AGENCY FOR HEALTH CARE ADMINISTRATION
RULE NO.:RULE TITLE:
59G-13.070Developmental Disabilities Individual Budgeting Waiver Services
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 44 No. 59, March 26, 2018 issue of the Florida Administrative Register.
There are no changes to the rule text.
The following changes have been made to the Florida Medicaid Developmental Disabilities Individual Budgeting Waiver Services Handbook, incorporated by reference in the rule:
Page 1-4, Definitions.
Behavior Analysis Services Plan. No change.
Budget Allocation. No change.
Case Review: A regularly scheduled review of consumer progress with the behavior analyst in which graphed data for targeted maladaptive and replacement behaviors or skill acquisition is shared with staff. Case review includes:
Positive feedback to staff on recipients who have had improvements;
Identification of targets that are not on track and actions needed to resolve;
Discussion of any slowing progress and identification of strategies to address progress; and
Discussion of recent reactive strategies and a plan for how the intervention might be avoided or improved upon in the future.
Central Record through Cost Beneficial. No change.
Page 2-64, Residential Habilitation (Enhanced Intensive Behavior), continued.
Who Can Provide. Second bullet now reads:
Staff responsible for providing behavior analysis services must be at least Level 3 board certified behavior analysts on active status with caseloads of no more than 18 EIB recipients (and no more than 20 total individuals), with at least one analyst on-call 24/7.
Fourth bullet now reads:
At the time of designation as an EIB provider, t The provider must have at least one registered behavior technician per shift, per site, at all times of operation.
The last bullet now reads:
Be a registered behavior technician (RBT) or have received 40 hours of training in RBT techniques provided by a Behavior Analyst Certification Board (BACB) certified RBT trainer within 6 months of providing direct care services in an EIB setting with successful completion of a competency assessment equivalent to the certified RBT assessment. Prior to rendering EIB services, direct care staff shall have successfully completed 20 classroom hours of-behavior analysis training and meet the criteria to become a behavior assistant. Registered behavior technician (RBT) certification may substitute. (Ninety hours of university or college instruction in applied behavior analysis will count as meeting the requirements of the 20 classroom hours.)
After EIB designation, all staff, including new hires, must complete RBT training within 6 months and must be certified within the first year of employment.
Page 2-65, Residential Habilitation (Enhanced Intensive Behavior), continued.
Staffing Requirements. First bullet now reads:
Maintain sufficient staffing ratios to meet all recipients’ needs:
Minimum direct staffing ratio of 1:1 during awake hours and 1:2 during each individual’s sleep
hours.
For EIB Medical, the minimum direct staffing ratio is 1:2 with 24-hour nursing coverage.
Last three bullets now read:
Monitor and document competency for 50% of staff in basic behavioral principles on a monthly basis.
Monitor and document competency for all 50% of staff in the use of basic behavioral principals when carrying out each client’s Behavior Analysis Service Plan on a quarterly monthly basis. This monitoring can be done in real time with the recipient or through staff role play.
Monitor and document competency for all 50% of staff in training formal skill acquisition programs for each client on a quarterly monthly basis. This monitoring can be done in real time with the recipient or through staff role play.
Page 2-66, Residential Habilitation (Enhanced Intensive Behavior), continued.
Service Requirements. First paragraph now reads:
Enhanced intensive behavior services include aggressive, consistent implementation of a program of treatment and training unique to the needs of the recipient. The service includes participation in training opportunities available to all recipients in the home, as well as individualized services needed for health, safety, and welfare. health services, and related services. The goal of EIB services is to prepare the recipient to re-integrate to a less restrictive setting or service, achievable through:
Page 2-68, Residential Habilitation (Enhanced Intensive Behavior), continued.
Reimbursement. Last paragraph now reads:
Behavior assistant, behavior analysis, and nursing services must not be provided as additional billable services in conjunction with are included in the rate for EIB residential habilitation. and are not reimbursable separately.
Appendix C, Service Specific Training Requirements.
Page C-8, Residential Habiliation (Enhanced Intensive Behavior), second paragraph in the right column now reads:
Annual In-Service Training Requirement
Providers must complete the equivalent of eight hours of annual in-service training through the participation in recipient case-review or in combination with training related to behavior analysis. An attendance sheet must be used for documenting participation in consumer case review and a summary of the case review discussion must be maintained in the provider’s records. Documentation of completion for the Behavior analysis in-service training that meets the requirements is specified at the beginning of this Appendix. Retaking basic APD training courses does not meet this requirement.
Appendix I, page I-1 now reads: Qualifications for Trainers/Trainer Agreement Form.
