FAMILY SUPPORT SERVICES
Type of Service
Definition
Specifics
Requirements
Behavioral
Consultation and
Support
Professional Services which train and
support the family in avoiding and/or
responding appropriately to behaviors
which may create barriers to the
individuals with a developmental
disability and their ability to remain in
the home and/or community.
Services intended to address problematic behaviors by
Behavior Specialist, Board Certified Behavior Analyst,
or Psychologist and any additional criteria as listed
$94.24 per hour with $2450.24 MaximumMust submit Denial letter from Insurance or
EOBs in order for services to be paid. Must
submit School Denial. Does not cover copays
or deductibles.
Child Day Care/After
School Services
Must apply for Caps first
$3000 Maximum
An array of services that support an
individual with a development disability
in being involved in their community,
based on their needs, wants, and
preferences.
The goal of services is to help the person learn to
improve their skills in personal care, being
independent, socializing with others, adjusting to
community life, using resources in their community,
and becoming independent outside of their home or
living environment as well as to increase the
individual’s skills and contacts in community living.
CAI- Maximum $29.08 per hour
CAG-Maximum $12.16 per hour
Provider must be approved by Avita
Maximum Funding $19.72 per hour or
$128.52 per Day
Community Living
Support
An array of services to assist an
individual with the developmental
disability to perform activities of daily
living.
These services include the following:
Assistance with, and/or training in activities of daily
living, i.e. bathing, dressing, grooming, feeding,
toileting, transferring, and other similar tasks. This
also includes the safety and the health of the
individual.
Accompanying individuals and facilitating their
participation in visits for medical care, therapies,
personal shopping, recreation and other community
activities. (This includes the staff to serve as
interpreters and communicators, as well as the
transportation cost to provide such services.
Training and assisting in the household duties in such
activities as meal preparation, cloth laundering, light
housekeeping, making of the bed, shopping, simple
home repair, yard care and other similar tasks.
Training and support in the areas of social, emotional,
physical and intellectual development.
Counseling
Services utilizing a varied number of
specific psycho-social approaches by a
licensed counselor for the individual with
a developmental disability and/or their
family.
These services are aimed at assisting the individual
with a developmental disability in coping with life
circumstances.( Behavioral, Mental Healthy, Family)
Licensed Psychologist, LPC, LCSW, and
Psychiatrist
$2450.24 Maximum-Must submit Denial
Letter from Insurance or Explanation of
Benefits. Must submit school denial. No
copays or deductibles
Community Access
Provider must be approved by Avita
Type of Service
Definition
Specifics
Requirements
Dental Services
The full array of services designed to care
for the teeth, oral cavity and
maxillofacial area.
Whether in-patient or out-patient, services must be
provided by or under the direct supervision of a
licensed dentist.
Must submit denial letter from Insurance or
Explanation of Benefits. Does not cover
copays, deductibles, orthodontics, or anything
labeled miscellenous
These modifications. Changes and/or repairs do not
change the square footage of the home.
Environmental
Modifications
Changes or repairs to the personal home
of the family/caregiver that are designed
to increase their ability to enhance the
development/functioning, health or well
being of the individual with a
developmental disability.
Prior Approval Required, Must have 3 quotes.
Lifetime Maximum $7,000 Annual-Must
submit proof of home ownership
With the utilization of Exceptional Disability Related
Living Cost, may be approved on a one-time,
emergency basis, or for ongoing needs.
Requires IFSP every 6 months-Must submit
proof of illness or need for equipment and
copy of utility bill and usage for last 12
months
Exceptional Disability
Related Living Cost
This service is to be utilized to pay living
expenses that are higher than normal
due to the nature of the person’s
developmental disability or to cover
unexpected emergency costs. EX: A
person who may be heat sensitive may
require an air conditioning during the
summer months. The family support
may include the cost of the extra cost due
to higher than normal electric bills
during the summer month as not to
stress the family household budget. Also
in the cases where the person with the
developmental disability may be on
special monitoring machines or
equipment.
Family Support
Transportation Family
Travel and travel related cost (including
subsistence cost) associated with the
receipt of a service identified in the plan,
and documented by the Family Support
Coordinator to be necessary to meet the
needs of the family
Travel must be over 100 miles round trip for medical
reasons or activities and services beyond the scope of
the family’s normal responsibilities
Must submit mapquest or proof of miles,
proof of appointment from provider, and
denial from Medicaid or Insurance for
Transportation
Family Support
Transportation
Provider
Travel and travel related cost (including
subsistence cost) associated with the
receipt of a service identified in the plan,
and documented by the Family Support
Coordinator to be necessary to meet the
needs of the family
Travel must be over 100 miles round trip for medical
reasons or activities and services beyond the scope of
the family’s normal responsibilities
$2797.34 Maximum
$13.78 One Way
Financial and Life
Planning Assistance
Homemaker Services
Professional services which assist the
family in planning for future services
and/or financial needs of the family
member with a developmental disability.
Light household works or tasks provided
in the home.
$75.00 Monthly or $1200 Maximum
These tasks include but are not limited to those which
are:
Must apply for CCSP first
Documentation of homemakers disability
Type of Service
Definition
Specifics
Requirements
Necessitated by the lack of a family member capable of
performing such task
By the incapacity or absence of the family member
who may normally perform the tasks
Those which are not available through an existing
program such as the Community Care Waiver
Medical Care
The array of medical care services which
are inclusive of diagnosis/evaluation,
service provision and consultation with
other medical/health care providers or
non-medical service providers.
Services are provided by or under the direct
supervision of a licensed physician or other licensed or
certified health care professional.
Will not cover copays or deductibles-Must
submit denial letter from Insurance or
Explanation of Benefits from Insurance for
each service. Need script for medication
Other Services
Any other services not listed above, in
the opinion of the family and
interdisciplinary team and are necessary
to meet the needs of an eligible
individual/family.
May include but not limited to services in which a
written request is submitted to and approved by
DBHDD-Regional Service Administrator for
Developmental Disabilities
Includes Rescue Payments-Must submit proof
of bill and list of agencies contacted for
assistance. Rescue payments approved only 1
time
Parent/Family
Training
Information and training doe the
parent/family member to enhance
understanding and to better address the
needs of the family member who has a
developmental disability.
Training may be provided as a one-time experience or
an on-going experience. This training may be
delivered in or out of the home setting.
$20.78 hourly
Maximum and $1787.08 yearly
Recreational/Social
Community
Integration
Activities and/or goods designed to
support the participation of the
individuals with a developmental
disability in recreational/leisure
activities in the home and/or
community.
Services can include, camps, recs, horse therapy,
music therapy, aquatics, etc.
Prior to receiving any Family Support funding, respite
care must be on a “List of Approved Respite
Providers.”
Maximum Funding $16.84 per hour or 96.00
per Day
Provider must be approved by Avita
Respite Care
A service designed to relieve the family
or caregiver of physical or emotional
stress associated with the care of the
member with a developmental disability
by the provision of temporary care of the
member with a developmental disability
in or out of the home. This service may
also include care of other young children
who are members of the family, when
necessary for the primary caregiver(s) to
devote exclusive time to attend to the
care and well being of the member with a
developmental disability.
Specialized Clothing &
Shoes
Services that include the assessment of
the need, design, construction, fitting
and/or cost of an article of clothing for
use for the individual with a
developmental disability.
Clothing should be necessitated by the handicapping
condition of the individual with the developmental
disability.
Maximum coverage is $1734.48
Requires prescription
Type of Service
Definition
Specifics
Requirements
Services are provided by a licensed professional:
Psychologist, LPC, LCSW, Psychiatrist
Specialized Diagnostic
Services
Specific investigative procedures
determined as needed by the family and
inter-disciplinary team are necessary to
complete the assessment of the needs of
the individual with disabilities and/or
family
Maximum coverage is $2450.24-Must submit
denial letter from Insurance or Explanation of
Benefits for Insurance. Does not cover copays
or deductibles, Need school denial
Specialized
Equipment
Adaptive and therapeutic devices
specifically prescribed to meet the
rehabilitative needs of the individual
with a developmental disability.
Equipment or device needed by the family to better
provide for the specific needs of the family member
with a developmental disability. Breathing machines,
wheelchairs, positioning boards, adaptive toys,
portable ramps, etc.
Prior Approval Required, Must have
prescription, Insurance Denial if medical
equipment, 3 quotes if over $200.00. $5200
Annual Maximum and $7,000 Lifetime
Maximum. Need school denial if
educationally related.
These services must be provided by a nutritionist
qualified by the state standards.
Specialized Nutrition
An array of services that include
assessment, planning, counseling,
supervision and provision of specific
dietary, nutritional, and feeding needs of
the individual with a developmental
disability.
Prescription from Dr or Nurse-Insurance
Denial or Explanation of Benefits
$1734.48 Maximum
Any number of items that are needed by the family to
better provide for the disability specific needs of the
family member with the developmental disability.
(incontinent supplies, chucks, maintenance
equipment, batteries, etc)
$1734.48 Maximum-Insurance Denial or
Explanation of Benefits
Supplies
Any number of items that may requires
frequent usage due to the individual’s
developmental disability. These supplies
may not be specialized or specific to the
needs of the individual with the
developmental disability, hut may be
necessary to the on-going operation or
maintenance of specialized devices.
Supported
Employment
Services to support individuals to
become gainfully employed and/or to
maintain their employment in the
community.
Support or services can include but are not limited to:
job exploration, job development, job coaching and
long term supports on the job.
SEG $7.20 per hour
SEI-$29.04 per hour
Therapeutic Services
A direct intervention service provided by
a licensed therapist aimed at reducing or
eliminating physical manifestations of a
developmental disability or in
improving/acquiring specific skills
precluded by the developmental
disability
An assessment/evaluation is required for the provision
of these services. Therapeutic services are inclusive of
audiology, physical therapy, occupational therapy and
speech therapy
Licensed OT, PT, ST
Must go thru school system if under 22.
$1800 Maximum
Insurance Denial or Explanation of Benefits
Copy of Assessment
Hydraulic Lift, ramps, special seats
Prior Approval required, must have 3 quotes,
$5000 Lifetime maximum
Vehicle Adaptation
Services