Home and Community Based Service (HCBS)

Home and community-based services (HCBS) offer beneficiaries the opportunity to receive long-term services and support in their own home or community rather than in an institution or other isolated setting. 

HCBS is designed to support children and youth with developmental and other chronic conditions that make them high-needs and high-risk candidates. Without this support, such families would need to place the children under institutionalized care, such as at a hospital, residential, or nursing home.

Award Behavioral Health focuses on facilitating, staffing, designing, organizing, and managing the healthcare needs of families and children diagnosed with neurodiversity, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). 

With the support services facilitated by Award, families can continue having their high-needs children living with the family and community and avoid institutional placement.

At Award Behavioral Health, HCBS is designed to surround every family with a network of professionals who can help them function better and achieve success. Additionally, trained therapists and providers can be assigned to help families develop and implement a comprehensive and well-organized daily care plan.

By coordinating with multiple providers, the Award Behavioral Health team ensures that every family who is part of the HCBS program receives maximized care and access to vital resources so that the parents’ minds can be at ease while dealing with the challenges of daily life.

Medicaid determines if a family is eligible for access to HCBS based on the following criteria:

• The child has two or more chronic conditions.
• The child has a single qualifying chronic condition and significant behavioral, medical, or social risk or complex trauma.
• The family is eligible to claim Medicaid for the child.

Award Behavioral Health can guide families through the entire process of screening and creating a care plan for approval by Medicaid, as well as providing the family with support services. These support services include ABA therapy, through HCBS, for neurodiverse children.

Children who are eligible and appropriate for HCBS must have a diagnosis of developmental disability, mental health concerns, or physical disability. This criteria ensures that support and care can be prioritized for children and families with significant needs that place them at risk, requiring a higher level of care. 

This includes both children with autism as well as other neurodiverse conditions, such as ADHD, executive dysfunction, and social-emotional behavioral delays. 

Families of children with autism may find it challenging and stressful to coordinate services for their children, and some families may not be able to pay for services that their children need.

Some parents of children with autism may also have difficulty holding a job outside the home while managing their children’s unique care needs. 

ASD includes lifelong conditions that require expensive support and intensive interventions. The increase in ASD diagnoses highlights the need for high-quality, accessible services and support that extend throughout the child's lifespan. 

Medicaid HCBS waivers significantly decrease unmet healthcare needs among children with ASD. Increases in Medicaid HCBS substantially reduce the likelihood that a parent is forced to stop working. 

HCBS waiver services help improve the quality of life for families of children with autism by removing financial barriers so children with autism can receive services in their homes and communities.

HCBS allows for a wide array of services, which are flexible and offered by service providers who are competent and well-trained.

Many families with children with neurodiversity conditions face the same challenges and need more comprehensive support, just like families with children with ASD. HCBS can provide support for children with a wide range of neurodiverse conditions.

Every participating family at Award Behavioral Health has ample choice in the types of services and the providers they can use to meet their needs. Here is an overview of the HCBS-focused services offered by Award Behavioral Health.

When caring for an affected child or youth, the word family is broadly defined as relational units created through birth, foster care, adoption, or a self-created unit.

Caregiver family support and services offered by Award Behavioral Health enhance the child or youth’s ability to function as part of their family unit. This service also increases the family’s ability to care for the children at home and within the community.

The Family Support and Services program encourages interaction and engagement for the child. It offers educational resources, family advocacy, and support services that help the family locate and access community activities and services.

By collaborating with individuals, families, and caregivers, Award Behavioral Health professionals provide an array of supportive opportunities outlined in the Services Plan.

Planned Respite services provide planned short-term relief for the family and caregivers. Scheduled breaks are rejuvenation mechanisms vital for enhancing the caregiver’s ability to support the child’s functional, mental health, developmental, or health care issues.

This service is a direct care service provided by Award Behavioral Health’s trained staff, who offer supervision and pro-social activities while the primary caregiver is away. All activities are selected carefully to match the child's developmental stage to ensure health and safety.

Planned Respite Services support the goals identified in the child’s Plan of Care (POC). Planned Respite also includes skill development activities. 

These activities are designed to support the child’s POC while giving family and caregivers small amounts of personal time to ensure they are taking care of themselves. This is just one way that HCBS supports the entire family. 

Planned respite may last for a few hours, or a few days, depending on what the family needs. Planned respite is designed to help families and caregivers avoid the need for crisis respite by ensuring the entire family gets the support they need to thrive. 

Crisis Respite is a short-term intervention strategy for children and their caregivers. It is used when it becomes necessary to address a child’s behavioral health, developmental, or medical crisis or trauma. 

This can include acutely challenging emotional or medical crises that the child cannot manage without intensive assistance and support—for instance, the loss of a family member or pet.

Crisis respite can occur both in-home and out-of-home, depending on the needs of the child and the exact situation that generated a crisis response.

Community Habilitation includes services and supports related to a child’s learning, maintenance, and enhancement of skills necessary to independently perform Activities of Daily Living (ADLs) or health-related tasks.

The learning, maintenance, and enhancement of skills are face-to-face services determined by a functional needs assessment. They must be identified in the plan of care (POC) for the child at an individual or group level.

Community habilitation services maximize personal independence for the child and promote integration in the community, preserve functioning, and prevent the likelihood of future institutional placement.

Skill acquisition, maintenance, and enhancement services are appropriate for children or youth who can learn to live in the community, with or without support.

• Maintenance of skills prevents regression from accomplishing the identified task. 
• Enhancement activities promote growth and independence with an already acquired skill level and support the child or youth’s goal outside the training environment.

Community Habilitation functional skills training accomplishes specific tasks with skills related to: 

• Self-care 
• Life safety 
• Medication and health management 
• Communication skills 
• Mobility 
• Community transportation skills 
• Community integration 
• Appropriate social behaviors 
• Problem-solving 
• Money management 

ADL services available for training include, but are not limited to: 

• Teaching personal hygiene, such as bathing, dressing, eating, mobility (ambulation and transferring), and toileting. 
• Teaching managing finances, such as providing or assisting with transportation (as indicated in the POC):
  • Shopping for food, clothes, and other essentials
  • Preparing meals
  • Assisting with the use of the telephone and other communication devices
  • Managing medications
  • Light housekeeping
  • Environmental maintenance such as maintaining safe egress, and laundry
• Teaching health-related tasks are defined as specific tasks related to the needs of the child or youth. These can be delegated or assigned by licensed healthcare professionals under State law to be performed by a certified home health aide or a direct service professional.

Health-related tasks also include tasks that home health aides or direct service professionals can perform under applicable exemptions from the Nurse Practice Act.

• Teaching to perform simple measurements and tests, such as:

• Assisting with the preparation of complex modified diets
• Assisting with a prescribed exercise program
• Pouring, administering, or recording medications
• Assisting with the use of medical equipment, supplies, and devices
• Assisting with special skincare
• Assisting with a dressing change
• Assisting with ostomy care

Award Behavioral Health prevocational training services help prepare teens and young adults (ages 14+) to engage in paid work, volunteer work, and career planning. These pieces of training are designed for young adults with disabilities who often cannot successfully access other types of prevocational services.

Award Behavioral Health prevocational services are unique because, unlike traditional vocational training, they are not job-specific or geared toward teaching the skills required to perform a particular job. 

Instead, they are intended to facilitate ongoing success for the child or youth in various work environments. The training addresses the underlying goals necessary to perform optimally in a competitive, integrated employment setting.

Prevocational services may include volunteer and internship opportunities, such as learning and training activities that develop and teach general skills. Such opportunities help provide experience and preparation for entry into the paid workforce. Training may be provided both in individual and group settings. 

The Award Behavioral Health prevocational services program aims to enable participants to attain work that best reflects their abilities, strengths, and interests in the most integrated setting possible. All positions follow the federal wage guidelines established by the U.S. Department of Labor. 

Award Behavioral Health prevocational training focuses on skills such as:

• Effective and appropriate communication with supervisors and coworkers
• Ability to follow directions, completion of tasks, and problem-solving
• Ability to abide by rules and norms such as punctuality, dress code, and workplace conduct
• Travel and mobility training
• Proper use of job-related equipment and general workplace safety
• Career planning, resume writing, and interviewing techniques
• Educational planning for future career and vocational goals and application for financial aid or scholarship opportunities

This service provides internal and external physical adaptations to the primary members of the family. This includes family members identified as essential for supporting the health, welfare, and safety of the child or youth. 

They could also be part of the extended support network that enables the child or youth to function with greater independence in the home to avoid institutionalization or more restrictive living.

Adaptive and Assistive Technology includes technological aids and devices identified within the child or youth’s POC that enable them to accomplish daily tasks necessary to support their health, welfare, and safety.

Adaptive and Assistive Technology cannot duplicate equipment otherwise available through the Medicaid State Plan or other federal/state funding streams. 

Adaptive and Assistive Technology Services include:

1.     Evaluation of the assistive technology needed by a child or youth. This includes a functional evaluation of the benefit derived from the technology and the appropriate services offered to the child or youth in their typical environment.
2.     Services to purchase, lease, or otherwise procure the assistive technology device.
3.   Services to select, design, fit, customize, adapt, apply, maintain, repair, or replace the specific device.
4.   Training or technical assistance for the child or youth, family members, guardians, advocates, or authorized representatives.
5.   Training or technical assistance for professionals or other individuals who provide services to employ or are substantially involved in the major life functions of the child or youth. 

Adaptive devices are expected to be a one-time-only purchase. Replacements, repairs, upgrades, or enhancements made to existing equipment can be paid for if documented as necessary and approved by the State or its designee.

Ongoing monitoring associated with telecare support services or other approved systems authorized under this definition may also be provided if necessary. This is done for health and safety and documented to the satisfaction of the State or designee.

Under these services, children receive one-on-one support after school or on weekends for help with academics, independent living skills, or socialization. 

Participants usually react to this service positively since it enables their children to learn new skills while the parents attend to other family obligations.

Under this service, children are involved in recreational or artistic activities within the community. Most participants describe this service positively.

Parent Training and Counseling assist family members in acquiring the knowledge and skills needed to understand and address the specific needs of the child. The training also details the treatment for the child and develops the family’s specific problem-solving skills, coping mechanisms, and strategies to enable symptom and behavior management for the child.

At Award Behavioral Health, we can help you apply and facilitate Medicaid’s HCBS services. If your child and family need support, please contact Award Behavioral Health for a consultation. 

To know more about our program and for appointments, please call us at (800) 249-9569 or contact us online.