Supported Living shall mean a type of residential service having individualized services and supports that enable a waiver participant to acquire, retain, or improve skills necessary to reside in a home that is under the control and responsibility of the residents. The service includes direct assistance as needed with activities of daily living (e.g., bathing, dressing, personal hygiene, eating, meal preparation (excluding cost of food), household chores essential to the health and safety of the waiver participant, budget management, attending appointments, and interpersonal and social skills building to enable the waiver participant to live in a home in the community. It also may include medication administration as permitted under Tennessee’s Nurse Practice Act.
The Supported Living provider shall not own the waiver participant’s place of residence or be a co-signer of a lease on the waiver participant’s place of residence unless the Supported Living provider signs a written agreement with the waiver participant that states that the waiver participant will not be required to move if the primary reason is because the waiver participant desires to change to a different Supported Living provider.
A Supported Living provider shall not own, be owned by, or be affiliated with any entity that leases or rents a place of residence to a waiver participant if such entity requires, as a condition of renting or leasing, the waiver participant to move if the Supported Living provider changes. The waiver participant (or the waiver participant’s legal representative acting on behalf of the waiver participant) shall have a voice in choosing the individuals who reside in the Supported Living residence and the staff who provide services and supports. The waiver participant shall have the right to manage personal funds as specified in the Individual Support Plan.
A Supported Living home shall have no more than 3 residents including the waiver participant. Unless the residence is individually licensed or inspected by a public housing agency utilizing the HUD Section 8 safety checklist, the residence pass a home inspection approved by the State Medicaid Agency.
Therapeutic goals and objectives shall be required for waiver participants receiving Supported Living. The Supported Living provider shall oversee the waiver participant’s health care needs.
The Supported Living provider shall be responsible for providing an appropriate level of services and supports 24 hours per day (unless otherwise indicated in the plan of care/ISP) during the hours the waiver participant is not receiving Day Services or is not at school or work. Thus, a waiver participant who is receiving Supported Living shall not be eligible to receive Personal Assistance or Respite (which would duplicate services that are the responsibility of the Supported Living provider).
Supported Living shall not be provided in inpatient hospitals, nursing facilities, and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). Supported Living shall not be provided in a home where a waiver participant lives with family members unless such family members are also waiver participants receiving Supported Living.
Family member shall be interpreted to mean the mother, father, grandmother, grandfather, sister, brother, son, daughter, or spouse, whether the relationship is by blood, by marriage, or by adoption. With the exception of the provider’s live-in caregiver staff (if applicable), only Supported Living waiver participants shall be allowed to reside in the Supported Living home.
Except for waiver participants who were already receiving Supported Living on December 31, 2009, Supported Living shall not be covered for waiver participants under age 18 years (since the Supported Living home must be “under the control and responsibility of the residents”, and only adults age 18 and older can legally assume such responsibility).
With the exception of transportation to and from medical services covered through the Medicaid State Plan/TennCare Program, transportation shall be a component of Supported Living and shall be included in the reimbursement rate for such.
Reimbursement for Supported Living shall not include payment for Supported Living provided by the spouse of a waiver participant. The Supported Living provider and provider staff shall not be the parent or custodial grandparent of a waiver participant under age 18 years, whether the relationship is by blood, by marriage, or by adoption; and reimbursement shall not include payment for Supported Living provided by such individuals.
Reimbursement for Supported Living shall not be made for room and board with the exception of a reasonable portion that is attributed to a live-in caregiver who is unrelated to the waiver participant and who provides services to the waiver participant in the waiver participant’s home. Reimbursement for Supported Living shall not include the cost of maintenance of the dwelling. Residential expenses (e.g., phone, cable TV, food, rent) shall be apportioned between the waiver participant, other residents in the home, and (as applicable) live-in or other caregivers.
Applicable limits, if any, on the amount, frequency, or duration of this service: None