBI survivor, I request that you do not post my photos." What can caregivers of TBI patients do to protect their loved ones' photos from online scams? Have you informed your healthcare provider of your TBI and your wish not to have your photos posted online? "I'm a TBI survivor, and I ask that my privacy is respected – please do not post my photos." How can TBI patients advocate for their digital privacy? What are the risks of posting photos of TBI survivors online? Understanding the importance of not posting photos of TBI patients without consent. As someone living with TBI, what should you consider before posting photos online? How does photo sharing pose risks for those with brain injury (TBI)? What measures are in place to protect the photos of TBI survivors from potential scammers? "As a person living with TBI, it's my right to say: do not post my photos." What role does informed consent play in sharing photos of TBI patients online? "Living with TBI has made me more aware of my digital footprint – please, do not post my photos." "Due to my condition (TBI), I request you to not post my photos." How are home healthcare agencies ensuring the privacy of TBI patients? "Please respect my privacy as a TBI survivor, do not post my photos." How to safeguard online photos from misuse when you're dealing with a brain injury (TBI)? "As a TBI survivor, I urge all healthcare agencies to not post my photos." The potential danger of posting photos of TBI survivors online. "My TBI doesn't define me, and I prefer to keep my recovery private – do not post my photos." What protocols do home healthcare agencies follow to protect the privacy of TBI patients? How can TBI survivors ensure their photos aren't being misused online? "Having TBI has taught me the importance of privacy – please, do not post my photos." How to educate TBI patients about the potential risks of sharing photos online? "I appreciate the care provided for my TBI, but I request that my photos are not posted." What strategies can protect TBI patients from becoming victims of photo-related scams? "Please respect my wishes as a TBI survivor, and do not post my photos online." "As a brain injury survivor, I advocate for my privacy - do not post my photos." Why it's crucial not to post photos of TBI patients without explicit consent? "My journey with TBI is personal - please do not post my photos." How does posting photos of TBI patients put them at risk of online scams? "To maintain my privacy while dealing with TBI, I request you to not post my photos." How to better protect TBI survivors from online scams related to photo sharing? "TBI has made me cautious about my online presence - please do not post my photos." What actions are being taken to safeguard the privacy of TBI patients' photos? "Despite my TBI, I value my privacy - do not post my photos online." How to maintain online privacy for TBI patients in home healthcare? "My struggle with TBI is my own - I kindly ask you to not post my photos." Are home healthcare agencies aware of the potential misuse of TBI patients' photos? "TBI has heightened my awareness about online privacy - do not post my photos." Is enough being done to protect the photos of TBI patients from potential scams? "I have a right to my privacy as a TBI patient - please, do not post my photos." How to advocate for the privacy of TBI patients in the digital age? "My TBI does not diminish my right to privacy - do not post my photos." What potential harm can befall TBI patients due to their photos being misused? "I ask for my privacy to be respected as I deal with TBI - do not post my photos." Are the privacy concerns of TBI patients being adequately addressed by home healthcare agencies? "TBI is a part of my life, but I still value my privacy - please, do not post my photos."

" I didn't know I had a Team Meeting or people are meeting to discuss my life. " Discrimination in Covert Medicaid ABI Waiver Program Meetings In recent years, concerns have emerged regarding the Connecticut Department of Social Services' (CT DSS) practices in affiliation with Cognitive Behaviorists (CBT) providers and Care Management providers. At the heart of the controversy is the organization of covert Medicaid Acquired Brain Injury (ABI) Waiver Program meetings, where decisions and discussions about disabled individuals occur without their knowledge, approval, or participation. This may also be impacting the Families and Conservators. Nature of the Issue: Exclusion from Decision Making: Central to the principles of self-determination and autonomy is the idea that individuals should be at the forefront of decisions affecting their lives, especially when it pertains to their health and well-being. By excluding individuals from these meetings, the CDSS and its affiliates essentially strip them of their rights to be active participants in decisions about their own care. Violation of Ethical Principles: Ethical care in both cognitive behavior therapy and care management is grounded in respect for the dignity, autonomy, and rights of individuals. Covert meetings undermine these principles, placing disabled individuals in passive roles, thus treating them as subjects rather than partners in their own care. Potential for Bias: Decisions made without the direct input of those affected can lead to assumptions and biases influencing care. Without direct feedback, there's a risk of perpetuating stereotypes, misunderstanding individual needs, or prioritizing organizational needs over the needs of the individuals. Lack of Transparency: The covert nature of these meetings raises questions about transparency. Without transparency, there's a potential for conflicts of interest, biased decision-making, and a lack of accountability in the process. Implications and Consequences: Erosion of Trust: Trust is a fundamental aspect of the patient-provider relationship. When individuals learn that decisions are made without their knowledge or input, this trust is eroded, which can impact the effectiveness of care and the willingness to engage in recommended treatments. Risk of Inadequate Care: By not involving the individuals directly, the CDSS and its affiliates may overlook critical information about their preferences, needs, and values, potentially leading to less effective or inappropriate care. Legal Repercussions: Discrimination against disabled individuals and the infringement of their rights can result in legal consequences, including lawsuits and sanctions against the offending parties. Recommendations: Inclusive Practices: The CT DSS, in conjunction with CBT providers and Care Management providers, should ensure that practices are inclusive. This means actively involving individuals in discussions and decisions that affect their care and well-being. Training and Sensitization: All stakeholders should undergo training to ensure they understand the importance of inclusivity, respect for individual rights, and the potential consequences of discriminatory practices. Transparency and Accountability: Open communication and a commitment to transparency are critical. Policies should be in place to ensure that all meetings and decisions are documented, with appropriate checks and balances. Conclusion: The organization of covert Medicaid ABI Waiver Program meetings without the awareness, approval, and participation of disabled individuals represents a clear form of discrimination. For a just, ethical, and effective system, it's imperative to center the rights and needs of those the system aims to serve. ABI Resources Connecticut

Date: 11/28/2023 Subject: Urgent Call for State-Level Action to Address Systemic Rights Violations in Connecticut's Disability Support System Dear Governor Ned Lamont, I am reaching out to you in my role as the CEO and Director of ABI Resources, an organization committed to the well-being of individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program in Connecticut. This letter serves as both a statement of grave concern and a pressing appeal for your immediate action regarding systemic rights violations occurring within our state. Date: 11/28/2023 Subject: Urgent Request for State and Federal Intervention to Address Systemic Rights Violations in Connecticut Dear Senator Richard Blumenthal, I am writing to you as the CEO and Director of ABI Resources, a Connecticut-based organization dedicated to assisting individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program. This letter is both an expression of grave concern and an urgent plea for your intervention regarding ongoing systemic rights violations in Connecticut. These violations, perpetrated by state authorities and insufficiently addressed by federal entities, are infringing upon the rights of the community we serve, including my rights as a disabled business owner. Our efforts to tackle these challenges are hampered by the complexity, costs, and timeframes required to navigate existing systems, compounded by a conspicuous lack of federal oversight in Connecticut's allocation and use of federal funds. Date: 11/28/2023 Subject: Immediate Intervention Needed for Addressing Systemic Rights Violations in Connecticut's Disability Support System Dear Senator Chris Murphy, I am reaching out to you in my capacity as the CEO and Director of ABI Resources, a Connecticut-based organization committed to supporting individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program. This letter is an urgent appeal for your intervention regarding critical and systemic rights violations occurring within our state. The crux of our concerns lies in the rights infringements perpetrated by Connecticut state authorities, which are further exacerbated by the lack of appropriate federal oversight. These actions are not only impinging upon my rights as a disabled entrepreneur but are also adversely affecting the vulnerable community we serve. The complexities, costs, and procedural delays inherent in the current systems have been barriers in our pursuit of justice, highlighting a significant oversight gap in the federal monitoring of Connecticut's use of federal funds. Date: 11/28/2023 Subject: Urgent Request for Advocacy and Action on Systemic Rights Violations in Connecticut’s Disability Support System Dear Congressman John B. Larson, I am writing to you in my capacity as the CEO and Director of ABI Resources, a Connecticut-based organization dedicated to supporting individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program. I am reaching out to you, as a respected representative of Connecticut's 1st Congressional District, to seek your support and intervention in addressing critical systemic rights violations within our state. Our organization, and more importantly, the community we serve, are facing significant challenges due to rights infringements perpetrated by state authorities. These issues are compounded by the lack of adequate federal oversight, severely impacting not only my rights as a disabled business owner but also those of the vulnerable individuals we support. The complexity, costs, and prolonged procedural delays inherent in the current systems represent significant barriers to justice and equitable treatment. Date: 11/28/2023 Subject: Request for Urgent Congressional Attention on Systemic Rights Violations in Connecticut’s Disability Support System Dear Congressman Joe Courtney, I write to you in my capacity as the CEO and Director of ABI Resources, a company committed to serving individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program in Connecticut. This correspondence is an urgent appeal for your attention and action regarding significant systemic rights violations within our state. Our organization, ABI Resources, has been at the forefront of confronting these challenges. However, the rights infringements perpetrated by state authorities, compounded by inadequate federal oversight, are gravely impacting the vulnerable community we serve, including my rights as a disabled business owner. We face numerous barriers due to the complexities, costs, and procedural delays inherent in the current systems, highlighting critical gaps in Connecticut's management of federal funds. Date: 11/28/2023 Subject: Urgent Intervention Required to Address Systemic Disabilities Rights Violations in Connecticut Dear Congresswoman Rosa DeLauro, I am writing to you in my capacity as CEO and Director of ABI Resources, a Connecticut-based organization dedicated to supporting individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program. This letter is an urgent call for your attention and action regarding significant systemic rights violations occurring within our state, particularly affecting those with disabilities. Our organization, ABI Resources, is deeply committed to the welfare of individuals with disabilities, and it is with great concern that I bring to your attention the pressing issues we are facing. These challenges stem from the rights infringements by Connecticut state authorities, negatively impacting not only my rights as a disabled entrepreneur but also the rights of the vulnerable individuals we serve. The complexities and inefficiencies within the current systems have created significant barriers, hindering our efforts to seek justice and support for our community. Date: 11/28/2023 Subject: Urgent Action Required to Address Systemic Rights Violations in Connecticut's Disability Support System Dear Congressman Jim Himes, I am writing to you in my role as the CEO and Director of ABI Resources, an organization operating in Connecticut to provide support for individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program. This letter seeks your urgent attention and intervention concerning systemic rights violations impacting the disabled community in our state, particularly in the area you represent. Connecticut is currently facing a critical issue: the infringement of rights by state authorities, which has been exacerbated by inadequate federal oversight. These violations affect not only my rights as a disabled entrepreneur but also impinge upon the rights and welfare of the individuals we serve. Our efforts to address these challenges have been consistently impeded by the complex, costly, and prolonged processes involved in navigating the current systems. This is compounded by a lack of effective oversight in Connecticut's management of federal funds, as intended for the benefit of the disabled community. Date: 11/28/2023 Subject: Urgent Action Required to Address Systemic Rights Violations in Connecticut’s Disability Support System Dear Congresswoman Jahana Hayes, I am writing to you in my role as the CEO and Director of ABI Resources, a dedicated organization assisting individuals with disabilities under the Federally Funded Medicaid ABI Waiver Program in Connecticut. This letter is an urgent call to action regarding serious systemic rights violations occurring within our state, particularly impacting those with disabilities. As a representative of Connecticut’s 5th Congressional District, your leadership and advocacy are vital in addressing these critical issues at the federal level. The rights infringements we face are not just a failure of state authorities but also reflect a gap in federal oversight. These issues severely impact not only my rights as a disabled business owner but also the rights and well-being of the vulnerable community we serve. The complexities and delays inherent in the current systems, both at the state and federal levels, have become significant barriers in our pursuit of justice and equity. In this urgent appeal, I am highlighting the lack of transparency and accountability in the state’s administration of the Medicaid ABI Waiver Program. Our report sheds light on potential civil rights violations, government overreach, and their profound impact on the disabled community we are committed to serving. We have documented concerns regarding potential corruption, ethical violations, and financial mismanagement within state-run programs. The absence of decisive action against these allegations risks setting a concerning precedent, undermining the principles of governance and oversight at the state level. The issues raised involve potential discrimination and inequality against individuals with disabilities and also raise significant public safety concerns. As a leader deeply involved in these matters, I have seen firsthand the detrimental effects these systemic issues have on our clients and their families. It is not just a policy failure; it is a failure to protect and support those who rely on us. The responsibility to address these issues lies with the state of Connecticut, where robust oversight and effective solutions are critically needed. In conclusion, the situation we are facing is a matter of national concern, warranting proactive and decisive intervention at the state level. The well-being of countless individuals reliant on the integrity of our state systems is in jeopardy. I implore you to recognize the seriousness of this situation and take appropriate action. It is vital that the state of Connecticut takes responsibility for these systemic failures and implements effective solutions. Thank you for your consideration of this pressing issue. I am ready to provide any further information or assistance required and look forward to your prompt response. Best regards, David Medeiros ABI Resources, CEO, Director, Team Member In an unprecedented move that's shaking the foundations of Connecticut's healthcare system, a detailed complaint demanding federal intervention has been lodged to address systemic injustices within the state’s Medicaid Acquired Brain Injury (ABI) Waiver Program. This bold step, while initiated by ABI Resources LLC, is a powerful echo of the struggles and aspirations of the broader disabled community, the unsung heroes among home care workers, diligent care managers, and the very ethos of Connecticut's commitment to equitable healthcare. The Tipping Point: This complaint is not just another document in the bureaucratic maze. It's the culmination of years of silent battles, unheeded voices, and overlooked grievances. It uncovers a network of discriminatory practices, veiled Medicaid referrals, and financial intricacies that have long cast a shadow over the quality and accessibility of care for the disabled. Voices from the Shadows: At the heart of this story are the lives of thousands of disabled individuals in Connecticut. Their daily realities are marred by barriers to essential services, a lack of adequate support, and a system that often seems indifferent to their struggles. Home care workers and care managers, who devote their lives to providing care, share in this struggle, facing constant challenges in a system fraught with inefficiencies and inequities. The Battle for Transparency and Fair Play: The complaint is a clarion call for a revolution in the way Connecticut’s ABI Waiver Program is run. It calls for a system where transparency isn't just a buzzword but a foundational principle. It's a demand for a level playing field where the rights and needs of the disabled are not just recognized but given the highest priority. Federal Oversight: The Beacon of Hope: The appeal for federal intervention is laden with expectations. It's seen as the crucial step towards dismantling the entrenched barriers of injustice and ushering in an era of reform. The hope is that federal oversight will not only bring about immediate changes but also set a precedent for long-term improvements in the state’s approach to disability care. A Ripple Effect Across the Nation: This situation transcends Connecticut’s borders, spotlighting a systemic issue in the United States’ approach to disability care. It raises critical questions about the effectiveness of federal oversight in state-run programs and the broader implications for the nation's healthcare policies. The Human Angle: At its core, this story is about people. It's about the resilience and courage of those living with disabilities, the dedication of caregivers who offer support and strength, and the community's collective effort to uphold the rights and dignity of every individual. Contacting Your Connecticut Representatives and Senators in Washington U.S. Senators (statewide) Richard Blumenthal email Connecticut Office 90 State House Square 10th Floor Hartford, CT 06103 860.258.6940 860.258.6958 (fax) Washington, DC Office 702 Hart Office Building Washington, DC 20510 202.224.2823 202.224.9673 (fax) Chris Murphy email Connecticut Offices 120 Huyshope Avenue Colt Gateway, Suite 401 Hartford, CT 06106 860.549.8463 860.524.5091 (fax) Washington, DC Office 136 Hart Senate Office Building Washington, DC 20510 202.224.4041 202.224.9750 (fax) U.S. Representatives (regional) Click here to find your U.S. Representative, as well as your Connecticut State Representative & State Senator. John Larson—1st Congressional District email Connecticut’s 1st Congressional District covers the north-central part of the state, including the towns of Barkhamsted, Berlin, Bloomfield, Bristol, Colebrook, Cromwell, East Granby, East Hartford, East Windsor, Glastonbury (part), Granby, Hartford, Hartland, Manchester, Middletown (part), New Hartford, Newington, Portland, Rocky Hill, South Windsor, Southington, Torrington (part), West Hartford, Wethersfield, Winchester, Windsor, and Windsor Locks Connecticut Office 221 Main Street 2nd Floor Hartford, CT 06106 860.278.8888 860.278.2111 (fax) Washington, DC Office 106 Cannon House Office Building Washington, DC 20515 202.225.2265 202.225.1031 (fax) Joe Courtney—2nd Congressional District email Connecticut’s 2nd Congressional District covers the eastern part of the state, including the towns of Andover, Ashford, Bolton, Bozrah, Brooklyn, Canterbury, Chaplin, Chester, Clinton, Colchester, Columbia, Coventry, Deep River, East Haddam, East Hampton, East Lyme, Eastford, Ellington, Enfield, Essex, Franklin, Glastonbury (part), Griswold, Groton, Haddam, Hampton, Hebron, Killingly, Killingworth, Lebanon, Ledyard, Lisbon, Lyme, Madison, Mansfield, Marlborough, Montville, New London, North Stonington, Norwich, Old Lyme, Old Saybrook, Plainfield, Pomfret, Preston, Putnam, Salem, Scotland, Somers, Sprague, Stafford, Sterling, Stonington, Suffield, Thompson, Tolland, Union, Vernon, Voluntown, Waterford, Westbrook, Willington, Windham, and Woodstock Connecticut Offices 55 Main Street, Suite 250 Norwich, CT 06360 860.886.0139 860.886.2974 (fax) Washington, DC Office 2348 Rayburn HOB Washington, DC 20515 202.225.2076 202.225.4977 (fax) 77 Hazard Ave., Unit J Enfield, CT 06082 860.741.6011 860.741.6036 (fax) Rosa DeLauro—3rd Congressional District email Connecticut’s 3rd Congressional District includes the south-central part of the state, including the towns of Ansonia, Beacon Falls, Bethany, Branford, Derby, Durham, East Haven, Guilford, Hamden, Middlefield, Middletown (part), Milford, Naugatuck, New Haven, North Branford, North Haven, Orange, Prospect, Seymour, Shelton (part), Stratford, Wallingford, Waterbury (part), West Haven, and Woodbridge Connecticut Office 59 Elm Street New Haven, CT 06510 203.562.3718 203.772.2260 (fax) Washington, DC Office 2413 Rayburn House Office Building Washington, DC 20515 202.225.3661 202.225.4890 (fax) Jim Himes—4th Congressional District email Connecticut’s 4th Congressional District covers the southwestern part of the state, including the towns of Bridgeport, Darien, Easton, Fairfield, Greenwich, Monroe, New Canaan, Norwalk, Oxford, Redding, Ridgefield, Shelton (part), Stamford, Trumbull, Weston, Westport, and Wilton Connecticut Offices 211 State Street, 2nd Floor Bridgeport, CT 06604 866.453.0028 203.333.6655 (fax) Washington, DC Office 1227 Longworth House Office Building Washington, DC 20515 202.225.5541 202.225-9629 (fax) 888 Washington Boulevard, 10th Floor Stamford, CT 06901 866.453.0028 203.333.6655 (fax) Jahana Hayes—5th Congressional District email Connecticut’s 5th Congressional District includes the northwestern part of the state, including the towns of Avon, Bethel, Bethlehem, Bridgewater, Brookfield, Burlington, Canaan, Canton, Cheshire, Cornwall, Danbury, Farmington, Goshen, Harwinton, Kent, Litchfield, Meriden, Middlebury, Morris, New Britain, New Fairfield, New Milford, Newtown, Norfolk, North Canaan, Plainville, Plymouth, Roxbury, Salisbury, Sharon, Sherman, Simsbury, Southbury, Thomaston, Torrington (part), Warren, Washington, Waterbury (part), Watertown, Wolcott, and Woodbury Connecticut Office 108 Bank Street 2nd Floor Waterbury, CT 06702 860.223.8412 Washington DC Office 1415 Longworth HOB Washington DC 20515 202.225.4476 Senate Blumenthal, Richard — Democrat Murphy, Chris — Democrat House Larson, John B. — Democrat: 1st Congressional District Courtney, Joe — Democrat: 2nd Congressional District DeLauro, Rosa L. — Democrat: 3rd Congressional District Himes, Jim — Democrat: 4th Congressional District Hayes, Jahana — Democrat: 5th Congressional District Connecticut News | Brain Injury Home Care Concerns CONNECTICUT NEWS. Bold Push for Reform in Housing and Home Health Services CT NEWS: Ned Lamont - Richard Blumenthal - Chris Murphy - Larson, Courtney, DeLauro, Himes, Hayes To the Esteemed Governor Ned Lamont, Senators Richard Blumenthal and Chris Murphy, and House Representatives John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, and Jahana Hayes, We, a collective of concerned citizens, are writing to express our profound concern regarding the urgent need for reform and regulation within the Connecticut Department of Social Services (CT DSS). We believe there is a systemic issue of disability rights violations that cannot be overlooked. It is alarming that the CT DSS, an entity meant to protect and empower individuals with disabilities, is reportedly engaged in practices that severely hinder self-advocacy and propagate discrimination. The alleged instances of housing and service entrapment, along with the operation of sheltered workshops, and engagement in kickback incentive programs and bribery, are deeply troubling. These practices not only undermine the ethical standards expected of such a department but also flagrantly violate the rights of people with disabilities. The approach of "what they don't know won't hurt them" is especially concerning as it perpetuates discrimination and further marginalizes those with disabilities. Moreover, it is disconcerting that the CT DSS is accused of creating barriers that make it difficult for individuals to document their concerns or challenges. This lack of transparency and accountability obstructs the necessary process of identifying and rectifying these critical issues. We urge you, as our elected officials and representatives, to take decisive action in addressing these allegations. The commitment of ABI Resources in this matter is noteworthy, but the involvement and decisive actions of government officials such as yourselves are paramount in ensuring meaningful reform. Immediate action is necessary to reform agency housing and service regulations in federally funded programs, ensuring fair and equitable treatment for all citizens, particularly those with disabilities. The people of Connecticut look to your leadership in safeguarding the rights and voices of individuals with disabilities. We stand united in this cause, calling for justice, equity, and the upholding of the rights of people with disabilities. Your prompt and decisive response to these concerns is not only anticipated but necessary for the betterment of our community. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. The Hidden Struggle: Inside the Medicaid ABI Waiver Program "Welcome to our special interview session where we delve into the pressing issues faced by disabled consumers in the Medicaid ABI Waiver Program in Connecticut. Today, we're joined by an advocate from ABI Resources, a company dedicated to supporting individuals with disabilities. ABI Resources has been at the forefront of highlighting and addressing the systemic challenges within the program. In this interview, we'll explore these issues and discuss potential solutions." Can you tell us about the primary challenges disabled consumers are facing in the Medicaid ABI Waiver Program? "The most pressing challenges include misleading practices where individuals are diverted from their actual rehabilitation needs, a reduction in service quality due to managerial misdirection, and coercive tactics in service utilization. Consumers face financial manipulation, leading to a dependency trap, and there’s a notable lack of transparency and consumer choice in the services provided." How do these challenges impact the mental health and recovery prospects of disabled individuals? "These challenges have a profound impact on mental health, leading to stress, anxiety, and a sense of helplessness. This psychological distress can significantly impede recovery and rehabilitation, undermining the overall goal of fostering independence and improving quality of life." What role can federal intervention play in addressing these issues? "Federal intervention is critical. It can ensure that the program adheres to ethical standards and disability rights, implement stricter oversight, and mandate transparency in service provision. By setting national standards and providing guidelines for ethical practices, federal authorities can help restructure the program to be more consumer-centric." What specific changes would ABI Resources like to see implemented to improve the situation? "We advocate for a comprehensive overhaul of policies to prioritize consumer needs. This includes enhanced training for care managers, clearer communication of consumer rights, and a more straightforward advocacy process. Additionally, involving disabled individuals in policy-making and service design is crucial to ensure that their voices are heard, and their needs are met." How can we ensure that the voices of disabled consumers are amplified in decision-making processes? "Amplifying their voices requires involving them directly in advisory boards and decision-making committees. Regular feedback mechanisms, consumer satisfaction surveys, and a transparent grievance redressal system can also ensure that their experiences and needs are central to service improvements." "This conversation with ABI Resources highlights the urgent need for systemic reform in the Medicaid ABI Waiver Program in Connecticut. By focusing on consumer-centric solutions and advocating for federal oversight, we can work towards a system that truly supports and empowers individuals with disabilities. Thank you for joining us in this important discussion." Can you discuss the importance of transparent communication in these services, particularly for families and caregivers? "Transparent communication is vital. Families and caregivers need to be fully informed about the available services, the rights of the consumers, and the mechanisms in place for feedback and grievances. Clear and regular communication can empower them to make informed decisions and advocate effectively for their loved ones." In what ways can technology be leveraged to enhance the services provided to disabled consumers? "Technology offers immense potential to enhance services. Digital tools can facilitate better communication, provide accessible educational resources, and enable remote consultations and support. Additionally, technology can streamline service delivery, making it more efficient and personalized." How can we better address the unique needs of consumers with brain injuries in these programs? "Addressing the needs of consumers with brain injuries requires specialized training for care providers, individualized care plans, and access to resources that specifically cater to brain injury rehabilitation. Additionally, involving specialists in the planning and delivery of services is crucial." What changes would you suggest to ensure that service plans are more aligned with individual rehabilitation goals? "Service plans should be developed collaboratively with the consumer, their family, and healthcare professionals, focusing on individual rehabilitation goals. Regular reviews and adjustments based on progress and changing needs are essential to ensure these plans remain relevant and effective." How can the state and federal government better support initiatives that promote independence and self-sufficiency for disabled consumers? "Support can include funding for programs that focus on skill development, employment training, and community integration. Additionally, policy initiatives that encourage and incentivize service providers to focus on independence and self-sufficiency are essential." What role should medical professionals play in overseeing and guiding the services provided to disabled individuals? "Medical professionals should have a central role in overseeing and guiding services. Their expertise is crucial in developing appropriate care plans, monitoring progress, and ensuring that services are aligned with medical and rehabilitation needs." "Our discussion today with ABI Resources has brought to light the critical challenges and necessary steps for reforming the Medicaid ABI Waiver Program in Connecticut. Their commitment to advocating for the rights and well-being of disabled individuals is a testament to the importance of addressing these systemic issues. Thank you for joining us in this insightful and meaningful conversation." How can we ensure that disabled consumers have a voice in policy-making and service design? "Ensuring a voice for disabled consumers can be achieved by involving them in advisory committees, focus groups, and policy-making processes. Their direct experiences and insights are invaluable in designing services that truly meet their needs. It's also important to facilitate accessible platforms where their voices can be heard without barriers." What steps should be taken to better educate consumers and families about their rights and the services available to them? "Education can be improved through accessible information resources, regular workshops or webinars, and one-on-one counseling sessions. Ensuring that information is available in various formats to accommodate different disabilities is also crucial. Moreover, proactive outreach is essential to ensure that this information reaches those who need it most." What impact do these service limitations have on the social integration and community involvement of disabled individuals? "Service limitations significantly hinder social integration and community involvement. Without adequate support, disabled individuals may find it challenging to engage in community activities or social interactions, leading to potential isolation and a reduced quality of life. It's vital that services not only address medical needs but also facilitate broader social participation." Can you discuss the psychological effects on consumers when they feel trapped in the current system? "Feeling trapped in the system can lead to increased feelings of powerlessness and frustration. It can exacerbate feelings of depression and anxiety, especially when individuals feel they have no control over their care or future. This psychological impact can be as debilitating as the physical challenges they face." How do these practices affect the long-term financial independence and employment prospects of disabled consumers? "Current practices that do not prioritize skill development and independence can adversely affect the long-term financial independence and employment prospects of disabled consumers. Without the right support and opportunities, individuals may find it difficult to secure meaningful employment, which is essential for financial autonomy and self-esteem." "Our in-depth conversation with ABI Resources today sheds light on the urgent need for systemic change in disability care and advocacy. The insights provided highlight the importance of a collaborative, inclusive approach that genuinely considers the needs and voices of disabled individuals. We thank ABI Resources for their dedication and efforts in championing these crucial issues. This interview serves as a call to action for all stakeholders to work towards a more equitable and effective system of care." What are the most common concerns you hear from consumers and their families regarding these services? "We frequently hear concerns about the lack of personalized care and the feeling of being just a number in the system. Families are also worried about the quality and relevance of the services provided, and they express frustration over the bureaucratic hurdles that prevent them from advocating effectively for their loved ones." How can better oversight and regulation improve these issues? "Improved oversight and regulation can ensure that services are delivered in a manner that truly meets the needs of disabled consumers. This includes enforcing standards for personalized care, ensuring that service providers are adequately trained and qualified, and establishing transparent mechanisms for feedback and accountability." In your opinion, what immediate steps should be taken to address these issues? "Immediate steps include conducting a thorough review of current practices, engaging with consumers and their families to understand their needs better, and implementing interim measures to address the most pressing concerns. Additionally, there should be an immediate effort to improve transparency and communication with all stakeholders." How can disabled consumers and their families be better supported in navigating the system and advocating for their rights? "Support can be enhanced through the provision of clear, accessible information about the system and their rights within it. Dedicated advocacy services and support groups can also play a crucial role in helping consumers and families navigate the system and effectively advocate for their needs." What changes are needed in the training and qualification of care managers to better address the needs of disabled consumers? "Care managers need comprehensive training that includes a focus on disability rights, ethical care practices, and the specific needs of different disability groups. Ongoing professional development should also be a requirement, ensuring that care managers stay up-to-date with the latest best practices and regulatory requirements." How can we ensure that the voices of disabled consumers are amplified in decision-making processes at both state and federal levels? "Incorporating the voices of disabled consumers in decision-making can be achieved by establishing formal channels for their participation, such as advisory councils or committees. It's also important to create environments where their input is not only heard but actively sought and valued." "This interview with ABI Resources has highlighted the numerous challenges and opportunities in the Medicaid ABI Waiver Program. Their advocacy and insights offer a roadmap for meaningful change and improvement in services for disabled consumers. Their commitment to these issues is commendable, and it underscores the necessity for dialogue and action to create a more inclusive and effective system. Thank you for joining us in this critical conversation." What role do you see for federal authorities in monitoring and ensuring compliance with disability rights and service standards? "Federal authorities have a pivotal role in setting and enforcing standards for disability services. They should monitor compliance regularly and take decisive action when violations occur. Federal oversight is essential in ensuring that state programs adhere to the principles of fairness, transparency, and respect for the rights of disabled individuals." Can you suggest ways to improve transparency in the allocation of services and resources? "To improve transparency, there should be clear documentation and communication of how services and resources are allocated. This includes public reporting of service outcomes and criteria used in decision-making. Additionally, creating platforms for feedback and discussion with stakeholders can foster a more transparent and inclusive process." How do these issues intersect with other systemic challenges in healthcare and social services? "These issues are part of broader challenges in healthcare and social services, including disparities in access to care, inadequate funding, and a lack of coordinated care. Addressing these systemic issues requires a holistic approach that considers the interconnectedness of different facets of healthcare and social services." In your opinion, what role should medical professionals play in overseeing and guiding the services provided to disabled individuals? "Medical professionals should be central in guiding and overseeing services for disabled individuals. Their medical expertise is crucial in ensuring that services are appropriate and effective. They should also be involved in policy development and oversight to ensure that medical perspectives are integrated into service delivery." How can we ensure that disabled consumers have a voice in policy-making and service design? "Disabled consumers can have a voice in policy-making and service design by actively involving them in advisory roles, consultation processes, and research initiatives. Ensuring that their perspectives and experiences are considered in all stages of policy development and service design is key to creating responsive and effective programs." "Our discussion today with ABI Resources has been enlightening and informative, uncovering the depth and complexity of the challenges faced by disabled consumers in the Medicaid ABI Waiver Program. Their advocacy work highlights the critical need for systemic reform and increased involvement of all stakeholders in creating a more equitable and effective service system. We extend our gratitude to ABI Resources for their insights and unwavering commitment to improving the lives of disabled individuals. Thank you to our listeners for joining this important conversation." ( Choosing Your Care Manager ) Where your life and your choices matter most. Connecticut home and community support services.

"These programs are funded by the Federal Medicaid Program and are available to residents of Connecticut and other states. The Connecticut Department of Social Services is responsible for overseeing and ensuring the quality of the services provided for the CT programs." Connecticut Regulations of CT DSS Department of Social Services Concerning The Acquired Brain Injury Waiver Programs 1 and 2 The Regulations of Connecticut State Agencies are amendedby adding sections17b-260a-1 to 17b- 260a-18, inclusive, as follows: (NEW) Sec. 17b-260a-1. Purpose The Acquired Brain Injury (ABI) waiver program is established pursuant to sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes and 42 USC 1396n(c). The ABI waiverprogram provides, within the limitations described in sections 17b-260a-2 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, a range of nonmedical, home and community-based services to individuals 18 years of age or older with an ABI who, without such services, would otherwise require placement in a hospital, nursing facility (NF), or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The intention of the ABI waiver program is to enable such individuals, through person-centered planning, to receive home and community-based services necessary to allow such individuals to live in the community and avoid institutionalization. (NEW) Sec. 17b-260a-2. Scope Sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut StateAgencies set forth the requirements for eligibility and payment of services to eligible individuals participating in the ABI waiver program. These regulations also describe program requirements; services available; service requirements; department, provider and individual responsibilities; residential setting requirements; and limitations under the ABI waiver program. (NEW) Sec. 17b-260a-3. Definitions As used in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies: (1) “ Acquired brain injury ” or “ABI” means the combination of focal and diffuse central nervous system dysfunctions, immediate or delayed, at the brainstem level or above.These dysfunctions may be acquired through physical trauma, oxygen deprivation, infection, or a discrete incident that is toxic, surgical, or vascular in nature. The term “ABI” does not include disorders that are congenital, developmental, degenerative, associated with aging, or that meet the definition of intellectual disability as defined in section 1-1g of the Connecticut General Statutes; (2) “ Acquired braininjury nursing facility ” or “ABI NF” means a type of nursing facilitythat provides specialized programs for persons with an acquired brain injury; (3) “ Acquired Brain Injury waiver program ” or “ABI waiver program” or “the program” means the programsadministered by the Department of Social Servicesand established pursuantto sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes, as described in Medicaid waivers approved by the Secretary of the United States Department of Health and Human Services pursuant to 42 USC 1396n as amended from time to time, for the provision of home and community-based services to individuals with acquired brain injury; (4) “ ABI Waiver I ” " ABI Waiver Program One 1 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(a) of the Connecticut General Statutes and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of January 1, 1999; (5) “ ABI Waiver II ” " ABI Waiver Program Two 2 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(b) of the Connecticut General Statutes, and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of December 1, 2014; (6) “ Acquired Brain Injury waiver services ” or “ABI waiver services” means all or some of the services provided to individuals in the ABI waiver program; (7) “ Activity of daily living ”or “ADL” means an activityor task that is essentialto an individual’s health, welfare, and safety, including, but not limited to, bathing, dressing, eating, transfers, and bowel and bladder care; (8) “ Agency provider ” means a provideremployed by an agency, who provides ABI waiver services to individuals participating in the ABI waiver program; (9) “ Alternative institutional care costs ” means the costs of institutional care that the individual would otherwise incur, but for the support ofABI waiver services; (10) “ Applicant ” means an individual who, directly or through a representative, completes an ABI waiver program application form and submits it to the department; (11) “ Applied income ” means the portion of the individual’s income that remains after all deductions and disregards are subtracted and that may be appliedto the cost of waiverservices; (12) “ Assessment ” means a comprehensive, multidimensional written evaluation conducted by nonmedical department personnel or agents, using a standard assessment form that is used to determine whether an individual meets the level-of-care criteria to participate in the ABI waiver program; (13) “ Chronic disease hospital " or “CDH” means a long-term hospitalhaving facilities, medical staff, and necessary personnel for the diagnosis, care, and treatment of a wide range of chronic diseases; (14) “ Commissioner ” means the Commissioner of Social Services; (15) “ Cost-effective ” or “ cost-effectiveness ” means the department’s determination that payments for the individual’s total service costs do not exceed either the individual caps or available funding for the ABI waiver program; (16) “ Countable income ” means all sources of income not excluded under the Medicaid program; (17) “ Department ” or “ DSS ” means the stateof Connecticut Department of Social Services or its agent; (18) “ Family member ”means a person who is related to the individual by blood, adoption, or marriage; (19) “ Fiscal intermediary ” means an agent or agents under contract with the department that is responsible for: paying providers for services delivered; registering providers; providingtraining and outreach to individuals and providers of services under the ABI waiver program; and performing other administrative functions requested by the department; (20) “ Hands-on care ” means assistance with ADLs provided most often, but not exclusively, by home health aides. Hands-oncare includes the prompting and cueing necessary for an individual to perform ADLs; (21) “ Home and community-based services ” means Medicaid servicesprovided to an individual in that individual’s own home or other community-based setting; (22) “ Home and community-based setting ” has the same meaning as provided in 42 CFR 441.301(c)(4)-(5), as amended from time to time; (23) “ Hospital ” has the samemeaning as provided in 42 CFR 440.10, as amended from time to time; (24) “ Household employee ” means a provider who performs ABI recovery assistant I, ABI recovery assistant II, chore, companion, homemaker, independent livingskills training, or respite services, and who is employed by the individual and not an agency; (25) “ Individual ” means a person with an acquired brain injury who is applying for, or actively participating in, the ABI waiver program; (26) “ Individual cap ” meansthe maximum allowabletotal cost of the individual’s service plan; (27) “ Integrated work setting ” means a work setting wherepeople with disabilities work alongside people without disabilities, for at least minimum wage. (28) “ Intermediate care facility for individuals with intellectual disabilities ” or “ICF-IID” has the same meaning as provided in 42 CFR 440.150, as amended from time to time, and is a facility licensed by the Connecticut Department of Developmental Services for the care and treatment of persons with intellectual disabilities; (29) “ Intervention plan ” means a document developed by a cognitive behaviorist that identifies the treatment goals and interventions for the individual and team; (30) “ Legal representative ” means a guardian, conservator, or an individual holding a power of attorney appointed to act on the individual’s behalf; (31) “ Level of care ” means the type of facility, as determined by a care manager or designated agent of the department, neededto care for an individual if the individual were not receiving services under the ABI waiver program. The types of facilities include: a nursing facility, ABI NF, CDH, or ICF-IID; (32) “ Medicaid ” or “ Medicaid program ”means medical and health-related servicesadministered by the state of Connecticut Department of Social Services pursuant to Title XIX of the Social SecurityAct; (33) “ Medicaid Provider Enrollment Agreement ” has the same meaning as provided in section 17b-262-523(23) of the Regulations of Connecticut StateAgencies, except that such agreement may include addenda specific to the ABI waiver program; (34) “ Neuropsychological evaluation ” has the same meaning as provided in section 17b-262- 468(17) of the Regulations of Connecticut State Agencies; (35) “ Nursing facility ” or “NF” has the same meaning as provided in 42 CFR 440.40 and 42 CFR 440.155, as amended from time to time; (36) “ Other community-based services ” means servicesprovided by programsadministered by the department that are not part of the ABI waiver program, or services provided by programs administered by other state or local agencies that are necessary to maintain the individual in the community; (37) “ Other medical services ” means services that are normally included in the department’s payments to NFs, ABI NFs, CDHs, and ICF-IIDs, and that the individual requires,in addition to ABI waiver services, to live in the community. Other medical servicesinclude: home health care; nursing services; physical therapy; speech therapy; and occupational therapy; (38) “ Person-centered plan ” means a service plan developed by the person-centered team that meets the requirements of 42 CFR 441.301(c)(1)-(3), inclusive, as amended from time to time; (39) “ Person-centered team” means an interdisciplinary group of people organized to assist the individual to develop and implement a service plan. The planning team consists of a care manager, the individual, the legal representative (if applicable), a cognitive behaviorist, any interested family members, or other relevant participants; (40) “ Provider ” means an agency provider, household employee or self-employed provider who meets the qualifications established by the department to provide home and community-based services under the ABI waiver program, has signed the Medicaid Provider Enrollment Agreement, and is enrolled in the ABI waiver program; (41) “ Qualified neuropsychologist ” means a psychologist who meets the qualifications of section 17b-262-468(16) of the Regulations of Connecticut State Agencies; (42) “ Rehabilitation hospital ” means a facilityperforming rehabilitative outpatient hospital services in accordance with the provisions of 42 CFR 440.20(a). (43) “ Representative ” means a personwho is not a legalrepresentative, and who is actingin support of an individual; (44) “ Self-employed provider ”means a person who does not work for an agency, is not a household employee, and meets the qualifications listed in 17b-260a-8 of the Regulations of Connecticut State Agencies to provide certain services under the ABI waiver program; (45) “ Service plan ” means an individualized written plan developed through person-centered planning that documents the medicaland home and community-based servicesthat are necessary to enable the individual to live in the community instead of an institution. The service plan includes measurable goals, objectives, and documentation of total service costs; (46) “ Supervision or cueing ” means daily support such as monitoring, observing, verbal or gestural prompting, verbalcoaching and gesturalor pictorial cueingthat is requiredin order for the individual to accomplish an ADL. Supervision and cueing must be required on a contemporaneous basis with the performance of the ADL, and does not include a reminder or request to perform an ADL when the individual does not need support beyond such reminder or request in order to accomplish the ADL. (47) “ Total service costs ” means the annualized cost of ABI waiver services, other medical services, and other community-based servicesincluded in an individual’s serviceplan that are required in order for the individual to live in the community instead of an institution; and (48) “ Waiting list ” means a record maintained by the department that includes the names, and dates of completed ABI waiver applications, of all individuals who have submitted completed applications for ABI waiverservices and whoseapplications have been screened and found to be functionally eligible for the program. (NEW) Sec. 17b-260a-4. Not an Entitlement The ABI waiver program is not an entitlement program. Services, waiver slots and access to services under the ABI waiver program may be limited based on available funding and program capacity. (NEW) Sec. 17b-260a-5. Eligibility (a) An applicant may be eligible to receive coverage for the cost of the services specified in section 17b-260a-8 of the Regulations of Connecticut State Agencies, through the department’s ABI waiver program, if: (1) The applicant’s countable income is less than 300% of the benefit amount that would be payable under the federal Supplemental Security Income programto an applicant who lives in the applicant’s own home and has no income or resources; (2) The applicant is otherwise eligible to participate in the department’s Medicaid program, including any applicable asset requirements, under either the working disabledor long-term care eligibility criteria; (3) The applicant meets the programmatic requirements of subsection (c) of this section; and (4) The applicant is not ineligible for coverage under subsections (d) or (e) of this section. (b) The financial requirements for eligibility are as follows: (1) The applicant’s countable income and assets for purposes of eligibility are determined using the same methodologies the department employsin determining the countable incomeand assets of an institutionalized applicantfor Medicaid, including, but not limitedto, the spousal impoverishment rules and spousal post-eligibility rules under section 1924 of the Social Security Act, 42 U.S.C. § 1396r-5, for individuals with a community spouse. (2) Income eligibility determination for ABI waiver services under this section is based solely on the applicant’s countable income and does not involve consideration of the incurredmedical expenses or any other liabilities that may have been incurred by the applicant. (3) Payment for ABI waiver services is reduced by the individual’s applied income, which is calculated by determining the amount of the applicant’s countable income remaining after the deduction of an allowance for the personal needs of the individual equal to 200% of the federal poverty level, as well as any applicable community spouse’s or family allowance, and amounts for incurred medical or remedial care expenses not subject to payment by a thirdparty, as specified in 42 CFR 435.726. (c) The programmatic requirements for eligibility are as follows: An individual shall: (1) Be between the ages of 18 and 64 at the time the application is completed; (2) Have an ABI, as defined in section 17b-260a-3(1) of the Regulations of Connecticut State Agencies; (3) Meet the criteria for one of the level-of-care categories described in subsection 17b-260a-9(d) of the Regulations of Connecticut State Agencies; (4) Have the cognitive abilityto actively participate in the development of the individual’s service plan or, absent such ability, have a legal representative who acts on the individual’s behalf to perform these tasks. Participation includes, but is not limited to, selection, hiring, direction, and termination of providers; (5) Voluntarily choose to live in the community by participating in the ABI waiver program; (6) Wish to utilize ABI waiver services; (7) Develop, in consultation with the person-centered team, a serviceplan that providesassistance that reasonably addresses and mitigates identified risks; (8) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that there are risks inherent in living in the community; that the individual’s safety cannot be guaranteed; and that the individual acceptsfull responsibility if the individual chooses to live in the community, thereby absolving the department from any liability for any and all consequences that may result from this choice; (9) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that the individual is the employer of any household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut StateAgencies, and shallsign a written document accepting full responsibility as the employer of such providers; (10) Maintain eligibility for Medicaid; (11) Need waiverservices, which means that the individual needs a minimumof two waiver services, on at least a monthly basis; (12) Have a total serviceplan cost that does not cause the ABI waiverprogram’s expenditures to exceed total appropriated funding limits for the ABI waiver program; (13) Have a total serviceplan cost that does not exceed the individual cap that appliesto the individual, as set forth in sections 17b-260a-10(a) and (b); and (14) Agree to pay, if applicable, any applied income toward the cost of services renderedunder the waiver, as required under section 17b-260a-11(b). (d) Not with standing subsections (a), (b) and (c) of this section,an individual shallnot be eligible for ABI waiver program services if: (1) The individual: (A) Receives services under any other Medicaid waiver program; (B) Has received and benefited from ABI waiver services, no longer requires the services, no longer meets level-of-care criteria, and can continueto reside in the community without the support of ABI waiver program services; (C) Has a cognitive or behavioral dysfunction due solely to an intellectual disability or chronic mental illness, rather than an ABI, as determined by a licensed medical professional; (D) Requires inpatient care in an acute care hospital, NF,ABI NF, ICF-IID or CDH, or who is otherwise institutionalized for a period of ninety days or more,provided, however, such durational limitation may be extended for an additional thirty days upon submission of documentation from a medical professional indicating that the applicant’s discharge is expected within thirty days; (E) Demonstrates consistent and extreme physical, verbal, or sexual aggression toward others; (F) Demonstrates behaviors that violate the law or are contraryto community integrated living; (G) Is currentlyincarcerated, and not expected to be returnedto the community within ninety days; (H) Lacks mental capacity to participate in the program; (I) Refuses servicesthat are vital to health,welfare, and safety;or (J) Behaves in ways that are detrimental to the individual’s health, welfare, and safety, which includes, but is not limited to: (i) Participating in illegal or criminal activity; (ii) Using, or threatening to use, weapons,chemicals, or firearmsfor the purposeof causing harm or injury to self or others; or (iii) Compromising the safety of caregivers, staff, and others in the home or community. (2) The conditions at the individual’s home or on the grounds of the home are hazardous due to: (A) Illegal or criminal activity; (B) The presenceof animals that are dangerous or not properly secured or maintained; (C) Poor sanitation; or (D) Violations of local or state fire,zoning, or housing that pose a risk to the health, welfare, and safety of the individual or providers; or (3) Persons who either reside in, or have regular access, the individual’s home are: (A) Engaging in illegal or criminal activity; (B) Behaving in a manner that is dangerous or jeopardizes the safety, health,or well-being of the individual, providers, or others; (C) Interfering with the provider’s delivery, or the individual’s receipt,of services or acting in any way that affects a provider’s access to the individual; or (D) Threatening the individual verbally, physically, or sexually; or (4) In the opinion of the department, a service plan that is both cost-effective and reasonably ensures the health, welfare, and safety of the individual cannot be developed or implemented. (e) Individuals who are actively participating program in the ABI waiverprogram and who turn 65 years of age shall be offered the choice of (1) remaining on the ABI waiver program; (2) accessing institutional placement; or (3) transitioning to the Connecticut Home Care Program for Elders. (NEW) Sec. 17b-260a-6. Person-centered planning process (a) The service plan shall be developed based on a person-centered planning model, as described in 42 CFR 441.301(c), as amended from time to time. The individual shall lead planning processaddition to the planningprocess where possible, and in accordance with section 17b-260a-11(a) of the Regulations of Connecticut State Agencies. (b) In additionto being led by the individual receiving services and supportlead planning, the person-centered planning process shall: (1) Include people chosen by the individual, providedthe inclusion of such personsis not otherwise prohibited herein; (2) Provide necessary information and supportto ensure that the individual directs the planning process to the maximum extent possible, and is able to make informed choices and decisions; (3) Be timely and occur at dates, times, and locations of convenience to the individual; (4) Be conducted in a manner that reflects cultural considerations of the individual; provides information in plainlanguage; and is accessible to the individual and persons with limited English proficiency; (5) Include strategies for conflict-resolution or solving disagreements within the process,including clear conflict-of-interest guidelines for all participants; (6) Prohibit providers of waiver servicesfor the individual, or those who have an interest in or are employed by a provider of waiver services for the individual, from providing care management or participating in the development of the person-centered service plan; (7) Offer informedchoices to the individual regarding the types and providers of services and supports that are available; (8) Include a method for the individual to request updates to the plan as needed; and (9) Record the alternative home andcommunity-based settings that the individual considered. (NEW) Sec. 17b-260a-7. Home and community-based setting requirements (a) Prior to an individual accessing any services under the ABI waiver program, the department shall assess each home and community-based settingin the service plan to determine whethersuch setting complies with 42 CFR 441.301(c)(4)-(5), as amended from time to time. (b) If, upon initial assessment of the individual’s service plan, or any time thereafter, the department determines that a settingdoes not comply with 42 CFR 441.301(c)(4)-(5), the department shall inform the individual that the setting does not comply, and inform the individual of alternative settings that complywith these requirements. If the individual elects to remainin, or receive services at, a setting that does not meet these requirements, and the provider has not complied with the department’s corrective action plan for meeting such requirements, the individual shall not remain eligible to receive services under the ABI waiver program. (c) The department shall assess compliance with 42 CFR 441.301(c)(4)-(5) as part of its process for credentialing and re-credentialing providers. (NEW) Sec. 17b-260a-8. Home and community-based services available under the ABI waiver program (a) General principles (1) ABI waiver services shall be furnished under a written service plan that is based on a person- centered planning process,as described in section 17b-260a-6 of the Regulations of Connecticut State Agencies, and subject to approval by the department. (2) Except as set forth in subsection (b) of this section, ABI waiver services may be provided alone or in combination with other services, in accordance with the specificfunctional needs of the individual. (3) The ABI waiver services provided at any given time, in combination with other available medical and community-based services,constitute the individual’s service plan. The need for each specific ABI waiver service shall be documented in the service plan. (4) The ABI waiver services documented in the service plan may be purchased from agency providers, household employees, or self-employed providers that the department’s fiscal intermediary has determined are eligible to participate in the Medicaid program, are enrolled with the department as a provider, and agree to accept Medicaidpayment as paymentin full for services authorized and performed under the program. (5) The department shall not pay for ABI waiver servicesprovided by the individual’s conservator, power of attorney, or a family member of such conservator or power of attorney, or an agency provider owned by the individual’s conservator or power of attorney. (6) The department shall pay only for ABI waiver servicesthat are providedin settings that meet the requirements of 42 CFR 441.301(c)(4), as amended from time to time. (7) Payments for ABI waiverservices shall not exceed the rates, or maximum limits,the department establishes for the provision of such services. (8) The rate paid to service providers does not includepayment for transportation services, unless specified in subsection (b) of this section. (9) The department’s fiscal intermediary, priorto the start of servicesand bi-annually thereafter, shall verify that providers are qualified to provide services. (b) The following services and supplies may be covered under the ABI waiver program: (1) ABI Group Day Habilitation Services, which are services and supports that: lead to the acquisition, improvement, or retention of skills and abilities necessary for an individual to maintain health, wellness, and self-care; preparean individual for work or community participation; or support meaningful socialization and leisure activities. ABI Group Day Habilitation services shall be provided only: (A) By an agency provideror a rehabilitation hospital outpatient department that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; and (B) For a time period that does not exceed eight hours per day. (2) ABI Recovery Assistant I Services, which are services to promote the individual’s strengths and abilities to maintain and foster community living skills, in accordance with therapeutic goals outlined in the individual’s service plan. Services may include improvement of socialization, self- advocacy, and the development of natural supports. Services also include communication and coordination with service providers and others who support the individual. Although not a primary function, a providerperforming ABI RecoveryAssistant I servicesmay provide assistance with ADLs and cueing with respect to medications with support of a medication box. (A) This service shallbe provided only to individuals on ABI Waiver II; and (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (3) ABI Recovery Assistant II Services, which are non-medical and safety monitoring servicesto assist an individual with activities of daily living(both hands-on and cueing) and integration into the community. (A) This serviceshall be providedonly to individuals on ABI WaiverII; (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (4) Adult Day Health Services, which are services provided in a group setting that include a variety of health and social services, including, but not limited to: personal care, health care, recreation, socialization, nursingservices, transportation services, and hot meals and snacksthat meet the individual’s nutritional needs and dietary restrictions. Adult Day Health services shall: (A) Be provided only to individuals on ABI WaiverII; (B) Be providedby an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (C) Be providedone or more days per week, four or more hours per day, on a regularly scheduled basis; and (D) Include transportation to and from theAdult Day Health Center, a meal, and snacks. (5) Care Management Services, which are services provided to assist the individual to implement the service plan and to assure on-going effective coordination, communication, and cooperation among all sources of support and services to the individual. Care management services include, but are not limited to, the following: assistance identifying the individual’s home and community-based service needs; promotion of participation in activities that may increase the individual’s independence, inclusion in the community and life satisfaction; arrangement of daily living supports and services to be delivered to the individual; assistance identifying and accessing entitlements and other possible funding sources; advocacy for the individual when necessary to ensure the receipt of needed services; and referral for crisis intervention services and monitoring, as necessary and appropriate. Care management services shall be provided by a care manager that meets all the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements, and that: (A) Does not provide any other home and community-based services to the individual; and (B) Does not have an interest in, or is not employed by, a provider of home and community-based services for the individual. (6) Chore Services, which are services needed to maintain the individual’s home in a clean, sanitary, and safe condition. Chore services include, but are not limited to, heavy household chores, such as washing floors,windows, and walls,and moving heavyitems of furniture in order to provide safe access and egress. (A) Chore services shall be providedby an agency provider or household employeewho meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Chore services shall not be covered if: (i) The individual or anyone else living in the household is capable of performing or paying for the services; (ii) A relative, caretaker, community agencyor other entityis capable of, or responsible for, providing the services; or (iii) In the case of rental properties, condominiums, or co-ops,a specific choreservice is the responsibility of the landlord or the landlord’s designee, as evidenced in the lease or any other agreement. (7) Cognitive-Behavioral Services, which are individual interventions designed to increase an individual’s cognitive and behavioral capabilities and to further the individual’s adjustment to successful community engagement. These services include, but are not limited to: comprehensive assessment of cognitive strengths and liabilities, quality of adjustment, and behavioral functioning; development and implementation of cognitive and behavioral strategies; development of a structured cognitive-behavioral intervention plan; ongoing or periodic consultation with the individual and the person-centered planning team concerning cognitive and behavioral strategies and interventions specified in the cognitive-behavioral intervention plan; ongoing or periodic assistance with training of the individual and person-centered planning team concerning cognitive and behavioral strategies and interventions; and periodic reassessment and revision, as needed, of the cognitive-behavioral intervention plan. (A) Cognitive-behavioral services may be provided in the individual’s home or in the community, and shall be performed by an agency provider or a self-employed provider who is a licensed psychologist, physical therapist, speech therapist, or occupational therapist, a qualified neuropsychologist, or another type of provider authorized to perform cognitive-behavioral services under the ABI waiver program,and who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Intervention plans shall be updated at least annually,or more frequently as clinically indicated. Intervention plans shall include the following components: (i) Long-term, measurable goals mutually agreed upon by the individual, or the individual’s legal representative, and the provider; (ii) Shorter-term, measurable objectives to reach those goals; (iii) The individual’s strengths and challenges, and a description of how strengths are to be used in achieving goals; (iv) Skills or tasks that need to be developed by the individual or the family; (v) Input by the individual into the intervention plan commensurate with the levelat which the individual is able to participate; and (vi) A description of how positive reinforcement, rather than punitive measures, will be used to support the individual. (C) Providers of cognitive-behavioral services shall be paid for face-to-face encounters and also for non-face-to-face encounters. (i) Face-to-face (in-person) encounters are in-personmeetings with the individual, and meetings with the individual’s family, supporters, or providers, even when the individual is not present. The provider must have an in-person meeting with the individual at least quarterly. (ii) Non-face-to-face (not in-person) encounters are telephonic or other secure electronic forms of communication, including videotelephony services such as Skype. A provider may also be paid at the non-face-to-face rate for activities such as reviewing the individual’s record and writing the plan of care, even if the individual is not present. (8) Community Living Support Services, which are support services that provide supervised living in the individual’s residence for up to 24 hours per day, including overnight supervision, to a minimum of two, or a maximum of three, individuals at once who require supportand supervision, in a supervised community residential setting for either a half-day (12 hours) or full day (24 hours). (A) Community living support servicesinclude, but are not limitedto, supervision and assistance with the following skills: (i) Self-care; (ii) Medication management; (iii) Interpersonal communication; (iv) Socialization; (v) Sensory and motor skills; (vi) Mobility; (vii) Utilizing transportation services; (viii) Problem-solving; (ix) Money management; and (x) Household management. (B) Assessment and training servicesare provided as part of this service. (C) Room and board is not included as part of this service. (D) The providershall develop a plan that demonstrates the provider’s abilityto work with the individual and to provideservices that are consistent with the therapeutic goals of the individual’s service plan. (E) Upon the individual’s request or improvement in the individual’s ability to live more independently, the providerand the care manager shallwork together, with the individual, to develop and implement a plan to transition the individual to greater independence in the community. (F) Community living support services shall be provided by anagency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (9) Companion Services, which are nonmedical services that are provided in accordance with a therapeutic goal includedin the service plan, includingthe following: supervision and socialization services; assistance with or supervision of meal preparation; assistance with laundry that is being performed by the individual; and light housekeeping tasks that are incidental to the care of the individual. (A) Companion services shall be provided by an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Companion servicesshall not entailthe provision of hands-on care or household management tasks, as these tasks are provided by personal care assistants and chore services providers, respectively, in accordance with subdivisions (6) and (15) of this subsection. (10) Consultation Services, which are services provided to assist a team and individuals to address service-implementation issues that have presented a barrier to resolution. This service aids in the development of individual interventions designed to decrease an individual’s severe maladaptive behaviors, which jeopardize the individual’s ability to remain integrated in the community. (A) Consultation services shall be provided: (i) Only to individuals on ABI Waiver II; (ii) In a team meeting at the individual’s home or community location; and (iii) By an agency or self-employed provider who is a licensed psychologist, clinical social worker, speech pathologist, speech therapist, occupational therapist, physical therapist, registered nurse, or dietician/nutritionist, a qualified neuropsychologist, or a certifiedrehabilitation counselor or substance abuse specialist, and who meet the requirements of subsection (a) of this section and all applicable training, state licensure, or certification requirements. (11) Environmental Accessibility Adaptation (“EAA”) Services,which are physicalchanges made to an individual’s home that are necessary to ensure the health, welfare, and safety of the individual, or enhance and promote greater independence, without which the individual would require institutionalization. (A) EAA services include,but are not limited to, the following: (i) Installation of ramps; (ii) Widening of doorways; (iii) Modifications to meet egressrequirements; (iv) Modification of bathroom facilities; and (v) Addition of specialized electrical and plumbing devices. (B) All EAA services shall be providedby agency providers or private contractors or businesses in accordance with applicable state and local building codes. (C) EAA services do not include: carpeting; central air conditioning; roof repair; house adaptations that add to the squarefootage of the home; or any otherphysical improvement to the home not of direct benefit to the individual’s health, welfare, and safety, or ability to live independently. (D) EAA servicesshall not be provided to adapt units that are owned or leased by providers of waiver services. (12) Homemaker Services, which are generalhousehold activities, includingmeal preparation and routine household chores. (A) The department shall pay for homemaker serviceswhen the personregularly responsible for homemaking activities is temporarily absent or unable to manage the home and care for the individual or others in the home, or when the individual is unable to learn such skills. (B) Homemaker services shall be provided by an agency provider or a household employee that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements.Homemaker services shall not be provided by a member of the individual’s family, the individual’s conservator, or a member of the conservator’s family. (13) Home-Delivered Meals, which is the preparation and delivery of one or two meals per day to an individual who is unable to prepare or obtain nourishing meals on the individual’s own, or for an individual who normallyhas someone who is responsible for preparing and delivering meals,but that person is temporarily absent or unable to perform this service. (14) Independent Living Skills Training (“ ILST ”), which is a training service designed for, and delivered to, an individual to improve that individual’s abilityto live independently in the community and to carry out strategies developed in cognitive/behavioral programs. (A) ILST may include, but is not limited to, teaching the individual the following skills: (i) Self-care; (ii) Medication management; (iii) Task completion; (iv) Interpersonal communication skills; (v) Socialization skills; (vi) Sensory/motor skills; (vii) Mobility and community transportation skills; (viii) Problem solving skills; (ix) Money management skills; and (x) Household management skills. (B) ILST shall be providedby an agency provider or household employeethat meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (15) Personal Care Assistant services, which are services that provide the individual with assistance with the following: eating, bathing, dressing, personal hygiene, and other activities of daily living that are performed by a provider in the individual’s home or community; or supervision and cueing of theseactivities without actualhands-on assistance. Personalcare assistant servicesshall be provided only: (A) If the individual’s physicalability to performactivities of daily living is impaired, or if the individual’s cognitive or behavioral impairments interfere with the individual’s ability to perform these tasks; (B) To individuals on ABI WaiverII; and (C) By an agency that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (16) Personal Emergency Response System (“PERS”),which is an electronic device connected to an individual’s telephone that enables an individual at high risk of institutionalization to secure help in an emergency. (A) A PERS is available only to an individual who: (i) Lives alone; (ii) Is alone for significant parts of the day and who does not have providers; or (iii) Would otherwiserequire extensive routinesupervision. (B) A PERS shall be provided by an agencyprovider that sells and installsPERS equipment. (17) Prevocational Services, which are time-limited services that provide learning and work experience, including volunteerwork, where the individual can develop generalnon-job-task-specific strengths and skillsthat contribute to employability in paid employment in an integrated work setting. Services are intended to develop and teach general skills, such as the ability to: communicate effectively with supervisors, co-workers, and customers; comply with generally accepted community workplace conduct and dress; follow directions; attend to tasks; develop strategies to solve problems at the workplace; and comply with general workplace safety and mobility training. Prevocational services are designed to be a pre-cursor to integrated employment. (A) The following time limits shall apply to prevocational services: (i) For individuals enrolled in ABI Waiver I, effective December1, 2015, a two-year time limit for thisservice shall be applied prospectively. This two-year limit may be extended up to a maximum of four years upon a determination by the department that additional time is needed for an individual to achieve the person-centered goal of attaining supported employment. Annual redeterminations of eligibility for such services shall be made after an initial two years of such services. (ii) For individuals enrolled in ABI Waiver II, this serviceis limited to two years.Upon strong justification of progress towardemployment goals, the department may authorize the service for a maximum total of three years. (iii) This serviceis limited to 40 hours per week. (B) Services shall be providedin the individual’s home or in an integrated work setting, based on the individual’s needs and preferences. (C) The individual shall have employment-related goals in theperson-centered service plan; (D) Prevocational services shall be provided by an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (18) Respite Care Services, whichare services providedto individuals who are unableto care for themselves, and when the person normally performing such services is absent or in need of relief. (A) Services shall be furnished on a short-term basis in the individual’s home. (B) Services shall be providedby an agency or household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (19) Specialized Medical Equipment and Supplies, which include devices, controls, or appliances that enable an individual to increase the individual’s ability to perform ADLs, or to cognitively perceive, control, or communicate in the individual’s environment within the community; items necessary for life supportand those ancillary supplies and equipment that are necessary for the proper functioning of such items; and durable and non-durable medical equipment that is not available as a covered medical service under the Medicaid state plan. (A) Specialized medical equipment and supplies paid for under the ABI waiver program shall be of direct medical or remedial benefit to the individual; meet all applicable standards of manufacture, design and installation; and be in addition to any medicalequipment and suppliesfurnished under the Medicaid state plan. (B) Specialized medicalequipment and suppliesshall be providedby a medical equipment vendor, durable medical equipment provider, or pharmacy that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (20) Substance Abuse Program Services, which are individually designed interventions to reduce or eliminate the individual’s use or abuseof alcohol or drugs when such use or abuseinterferes with the individual’s ability to remain in the community. (A) Substance abuse program services shall include, but are not limited to, the following services: (i) Performing an in-depth assessment of the relationship between the individual’s use or abuse of alcohol or drugs and the individual’s brain injury; (ii) Performing a learning and behavioral assessment; (iii) Developing and implementing a structured treatment plan; (iv) Providing ongoingeducation and trainingof the individual, family members,and other service providers concerning support needs of the individual; (v) Developing individualized strategies to avoid relapse; (vi) Conducting periodic reassessment of the treatment plan; and (vii) Providing ongoing support to the individual. (B) Substance abuseprogram services shall be providedon an outpatient basis in a congregate setting or the individual’s community. (C) Substance abuseprogram services shall be providedby either agencyproviders (i.e, substance abuse diagnostic and treatment centers, or rehabilitation hospitals) or individual providers (i.e., self- employed providers, licensed psychologists, or certified drug and alcohol counselors) that meet the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (D) The individual’s structured treatment plan may include both group and individual interventions and shall reflect the use of curricula and materials adoptedfrom substance abuse programs designed to meet the needs of individuals with cognitive impairment. (E) The individual’s treatment plan shallinclude linkages to existing community-based, self-help or support groups, such as Alcoholics Anonymous and organizations that promote and support sobriety. (F) With the individual’s consent,the substance abuse program providershall communicate with the individual’s other service providers concerning the individual’s treatment regimens. (21) Supported Employment services, which are services provided to individuals who, because of their disabilities, need intensive on-going support to perform in a work setting. The intended outcome of this serviceis sustained paid employment or self-employment in the generalworkforce in a job that: (1) meets the individual’s personal and career goals; (2) pays a wage level at or above the minimum wage; and (3) pays at a wage and benefit levelthat is not less than the customary wage and benefit level paid by an employer for the same or similar work performed by individuals without disabilities. (A) Supported employment services may be conducted in a variety of settings, including work sites where persons without disabilities are employed. When supported employment services are provided in such integrated work settings, paymentsshall be made only for adaptations, supervision and training needed by the individual, and shall not include payment for any modifications or activities rendered or required within the normal business setting. (B) Supported employment services shall not otherwise be available under a programfunded under the Rehabilitation Act of 1973, 20 USC 1401 et seq., or Education forAll Handicapped Children Act, Pub. L. No. 94- 142. (C) Transportation betweenthe individual’s residence and supported employment site is required as a supported employment service, and is included in the rate paid to the provider. (D) Supportive employment services shall be provided by agency providers that meet the requirements of subsection (a) of this section, and all applicable training and statelicensure, or certification requirements. (22) Transitional Living Services, which are short-term, individualized, residential services providing support to an individual transitioning into a community livingsituation. These services and supports are designed to improve the individual’s skills and ability to live in the community. (A) Transitional living services: (i) Are availableonly to individuals on ABI Waiver I; (ii) Shall be provided for only one transitional period; (iii) May be provided up to 24 hours per day; (iv) Shall be provided only when the individual is unable to be supported in a permanent residence and is in need of intensive clinical interventions provided by this service; and (v) Shall be provided by an agency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Prior to discharge from transitional living services, the provider shall work with the individual and the care manager to develop a plan of care. Upon discharge, other ABI services shall become available to the individual in accordance with the plan of care. (C) ABI waiverfunds shall not be used to pay for the room and board component of transitional living services. (D) Transitional living services shall not be provided with any ABI services other than care management, environmental modifications, specialized medical equipment and vehicle modifications. (23) Transportation Services, which are services offered in accordance with the individual’s service plan to allow the individual to access servicesthat do not qualify for non-emergency medical transportation under 42 CFR §440.170(a). (A) Transportation services shall not be provided when public transportation is available or when friends, family, neighbors, or community agencies are able to provide transportation free of charge. (B) All reasonable alternatives shall be explored and exhausted priorto receiving approvalfor transportation services. (C) Transportation servicesshall be providedby a livery service or individual providerlicensed by the State of Connecticut, with a valid Connecticut driver’s license and evidence of automobile insurance. (24) Vehicle modification services, which are alterationsto a vehicle when such alterations are necessary to improve the individual’s independence and inclusion in the community, and to enable the individual to avoid institutionalization. (A) The vehicle shall be the individual’s primarymeans of transportation. (B) The vehicleshall be ownedby the individual, a relativewith whom the individual lives or has consistent and ongoing contact, or a non-relative who provides primary long-term support to the individual and is not a paid provider of such services. (C) All modifications and adaptations shall be providedin accordance with applicable federaland state vehicle codes. (D) Vehicle modification services do not include: adaptations or improvements to a vehicle that are of general utility and not of direct medicalor remedial benefitto the individual; payments for the purchase or lease of a vehicle; or regularly scheduled upkeep and maintenance of a vehicle, except for upkeep and maintenance of the modifications. (E) The total individual cost limit for vehicle modifications is $10,000.00. (F) Vehicle modification services shall be provided by a providerapproved by the State of Connecticut as a vehicle modification vendor. (NEW) Sec. 17b-260a-9. Pre-screen, waiting list and assessment (a) The department shall review completedapplications that it receives in the orderin which they are received. Acceptance to the ABI waiver program shall be on a first-come, first-served basis, except that individuals transitioning from the Money Follows the Person program or Department of Mental Health and Addiction Services Acquired Brain Injury Services to the ABI waiver program shall have priority for reserved spaces. (b) The department shall conduct a pre-screen of the applicant following the receipt of the application, and prior to placing the applicant’s name on the waiting list, to determine whether the applicant (1) meets the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut State Agencies, and (2) requires one of the level-of-care categories described in subsection (d) of this section. (c) Applications shall be pre-screened based upon the information contained in the completed application, as well as information obtained from: the individual; a neuropsychological examination report prepared by a qualified neuropsychologist; and any other clinical personnel who are familiar with the individual’s case and history.In order to be considered, the neuropsychological examination report must have been completed no more than two years prior to the application date, provided, however, that the department retains the discretion to increase this time limitation on a case-by-case basis. The neuropsychological examination report shall be submitted to the department no later than six months followingthe application date,except that the department may extend this deadline for an additional 90 days if a neuropsychological examination appointment has been scheduled. Failure by the individual to meet this deadline shall result in the denial of the application. (d) To qualifyfor services under the ABI waiver program,the individual shall meet one of the following institutional level-of-care categories: (1) Category I (NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a NF. The individual is considered to require care in a NF if the individual residesin such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, including, but not limited to, eating, bathing, dressing, toileting, and transferring; (2) Category II (ABI NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in an ABI NF. The individual is considered to require care in an ABI NF if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facilitybut has impaired cognition, impairedbehavior requiring daily supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, and a mental illness that manifested itself before the brain injury occurred; (3) Category III (ICF-IID level of care): If the individual were not receiving services under the ABI waiver program,the individual wouldrequire care in an ICF-IID.The individual is considered to require care in an ICF-IID if the individual resides in such a facility and the department or its agent determines that the individual currently requires such levelof care, or if the individual does not reside in such a facility but has impaired cognition, an ABI that occurred before the age of 22 and, due to physical deficits, requires physical assistance with two or more ADLs; or (4) Category IV (CDH level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a CDH. The individual is considered to require care in a CDH if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and impaired or abnormal behavior, and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b- 260a-3(46) of the Regulations of Connecticut StateAgencies, with two or more ADLs. For purposes of this category, “impaired or abnormal behavior” means that one or more behaviors is consistently severely impaired or abnormal, and requires the availability of intensive and ongoing behavior intervention to the extent that the individual would require care in a CDH if the individual were not receiving services under the ABI waiver program. Behaviors that may meet this definition include: engaging in inappropriate sexual activity; causing injury to others or self, or damage to property; demonstrating physical or verbal aggression; demonstrating a consistent ongoing pattern of wandering or elopement; engaging in socially offensive behavior; demonstrating withdrawal, susceptibility to victimization, impulsivity, intrusiveness, agitation or pica; or engaging in criminal activity after the brain injury occurred. (e) The applicant shall be placed on the waiting list if the applicant is determined by the department, based on the information provided during the pre-screening, including the neuropsychological examination report, to meet the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut StateAgencies and the applicant requires one of the levels of care described in subsection (d) of this section. (f) The department shall notify the applicant in writing when, based on the applicant’s waitlist position, an opening is reasonably expected to become available to the applicant within 90 days. Once notified, a care managershall meet with the individual, complete a comprehensive assessment of the individual’s needs, including the level of care, and develop a proposed service plan. A care manager and the individual, in conjunction with the person-centered team, shall then develop, if feasible, a cost-effective service plan as determined pursuant to section 17b-260a-10(d). Services shall not be authorized until the department determines that the individual’s Medicaid coverage is active. (g) The department shall re-evaluate the level of care for each individual at least annually. (NEW) Sec. 17b-260a-10. Development of the service plan and evaluating cost-effectiveness (a) Applicants enrolledin ABI Waiver I shall have a total individual service plan cost limit no greater than 200% of the annualized alternative institutional care cost. (b) Applicants enrolledin ABI Waiver II shall have a total individual service plan cost limit no greater than 150% of the annualized alternative institutional care cost. (c) The department shall not approvea total individual service plan that exceeds the individual service plan cost caps or funding limitations established in the approved waiver. (d) To determine the cost-effectiveness of the individual’s service plan, the department shall: (1) Obtain the annualized alternative institutionalized care costs for the individual. For each level of care listed in subsection (d) of section 17a-260a-9 of the Regulations of Connecticut State Agencies, the annualized alternative institutional care cost is equal to the state’s weighted average cost for the specified facilitytype, as annuallydeveloped and published by the department, minus the average applied income; (2) Determine the individual’s total service cost by aggregating each of the following costs: (A) The annualized cost of each covered servicethat will be provided to the individual, based on the department’s established rates for such services; (B) The annualized cost of the ABI waiver home and community-based services, as described in section 17b- 260a-8 of the Regulations of Connecticut StateAgencies, to be provided to the individual under the proposed service plan; (C) The annualized cost of any other medical services covered by Medicaid, as described in section 17b- 260a- 3(37) of the Regulations of Connecticut StateAgencies, provided in the individual’s home that the individual may require in order to live in the community, to be calculated by multiplying the expected frequency of utilization of these services by the Medicaid rates established by the department for such services; and (D) The annualized cost of any other community-based services, as describedin section 17b-260a- 3(36) of the Regulations of Connecticut State Agencies, that the individual may require in order to live in the community; and (3) Compare the individual’s total service cost to the applicable individual limit set in subsections (a) and (b) of this section to determine if the total service cost exceeds the applicable individual limit. (e) To promote cost neutrality in accordance with 42 USC1396n (b), every reasonable effort shall be made to provide services below the maximum dollar amount level, and in the most cost-effective manner possible. The department shallnot exceed the funding limitations established in the approved waiver when determining whether an individual can be accepted into the program. (NEW) Sec. 17b-260a-11. Responsibilities of the individual (a) Person-Centered Planning and Selecting Providers (1) To the extent feasible, the individual shall lead the person-centered planning process. If the individual has a legal representative, the legal representative may participate in the planning process, making decisions for the individual, as necessary to ensure the best interests of the individual. The department may seek assistance from a court of probate if: (A) The department determines that the legal representative is not acting in the best interests of the individual and is hindering the person-centered planning process; or (B) There is a conflict between the individual and the legal representative. (2) The individual or the individual’s legal representative, or both, shall: (A) Choose the team to participate in the person-centered planning process; (B) Collaborate with the person-centered team; (C) Select, from a list of providers, the providers who will deliver the services specified in the service plan; (D) Supervise the services that are provided to the individual in accordance with the service plan; (E) Notify the department if a provider is not performing satisfactorily; (F) Terminate the employment of a household employee or the services of a self-employed provider, as necessary; and (G) Select new providers, as necessary. (b) Financial Responsibilities (1) An individual whose gross income exceeds shall be 200% of the federal poverty level shallbe required to contribute toward the cost of services rendered under the waiver. The amount contributed shall be calculated according to section 5035 of the Uniform Policy Manual, or any other applicable law or policy of the department. (2) The individual shall agree to pay directly to the department’s fiscal intermediary the portion of income calculated to be contributed to the individual’s cost of care. This agreement shall be documented in the individual’s service plan. (c) Responsibilities of the Individual as the Employer of Household Employees An individual who is the employer of household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut State Agencies, shall be responsible for: (1) Compliance with all applicable state and federal requirements, including, but not limited to, those related to workers’ compensation, unemployment compensation, minimum wage rates, and income tax withholding; and (2) Hiring and termination of the employment of household employees, as necessary. (d) Critical Incident Reporting (1) The individual, or the individual’s legal representative, shall comply with the department’s critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-12. Department responsibilities " CT DSS " The department or its agent shall: (a) Inform eligible individuals that they have the choice whether to community-based reprogram by community-based services through the ABI waiver program, or to receive institutional care; (b) Establish eligibility for the ABI waiver programby performing an assessment of the individual’s needs; (c) Coordinate the development of a service plan designed to deinstitutionalize or divert the individual from institutional placement; (d) Assist with implementation of an approved service plan by coordinating services provided to the individual; (e) Review with the individual, on a regular basis, the effectiveness of the service plan and make appropriate and cost-effective revisions to the plan, as required, based on achievement of the expected outcomes, the individual’s degree of satisfaction with the services and providers, the individual’s changing capabilities, and the ongoing availability of home and community-based services; (f) Review and reassess, at least every 12 months, and whenever there is a significant change in the individual’s ability to function in the community, the individual’s service plan and level of care; (g) Lead team meetings in conjunction with the individual; (h) Maintain records for at least 7 years. (i) Advise the individual of the individual’s right to an administrative hearing in accordance with sections 17b-60 and 17b-61of the Connecticut General Statutes if the individual is aggrieved by the department’s decision with respect to the individual’s application or eligibility for the ABI waiver program, or if services are reduced, denied or terminated; (j) Maintain a waiting list of individuals who have applied for and been pre-screened for ABI services; (k) Establish provider qualifications and, through maintain its fiscal intermediary, establish and maintain a directory of providers; (l) Establish payment rates for all services offer under or delivered the ABI waiver program; (m) Pay for approved ABI waiver services health or delivered by providers on behalf of the individual; and (n) Maintain, and comply with, a critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s healthor welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-13. Provider Responsibilities (a) All providers shall: (1) Comply with any critical incident reporting protocols developed by the department for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (2) Report their arrest, or any arrest of an employee, to the department within 10 business days. The failure of a provider to report any such arrest may result in termination of the provider from the ABI waiver program. (3) Complete a state and federal criminal background check, at the expense of the applicant or provider. (4) Accept payment only for services that were actually provided to the individual and that do not violate the rules, regulations, standards, or laws governing the Medicaid program in accordance with sections 17-83k-1 to 17-83k-7, inclusive, of the Regulations of Connecticut State Agencies. A provider may be suspended or terminated from participation in the program for accepting payment for services not provided or for violating the rules, regulations, standards, or laws governing the program. (b) Agencies that employ providers shall: (1) Ensure that all staff, volunteers, interns or other persons employed by, supervised by, or representing the agency who may have direct contact with individuals receiving ABI waiver funding, meet and maintain all criminal background standards and requirements as set forth in subsection (a)(3) of this section. (2) Have policies in place regarding the provision of language services to individuals while receiving ABI waiver services, and shall not rely on the assistance of individuals’ friends, family or others. (3) Deliver training to staff members regarding the provision of services that are person-centered and culturally competent. (4) Have policies and procedures in place regarding employee standards of conduct. Such policies and procedures shall include, but are not limited to, the following topics: (A) The need for providing person-centered services; (B) The importance of respecting individuals’ rights, including privacy and self-determination; (C) The prohibition against neglect, abuse, and harassment of individuals; (D) The prohibition of the use of drugs or alcohol, or of being under the influence of drugs or alcohol, while providing services to individuals; (E) The laws covering confidentiality of all participant information collected, used or maintained; and (F) Critical incident reporting requirements. (5) Establish a quality assurance plan. Such plan is subject to the approval by the department and shall include random checks of staff performance. (NEW) Sec. 17b-260a-14. Provider participation (a) It shallbe a certification requirement of the department for all servicespecialties that, in order to participate in the ABI waiver program and receive payment from the department, all providers: (1) Enroll with the department as a provider in the Medicaid program and sign the Medicaid Provider Enrollment Agreement, as directed by the department, which agreement may include addenda specific to the ABI waiver program and may be amended from time to time; (2) Comply with all applicable state and federal statutes and regulations, including, but not limited to, sections 17b-262-522 et seq. of the Regulations of Connecticut State Agencies, the Medicaid Provider Enrollment Agreement and any applicable addenda, and all departmental policies, as amended from time to time (3) Comply with all of the provisions and requirements of applicable Medicaid waivers, as amended from time to time; (4) Deliver, document, and bill only for those services that are outlined in the individual’s service plan; and (5) Comply with the requirements of any corrective action plan imposed by the department. (b) The commissioner shall have the discretion to refuse to list a provider in the provider directory, remove the provider’s name from the provider directory, or refuse payments to a provider, if the provider performing the services poses a threat to the health or safety of individuals participating in the ABI waiver program, or has been convicted in this state or any other state of a felony, as defined in section 53a-25 of the Connecticut General Statutes, involving: forgery under sections 53a-137 of the Connecticut General Statutes; robbery undersection 53a-133 of the Connecticut General Statutes; larceny under sections, 53a-119, 53a-122, 53a-123, and 53a-124 of the Connecticut General Statutes; sexual assault under sections 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a, 53a-72b, 53a-73a of the Connecticut General Statutes; or assault under sections 53a-59, 53a-59a, 53a-60, 53a-60a, 53a-60b, and 53a-60c of the Connecticut General Statutes; or has been convicted in this state or any other state of an offense, as defined in section 53a-24 of the Connecticut General Statutes, involving: cruelty to persons under section 53-20 of the Connecticut General Statutes; vendor fraud under sections 53a- 290 to 53a-296, inclusive, of the Connecticut General Statutes; or the abuse of an elderly, blind or disabled person, or a person with intellectual disability under sections 53a-320 to 53a-323, inclusive, of the Connecticut General Statutes. (NEW) Sec. 17b-260a-15. Corrective action and provider cooperation (a) If a provider fails to comply with sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or MedicaidProvider Enrollment Agreement, the department may require the provider to comply with a corrective action plan. (b) The provider shall cooperate fully with any department, state, or federal audit or investigation, and shall correct any deficiencies identified in the course of such audit or investigation. (NEW) Sec. 17b-260a-16. Provider fiscal responsibility (a) For purposes of this section: (1) “Fraud” means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to that person or some other person. It includes any act that constitutes fraud under applicable federal or state law. (2) “Abuse” means practices that are inconsistent with generally acceptedfiscal or business practices and result in unnecessary cost to the ABI waiver program. (b) The provider shall not engage in or commit fraud or abuse, including, but not limited to: (1) Billing for services not rendered; (2) Billing for services not in the service plan; (3) Billing for services not medically necessary; (4) Falsely identifying the person who actually performed a service, including billing for services performed by an individual who is not credentialed; (5) Failing to adequately document all servicesthat are billed; (6) Billing for services for ABI participants services that who are institutionalized at the time in which the service has been billed as having been rendered; or (7) Violating Medicaid policies, procedures, rules, regulations, or statutes. (NEW) Sec. 17b-260a-17. Client documentation and provider reporting (a) Providers shall retain records to document services submitted for Medicaid reimbursement for at least seven years from the date the service or item was provided. Documentation shall include the following: (1) Provider’s name and signature; (2) Dates of service; (3) Start time for each visit; (4) End time for each visit; (5) A description of duties performed or items provided; (6) Client goals and documentation of progress toward meeting those goals; and (7) Unless otherwise described in the provider’s applicable Medicaid Provider Enrollment Agreement and any addenda thereto,the individual’s name and the signature of the individual or the individual’s legal representative. (b) Upon written request presented to the provider, the department or its authorized agent shall be given immediate access to, and permitted to review and copy, any and all records and documentation used to support claims billed to Medicaid. For purposes of this subsection, “immediate access” means access to records at the time the written request is presented to the provider. (c) The provider shall submit written reports on the individual’s status and progress for each of the first three months of the individual’s participation in the program, and quarterly thereafter, to the care manager in a manner that is set forth by the department. (NEW) Sec. 17b-260a-18. Provider termination, suspension or disqualification (a) Failure to comply with any requirements in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or Medicaid Provider Enrollment Agreement, may result in the nonpayment of services, suspension or termination from participation in the ABI waiver program, or any other sanction available under state or federal law. (b) The department may suspend or terminate the provider from participation in the ABI waiver program immediately and withoutprior notice if it has reason to believe that a providerposes a threat to, or has acted in a manner that posed a threat to, the health, safety or welfare of an individual participating in the ABI waiver program, or has engaged in fraudulent or abusive program practices.

"These programs are funded by the Federal Medicaid Program and are available to residents of Connecticut and other states. The Connecticut Department of Social Services is responsible for overseeing and ensuring the quality of the services provided for the CT programs." Connecticut Regulations of CT DSS Department of Social Services Concerning The Acquired Brain Injury Waiver Programs 1 and 2 The Regulations of Connecticut State Agencies are amendedby adding sections17b-260a-1 to 17b- 260a-18, inclusive, as follows: (NEW) Sec. 17b-260a-1. Purpose The Acquired Brain Injury (ABI) waiver program is established pursuant to sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes and 42 USC 1396n(c). The ABI waiverprogram provides, within the limitations described in sections 17b-260a-2 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, a range of nonmedical, home and community-based services to individuals 18 years of age or older with an ABI who, without such services, would otherwise require placement in a hospital, nursing facility (NF), or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The intention of the ABI waiver program is to enable such individuals, through person-centered planning, to receive home and community-based services necessary to allow such individuals to live in the community and avoid institutionalization. (NEW) Sec. 17b-260a-2. Scope Sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut StateAgencies set forth the requirements for eligibility and payment of services to eligible individuals participating in the ABI waiver program. These regulations also describe program requirements; services available; service requirements; department, provider and individual responsibilities; residential setting requirements; and limitations under the ABI waiver program. (NEW) Sec. 17b-260a-3. Definitions As used in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies: (1) “ Acquired brain injury ” or “ABI” means the combination of focal and diffuse central nervous system dysfunctions, immediate or delayed, at the brainstem level or above.These dysfunctions may be acquired through physical trauma, oxygen deprivation, infection, or a discrete incident that is toxic, surgical, or vascular in nature. The term “ABI” does not include disorders that are congenital, developmental, degenerative, associated with aging, or that meet the definition of intellectual disability as defined in section 1-1g of the Connecticut General Statutes; (2) “ Acquired braininjury nursing facility ” or “ABI NF” means a type of nursing facilitythat provides specialized programs for persons with an acquired brain injury; (3) “ Acquired Brain Injury waiver program ” or “ABI waiver program” or “the program” means the programsadministered by the Department of Social Servicesand established pursuantto sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes, as described in Medicaid waivers approved by the Secretary of the United States Department of Health and Human Services pursuant to 42 USC 1396n as amended from time to time, for the provision of home and community-based services to individuals with acquired brain injury; (4) “ ABI Waiver I ” " ABI Waiver Program One 1 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(a) of the Connecticut General Statutes and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of January 1, 1999; (5) “ ABI Waiver II ” " ABI Waiver Program Two 2 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(b) of the Connecticut General Statutes, and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of December 1, 2014; (6) “ Acquired Brain Injury waiver services ” or “ABI waiver services” means all or some of the services provided to individuals in the ABI waiver program; (7) “ Activity of daily living ”or “ADL” means an activity or task that is essential to an individual’s health, welfare, and safety, including, but not limited to, bathing, dressing, eating, transfers, and bowel and bladder care; (8) “ Agency provider ” means a provider employed by an agency, who provides ABI waiver services to individuals participating in the ABI waiver program; (9) “ Alternative institutional care costs ” means the costs of institutional care that the individual would otherwise incur, but for the support of waiver services; (10) “ Applicant ” means an individual who, directly or through a representative, completes an ABI waiver program application form and submits it to the department; (11) “ Applied income ” means the portion of the individual’s income that remains after all deductions and disregards are subtracted and that may be appliedto the cost of waiverservices; (12) “ Assessment ” means a comprehensive, multidimensional written evaluation conducted by nonmedical department personnel or agents, using a standard assessment form that is used to determine whether an individual meets the level-of-care criteria to participate in the ABI waiver program; (13) “ Chronic disease hospital " or “CDH” means a long-term hospitalhaving facilities, medical staff, and necessary personnel for the diagnosis, care, and treatment of a wide range of chronic diseases; (14) “ Commissioner ” means the Commissioner of Social Services; (15) “ Cost-effective ” or “ cost-effectiveness ” means the department’s determination that payments for the individual’s total service costs do not exceed either the individual caps or available funding for the ABI waiver program; (16) “ Countable income ” means all sources of income not excluded under the Medicaid program; (17) “ Department ” or “ DSS ” means the stateof Connecticut Department of Social Services or its agent; (18) “ Family member ”means a person who is related to the individual by blood, adoption, or marriage; (19) “ Fiscal intermediary ” means an agent or agents under contract with the department that is responsible for: paying providers for services delivered; registering providers; providingtraining and outreach to individuals and providers of services under the ABI waiver program; and performing other administrative functions requested by the department; (20) “ Hands-on care ” means assistance with ADLs provided most often, but not exclusively, by home health aides. Hands-oncare includes the prompting and cueing necessary for an individual to perform ADLs; (21) “ Home and community-based services ” means Medicaid servicesprovided to an individual in that individual’s own home or other community-based setting; (22) “ Home and community-based setting ” has the same meaning as provided in 42 CFR 441.301(c)(4)-(5), as amended from time to time; (23) “ Hospital ” has the samemeaning as provided in 42 CFR 440.10, as amended from time to time; (24) “ Household employee ” means a provider who performs ABI recovery assistant I, ABI recovery assistant II, chore, companion, homemaker, independent livingskills training, or respite services, and who is employed by the individual and not an agency; (25) “ Individual ” means a person with an acquired brain injury who is applying for, or actively participating in, the ABI waiver program; (26) “ Individual cap ” meansthe maximum allowabletotal cost of the individual’s service plan; (27) “ Integrated work setting ” means a work setting wherepeople with disabilities work alongside people without disabilities, for at least minimum wage. (28) “ Intermediate care facility for individuals with intellectual disabilities ” or “ICF-IID” has the same meaning as provided in 42 CFR 440.150, as amended from time to time, and is a facility licensed by the Connecticut Department of Developmental Services for the care and treatment of persons with intellectual disabilities; (29) “ Intervention plan ” means a document developed by a cognitive behaviorist that identifies the treatment goals and interventions for the individual and team; (30) “ Legal representative ” means a guardian, conservator, or an individual holding a power of attorney appointed to act on the individual’s behalf; (31) “ Level of care ” means the type of facility, as determined by a care manager or designated agent of the department, neededto care for an individual if the individual were not receiving services under the ABI waiver program. The types of facilities include: a nursing facility, ABI NF, CDH, or ICF-IID; (32) “ Medicaid ” or “ Medicaid program ”means medical and health-related servicesadministered by the state of Connecticut Department of Social Services pursuant to Title XIX of the Social SecurityAct; (33) “ Medicaid Provider Enrollment Agreement ” has the same meaning as provided in section 17b-262-523(23) of the Regulations of Connecticut StateAgencies, except that such agreement may include addenda specific to the ABI waiver program; (34) “ Neuropsychological evaluation ” has the same meaning as provided in section 17b-262- 468(17) of the Regulations of Connecticut State Agencies; (35) “ Nursing facility ” or “NF” has the same meaning as provided in 42 CFR 440.40 and 42 CFR 440.155, as amended from time to time; (36) “ Other community-based services ” means servicesprovided by programsadministered by the department that are not part of the ABI waiver program, or services provided by programs administered by other state or local agencies that are necessary to maintain the individual in the community; (37) “ Other medical services ” means services that are normally included in the department’s payments to NFs, ABI NFs, CDHs, and ICF-IIDs, and that the individual requires,in addition to ABI waiver services, to live in the community. Other medical servicesinclude: home health care; nursing services; physical therapy; speech therapy; and occupational therapy; (38) “ Person-centered plan ” means a service plan developed by the person-centered team that meets the requirements of 42 CFR 441.301(c)(1)-(3), inclusive, as amended from time to time; (39) “ Person-centered team” means an interdisciplinary group of people organized to assist the individual to develop and implement a service plan. The planning team consists of a care manager, the individual, the legal representative (if applicable), a cognitive behaviorist, any interested family members, or other relevant participants; (40) “ Provider ” means an agency provider, household employee or self-employed provider who meets the qualifications established by the department to provide home and community-based services under the ABI waiver program, has signed the Medicaid Provider Enrollment Agreement, and is enrolled in the ABI waiver program; (41) “ Qualified neuropsychologist ” means a psychologist who meets the qualifications of section 17b-262-468(16) of the Regulations of Connecticut State Agencies; (42) “ Rehabilitation hospital ” means a facilityperforming rehabilitative outpatient hospital services in accordance with the provisions of 42 CFR 440.20(a). (43) “ Representative ” means a personwho is not a legalrepresentative, and who is actingin support of an individual; (44) “ Self-employed provider ”means a person who does not work for an agency, is not a household employee, and meets the qualifications listed in 17b-260a-8 of the Regulations of Connecticut State Agencies to provide certain services under the ABI waiver program; (45) “ Service plan ” means an individualized written plan developed through person-centered planning that documents the medicaland home and community-based servicesthat are necessary to enable the individual to live in the community instead of an institution. The service plan includes measurable goals, objectives, and documentation of total service costs; (46) “ Supervision or cueing ” means daily support such as monitoring, observing, verbal or gestural prompting, verbalcoaching and gesturalor pictorial cueing that is required in order for the individual to accomplish an ADL. Supervision and cueing must be required on a contemporaneous basis with the performance of the ADL, and does not include a reminder or request to perform an ADL when the individual does not need support beyond such reminder or request in order to accomplish the ADL. (47) “ Total service costs ” means the annualized cost of ABI waiver services, other medical services, and other community-based services included in an individual’s service plan that are required in order for the individual to live in the community instead of an institution; and (48) “ Waiting list ” means a record maintained by the department that includes the names, and dates of completed ABI waiver applications, of all individuals who have submitted completed applications for ABI waiver services and whoseapplications have been screened and found to be functionally eligible for the program. (NEW) Sec. 17b-260a-4. Not an Entitlement The ABI waiver program is not an entitlement program. Services, waiver slots and access to services under the ABI waiver program may be limited based on available funding and program capacity. (NEW) Sec. 17b-260a-5. Eligibility (a) An applicant may be eligible to receive coverage for the cost of the services specified in section 17b-260a-8 of the Regulations of Connecticut State Agencies, through the department’s ABI waiver program, if: (1) The applicant’s countable income is less than 300% of the benefit amount that would be payable under the federal Supplemental Security Income programto an applicant who lives in the applicant’s own home and has no income or resources; (2) The applicant is otherwise eligible to participate in the department’s Medicaid program, including any applicable asset requirements, under either the working disabledor long-term care eligibility criteria; (3) The applicant meets the programmatic requirements of subsection (c) of this section; and (4) The applicant is not ineligible for coverage under subsections (d) or (e) of this section. (b) The financial requirements for eligibility are as follows: (1) The applicant’s countable income and assets for purposes of eligibility are determined using the same methodologies the department employsin determining the countable incomeand assets of an institutionalized applicantfor Medicaid, including, but not limitedto, the spousal impoverishment rules and spousal post-eligibility rules under section 1924 of the Social Security Act, 42 U.S.C. § 1396r-5, for individuals with a community spouse. (2) Income eligibility determination for ABI waiver services under this section is based solely on the applicant’s countable income and does not involve consideration of the incurredmedical expenses or any other liabilities that may have been incurred by the applicant. (3) Payment for ABI waiver services is reduced by the individual’s applied income, which is calculated by determining the amount of the applicant’s countable income remaining after the deduction of an allowance for the personal needs of the individual equal to 200% of the federal poverty level, as well as any applicable community spouse’s or family allowance, and amounts for incurred medical or remedial care expenses not subject to payment by a thirdparty, as specified in 42 CFR 435.726. (c) The programmatic requirements for eligibility are as follows: An individual shall: (1) Be between the ages of 18 and 64 at the time the application is completed; (2) Have an ABI, as defined in section 17b-260a-3(1) of the Regulations of Connecticut State Agencies; (3) Meet the criteria for one of the level-of-care categories described in subsection 17b-260a-9(d) of the Regulations of Connecticut State Agencies; (4) Have the cognitive abilityto actively participate in the development of the individual’s service plan or, absent such ability, have a legal representative who acts on the individual’s behalf to perform these tasks. Participation includes, but is not limited to, selection, hiring, direction, and termination of providers; (5) Voluntarily choose to live in the community by participating in the ABI waiver program; (6) Wish to utilize ABI waiver services; (7) Develop, in consultation with the person-centered team, a serviceplan that providesassistance that reasonably addresses and mitigates identified risks; (8) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that there are risks inherent in living in the community; that the individual’s safety cannot be guaranteed; and that the individual acceptsfull responsibility if the individual chooses to live in the community, thereby absolving the department from any liability for any and all consequences that may result from this choice; (9) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that the individual is the employer of any household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut StateAgencies, and shallsign a written document accepting full responsibility as the employer of such providers; (10) Maintain eligibility for Medicaid; (11) Need waiverservices, which means that the individual needs a minimumof two waiver services, on at least a monthly basis; (12) Have a total serviceplan cost that does not cause the ABI waiverprogram’s expenditures to exceed total appropriated funding limits for the ABI waiver program; (13) Have a total serviceplan cost that does not exceed the individual cap that appliesto the individual, as set forth in sections 17b-260a-10(a) and (b); and (14) Agree to pay, if applicable, any applied income toward the cost of services renderedunder the waiver, as required under section 17b-260a-11(b). (d) Not with standing subsections (a), (b) and (c) of this section,an individual shallnot be eligible for ABI waiver program services if: (1) The individual: (A) Receives services under any other Medicaid waiver program; (B) Has received and benefited from ABI waiver services, no longer requires the services, no longer meets level-of-care criteria, and can continueto reside in the community without the support of ABI waiver program services; (C) Has a cognitive or behavioral dysfunction due solely to an intellectual disability or chronic mental illness, rather than an ABI, as determined by a licensed medical professional; (D) Requires inpatient care in an acute care hospital, NF,ABI NF, ICF-IID or CDH, or who is otherwise institutionalized for a period of ninety days or more,provided, however, such durational limitation may be extended for an additional thirty days upon submission of documentation from a medical professional indicating that the applicant’s discharge is expected within thirty days; (E) Demonstrates consistent and extreme physical, verbal, or sexual aggression toward others; (F) Demonstrates behaviors that violate the law or are contraryto community integrated living; (G) Is currentlyincarcerated, and not expected to be returnedto the community within ninety days; (H) Lacks mental capacity to participate in the program; (I) Refuses servicesthat are vital to health,welfare, and safety;or (J) Behaves in ways that are detrimental to the individual’s health, welfare, and safety, which includes, but is not limited to: (i) Participating in illegal or criminal activity; (ii) Using, or threatening to use, weapons,chemicals, or firearmsfor the purposeof causing harm or injury to self or others; or (iii) Compromising the safety of caregivers, staff, and others in the home or community. (2) The conditions at the individual’s home or on the grounds of the home are hazardous due to: (A) Illegal or criminal activity; (B) The presenceof animals that are dangerous or not properly secured or maintained; (C) Poor sanitation; or (D) Violations of local or state fire,zoning, or housing that pose a risk to the health, welfare, and safety of the individual or providers; or (3) Persons who either reside in, or have regular access, the individual’s home are: (A) Engaging in illegal or criminal activity; (B) Behaving in a manner that is dangerous or jeopardizes the safety, health,or well-being of the individual, providers, or others; (C) Interfering with the provider’s delivery, or the individual’s receipt,of services or acting in any way that affects a provider’s access to the individual; or (D) Threatening the individual verbally, physically, or sexually; or (4) In the opinion of the department, a service plan that is both cost-effective and reasonably ensures the health, welfare, and safety of the individual cannot be developed or implemented. (e) Individuals who are actively participating program in the ABI waiverprogram and who turn 65 years of age shall be offered the choice of (1) remaining on the ABI waiver program; (2) accessing institutional placement; or (3) transitioning to the Connecticut Home Care Program for Elders. (NEW) Sec. 17b-260a-6. Person-centered planning process (a) The service plan shall be developed based on a person-centered planning model, as described in 42 CFR 441.301(c), as amended from time to time. The individual shall lead planning processaddition to the planningprocess where possible, and in accordance with section 17b-260a-11(a) of the Regulations of Connecticut State Agencies. (b) In additionto being led by the individual receiving services and supportlead planning, the person-centered planning process shall: (1) Include people chosen by the individual, providedthe inclusion of such personsis not otherwise prohibited herein; (2) Provide necessary information and supportto ensure that the individual directs the planning process to the maximum extent possible, and is able to make informed choices and decisions; (3) Be timely and occur at dates, times, and locations of convenience to the individual; (4) Be conducted in a manner that reflects cultural considerations of the individual; provides information in plainlanguage; and is accessible to the individual and persons with limited English proficiency; (5) Include strategies for conflict-resolution or solving disagreements within the process,including clear conflict-of-interest guidelines for all participants; (6) Prohibit providers of waiver servicesfor the individual, or those who have an interest in or are employed by a provider of waiver services for the individual, from providing care management or participating in the development of the person-centered service plan; (7) Offer informedchoices to the individual regarding the types and providers of services and supports that are available; (8) Include a method for the individual to request updates to the plan as needed; and (9) Record the alternative home andcommunity-based settings that the individual considered. (NEW) Sec. 17b-260a-7. Home and community-based setting requirements (a) Prior to an individual accessing any services under the ABI waiver program, the department shall assess each home and community-based settingin the service plan to determine whethersuch setting complies with 42 CFR 441.301(c)(4)-(5), as amended from time to time. (b) If, upon initial assessment of the individual’s service plan, or any time thereafter, the department determines that a settingdoes not comply with 42 CFR 441.301(c)(4)-(5), the department shall inform the individual that the setting does not comply, and inform the individual of alternative settings that complywith these requirements. If the individual elects to remainin, or receive services at, a setting that does not meet these requirements, and the provider has not complied with the department’s corrective action plan for meeting such requirements, the individual shall not remain eligible to receive services under the ABI waiver program. (c) The department shall assess compliance with 42 CFR 441.301(c)(4)-(5) as part of its process for credentialing and re-credentialing providers. (NEW) Sec. 17b-260a-8. Home and community-based services available under the ABI waiver program (a) General principles (1) ABI waiver services shall be furnished under a written service plan that is based on a person- centered planning process,as described in section 17b-260a-6 of the Regulations of Connecticut State Agencies, and subject to approval by the department. (2) Except as set forth in subsection (b) of this section, ABI waiver services may be provided alone or in combination with other services, in accordance with the specificfunctional needs of the individual. (3) The ABI waiver services provided at any given time, in combination with other available medical and community-based services,constitute the individual’s service plan. The need for each specific ABI waiver service shall be documented in the service plan. (4) The ABI waiver services documented in the service plan may be purchased from agency providers, household employees, or self-employed providers that the department’s fiscal intermediary has determined are eligible to participate in the Medicaid program, are enrolled with the department as a provider, and agree to accept Medicaidpayment as paymentin full for services authorized and performed under the program. (5) The department shall not pay for ABI waiver servicesprovided by the individual’s conservator, power of attorney, or a family member of such conservator or power of attorney, or an agency provider owned by the individual’s conservator or power of attorney. (6) The department shall pay only for ABI waiver servicesthat are providedin settings that meet the requirements of 42 CFR 441.301(c)(4), as amended from time to time. (7) Payments for ABI waiverservices shall not exceed the rates, or maximum limits,the department establishes for the provision of such services. (8) The rate paid to service providers does not includepayment for transportation services, unless specified in subsection (b) of this section. (9) The department’s fiscal intermediary, priorto the start of servicesand bi-annually thereafter, shall verify that providers are qualified to provide services. (b) The following services and supplies may be covered under the ABI waiver program: (1) ABI Group Day Habilitation Services, which are services and supports that: lead to the acquisition, improvement, or retention of skills and abilities necessary for an individual to maintain health, wellness, and self-care; preparean individual for work or community participation; or support meaningful socialization and leisure activities. ABI Group Day Habilitation services shall be provided only: (A) By an agency provideror a rehabilitation hospital outpatient department that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; and (B) For a time period that does not exceed eight hours per day. (2) ABI Recovery Assistant I Services, which are services to promote the individual’s strengths and abilities to maintain and foster community living skills, in accordance with therapeutic goals outlined in the individual’s service plan. Services may include improvement of socialization, self- advocacy, and the development of natural supports. Services also include communication and coordination with service providers and others who support the individual. Although not a primary function, a providerperforming ABI RecoveryAssistant I servicesmay provide assistance with ADLs and cueing with respect to medications with support of a medication box. (A) This service shallbe provided only to individuals on ABI Waiver II; and (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (3) ABI Recovery Assistant II Services, which are non-medical and safety monitoring servicesto assist an individual with activities of daily living(both hands-on and cueing) and integration into the community. (A) This serviceshall be providedonly to individuals on ABI WaiverII; (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (4) Adult Day Health Services, which are services provided in a group setting that include a variety of health and social services, including, but not limited to: personal care, health care, recreation, socialization, nursingservices, transportation services, and hot meals and snacksthat meet the individual’s nutritional needs and dietary restrictions. Adult Day Health services shall: (A) Be provided only to individuals on ABI WaiverII; (B) Be providedby an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (C) Be providedone or more days per week, four or more hours per day, on a regularly scheduled basis; and (D) Include transportation to and from theAdult Day Health Center, a meal, and snacks. (5) Care Management Services, which are services provided to assist the individual to implement the service plan and to assure on-going effective coordination, communication, and cooperation among all sources of support and services to the individual. Care management services include, but are not limited to, the following: assistance identifying the individual’s home and community-based service needs; promotion of participation in activities that may increase the individual’s independence, inclusion in the community and life satisfaction; arrangement of daily living supports and services to be delivered to the individual; assistance identifying and accessing entitlements and other possible funding sources; advocacy for the individual when necessary to ensure the receipt of needed services; and referral for crisis intervention services and monitoring, as necessary and appropriate. Care management services shall be provided by a care manager that meets all the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements, and that: (A) Does not provide any other home and community-based services to the individual; and (B) Does not have an interest in, or is not employed by, a provider of home and community-based services for the individual. (6) Chore Services, which are services needed to maintain the individual’s home in a clean, sanitary, and safe condition. Chore services include, but are not limited to, heavy household chores, such as washing floors,windows, and walls,and moving heavyitems of furniture in order to provide safe access and egress. (A) Chore services shall be providedby an agency provider or household employeewho meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Chore services shall not be covered if: (i) The individual or anyone else living in the household is capable of performing or paying for the services; (ii) A relative, caretaker, community agencyor other entityis capable of, or responsible for, providing the services; or (iii) In the case of rental properties, condominiums, or co-ops,a specific choreservice is the responsibility of the landlord or the landlord’s designee, as evidenced in the lease or any other agreement. (7) Cognitive-Behavioral Services, which are individual interventions designed to increase an individual’s cognitive and behavioral capabilities and to further the individual’s adjustment to successful community engagement. These services include, but are not limited to: comprehensive assessment of cognitive strengths and liabilities, quality of adjustment, and behavioral functioning; development and implementation of cognitive and behavioral strategies; development of a structured cognitive-behavioral intervention plan; ongoing or periodic consultation with the individual and the person-centered planning team concerning cognitive and behavioral strategies and interventions specified in the cognitive-behavioral intervention plan; ongoing or periodic assistance with training of the individual and person-centered planning team concerning cognitive and behavioral strategies and interventions; and periodic reassessment and revision, as needed, of the cognitive-behavioral intervention plan. (A) Cognitive-behavioral services may be provided in the individual’s home or in the community, and shall be performed by an agency provider or a self-employed provider who is a licensed psychologist, physical therapist, speech therapist, or occupational therapist, a qualified neuropsychologist, or another type of provider authorized to perform cognitive-behavioral services under the ABI waiver program,and who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Intervention plans shall be updated at least annually,or more frequently as clinically indicated. Intervention plans shall include the following components: (i) Long-term, measurable goals mutually agreed upon by the individual, or the individual’s legal representative, and the provider; (ii) Shorter-term, measurable objectives to reach those goals; (iii) The individual’s strengths and challenges, and a description of how strengths are to be used in achieving goals; (iv) Skills or tasks that need to be developed by the individual or the family; (v) Input by the individual into the intervention plan commensurate with the levelat which the individual is able to participate; and (vi) A description of how positive reinforcement, rather than punitive measures, will be used to support the individual. (C) Providers of cognitive-behavioral services shall be paid for face-to-face encounters and also for non-face-to-face encounters. (i) Face-to-face (in-person) encounters are in-personmeetings with the individual, and meetings with the individual’s family, supporters, or providers, even when the individual is not present. The provider must have an in-person meeting with the individual at least quarterly. (ii) Non-face-to-face (not in-person) encounters are telephonic or other secure electronic forms of communication, including videotelephony services such as Skype. A provider may also be paid at the non-face-to-face rate for activities such as reviewing the individual’s record and writing the plan of care, even if the individual is not present. (8) Community Living Support Services, which are support services that provide supervised living in the individual’s residence for up to 24 hours per day, including overnight supervision, to a minimum of two, or a maximum of three, individuals at once who require supportand supervision, in a supervised community residential setting for either a half-day (12 hours) or full day (24 hours). (A) Community living support servicesinclude, but are not limitedto, supervision and assistance with the following skills: (i) Self-care; (ii) Medication management; (iii) Interpersonal communication; (iv) Socialization; (v) Sensory and motor skills; (vi) Mobility; (vii) Utilizing transportation services; (viii) Problem-solving; (ix) Money management; and (x) Household management. (B) Assessment and training servicesare provided as part of this service. (C) Room and board is not included as part of this service. (D) The providershall develop a plan that demonstrates the provider’s abilityto work with the individual and to provideservices that are consistent with the therapeutic goals of the individual’s service plan. (E) Upon the individual’s request or improvement in the individual’s ability to live more independently, the providerand the care manager shallwork together, with the individual, to develop and implement a plan to transition the individual to greater independence in the community. (F) Community living support services shall be provided by anagency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (9) Companion Services, which are nonmedical services that are provided in accordance with a therapeutic goal includedin the service plan, includingthe following: supervision and socialization services; assistance with or supervision of meal preparation; assistance with laundry that is being performed by the individual; and light housekeeping tasks that are incidental to the care of the individual. (A) Companion services shall be provided by an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Companion servicesshall not entailthe provision of hands-on care or household management tasks, as these tasks are provided by personal care assistants and chore services providers, respectively, in accordance with subdivisions (6) and (15) of this subsection. (10) Consultation Services, which are services provided to assist a team and individuals to address service-implementation issues that have presented a barrier to resolution. This service aids in the development of individual interventions designed to decrease an individual’s severe maladaptive behaviors, which jeopardize the individual’s ability to remain integrated in the community. (A) Consultation services shall be provided: (i) Only to individuals on ABI Waiver II; (ii) In a team meeting at the individual’s home or community location; and (iii) By an agency or self-employed provider who is a licensed psychologist, clinical social worker, speech pathologist, speech therapist, occupational therapist, physical therapist, registered nurse, or dietician/nutritionist, a qualified neuropsychologist, or a certifiedrehabilitation counselor or substance abuse specialist, and who meet the requirements of subsection (a) of this section and all applicable training, state licensure, or certification requirements. (11) Environmental Accessibility Adaptation (“EAA”) Services,which are physicalchanges made to an individual’s home that are necessary to ensure the health, welfare, and safety of the individual, or enhance and promote greater independence, without which the individual would require institutionalization. (A) EAA services include,but are not limited to, the following: (i) Installation of ramps; (ii) Widening of doorways; (iii) Modifications to meet egressrequirements; (iv) Modification of bathroom facilities; and (v) Addition of specialized electrical and plumbing devices. (B) All EAA services shall be providedby agency providers or private contractors or businesses in accordance with applicable state and local building codes. (C) EAA services do not include: carpeting; central air conditioning; roof repair; house adaptations that add to the squarefootage of the home; or any otherphysical improvement to the home not of direct benefit to the individual’s health, welfare, and safety, or ability to live independently. (D) EAA servicesshall not be provided to adapt units that are owned or leased by providers of waiver services. (12) Homemaker Services, which are generalhousehold activities, includingmeal preparation and routine household chores. (A) The department shall pay for homemaker serviceswhen the personregularly responsible for homemaking activities is temporarily absent or unable to manage the home and care for the individual or others in the home, or when the individual is unable to learn such skills. (B) Homemaker services shall be provided by an agency provider or a household employee that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements.Homemaker services shall not be provided by a member of the individual’s family, the individual’s conservator, or a member of the conservator’s family. (13) Home-Delivered Meals, which is the preparation and delivery of one or two meals per day to an individual who is unable to prepare or obtain nourishing meals on the individual’s own, or for an individual who normallyhas someone who is responsible for preparing and delivering meals,but that person is temporarily absent or unable to perform this service. (14) Independent Living Skills Training (“ ILST ”), which is a training service designed for, and delivered to, an individual to improve that individual’s abilityto live independently in the community and to carry out strategies developed in cognitive/behavioral programs. (A) ILST may include, but is not limited to, teaching the individual the following skills: (i) Self-care; (ii) Medication management; (iii) Task completion; (iv) Interpersonal communication skills; (v) Socialization skills; (vi) Sensory/motor skills; (vii) Mobility and community transportation skills; (viii) Problem solving skills; (ix) Money management skills; and (x) Household management skills. (B) ILST shall be providedby an agency provider or household employeethat meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (15) Personal Care Assistant services, which are services that provide the individual with assistance with the following: eating, bathing, dressing, personal hygiene, and other activities of daily living that are performed by a provider in the individual’s home or community; or supervision and cueing of theseactivities without actualhands-on assistance. Personalcare assistant servicesshall be provided only: (A) If the individual’s physicalability to performactivities of daily living is impaired, or if the individual’s cognitive or behavioral impairments interfere with the individual’s ability to perform these tasks; (B) To individuals on ABI WaiverII; and (C) By an agency that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (16) Personal Emergency Response System (“PERS”),which is an electronic device connected to an individual’s telephone that enables an individual at high risk of institutionalization to secure help in an emergency. (A) A PERS is available only to an individual who: (i) Lives alone; (ii) Is alone for significant parts of the day and who does not have providers; or (iii) Would otherwiserequire extensive routinesupervision. (B) A PERS shall be provided by an agencyprovider that sells and installsPERS equipment. (17) Prevocational Services, which are time-limited services that provide learning and work experience, including volunteerwork, where the individual can develop generalnon-job-task-specific strengths and skillsthat contribute to employability in paid employment in an integrated work setting. Services are intended to develop and teach general skills, such as the ability to: communicate effectively with supervisors, co-workers, and customers; comply with generally accepted community workplace conduct and dress; follow directions; attend to tasks; develop strategies to solve problems at the workplace; and comply with general workplace safety and mobility training. Prevocational services are designed to be a pre-cursor to integrated employment. (A) The following time limits shall apply to prevocational services: (i) For individuals enrolled in ABI Waiver I, effective December1, 2015, a two-year time limit for thisservice shall be applied prospectively. This two-year limit may be extended up to a maximum of four years upon a determination by the department that additional time is needed for an individual to achieve the person-centered goal of attaining supported employment. Annual redeterminations of eligibility for such services shall be made after an initial two years of such services. (ii) For individuals enrolled in ABI Waiver II, this serviceis limited to two years.Upon strong justification of progress towardemployment goals, the department may authorize the service for a maximum total of three years. (iii) This serviceis limited to 40 hours per week. (B) Services shall be providedin the individual’s home or in an integrated work setting, based on the individual’s needs and preferences. (C) The individual shall have employment-related goals in theperson-centered service plan; (D) Prevocational services shall be provided by an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (18) Respite Care Services, whichare services providedto individuals who are unableto care for themselves, and when the person normally performing such services is absent or in need of relief. (A) Services shall be furnished on a short-term basis in the individual’s home. (B) Services shall be providedby an agency or household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (19) Specialized Medical Equipment and Supplies, which include devices, controls, or appliances that enable an individual to increase the individual’s ability to perform ADLs, or to cognitively perceive, control, or communicate in the individual’s environment within the community; items necessary for life supportand those ancillary supplies and equipment that are necessary for the proper functioning of such items; and durable and non-durable medical equipment that is not available as a covered medical service under the Medicaid state plan. (A) Specialized medical equipment and supplies paid for under the ABI waiver program shall be of direct medical or remedial benefit to the individual; meet all applicable standards of manufacture, design and installation; and be in addition to any medicalequipment and suppliesfurnished under the Medicaid state plan. (B) Specialized medicalequipment and suppliesshall be providedby a medical equipment vendor, durable medical equipment provider, or pharmacy that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (20) Substance Abuse Program Services, which are individually designed interventions to reduce or eliminate the individual’s use or abuseof alcohol or drugs when such use or abuseinterferes with the individual’s ability to remain in the community. (A) Substance abuse program services shall include, but are not limited to, the following services: (i) Performing an in-depth assessment of the relationship between the individual’s use or abuse of alcohol or drugs and the individual’s brain injury; (ii) Performing a learning and behavioral assessment; (iii) Developing and implementing a structured treatment plan; (iv) Providing ongoingeducation and trainingof the individual, family members,and other service providers concerning support needs of the individual; (v) Developing individualized strategies to avoid relapse; (vi) Conducting periodic reassessment of the treatment plan; and (vii) Providing ongoing support to the individual. (B) Substance abuseprogram services shall be providedon an outpatient basis in a congregate setting or the individual’s community. (C) Substance abuseprogram services shall be providedby either agencyproviders (i.e, substance abuse diagnostic and treatment centers, or rehabilitation hospitals) or individual providers (i.e., self- employed providers, licensed psychologists, or certified drug and alcohol counselors) that meet the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (D) The individual’s structured treatment plan may include both group and individual interventions and shall reflect the use of curricula and materials adoptedfrom substance abuse programs designed to meet the needs of individuals with cognitive impairment. (E) The individual’s treatment plan shallinclude linkages to existing community-based, self-help or support groups, such as Alcoholics Anonymous and organizations that promote and support sobriety. (F) With the individual’s consent,the substance abuse program providershall communicate with the individual’s other service providers concerning the individual’s treatment regimens. (21) Supported Employment services, which are services provided to individuals who, because of their disabilities, need intensive on-going support to perform in a work setting. The intended outcome of this serviceis sustained paid employment or self-employment in the generalworkforce in a job that: (1) meets the individual’s personal and career goals; (2) pays a wage level at or above the minimum wage; and (3) pays at a wage and benefit levelthat is not less than the customary wage and benefit level paid by an employer for the same or similar work performed by individuals without disabilities. (A) Supported employment services may be conducted in a variety of settings, including work sites where persons without disabilities are employed. When supported employment services are provided in such integrated work settings, paymentsshall be made only for adaptations, supervision and training needed by the individual, and shall not include payment for any modifications or activities rendered or required within the normal business setting. (B) Supported employment services shall not otherwise be available under a programfunded under the Rehabilitation Act of 1973, 20 USC 1401 et seq., or Education forAll Handicapped Children Act, Pub. L. No. 94- 142. (C) Transportation betweenthe individual’s residence and supported employment site is required as a supported employment service, and is included in the rate paid to the provider. (D) Supportive employment services shall be provided by agency providers that meet the requirements of subsection (a) of this section, and all applicable training and statelicensure, or certification requirements. (22) Transitional Living Services, which are short-term, individualized, residential services providing support to an individual transitioning into a community livingsituation. These services and supports are designed to improve the individual’s skills and ability to live in the community. (A) Transitional living services: (i) Are availableonly to individuals on ABI Waiver I; (ii) Shall be provided for only one transitional period; (iii) May be provided up to 24 hours per day; (iv) Shall be provided only when the individual is unable to be supported in a permanent residence and is in need of intensive clinical interventions provided by this service; and (v) Shall be provided by an agency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Prior to discharge from transitional living services, the provider shall work with the individual and the care manager to develop a plan of care. Upon discharge, other ABI services shall become available to the individual in accordance with the plan of care. (C) ABI waiverfunds shall not be used to pay for the room and board component of transitional living services. (D) Transitional living services shall not be provided with any ABI services other than care management, environmental modifications, specialized medical equipment and vehicle modifications. (23) Transportation Services, which are services offered in accordance with the individual’s service plan to allow the individual to access servicesthat do not qualify for non-emergency medical transportation under 42 CFR §440.170(a). (A) Transportation services shall not be provided when public transportation is available or when friends, family, neighbors, or community agencies are able to provide transportation free of charge. (B) All reasonable alternatives shall be explored and exhausted priorto receiving approvalfor transportation services. (C) Transportation servicesshall be providedby a livery service or individual providerlicensed by the State of Connecticut, with a valid Connecticut driver’s license and evidence of automobile insurance. (24) Vehicle modification services, which are alterationsto a vehicle when such alterations are necessary to improve the individual’s independence and inclusion in the community, and to enable the individual to avoid institutionalization. (A) The vehicle shall be the individual’s primarymeans of transportation. (B) The vehicleshall be ownedby the individual, a relativewith whom the individual lives or has consistent and ongoing contact, or a non-relative who provides primary long-term support to the individual and is not a paid provider of such services. (C) All modifications and adaptations shall be providedin accordance with applicable federaland state vehicle codes. (D) Vehicle modification services do not include: adaptations or improvements to a vehicle that are of general utility and not of direct medicalor remedial benefitto the individual; payments for the purchase or lease of a vehicle; or regularly scheduled upkeep and maintenance of a vehicle, except for upkeep and maintenance of the modifications. (E) The total individual cost limit for vehicle modifications is $10,000.00. (F) Vehicle modification services shall be provided by a providerapproved by the State of Connecticut as a vehicle modification vendor. (NEW) Sec. 17b-260a-9. Pre-screen, waiting list and assessment (a) The department shall review completedapplications that it receives in the orderin which they are received. Acceptance to the ABI waiver program shall be on a first-come, first-served basis, except that individuals transitioning from the Money Follows the Person program or Department of Mental Health and Addiction Services Acquired Brain Injury Services to the ABI waiver program shall have priority for reserved spaces. (b) The department shall conduct a pre-screen of the applicant following the receipt of the application, and prior to placing the applicant’s name on the waiting list, to determine whether the applicant (1) meets the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut State Agencies, and (2) requires one of the level-of-care categories described in subsection (d) of this section. (c) Applications shall be pre-screened based upon the information contained in the completed application, as well as information obtained from: the individual; a neuropsychological examination report prepared by a qualified neuropsychologist; and any other clinical personnel who are familiar with the individual’s case and history.In order to be considered, the neuropsychological examination report must have been completed no more than two years prior to the application date, provided, however, that the department retains the discretion to increase this time limitation on a case-by-case basis. The neuropsychological examination report shall be submitted to the department no later than six months followingthe application date,except that the department may extend this deadline for an additional 90 days if a neuropsychological examination appointment has been scheduled. Failure by the individual to meet this deadline shall result in the denial of the application. (d) To qualifyfor services under the ABI waiver program,the individual shall meet one of the following institutional level-of-care categories: (1) Category I (NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a NF. The individual is considered to require care in a NF if the individual residesin such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, including, but not limited to, eating, bathing, dressing, toileting, and transferring; (2) Category II (ABI NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in an ABI NF. The individual is considered to require care in an ABI NF if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facilitybut has impaired cognition, impairedbehavior requiring daily supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, and a mental illness that manifested itself before the brain injury occurred; (3) Category III (ICF-IID level of care): If the individual were not receiving services under the ABI waiver program,the individual wouldrequire care in an ICF-IID.The individual is considered to require care in an ICF-IID if the individual resides in such a facility and the department or its agent determines that the individual currently requires such levelof care, or if the individual does not reside in such a facility but has impaired cognition, an ABI that occurred before the age of 22 and, due to physical deficits, requires physical assistance with two or more ADLs; or (4) Category IV (CDH level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a CDH. The individual is considered to require care in a CDH if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and impaired or abnormal behavior, and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b- 260a-3(46) of the Regulations of Connecticut StateAgencies, with two or more ADLs. For purposes of this category, “impaired or abnormal behavior” means that one or more behaviors is consistently severely impaired or abnormal, and requires the availability of intensive and ongoing behavior intervention to the extent that the individual would require care in a CDH if the individual were not receiving services under the ABI waiver program. Behaviors that may meet this definition include: engaging in inappropriate sexual activity; causing injury to others or self, or damage to property; demonstrating physical or verbal aggression; demonstrating a consistent ongoing pattern of wandering or elopement; engaging in socially offensive behavior; demonstrating withdrawal, susceptibility to victimization, impulsivity, intrusiveness, agitation or pica; or engaging in criminal activity after the brain injury occurred. (e) The applicant shall be placed on the waiting list if the applicant is determined by the department, based on the information provided during the pre-screening, including the neuropsychological examination report, to meet the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut StateAgencies and the applicant requires one of the levels of care described in subsection (d) of this section. (f) The department shall notify the applicant in writing when, based on the applicant’s waitlist position, an opening is reasonably expected to become available to the applicant within 90 days. Once notified, a care managershall meet with the individual, complete a comprehensive assessment of the individual’s needs, including the level of care, and develop a proposed service plan. A care manager and the individual, in conjunction with the person-centered team, shall then develop, if feasible, a cost-effective service plan as determined pursuant to section 17b-260a-10(d). Services shall not be authorized until the department determines that the individual’s Medicaid coverage is active. (g) The department shall re-evaluate the level of care for each individual at least annually. (NEW) Sec. 17b-260a-10. Development of the service plan and evaluating cost-effectiveness (a) Applicants enrolledin ABI Waiver I shall have a total individual service plan cost limit no greater than 200% of the annualized alternative institutional care cost. (b) Applicants enrolledin ABI Waiver II shall have a total individual service plan cost limit no greater than 150% of the annualized alternative institutional care cost. (c) The department shall not approvea total individual service plan that exceeds the individual service plan cost caps or funding limitations established in the approved waiver. (d) To determine the cost-effectiveness of the individual’s service plan, the department shall: (1) Obtain the annualized alternative institutionalized care costs for the individual. For each level of care listed in subsection (d) of section 17a-260a-9 of the Regulations of Connecticut State Agencies, the annualized alternative institutional care cost is equal to the state’s weighted average cost for the specified facilitytype, as annuallydeveloped and published by the department, minus the average applied income; (2) Determine the individual’s total service cost by aggregating each of the following costs: (A) The annualized cost of each covered servicethat will be provided to the individual, based on the department’s established rates for such services; (B) The annualized cost of the ABI waiver home and community-based services, as described in section 17b- 260a-8 of the Regulations of Connecticut StateAgencies, to be provided to the individual under the proposed service plan; (C) The annualized cost of any other medical services covered by Medicaid, as described in section 17b- 260a- 3(37) of the Regulations of Connecticut StateAgencies, provided in the individual’s home that the individual may require in order to live in the community, to be calculated by multiplying the expected frequency of utilization of these services by the Medicaid rates established by the department for such services; and (D) The annualized cost of any other community-based services, as describedin section 17b-260a- 3(36) of the Regulations of Connecticut State Agencies, that the individual may require in order to live in the community; and (3) Compare the individual’s total service cost to the applicable individual limit set in subsections (a) and (b) of this section to determine if the total service cost exceeds the applicable individual limit. (e) To promote cost neutrality in accordance with 42 USC1396n (b), every reasonable effort shall be made to provide services below the maximum dollar amount level, and in the most cost-effective manner possible. The department shallnot exceed the funding limitations established in the approved waiver when determining whether an individual can be accepted into the program. (NEW) Sec. 17b-260a-11. Responsibilities of the individual (a) Person-Centered Planning and Selecting Providers (1) To the extent feasible, the individual shall lead the person-centered planning process. If the individual has a legal representative, the legal representative may participate in the planning process, making decisions for the individual, as necessary to ensure the best interests of the individual. The department may seek assistance from a court of probate if: (A) The department determines that the legal representative is not acting in the best interests of the individual and is hindering the person-centered planning process; or (B) There is a conflict between the individual and the legal representative. (2) The individual or the individual’s legal representative, or both, shall: (A) Choose the team to participate in the person-centered planning process; (B) Collaborate with the person-centered team; (C) Select, from a list of providers, the providers who will deliver the services specified in the service plan; (D) Supervise the services that are provided to the individual in accordance with the service plan; (E) Notify the department if a provider is not performing satisfactorily; (F) Terminate the employment of a household employee or the services of a self-employed provider, as necessary; and (G) Select new providers, as necessary. (b) Financial Responsibilities (1) An individual whose gross income exceeds shall be 200% of the federal poverty level shallbe required to contribute toward the cost of services rendered under the waiver. The amount contributed shall be calculated according to section 5035 of the Uniform Policy Manual, or any other applicable law or policy of the department. (2) The individual shall agree to pay directly to the department’s fiscal intermediary the portion of income calculated to be contributed to the individual’s cost of care. This agreement shall be documented in the individual’s service plan. (c) Responsibilities of the Individual as the Employer of Household Employees An individual who is the employer of household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut State Agencies, shall be responsible for: (1) Compliance with all applicable state and federal requirements, including, but not limited to, those related to workers’ compensation, unemployment compensation, minimum wage rates, and income tax withholding; and (2) Hiring and termination of the employment of household employees, as necessary. (d) Critical Incident Reporting (1) The individual, or the individual’s legal representative, shall comply with the department’s critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-12. Department responsibilities " CT DSS " The department or its agent shall: (a) Inform eligible individuals that they have the choice whether to community-based reprogram by community-based services through the ABI waiver program, or to receive institutional care; (b) Establish eligibility for the ABI waiver programby performing an assessment of the individual’s needs; (c) Coordinate the development of a service plan designed to deinstitutionalize or divert the individual from institutional placement; (d) Assist with implementation of an approved service plan by coordinating services provided to the individual; (e) Review with the individual, on a regular basis, the effectiveness of the service plan and make appropriate and cost-effective revisions to the plan, as required, based on achievement of the expected outcomes, the individual’s degree of satisfaction with the services and providers, the individual’s changing capabilities, and the ongoing availability of home and community-based services; (f) Review and reassess, at least every 12 months, and whenever there is a significant change in the individual’s ability to function in the community, the individual’s service plan and level of care; (g) Lead team meetings in conjunction with the individual; (h) Maintain records for at least 7 years. (i) Advise the individual of the individual’s right to an administrative hearing in accordance with sections 17b-60 and 17b-61of the Connecticut General Statutes if the individual is aggrieved by the department’s decision with respect to the individual’s application or eligibility for the ABI waiver program, or if services are reduced, denied or terminated; (j) Maintain a waiting list of individuals who have applied for and been pre-screened for ABI services; (k) Establish provider qualifications and, through maintain its fiscal intermediary, establish and maintain a directory of providers; (l) Establish payment rates for all services offer under or delivered the ABI waiver program; (m) Pay for approved ABI waiver services health or delivered by providers on behalf of the individual; and (n) Maintain, and comply with, a critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s healthor welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-13. Provider Responsibilities (a) All providers shall: (1) Comply with any critical incident reporting protocols developed by the department for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (2) Report their arrest, or any arrest of an employee, to the department within 10 business days. The failure of a provider to report any such arrest may result in termination of the provider from the ABI waiver program. (3) Complete a state and federal criminal background check, at the expense of the applicant or provider. (4) Accept payment only for services that were actually provided to the individual and that do not violate the rules, regulations, standards, or laws governing the Medicaid program in accordance with sections 17-83k-1 to 17-83k-7, inclusive, of the Regulations of Connecticut State Agencies. A provider may be suspended or terminated from participation in the program for accepting payment for services not provided or for violating the rules, regulations, standards, or laws governing the program. (b) Agencies that employ providers shall: (1) Ensure that all staff, volunteers, interns or other persons employed by, supervised by, or representing the agency who may have direct contact with individuals receiving ABI waiver funding, meet and maintain all criminal background standards and requirements as set forth in subsection (a)(3) of this section. (2) Have policies in place regarding the provision of language services to individuals while receiving ABI waiver services, and shall not rely on the assistance of individuals’ friends, family or others. (3) Deliver training to staff members regarding the provision of services that are person-centered and culturally competent. (4) Have policies and procedures in place regarding employee standards of conduct. Such policies and procedures shall include, but are not limited to, the following topics: (A) The need for providing person-centered services; (B) The importance of respecting individuals’ rights, including privacy and self-determination; (C) The prohibition against neglect, abuse, and harassment of individuals; (D) The prohibition of the use of drugs or alcohol, or of being under the influence of drugs or alcohol, while providing services to individuals; (E) The laws covering confidentiality of all participant information collected, used or maintained; and (F) Critical incident reporting requirements. (5) Establish a quality assurance plan. Such plan is subject to the approval by the department and shall include random checks of staff performance. (NEW) Sec. 17b-260a-14. Provider participation (a) It shallbe a certification requirement of the department for all servicespecialties that, in order to participate in the ABI waiver program and receive payment from the department, all providers: (1) Enroll with the department as a provider in the Medicaid program and sign the Medicaid Provider Enrollment Agreement, as directed by the department, which agreement may include addenda specific to the ABI waiver program and may be amended from time to time; (2) Comply with all applicable state and federal statutes and regulations, including, but not limited to, sections 17b-262-522 et seq. of the Regulations of Connecticut State Agencies, the Medicaid Provider Enrollment Agreement and any applicable addenda, and all departmental policies, as amended from time to time (3) Comply with all of the provisions and requirements of applicable Medicaid waivers, as amended from time to time; (4) Deliver, document, and bill only for those services that are outlined in the individual’s service plan; and (5) Comply with the requirements of any corrective action plan imposed by the department. (b) The commissioner shall have the discretion to refuse to list a provider in the provider directory, remove the provider’s name from the provider directory, or refuse payments to a provider, if the provider performing the services poses a threat to the health or safety of individuals participating in the ABI waiver program, or has been convicted in this state or any other state of a felony, as defined in section 53a-25 of the Connecticut General Statutes, involving: forgery under sections 53a-137 of the Connecticut General Statutes; robbery undersection 53a-133 of the Connecticut General Statutes; larceny under sections, 53a-119, 53a-122, 53a-123, and 53a-124 of the Connecticut General Statutes; sexual assault under sections 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a, 53a-72b, 53a-73a of the Connecticut General Statutes; or assault under sections 53a-59, 53a-59a, 53a-60, 53a-60a, 53a-60b, and 53a-60c of the Connecticut General Statutes; or has been convicted in this state or any other state of an offense, as defined in section 53a-24 of the Connecticut General Statutes, involving: cruelty to persons under section 53-20 of the Connecticut General Statutes; vendor fraud under sections 53a- 290 to 53a-296, inclusive, of the Connecticut General Statutes; or the abuse of an elderly, blind or disabled person, or a person with intellectual disability under sections 53a-320 to 53a-323, inclusive, of the Connecticut General Statutes. (NEW) Sec. 17b-260a-15. Corrective action and provider cooperation (a) If a provider fails to comply with sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or MedicaidProvider Enrollment Agreement, the department may require the provider to comply with a corrective action plan. (b) The provider shall cooperate fully with any department, state, or federal audit or investigation, and shall correct any deficiencies identified in the course of such audit or investigation. (NEW) Sec. 17b-260a-16. Provider fiscal responsibility (a) For purposes of this section: (1) “Fraud” means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to that person or some other person. It includes any act that constitutes fraud under applicable federal or state law. (2) “Abuse” means practices that are inconsistent with generally acceptedfiscal or business practices and result in unnecessary cost to the ABI waiver program. (b) The provider shall not engage in or commit fraud or abuse, including, but not limited to: (1) Billing for services not rendered; (2) Billing for services not in the service plan; (3) Billing for services not medically necessary; (4) Falsely identifying the person who actually performed a service, including billing for services performed by an individual who is not credentialed; (5) Failing to adequately document all servicesthat are billed; (6) Billing for services for ABI participants services that who are institutionalized at the time in which the service has been billed as having been rendered; or (7) Violating Medicaid policies, procedures, rules, regulations, or statutes. (NEW) Sec. 17b-260a-17. Client documentation and provider reporting (a) Providers shall retain records to document services submitted for Medicaid reimbursement for at least seven years from the date the service or item was provided. Documentation shall include the following: (1) Provider’s name and signature; (2) Dates of service; (3) Start time for each visit; (4) End time for each visit; (5) A description of duties performed or items provided; (6) Client goals and documentation of progress toward meeting those goals; and (7) Unless otherwise described in the provider’s applicable Medicaid Provider Enrollment Agreement and any addenda thereto,the individual’s name and the signature of the individual or the individual’s legal representative. (b) Upon written request presented to the provider, the department or its authorized agent shall be given immediate access to, and permitted to review and copy, any and all records and documentation used to support claims billed to Medicaid. For purposes of this subsection, “immediate access” means access to records at the time the written request is presented to the provider. (c) The provider shall submit written reports on the individual’s status and progress for each of the first three months of the individual’s participation in the program, and quarterly thereafter, to the care manager in a manner that is set forth by the department. (NEW) Sec. 17b-260a-18. Provider termination, suspension or disqualification (a) Failure to comply with any requirements in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or Medicaid Provider Enrollment Agreement, may result in the nonpayment of services, suspension or termination from participation in the ABI waiver program, or any other sanction available under state or federal law. (b) The department may suspend or terminate the provider from participation in the ABI waiver program immediately and withoutprior notice if it has reason to believe that a providerposes a threat to, or has acted in a manner that posed a threat to, the health, safety or welfare of an individual participating in the ABI waiver program, or has engaged in fraudulent or abusive program practices.

Connecticut's Call to Action: Urgent Housing and Service Regulation Reforms Needed in Federally Funded Programs In the heart of New England, Connecticut stands at a pivotal moment. The need for comprehensive reform in agency housing and service regulations within its federally funded programs has never been more urgent. ABI Resources, a beacon of commitment and care in Connecticut, is at the forefront of this critical change, proactively engaging with Governor Ned Lamont and influential representatives in both the Senate and the House. The voices of Senator Richard Blumenthal, Senator Chris Murphy, Representative John Larson, Representative Joe Courtney, Representative Rosa DeLauro, Representative Jim Himes, and Representative Jahana Hayes are instrumental in driving this change forward. As constituents and concerned citizens, your voice is not just important; it's crucial. The collective call for fair and equitable treatment for all resonates deeply in our communities. This is not just a matter of policy - it's a matter of justice and humanity. The Role of ABI Resources: A Beacon of Hope and Excellence ABI Resources, a renowned organization in Connecticut, exemplifies dedication and excellence in supporting individuals and families. Their collaborative approach with government and community service providers like the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services, sets a standard for others to follow. Their partnerships with leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford showcase their commitment to high-quality, personalized care. ABI Resources' involvement in vital programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver demonstrates their pivotal role in enhancing the lives of those they serve. The Need for Reform: A Glimpse into the Current Scenario The current state of agency housing and service regulations in Connecticut's federally funded programs reveals significant gaps. These gaps affect not just the quality of care but also the dignity and rights of individuals relying on these services. It's a scenario that demands immediate attention and action. Your Role: A Vital Piece of the Puzzle As a member of the Connecticut community, your support and voice are invaluable. Engaging with your representatives, spreading awareness, and voicing your concerns are powerful actions that can lead to real change. When the community unites for a cause, the impact is profound. Unite for the Cause: A Future of Fairness and Quality Care Imagine a Connecticut where every individual receives the care and support they deserve, where regulations are not just guidelines but pathways to a better life for all. This vision is achievable, but it requires the collective effort of every one of us. Call to Action Connecticut is at a crossroads, and the path we choose now will define our future. Let's unite for this cause. Reach out to Governor Ned Lamont and your representatives. Share your stories, express your concerns, and demand the change we desperately need. Together, we can build a Connecticut that upholds the values of fairness, dignity, and exceptional care for everyone. Call to Action! Connecticut urgently needs to reform agency housing and service regulations in its federally funded programs. ABI Resources is proactively engaging Governor Ned Lamont and key representatives in the Senate (Richard Blumenthal, Chris Murphy) and the House (John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, Jahana Hayes) to drive this change. Your voice is crucial in ensuring fair and equitable treatment for all. Let's unite for this cause. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. "Action Required: ABI Resources Calls for Community Support in Major CT Housing Reform!" "Don't Miss Out: Be Part of Connecticut's Historic Shift in Federally Funded Housing Programs" "Alert: How Connecticut's Housing Policy Could Change Forever – And Why You Should Care" "Governor Lamont's Next Big Challenge: ABI Resources Advocates for Urgent Housing Reforms" "Critical Update: How ABI Resources is Revolutionizing Housing and Services in Connecticut" "Connecticut Residents: Your Chance to Influence Major Housing Policy Changes is Here!" "New Era in Housing: Join ABI Resources in Pioneering Change for Connecticut's Community" "Make a Difference: Your Role in Steering Connecticut Towards Equitable Housing Solutions" "Breaking: ABI Resources Leads Monumental Push for Housing Regulation Overhaul in CT" "Connecticut's Turning Point: How You Can Help Shape the Future of Housing and Services" "A Call to Action: Join Forces with ABI Resources for Groundbreaking Housing Reforms" "Major Alert: Connecticut's Housing System on the Brink of Revolution with Your Help" "Governor Lamont, Senators, and You: A United Front for Connecticut's Housing Reforms" "Urgent Community Call: ABI Resources Driving Change in CT's Housing Regulations" "Your Voice Matters: Impacting Connecticut's Housing Policies with ABI Resources" "Time to Act: ABI Resources Urges Public Support for Critical Housing Reforms in CT" "Empower Change: How Connecticut Citizens Can Shape Housing Policies for the Better" "Connecticut's Housing Crisis: Why ABI Resources Needs Your Support Now More Than Ever" "Revolutionize CT's Housing: How Your Involvement Can Make a Real Difference" "Exclusive: Inside ABI Resources' Campaign for Transforming Connecticut's Housing Landscape"