Community Choice Guide/ person centered planning consultation

Contracted option for intensive one on one relocation support to:

• Assess and/or implement person-centered transition plan authorized by case management.
• Serve as a liaison between nursing facility, in home case management, staff at institutional settings, housing or AFH contacts, informal supports, medical personnel, legal personnel, and any other involved party.
• Help arrange the participant’s physical move from the institutional setting.
• Work with local housing authorities and other community resources regarding housing availability, subsidies, and voucher capacity.
• Act as a single point liaison between landlords or housing providers.

Life skills consultation and training, including community access and self-advocacy training

Training or education to help the participant and their caregiver with personal skill development related to the individual’s care plan. 

• Examples: 
• Budgeting on a limited income
• Self management of diabetes.
• Support of less formal or atypical daily activities, such as those that might be found through local YMCA-type organizations, Senior or Community Centers, etc.
• Services that may be accomplished by a Peer Coach.

Family and informal caregiver support

• In home respite care for informal caregivers.
• Support groups/self care/stress management.
• Training for informal caregivers.
• Assistance with challenging behaviors.
• Brief solution focused therapy.

Extended state plan services including mental health

If not otherwise covered by Medicaid, provide:

• Supports and services provided by people with specialized skill, certification, or licenses such as Physical, Occupational, and Cognitive Therapy.
• Mental health services for participants who do not meet current Access to Care standards, such as someone experiencing mild depression or anxiety related to their transition, or instances in which the authorized level of service does not meet the individual’s needs.

Consultation and training regarding challenging behavior issues

• Direct interventions to decrease aggressive, destructive, and sexually inappropriate or other behaviors that compromise the participant’s ability to remain in the community.
• Specialized cognitive counseling (TBI, dementia).
• Consultation may be in the participant’s home or in common community settings that the person needs to navigate (e.g. stores, offices, parks etc.).

Service animals/related training

• Purchase and training of a certified service animal, including training for owner.

Assistive technology and home and vehicle adaptations

• Services which modify a participant’s residence or vehicle to accommodate the participant’s disability and promote functional independence, health, safety and welfare.  Demonstration services will cover items that are beyond the scope of what are typically covered.  Examples:
• computers
• upgraded wheelchairs