PURPOSE: This rule describes requirements for certification as a provider of individualized supported living services reimbursed under Missouri’s Medicaid waiver for persons with mental retardation and other developmental disabilities. Specifically, this rule describes outcomes expected for individuals who receive individualized supported living services. Achievement of these outcomes will ensure that individuals assisted under this program receive services and supports adequate to assure their health and safety while enjoying an improved quality of life. This rule requires a certified provider of individualized supported living services to provide or arrange the services, supports and opportunities necessary for individuals to achieve these outcomes.

1. (1) The individualized habilitation plan developed by the certified provider and the regional center shall address assistance and support required by individuals to achieve outcomes specified in the seven (7) areas identified under section (2) of this rule.

2. (2) The certified provider shall promote conditions that provide a valued lifestyle for the individuals and shall document and demonstrate efforts to assist and support the individuals in the following areas:

   1. (A) Financial Resource Management.

      1. 1. The individual has sufficient available

resources to cover his/her basic living needs, including, but not limited to, shelter, food, transportation and clothing.

1. 2. There is effective management of the

individual’s financial resources to ensure that basic needs are met.

1. 3. The individual is able to participate

as fully as possible in decision-making about use of his/her financial resources through development of money and budgeting concepts, and values that encourage financial responsibility;

1. (B) Housing.

   1. 1. The individual has housing that meets

local requirements for residential homes, is secure and has adequate heating, water and electricity.

1. 2. The individual has basic furnishings

necessary for daily living, including, but not limited to, a bed, chairs, table, kitchen facilities and lighting.

1. 3. The individual has opportunity to live

in a neighborhood with ready access to needed resources.

1. 4. The interior and exterior of the home

are safe and clean.

1. 5. The individual is given needed sup-

port in choosing his/her own residence and persons with whom s/he will reside, if any.

1. 6. The individual is able to exercise con-

trol over his/her home environment, including choice of location, personalized furnishings and decor, and control of temperature and lighting;

1. (C) Health.

   1. 1. The individual’s health is maintained

through adequate nutrition, exercise, safe behavior, medical and dental monitoring, and appropriate medications when needed.

1. 2. The individual receives prompt and

up-to-date treatment for physical problems.

1. 3. The individual’s lifestyle encourages

wellness;

1. (D) Safety.

   1. 1. Potential environmental dangers are

minimized.

1. 2. The individual has access to prompt

and appropriate emergency services, such as police, fire department, ambulance and crisis line. In addition, the certified provider must provide an around-the-clock crisis response system;

1. (E) Appearance and Hygiene. The individual—

   1. 1. Minimizes health-related problems

through adequate personal hygiene and clothing choices appropriate for weather conditions.

1. 2. Maintains acceptable hygiene and

appearance so as not to restrict where s/he can live, work and socialize;

1. (F) Relating With Others. The individual has—

   1. 1. The means to communicate on a daily

basis with primary people in his/her life.

1. 2. Support people with whom s/he is

able to maintain contact.

1. 3. Opportunity for relationships with

friends and peers that provide companionship, intimacy and support.

1. 4. Opportunity for relationships with

people who are nondisabled; and

1. (G) Activities. The individual has—

   1. 1. Means to move about his/her home

and community as necessary to satisfy his/her basic needs.

1. 2. Access to a wide range of community

resources for work, leisure and shopping.

1. (3) The certified provider shall not knowingly employ nor retain in employment any staff in positions providing direct services to individuals when that person has been convicted of, or has charges pending for, a disqualifying felony offense.
2. (4) In accordance with general state or local government policy, or both, and sound business practice, the certified provider shall maintain liability insurance on staff who provide direct services to individuals.
3. (5) Major unusual incidents shall be reported to the regional center.

AUTHORITY: section 630.050, RSMo 1994.* This rule was originally filed as 9 CSR 30- 5.020. Emergency rule filed Aug. 4, 1992, effective Sept. 1, 1992, expired Dec. 29, 1992. Original rule filed Aug. 4, 1992, effective Feb. 26, 1993. Amended: Filed May 25, 1995, effective Dec. 30, 1995. *Original authority 1980, amended 1993.