Available for people using Individual Options, Level One, and SELF waivers

Adult Day Support (sometimes called “Day Hab” or “Adult Day Array”) helps a person build connections in their community. With this service, people can learn:

• how to meet and talk with new people,
• what activities are in their community,
• how to get places independently,
• and what jobs are available in their area.

While taking part in Adult Day Support services, a person can also have help with personal care, such as going to the restroom, eating meals, and taking medication. 

When to Apply this Service

Adult Day Support may be available based on an understanding of each person’s needs, discovered during an assessment. The focus of this mode of supporting a person is discovering and developing skills, interests and talents, and finding ways to connect to the community based on them. Outcomes related to Adult Day Support should emphasize relationships with people with and without disabilities, and progress toward a better understanding of where and how each person can develop their interests and talents with others.

Other ongoing support activities for this service include activities such as personal care and supervision, skill reinforcement, and training in self- determination.

Providing this Service

Agency providers that have a Medicaid provider agreement and are DODD-certified can provide this service.

Adult Day Support is provided as a group service.  Staffing ratios should be a part of the person-centered planning process.  The team is responsible for considering the level of supervision and support the person may require in various environments to ensure health and safety and achievements of outcomes in the ISP. No more than 16 people may receive services in one group regardless of funding source or service delivery needed.

Adult Day Support services can be delivered using the following methods:

• In-person in a non-residential setting separate from the person’s home
• In-person in an integrated community setting for a group of four or fewer

Virtual support using interactive technology that has the capability to engage in two-way, real-time audio and video communication.

Adult Day Support helps a person build connections in their community. With this service, people can learn about

• how to meet and talk with new people,
• what activities are in their community,
• how to get places independently,
• and what jobs are available in their area.

While taking part in Adult Day Support services, a person can also have help with personal care, such as going to the restroom, eating meals, and taking medication.

When to Apply this Service

The person’s service and support administrator, or SSA, will assess them for a need for Adult Day Support. If there is a need, the SSA will include it in the person’s individual service plan.

This service includes activities such as

• personal care including support and supervision in the areas of personal hygiene, eating, communication, mobility, toileting, and dressing to ensure a person’s ability to experience and participate in community living,
   
• skill reinforcement including the implementation of behavioral support strategies, assistance in the use of communication and mobility devices, and other activities that reinforce skills necessary to ensure the person's participation in community life,
   
• training in self-determination including assisting the person to develop self-advocacy skills, and 
   
• recreation and leisure including supports identified in the individual service plan as being therapeutic in nature, rather than merely providing a diversion, and being necessary to assist the person to develop or maintain social relationships and family contacts.

Providing this Service

Agency providers that have a Medicaid provider agreement and are DODD-certified can provide this service.

The Acuity Assessment Instrument or AAI identifies the maximum group size allowable; however, the provider must ensure that sufficient staff are available to support people with disabilities with achieving outcomes and maintaining health and welfare. Staffing ratio should be a part of the person-centered planning process. The team is responsible for considering the level of supervision and support the person may require in various environments. The AAI is utilized for the purpose of the billed unit and is no longer calculating a cap amount of funds available based on the score.

Training Requirements for this Service

After initial provider certification and completing annual training requirements, the following is required to provide this service.

During the First Year

During the first year after hire, providers (other than those who have at least one year of experience providing Adult Day Support at the point of hire) will be assigned and have access to a mentor.

No later than one year after hire, providers (other than those who have at least one year of experience providing Adult Day Support at the point of hire) must successfully complete at least eight hours of training specific to Adult Day Support that includes but is not limited to

• developing natural supports,
• and learning about self-determination, which includes assisting the person to develop self-advocacy skills, to exercise his or her civil rights, to exercise control and responsibility over the services he or she receives, and to acquire skills that enable him or her to become more independent, productive, and integrated within the community.

Providers must successfully complete on-the-job training specific to each person he or she serves, including

• what is important to the person and what is important for the person,
• and the person’s support needs, such as behavioral support strategy, management of the person’s funds, and medication administration or delegated nursing.

During the Second Year

Beginning in the second year of hire, providers must annually complete at least eight hours of training that includes

• the role and responsibilities of direct services staff regarding services including person-centered planning, community integration, self-determination, and self-advocacy,
• a person’s rights,
• the requirement of the Major Unusual Incidents rule, including a review of Health and Welfare Alerts issued by DODD since the previous year’s training,
• the requirements for providing behavioral support to the person,
• and best practices related to providing Adult Day Support.

Billing and Payment Information

All services must be delivered as specified in the individual service plan and authorized in Payment Authorization for Waiver Services, known as PAWS, to be successfully submitted for payment through eMBS.

Rates and limits for Adult Day Support are contained in the service rule's appendix.