CHAPTER 1800 Community Guide Services

CHAPTER 1800
SPECIFIC PROGRAM REQUIREMENTS
FOR
COMMUNITY GUIDE SERVICES
SCOPE OF SERVICES
1801 General
Community Guide Services are direct assistance to participants in skills building and information in meeting participant-direction responsibilities. These services are available only for participants who choose the participant-direction option for service delivery. The participant, with the Support Coordinator, determines the amount of Community Guide Services, if any, and the specific services that the Community Guide will provide. The specific Community Guide Services for the participant are specified in the Individual Service Plan. Participants may elect to receive Community Guide Services, and when elected, participants choose their Community Guide.
Community Guide Services are individualized services designed to assist participants in meeting their responsibilities in the participant-direction option for service delivery. Community Guides provide information, direct assistance, and training to participants in support of participant direction. The intended outcome of these services is to improve the participant’s knowledge and skills for participant direction.
Community Guides assist and train participants to build the skills required for participant direction, such as exploring and brokering available community resources, problem solving and decision-making, being an effective employer of support workers, developing and managing the individual budget, and record keeping. Information provided by the Community Guide helps the participant’s understanding of provider qualifications, record keeping, and other participant-direction responsibilities.
The scope, intensity, and frequency of Community Guide Services may change over time, based on the needs of the participant. Community Guide Services providers offer (or arrange when needed) any of the standard services listed in section 1805 – Covered Services that are needed by the participants served and specified in the participants’ Individual Service Plans.
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1802 Special Requirements of Participation
1802.1 Individual Provider
In addition to those conditions of participation in the Medical Assistance Program as outlined in Part I, Policies and Procedures for Medicaid/PeachCare for Kids Manual applicable to all Medicaid providers, Section 106 (General Conditions of Participation), and PART II, Chapter 600 Policies and Procedures for the COMP Program, Community Guide Services providers must meet the following requirements:
1. Individual Providers of Community Guide Services must:
a. Be 18 years or older;
b. Have a minimum of a bachelor’s degree in a human service field and experience in providing direct assistance to individuals with disabilities to network within a local community or comparable training, education or skills;
c. Agree to or provide required documentation of a criminal records check, prior to providing Community Guide services;
d. Be knowledgeable about resources in any local community in which the provider is a Community Guide;
e. Have demonstrated connections to the informal structures of any local community in which the provider is a Community Guide;
f. Have an understanding of Community Guide services, DD waiver participant-direction service delivery requirements, and strategies for working effectively and communicating clearly with individuals with DD and their families/representatives;
g. Attend all mandatory, DBHDD training.
2. Participant-Directed Services Documentation and other Requirements: Documentation and other requirements for individual providers of participant-directed services are specified in Part II Policies and Procedures for COMP, Chapter 1200.
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3. Duties of the Community Guide include but are not limited to the covered services in 1805.
1802.2 Provider Agencies
In addition to those conditions of participation in the Medical Assistance Program as outlined in Part I, Policies and Procedures for Medicaid/PeachCare for Kids Manual applicable to all Medicaid providers, Section 106 (General Conditions of Participation), and PART II, Chapter 600 Policies and Procedures for the COMP Program, Community Guide Services provider agencies must meet the following requirements:
1. Staffing Qualifications and Responsibilities
Provider agencies rendering Community Guide Services must have staffing that meets the following requirements:
a. A designated agency director who must:
 Have either a bachelor’s degree in a human service field (such as social work, psychology, education, nursing, or closely related field) and five years of experience in service delivery to persons with developmental disabilities, with at least two of these years serving in a supervisory capacity; or
 Have an associate degree in nursing, education or a related field and six years of experience in service delivery to persons with developmental disabilities, with at least two of these years serving in a supervisory capacity; or
b. Duties of the Agency Director include, but are not limited to:
 Oversees the day-to-day operation of the agency;
 Manages the use of agency funds;
 Ensures the development and updating of required policies of the agency;
 Manages the employment of staff and professional contracts for the agency;
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 Designates another agency staff member to oversee the agency, in his or her absence.
c. At least one agency employee or professional under contract with the agency must:
9. Be a Developmental Disability Professional (DDP) (for definition, see Part II Policies and Procedures for COMP, Appendix I);
10. Have responsibility for overseeing the delivery of Community Guide Services to participants.
d. The same individual may serve as both the agency director and the Developmental Disability Professional;
e. Duties of the DDP include, but are not limited to:
 Overseeing the services and supports provided to participants;
 Supervising the formulation of the participant’s plan for delivery of Community Guide Services;
 Conducting functional assessments; and
 Supervising high intensity services.
f. Provider agencies must have available a sufficient number of employees that meet the Community Guide experience, training, education or skills qualification specified above for Individual Providers to provide all Community Guide Services that are needed by the participants served and specified in the participants’ Individual Service Plans. .
g. Duties of the Community Guide include but are not limited to the covered services in 1805.
2. Agency Policies and Procedures – Each provider agency must develop written policies and procedures to govern the operations of Community Guide Services, which follow the Standards for the Georgia Department of Behavioral Health and Developmental Disabilities refer to Part II Policies and Procedures for COMP.
3. Participant-Directed Services Documentation and other
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Requirements: Documentation and other requirements for providers of participant-directed services are specified in Part II Policies and Procedures for COMP, Chapter 1200.
4. DBHDD Contract/LOA and DBHDD Community Service Standards: Providers must adhere to DBHDD Contract/LOA, DBHDD Core Requirements for All Providers and all other applicable DBHDD Standards, including accreditation by a national organization (CARF, JCAHO, The Council, Council on Accreditation) or certification by DBHDD (see Part II Policies and Procedures for COMP, Chapter 603).
1803 Special Eligibility Conditions
A. Community Guide Services are only for participants who opt for participant-direction.
B. The participant determines the amount of Community Guide Services, if any, and the specific services that the Community Guide will provide.
C. The specific Community Guide Services for the participant are specified in the Individual Service Plan.
D. Participants may elect to receive Community Guide Services, and when elected, participants choose their Community Guide.
E. The need for Community Guide Services must be related to the individual disability and tied to a specific goal in the Intake and Evaluation Team approved Individual Service Plan (ISP).
1804 Prior Approval
Community Guide Services must be authorized prior to service delivery by the applicable DBHDD Regional Office at least annually in conjunction with the Individual Service Plan development and with any ISP revisions.
1805 Covered Services
Reimbursable Community Guide Services include the following based on the assessed need of the participant and as specified in the approved ISP:
1. Direct assistance to participants in exploring and brokering available community resources.
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2. Direct assistance to participants in meeting their participant-direction responsibilities.
3. Information and assistance that helps the participant in problem solving and decision-making.
4. Information and assistance that helps the participant in developing supportive community relationships and other resources that promote implementation of the Individual Service Plan.
5. Assistance with developing and managing the individual budget;
6. Assistance with recruiting, hiring, training, managing, evaluating, and changing employees;
7. Assistance with scheduling and outlining the duties of employees;
8. Training the participant to be an effective employer of support workers;
9. Information and assistance in understanding provider qualifications, record keeping and other participant-direction requirements.
1806 Non-Covered Services
a. Community Guide services cannot duplicate Support Coordination services.
b. Community Guides cannot provide other direct waiver services, including Support Coordination, to any waiver participant.
c. Community Guide agencies cannot provide Support Coordination services.
d. Payment is not made, directly or indirectly, to members of the individual’s immediate family, except as approved as indicated in Part II Policies and Procedures for COMP, Chapter 900.
e. Payment is not made for those goods and services covered by the State Medicaid Plan except where a participant’s need exceeds State Plan coverage limits and exceptions to the coverage limits are not available.
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1807 Basis for Reimbursement
The reimbursement rate for Community Guide Services is found in Appendix A.
A. The unit of service is 15 minutes.
B. The daily maximum number of units is 32.
C. Annual maximum is $2,000.32.
Self-Directed
Limit: 1 unit = $1.00
Annual limit is as authorized in the individual budget up to an annual maximum of $2,000.
1808 Participant-Direction Options
A. Participants can choose the self-direction or co-employer options with Community Guide Services.
B. An individual serving as a representative for a waiver participant in self-directed services is not eligible to be a participant-directed provider of Community Guide Services.
C. For details on participant-direction, see Part II Policies and Procedures for COMP, Chapter 1200.
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