Know Your Rights as a Disabled Person #KnowYourRights Every person in the world has rights - rights that are like superpowers. It doesn't matter who you are, where you're from, or whether you have a disability or not. So, let's embark on a journey together to understand these superpowers better. Knowing Your Rights As a person with a disability, it's essential to know your rights under the law. In many places, laws like the Americans with Disabilities Act (ADA) in the United States protect you. They ensure that you have equal access to public places, employment, and services, just like everyone else. Equal Opportunity: This right means that whether it's school, work, or any other activity, you should have the same opportunities as everyone else. Non-Discrimination: This right protects you from being treated unfairly because of your disability. Reasonable Accommodation: This right ensures that you get necessary adjustments to help you participate fully in life's activities. Taking Action When Rights are Violated It's unfortunate, but sometimes, people might not respect these rights. If you ever feel that your rights are violated, you don't need to feel powerless. Here are simple steps you can take: Record the Incident: Note down what happened, when, and who was involved. Talk About It: Speak up about the incident to a trusted adult. This can be a teacher, parent, or counselor. Contact an Advocate or Organization: Reach out to disability advocacy groups. They can guide you and provide necessary support. File a Complaint Online Here: If needed, file a formal complaint. You can reach the ADA Information Line at 1-800-514-0301 (voice) or 1-833-610-1264 (TTY). Now, take a moment and ask yourself these self-reflective questions: Do I fully understand my rights as a person with a disability? Have I ever felt that my rights were violated? Did I take action when I felt my rights were violated? Do I have supportive people around me who understand my rights? Am I taking steps to ensure that I am treated with respect and equality? Even if your answers indicate that you're facing challenges, don't worry. Remember that you are not alone and there are resources available to support you. Each challenge is an opportunity for growth and change. As a person with a disability, you have rights that protect you from discrimination and ensure equal opportunities. If these rights are violated, don't hesitate to take action - record the incident, talk about it, seek help from advocacy groups, and file a complaint if needed. Never forget that your voice matters and you deserve respect and equality. ________________________ Explore your rights as a disabled person and learn the steps to take if they are violated. Empower yourself and ensure equality for all. https://www.ctbraininjury.com/post/disability-rights-file-a-complaint Disabled rights, disability, empowerment, non-discrimination, equality, ADA, reasonable accommodation, equal opportunity, discrimination, advocacy, rights violation, incident record, formal complaint, self-reflection, self-advocacy, respect, support groups, person with disability, understanding rights, disability law, disability rights, personal growth, taking action, knowing your rights, stand tall, disability awareness, fairness, inclusion, accessible, disability support, human rights, equality act, legal rights, disability legislation, rights education, legal assistance, social justice, accessible services, individual rights, disabled community, disability justice, disability equality, legal protection, advocacy groups, disabled individuals, disability representation, disabled advocacy, disability resources, empowerment strategies, respect for all, human dignity, disability respect, social equality, accessible environments, disability rights movement, disability legislation, global disability rights, disability inclusion, disability pride, disability discrimination, disability rights advocate, disability empowerment, disability services, disability rights education, civil rights, inclusive society, equal rights, rights awareness, disability activism, disability community, equal access, disability rights violation, special needs rights, respect for disabilities, disability justice movement, right to participation, universal accessibility, legal rights of disabled, discrimination against disabled, support for disabled, legal recourse, self-respect, disability acceptance, disability self-advocacy, ableism, inclusion and diversity, disability rights activists, disability rights and advocacy, dignity and respect. 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ABI WAIVER | What is a care plan? Do you have one? Have you seen it? Building Effective Person-Centered Care Plans in the Acquired Brain Injury (ABI) Waiver Program: A Comprehensive Approach Abstract: The following article explores the process of creating person-centered care plans within the framework of the Acquired Brain Injury (ABI) Waiver Program. It provides insights into the fundamental elements required for these plans and outlines how care managers drive the development of these plans and effectively communicate them to the care team. Introduction The Acquired Brain Injury (ABI) Waiver Program is an essential initiative aimed at helping individuals with brain injuries live independently within their community. A cornerstone of this program is the Person-Centered Care Plan, a strategic approach to care that focuses on the unique needs, goals, and preferences of each individual. This comprehensive, tailored plan is developed by care managers and communicated to the wider care team. Key Elements of a Person-Centered Care Plan Person-centered care planning within the ABI Waiver Program incorporates several core components, including: Individual Assessment : A detailed and accurate assessment of the individual's current health status, abilities, and needs forms the basis of any person-centered care plan. This assessment should also identify their personal goals and objectives, which guide the care plan development process. Personal Goals and Preferences : The individual's personal goals, lifestyle preferences, and values should be at the heart of the care plan. This may include their aspirations for living arrangements, social activities, or vocational pursuits. Interdisciplinary Input : Collaboration with different professional disciplines, such as physical therapists, occupational therapists, neurologists, social workers, and others, helps to ensure a holistic approach to the individual's care plan. Family and Community Involvement : Where possible, the care plan should incorporate input from family members and relevant community resources, ensuring a supportive and integrated approach to care. Role of Care Managers in Care Plan Development The role of care managers in creating a person-centered care plan is multifaceted and vital. Care managers are responsible for coordinating the comprehensive assessment, facilitating discussions about personal goals, gathering interdisciplinary input, and connecting with family and community resources. These professionals act as the central hub for all information, ensuring that the care plan addresses all aspects of an individual's health, well-being, and goals. They employ their expertise to address potential challenges, create innovative solutions, and ensure the person's voice is central throughout the planning process. Communication with the Care Team Once the care plan is developed, care managers take the lead in communicating the plan to the broader care team. This communication ensures that every member of the team - from physicians and therapists to direct support professionals - understand their role in the individual's care and the overall goals of the care plan. Effective communication strategies may include team meetings, written care plan summaries, training sessions, and ongoing check-ins. It's essential that all team members have opportunities to ask questions, clarify responsibilities, and provide input. The ABI Waiver Program's person-centered care plans are more than just strategic documents; they are blueprints for empowering individuals with brain injuries to live their lives to the fullest. Care managers play a pivotal role in these plans, creating a tailored approach that aligns with each person's unique needs and goals and effectively communicating this plan to the wider team. Through such comprehensive and person-centered planning, we can enhance the quality of care and enrich the lives of those within the ABI community. How have I contributed to the development and execution of a person-centered care plan for a client within the ABI Waiver Program? Reflect on your role in this process, your level of interaction with the client, the family, and other team members. Even if you aren't a care manager, your actions and insights can significantly impact the overall care plan. What steps have I taken to truly understand a client's personal goals and preferences? Every interaction with a client offers opportunities to learn about their life, goals, and preferences. Remember, an effective care plan goes beyond medical needs—it considers the individual as a whole person. How do I ensure interdisciplinary collaboration in care plan development? Reflection on how you actively seek and integrate input from different disciplines can highlight areas of strength or identify opportunities for improvement. How have I involved family members and community resources in the care planning process? The family and community play crucial roles in the care plan. Think about how you have engaged these resources and consider ways to enhance their involvement. How effectively have I communicated the care plan to the wider team? Communication is critical for successful execution of the care plan. Reflect on how you share information, how you create opportunities for feedback, and how you ensure everyone understands their role. Person-centered care plans are fundamental components of the ABI Waiver Program, designed to ensure individuals with brain injuries can live as independently as possible within their community. Care managers play a pivotal role in creating these plans, which are designed based on the individual's needs, goals, and preferences, and incorporate interdisciplinary input, family and community involvement. The care plan is then communicated effectively across the wider team, ensuring a holistic approach to care. ______________________________ What is a Care Plan? Do you have one? Have you seen it? "Explore the development and execution of person-centered care plans within the ABI Waiver Program, emphasizing the central role of care managers." https://www.ctbraininjury.com/post/care-plans ABI Waiver Program, person-centered care, care plan, care managers, team communication, brain injuries, individual assessment, personal goals, preferences, interdisciplinary input, family involvement, community resources, holistic approach, care team, physicians, therapists, direct support professionals, written care plan summaries, training sessions, check-ins, health, well-being, living arrangements, social activities, vocational pursuits, professional disciplines, physical therapists, occupational therapists, neurologists, social workers, strategic documents, empowering, quality of care, enrich lives, ABI community, collaboration, strategic approach, unique needs, supportive approach, integrated approach, assessment, challenges, innovative solutions, team meetings, health status, abilities, neurorehabilitation, independent living, supported living, community care, stroke, TBI, lifestyle, neurology, ABI, family, community, collaboration, communication, goals, patient advocacy, patient rights, personal objectives, care coordination, health plan, post-stroke, traumatic brain injury, rehabilitation, medical needs, neurologic care, health professionals, family care, physical recovery, cognitive recovery, medical professionals, interdisciplinary care, healthcare, healthcare providers, social care, case manager, individual care, rehabilitation services, healthcare team, patient-centered care, patient involvement, healthcare management, medical services, brain injury recovery, life enrichment, care planning process, team roles, care plan goals, community integration, vocational rehabilitation. ABI Waiver Program, person-centered care, care management, traumatic brain injury, stroke recovery, community-based care, neurorehabilitation, interdisciplinary care, care coordination, family involvement in healthcare, personal goal setting in healthcare, healthcare communication, ABI resources, supported living, patient advocacy, healthcare team collaboration, independent living post-ABI, occupational therapy, physical therapy, cognitive therapy, patient-centered planning, community resources in healthcare, health plan development, vocational rehabilitation, neurologic care. Person-Centered Care Planning in the ABI Waiver Program: A Comprehensive Guide The Role of Care Managers in ABI Waiver Program Navigating Person-Centered Care Planning for ABI Patients Unveiling the ABI Waiver Program: A Focus on Person-Centered Care Integrated Approach to Care: A Deep Dive into ABI Care Planning Building Bridges: The Intersection of Care Management and ABI Strategies for Successful Care Planning in ABI Waiver Program The Power of Communication in ABI Care Planning ABI Care Plans: From Development to Execution The ABI Waiver Program: Pioneering Person-Centered Care in Brain Injury What is a care plan? How do I create a care plan? Key components of a care plan? Importance of care plans in healthcare. How often should care plans be updated? Challenges in implementing care plans. Involving patients in care plan development. Care plan vs. treatment plan. Benefits of having a care plan. Effective communication of care plans. Technology and care plan support. Nursing process and care plan development. Incorporating preferences into care plans. Legal and ethical considerations in care plans. Risks of not following care plans. Collaboration among healthcare team. Addressing psychosocial needs in care plans. Evaluating care plan effectiveness. Modifying care plans for changing conditions. Resources for care plan implementation. Patient empowerment in care plans. Developing care plans for specific conditions. Role of patient education in care plans. Medication management in care plans. Interdisciplinary collaboration in care plans. What community care resources are beneficial for people recovering from a stroke or TBI in the ABI Waiver Program? ABI resources are crucial in providing supported living for consumers with brain injuries. How can interdisciplinary collaboration enhance the care plan for a person recovering from a stroke in the ABI Waiver Program? Supported living is a significant component in the care plan for people living with a TBI in the ABI Waiver Program. ABI resources can empower consumers and their families to make informed decisions post brain injury. How can ABI resources support individuals with a TBI or stroke in navigating community care? The care plan for people who have experienced a stroke within the ABI Waiver Program emphasizes the importance of supported living and community care. How can the care team effectively communicate the care plan to a person with a TBI in the ABI Waiver Program? Care managers in the ABI Waiver Program work closely with individuals who have had a stroke to develop a comprehensive, person-centered care plan. The ABI Waiver Program offers extensive community care and supported living options for people with brain injuries. How can the ABI Waiver Program enable a person with TBI to live independently in their community? ABI resources play a critical role in facilitating community integration for people recovering from brain injuries. The ABI Waiver Program's person-centered care plan aligns with the unique needs of people who have had a stroke or TBI. Care managers in the ABI Waiver Program collaborate with various healthcare professionals to develop a comprehensive care plan for people living with a TBI. How can ABI resources contribute to an enriched life for a person with a brain injury in a supported living environment? The role of care managers in the ABI Waiver Program is crucial to effectively tailor the care plan to meet the needs of people with brain injuries. The person-centered care plan of the ABI Waiver Program is a roadmap to independence and fulfillment for people living with a TBI or stroke. How can effective communication between care team members contribute to the success of the ABI Waiver Program for people with brain injuries? ABI resources are dedicated to promoting the well-being and independence of people who have experienced a stroke or TBI. Care managers work closely with people who have experienced a stroke to understand their lifestyle preferences and personal goals within the ABI Waiver Program. The ABI Waiver Program creates an environment of supported living for people with TBI, focusing on their unique needs and aspirations. How does the ABI Waiver Program incorporate the personal goals and preferences of people recovering from a stroke in the care plan? ABI resources, when effectively utilized, can significantly enhance the quality of life for people living with a brain injury. How can family and community involvement be better integrated into the care plan within the ABI Waiver Program for a person with a TBI? The interdisciplinary approach of the ABI Waiver Program allows for comprehensive care planning for people who have experienced a stroke. Supported living within the ABI Waiver Program encourages community participation and independence for people living with a TBI. How does the ABI Waiver Program assist people with brain injuries in reaching their vocational pursuits? ABI resources provide people who have experienced a stroke with the necessary support to live independently and participate fully in their community. The person-centered care plan of the ABI Waiver Program is instrumental in helping people with TBI regain control of their lives. How do care managers in the ABI Waiver Program ensure that the unique needs and preferences of people with brain injuries are met? Community care within the ABI Waiver Program fosters a sense of belonging and independence for people recovering from a stroke. ABI resources are focused on enhancing the well-being and independence of people living with a TBI. How can care teams effectively work with people who have experienced a stroke to develop and implement their care plan in the ABI Waiver Program? Care managers play a pivotal role in the ABI Waiver Program by ensuring that the care plan meets the specific needs of people with TBI. The ABI Waiver Program offers a person-centered approach, prioritizing the personal goals and lifestyle preferences of people recovering from brain injuries. How do ABI resources contribute to creating a supportive and inclusive community for people living with a TBI? The care team within the ABI Waiver Program works collaboratively to ensure the successful implementation of the care plan for people who have had a stroke. Supported living and community care are key components of the ABI Waiver Program, fostering independence for people with brain injuries. How can the person-centered care plan within the ABI Waiver Program be tailored to meet the vocational aspirations of a person with a TBI? ABI resources are dedicated to empowering people who have experienced a stroke, promoting their independence and integration into the community. Care managers in the ABI Waiver Program collaborate with people with TBI to develop a care plan that resonates with their personal goals and preferences. How does the ABI Waiver Program ensure a holistic approach in the care of people recovering from a stroke? ABI resources provide invaluable support for people with TBI, facilitating their transition to independent living within their community. The ABI Waiver Program, through its person-centered care plan, empowers people who have experienced a stroke to live a fulfilling life. How does the ABI Waiver Program work with care teams to ensure the successful implementation of the care plan for people with brain injuries? ABI resources play a significant role in providing a supportive living environment for people living with a TBI. The ABI Waiver Program encourages the active involvement of people who have had a stroke in the development of their care plan. How can care managers within the ABI Waiver Program ensure effective communication of the care plan to people with brain injuries and their care team? The ABI Waiver Program supports people with TBI in their journey towards independent living and community participation. How can ABI resources be effectively utilized to enhance the quality of life for a person recovering from a stroke in a supported living environment?

Exploiting Vulnerabilities: How Scammers are using Photos from Home Healthcare Agencies! How Fraudsters Leverage Home Healthcare Photos. Facial Recognition Apps and Software. Amid an increasingly interconnected digital landscape, scammers are turning to home healthcare agencies' media assets for malign activities, causing concern for the safety of vulnerable populations worldwide. These malefactors utilize seemingly benign photographs from these agencies to target susceptible individuals and their families, leading to numerous troubling consequences. The most prevalent issues include establishing fake relationships, identity theft, and even sexual predation. Home healthcare agencies typically share photos of their clients and employees on their websites and social media platforms to promote their services, celebrate achievements, and build community engagement. However, scam artists have manipulated these images, employing sophisticated facial recognition tools and artificial intelligence (AI) algorithms to identify and target individuals. This innovative misuse of technology is an escalating issue that threatens the privacy and security of countless individuals. Victims are often older adults, people with disabilities, and those dealing with chronic illnesses--populations that home healthcare agencies are intended to protect and serve. Unfortunately, the offenders often masquerade behind a veneer of normalcy. They may pose as potential romantic interests, healthcare workers, or friends, utilizing photos and information from home healthcare agencies to cultivate a sense of trust and authenticity. Subsequently, they exploit this established relationship to manipulate victims into sharing personal information, sending money, or engaging in compromising activities. As a result, home healthcare agencies worldwide have started reevaluating their online practices, including ceasing the posting of client and employee photos. While this strategy minimizes risk, it also means these organizations lose a valuable tool for communication, community-building, and public relations. Simultaneously, these agencies are working to educate their clients, employees, and the public about these scams. They're focusing on teaching how to recognize potential scams, the importance of safeguarding personal information, and the steps to take if targeted. Additionally, they're advocating for more robust privacy laws and stricter regulation of facial recognition technology and AI. Still, the challenges are immense. The fraudulent activities are often difficult to trace and the perpetrators hard to catch. Moreover, the victims may be reluctant to come forward due to embarrassment, fear, or lack of awareness. Even when they do, the damage--financial loss, emotional trauma, and privacy invasion--may be irreparable. This situation underscores the need for continued vigilance in the face of evolving cyber threats. As technological advancements facilitate new methods of exploitation, all sectors, including healthcare, must adapt their practices and prioritize the safety and privacy of the vulnerable populations they serve. Agencies, families, and communities must work together to fight against these cyber threats. The evolving landscape of digital security may be daunting, but only through collective awareness and action can the most vulnerable be protected from such exploitation. Remember, knowledge and awareness are powerful tools in combating these malicious practices. While the digital landscape continues to evolve, creating new threats, we must evolve with it, taking every necessary measure to protect the most vulnerable among us from these predatory tactics. Do you know how to spot a potential scam, particularly one leveraging personal photographs? Recognizing potential scams can involve a critical examination of the situation: unfamiliar contacts reaching out for personal details, unsolicited requests for financial aid, or communications that demand urgency or secrecy are often indicative of scam attempts. Are you aware of the privacy settings on your social media profiles? Awareness and usage of privacy settings are key to protecting your online presence. Ensure that your personal details and photos are only accessible to trusted individuals. Have you spoken to your loved ones about the importance of online privacy and the risk of scams? Regular conversations about the threats posed by online scams can equip your loved ones, especially those from vulnerable populations, with the knowledge to protect themselves better. Do you think enough about the implications of sharing photos of yourself or your family online? As innocent as it may seem, sharing personal photos can lead to unintended consequences, like identity theft and scams. Before posting, consider potential risks and implications. Do you understand the power and potential misuse of facial recognition technologies and AI in our digital age? These technologies, while beneficial, can be exploited for malicious activities, like scams. It's important to stay informed about such developments and adapt our online behaviors accordingly. In a concerning trend, fraudsters are leveraging photos and information from home healthcare agencies to target vulnerable populations worldwide. They use sophisticated facial recognition tools and AI algorithms to create scams ranging from fake relationships to identity theft. As a result, many home healthcare agencies have ceased posting client and employee photos and are educating their constituencies about scam recognition and privacy protection. The situation calls for vigilance, regulation, and collective action to protect the most vulnerable. ___________________________ "Scammers use Home healthcare photos and AI for sinister scams, targeting the vulnerable. Awareness, privacy, and regulation are needed." https://www.ctbraininjury.com/post/faces-of-fraud-scammers-are-using-photos-from-home-healthcare-agencies Online Privacy, Cybersecurity, Elderly Scams, Identity Theft, Home Healthcare, Digital Safety, Facial Recognition Technology, AI Misuse, Social Media Scams, Fake Relationships, Online Predation, Personal Data Protection, Cyber Threats, Healthcare Industry Scams, Tech-enabled Exploitation, Vulnerable Populations, Digital Literacy, Internet Fraud, Online Vulnerability, Regulation of AI, Privacy Laws, Health Information Privacy, Photo-sharing Risks, Internet Safety Education, Impact of Cybercrime Digital Deception: A Dark Side of Home Healthcare Faces of Fraud: Misuse of Home Healthcare Photos Cyber Predators: Leveraging AI and Photos for Scams Unveiling Online Scams: A Focus on Home Healthcare A New Face of Cybercrime: Exploiting the Vulnerable Against the Digital Threat: Protecting Home Healthcare Online Scams: Targeting the Vulnerable via Healthcare Photos Privacy and Protection: Guarding Against Healthcare Scams AI and Photos: Tools for Modern Scammers Protecting Vulnerable Populations in the Digital Age "Do Not Post My Photos": (Note: TBI stands for Traumatic Brain Injury) What precautions should TBI survivors take to prevent their photos from being used maliciously? How can individuals with a brain injury (TBI) protect their online photos from misuse? "As a TBI survivor, I request that you do not post my photos." What can caregivers of TBI patients do to protect their loved ones' photos from online scams? Have you informed your healthcare provider of your TBI and your wish not to have your photos posted online? "I'm a TBI survivor, and I ask that my privacy is respected – please, do not post my photos." How can TBI patients advocate for their digital privacy? What are the risks of posting photos of TBI survivors online? Understanding the importance of not posting photos of TBI patients without consent. What precautions should TBI survivors take to prevent their photos from being used maliciously? How can individuals with a brain injury (TBI) protect their online photos from misuse? "As a TBI survivor, I request that you do not post my photos." What can caregivers of TBI patients do to protect their loved ones' photos from online scams? Have you informed your healthcare provider of your TBI and your wish not to have your photos posted online? "I'm a TBI survivor, and I ask that my privacy is respected – p lease do not post my photos." How can TBI patients advocate for their digital privacy? What are the risks of posting photos of TBI survivors online? Understanding the importance of not posting photos of TBI patients without consent. As someone living with TBI, what should you consider before posting photos online? How does photo sharing pose risks for those with brain injury (TBI)? What measures are in place to protect the photos of TBI survivors from potential scammers? "As a person living with TBI, it's my right to say: do not post my photos." What role does informed consent play in sharing photos of TBI patients online? "Living with TBI has made me more aware of my digital footprint – please, do not post my photos." "Due to my condition (TBI), I request you to not post my photos." How are home healthcare agencies ensuring the privacy of TBI patients? "Please respect my privacy as a TBI survivor, do not post my photos." How to safeguard online photos from misuse when you're dealing with a brain injury (TBI)? "As a TBI survivor, I urge all healthcare agencies to not post my photos." The potential danger of posting photos of TBI survivors online. "My TBI doesn't define me, and I prefer to keep my recovery private – do not post my photos." What protocols do home healthcare agencies follow to protect the privacy of TBI patients? How can TBI survivors ensure their photos aren't being misused online? "Having TBI has taught me the importance of privacy – please, do not post my photos." How to educate TBI patients about the potential risks of sharing photos online? "I appreciate the care provided for my TBI, but I request that my photos are not posted." What strategies can protect TBI patients from becoming victims of photo-related scams? "Please respect my wishes as a TBI survivor, and do not post my photos online." "As a brain injury survivor, I advocate for my privacy - do not post my photos." Why it's crucial not to post photos of TBI patients without explicit consent? "My journey with TBI is personal - please do not post my photos." How does posting photos of TBI patients put them at risk of online scams? "To maintain my privacy while dealing with TBI, I request you to not post my photos." How to better protect TBI survivors from online scams related to photo sharing? "TBI has made me cautious about my online presence - please do not post my photos." What actions are being taken to safeguard the privacy of TBI patients' photos? "Despite my TBI, I value my privacy - do not post my photos online." How to maintain online privacy for TBI patients in home healthcare? "My struggle with TBI is my own - I kindly ask you to not post my photos." Are home healthcare agencies aware of the potential misuse of TBI patients' photos? "TBI has heightened my awareness about online privacy - do not post my photos." Is enough being done to protect the photos of TBI patients from potential scams? "I have a right to my privacy as a TBI patient - please, do not post my photos." How to advocate for the privacy of TBI patients in the digital age? "My TBI does not diminish my right to privacy - do not post my photos." What potential harm can befall TBI patients due to their photos being misused? "I ask for my privacy to be respected as I deal with TBI - do not post my photos." Are the privacy concerns of TBI patients being adequately addressed by home healthcare agencies? "TBI is a part of my life, but I still value my privacy - please, do not post my photos."

" I didn't know I had a Team Meeting or people are meeting to discuss my life. " Discrimination in Covert Medicaid ABI Waiver Program Meetings In recent years, concerns have emerged regarding the Connecticut Department of Social Services' (CT DSS) practices in affiliation with Cognitive Behaviorists (CBT) providers and Care Management providers. At the heart of the controversy is the organization of covert Medicaid Acquired Brain Injury (ABI) Waiver Program meetings, where decisions and discussions about disabled individuals occur without their knowledge, approval, or participation. This may also be impacting the Families and Conservators. Nature of the Issue: Exclusion from Decision Making: Central to the principles of self-determination and autonomy is the idea that individuals should be at the forefront of decisions affecting their lives, especially when it pertains to their health and well-being. By excluding individuals from these meetings, the CDSS and its affiliates essentially strip them of their rights to be active participants in decisions about their own care. Violation of Ethical Principles: Ethical care in both cognitive behavior therapy and care management is grounded in respect for the dignity, autonomy, and rights of individuals. Covert meetings undermine these principles, placing disabled individuals in passive roles, thus treating them as subjects rather than partners in their own care. Potential for Bias: Decisions made without the direct input of those affected can lead to assumptions and biases influencing care. Without direct feedback, there's a risk of perpetuating stereotypes, misunderstanding individual needs, or prioritizing organizational needs over the needs of the individuals. Lack of Transparency: The covert nature of these meetings raises questions about transparency. Without transparency, there's a potential for conflicts of interest, biased decision-making, and a lack of accountability in the process. Implications and Consequences: Erosion of Trust: Trust is a fundamental aspect of the patient-provider relationship. When individuals learn that decisions are made without their knowledge or input, this trust is eroded, which can impact the effectiveness of care and the willingness to engage in recommended treatments. Risk of Inadequate Care: By not involving the individuals directly, the CDSS and its affiliates may overlook critical information about their preferences, needs, and values, potentially leading to less effective or inappropriate care. Legal Repercussions: Discrimination against disabled individuals and the infringement of their rights can result in legal consequences, including lawsuits and sanctions against the offending parties. Recommendations: Inclusive Practices: The CT DSS, in conjunction with CBT providers and Care Management providers, should ensure that practices are inclusive. This means actively involving individuals in discussions and decisions that affect their care and well-being. Training and Sensitization: All stakeholders should undergo training to ensure they understand the importance of inclusivity, respect for individual rights, and the potential consequences of discriminatory practices. Transparency and Accountability: Open communication and a commitment to transparency are critical. Policies should be in place to ensure that all meetings and decisions are documented, with appropriate checks and balances. Conclusion: The organization of covert Medicaid ABI Waiver Program meetings without the awareness, approval, and participation of disabled individuals represents a clear form of discrimination. For a just, ethical, and effective system, it's imperative to center the rights and needs of those the system aims to serve. ABI Resources Connecticut

"These programs are funded by the Federal Medicaid Program and are available to residents of Connecticut and other states. The Connecticut Department of Social Services is responsible for overseeing and ensuring the quality of the services provided for the CT programs." Connecticut Regulations of CT DSS Department of Social Services Concerning The Acquired Brain Injury Waiver Programs 1 and 2 The Regulations of Connecticut State Agencies are amendedby adding sections17b-260a-1 to 17b- 260a-18, inclusive, as follows: (NEW) Sec. 17b-260a-1. Purpose The Acquired Brain Injury (ABI) waiver program is established pursuant to sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes and 42 USC 1396n(c). The ABI waiverprogram provides, within the limitations described in sections 17b-260a-2 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, a range of nonmedical, home and community-based services to individuals 18 years of age or older with an ABI who, without such services, would otherwise require placement in a hospital, nursing facility (NF), or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The intention of the ABI waiver program is to enable such individuals, through person-centered planning, to receive home and community-based services necessary to allow such individuals to live in the community and avoid institutionalization. (NEW) Sec. 17b-260a-2. Scope Sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut StateAgencies set forth the requirements for eligibility and payment of services to eligible individuals participating in the ABI waiver program. These regulations also describe program requirements; services available; service requirements; department, provider and individual responsibilities; residential setting requirements; and limitations under the ABI waiver program. (NEW) Sec. 17b-260a-3. Definitions As used in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies: (1) “ Acquired brain injury ” or “ABI” means the combination of focal and diffuse central nervous system dysfunctions, immediate or delayed, at the brainstem level or above.These dysfunctions may be acquired through physical trauma, oxygen deprivation, infection, or a discrete incident that is toxic, surgical, or vascular in nature. The term “ABI” does not include disorders that are congenital, developmental, degenerative, associated with aging, or that meet the definition of intellectual disability as defined in section 1-1g of the Connecticut General Statutes; (2) “ Acquired braininjury nursing facility ” or “ABI NF” means a type of nursing facilitythat provides specialized programs for persons with an acquired brain injury; (3) “ Acquired Brain Injury waiver program ” or “ABI waiver program” or “the program” means the programsadministered by the Department of Social Servicesand established pursuantto sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes, as described in Medicaid waivers approved by the Secretary of the United States Department of Health and Human Services pursuant to 42 USC 1396n as amended from time to time, for the provision of home and community-based services to individuals with acquired brain injury; (4) “ ABI Waiver I ” " ABI Waiver Program One 1 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(a) of the Connecticut General Statutes and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of January 1, 1999; (5) “ ABI Waiver II ” " ABI Waiver Program Two 2 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(b) of the Connecticut General Statutes, and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of December 1, 2014; (6) “ Acquired Brain Injury waiver services ” or “ABI waiver services” means all or some of the services provided to individuals in the ABI waiver program; (7) “ Activity of daily living ”or “ADL” means an activityor task that is essentialto an individual’s health, welfare, and safety, including, but not limited to, bathing, dressing, eating, transfers, and bowel and bladder care; (8) “ Agency provider ” means a provideremployed by an agency, who provides ABI waiver services to individuals participating in the ABI waiver program; (9) “ Alternative institutional care costs ” means the costs of institutional care that the individual would otherwise incur, but for the support ofABI waiver services; (10) “ Applicant ” means an individual who, directly or through a representative, completes an ABI waiver program application form and submits it to the department; (11) “ Applied income ” means the portion of the individual’s income that remains after all deductions and disregards are subtracted and that may be appliedto the cost of waiverservices; (12) “ Assessment ” means a comprehensive, multidimensional written evaluation conducted by nonmedical department personnel or agents, using a standard assessment form that is used to determine whether an individual meets the level-of-care criteria to participate in the ABI waiver program; (13) “ Chronic disease hospital " or “CDH” means a long-term hospitalhaving facilities, medical staff, and necessary personnel for the diagnosis, care, and treatment of a wide range of chronic diseases; (14) “ Commissioner ” means the Commissioner of Social Services; (15) “ Cost-effective ” or “ cost-effectiveness ” means the department’s determination that payments for the individual’s total service costs do not exceed either the individual caps or available funding for the ABI waiver program; (16) “ Countable income ” means all sources of income not excluded under the Medicaid program; (17) “ Department ” or “ DSS ” means the stateof Connecticut Department of Social Services or its agent; (18) “ Family member ”means a person who is related to the individual by blood, adoption, or marriage; (19) “ Fiscal intermediary ” means an agent or agents under contract with the department that is responsible for: paying providers for services delivered; registering providers; providingtraining and outreach to individuals and providers of services under the ABI waiver program; and performing other administrative functions requested by the department; (20) “ Hands-on care ” means assistance with ADLs provided most often, but not exclusively, by home health aides. Hands-oncare includes the prompting and cueing necessary for an individual to perform ADLs; (21) “ Home and community-based services ” means Medicaid servicesprovided to an individual in that individual’s own home or other community-based setting; (22) “ Home and community-based setting ” has the same meaning as provided in 42 CFR 441.301(c)(4)-(5), as amended from time to time; (23) “ Hospital ” has the samemeaning as provided in 42 CFR 440.10, as amended from time to time; (24) “ Household employee ” means a provider who performs ABI recovery assistant I, ABI recovery assistant II, chore, companion, homemaker, independent livingskills training, or respite services, and who is employed by the individual and not an agency; (25) “ Individual ” means a person with an acquired brain injury who is applying for, or actively participating in, the ABI waiver program; (26) “ Individual cap ” meansthe maximum allowabletotal cost of the individual’s service plan; (27) “ Integrated work setting ” means a work setting wherepeople with disabilities work alongside people without disabilities, for at least minimum wage. (28) “ Intermediate care facility for individuals with intellectual disabilities ” or “ICF-IID” has the same meaning as provided in 42 CFR 440.150, as amended from time to time, and is a facility licensed by the Connecticut Department of Developmental Services for the care and treatment of persons with intellectual disabilities; (29) “ Intervention plan ” means a document developed by a cognitive behaviorist that identifies the treatment goals and interventions for the individual and team; (30) “ Legal representative ” means a guardian, conservator, or an individual holding a power of attorney appointed to act on the individual’s behalf; (31) “ Level of care ” means the type of facility, as determined by a care manager or designated agent of the department, neededto care for an individual if the individual were not receiving services under the ABI waiver program. The types of facilities include: a nursing facility, ABI NF, CDH, or ICF-IID; (32) “ Medicaid ” or “ Medicaid program ”means medical and health-related servicesadministered by the state of Connecticut Department of Social Services pursuant to Title XIX of the Social SecurityAct; (33) “ Medicaid Provider Enrollment Agreement ” has the same meaning as provided in section 17b-262-523(23) of the Regulations of Connecticut StateAgencies, except that such agreement may include addenda specific to the ABI waiver program; (34) “ Neuropsychological evaluation ” has the same meaning as provided in section 17b-262- 468(17) of the Regulations of Connecticut State Agencies; (35) “ Nursing facility ” or “NF” has the same meaning as provided in 42 CFR 440.40 and 42 CFR 440.155, as amended from time to time; (36) “ Other community-based services ” means servicesprovided by programsadministered by the department that are not part of the ABI waiver program, or services provided by programs administered by other state or local agencies that are necessary to maintain the individual in the community; (37) “ Other medical services ” means services that are normally included in the department’s payments to NFs, ABI NFs, CDHs, and ICF-IIDs, and that the individual requires,in addition to ABI waiver services, to live in the community. Other medical servicesinclude: home health care; nursing services; physical therapy; speech therapy; and occupational therapy; (38) “ Person-centered plan ” means a service plan developed by the person-centered team that meets the requirements of 42 CFR 441.301(c)(1)-(3), inclusive, as amended from time to time; (39) “ Person-centered team ” means an interdisciplinary group of people organized to assist the individual to develop and implement a service plan. The planning team consists of a care manager, the individual, the legal representative (if applicable), a cognitive behaviorist, any interested family members, or other relevant participants; (40) “ Provider ” means an agency provider, household employee or self-employed provider who meets the qualifications established by the department to provide home and community-based services under the ABI waiver program, has signed the Medicaid Provider Enrollment Agreement, and is enrolled in the ABI waiver program; (41) “ Qualified neuropsychologist ” means a psychologist who meets the qualifications of section 17b-262-468(16) of the Regulations of Connecticut State Agencies; (42) “ Rehabilitation hospital ” means a facilityperforming rehabilitative outpatient hospital services in accordance with the provisions of 42 CFR 440.20(a). (43) “ Representative ” means a personwho is not a legalrepresentative, and who is actingin support of an individual; (44) “ Self-employed provider ”means a person who does not work for an agency, is not a household employee, and meets the qualifications listed in 17b-260a-8 of the Regulations of Connecticut State Agencies to provide certain services under the ABI waiver program; (45) “ Service plan ” means an individualized written plan developed through person-centered planning that documents the medicaland home and community-based servicesthat are necessary to enable the individual to live in the community instead of an institution. The service plan includes measurable goals, objectives, and documentation of total service costs; (46) “ Supervision or cueing ” means daily support such as monitoring, observing, verbal or gestural prompting, verbalcoaching and gesturalor pictorial cueingthat is requiredin order for the individual to accomplish an ADL. Supervision and cueing must be required on a contemporaneous basis with the performance of the ADL, and does not include a reminder or request to perform an ADL when the individual does not need support beyond such reminder or request in order to accomplish the ADL. (47) “ Total service costs ” means the annualized cost of ABI waiver services, other medical services, and other community-based servicesincluded in an individual’s serviceplan that are required in order for the individual to live in the community instead of an institution; and (48) “ Waiting list ” means a record maintained by the department that includes the names, and dates of completed ABI waiver applications, of all individuals who have submitted completed applications for ABI waiverservices and whoseapplications have been screened and found to be functionally eligible for the program. (NEW) Sec. 17b-260a-4. Not an Entitlement The ABI waiver program is not an entitlement program. Services, waiver slots and access to services under the ABI waiver program may be limited based on available funding and program capacity. (NEW) Sec. 17b-260a-5. Eligibility (a) An applicant may be eligible to receive coverage for the cost of the services specified in section 17b-260a-8 of the Regulations of Connecticut State Agencies, through the department’s ABI waiver program, if: (1) The applicant’s countable income is less than 300% of the benefit amount that would be payable under the federal Supplemental Security Income programto an applicant who lives in the applicant’s own home and has no income or resources; (2) The applicant is otherwise eligible to participate in the department’s Medicaid program, including any applicable asset requirements, under either the working disabledor long-term care eligibility criteria; (3) The applicant meets the programmatic requirements of subsection (c) of this section; and (4) The applicant is not ineligible for coverage under subsections (d) or (e) of this section. (b) The financial requirements for eligibility are as follows: (1) The applicant’s countable income and assets for purposes of eligibility are determined using the same methodologies the department employsin determining the countable incomeand assets of an institutionalized applicantfor Medicaid, including, but not limitedto, the spousal impoverishment rules and spousal post-eligibility rules under section 1924 of the Social Security Act, 42 U.S.C. § 1396r-5, for individuals with a community spouse. (2) Income eligibility determination for ABI waiver services under this section is based solely on the applicant’s countable income and does not involve consideration of the incurredmedical expenses or any other liabilities that may have been incurred by the applicant. (3) Payment for ABI waiver services is reduced by the individual’s applied income, which is calculated by determining the amount of the applicant’s countable income remaining after the deduction of an allowance for the personal needs of the individual equal to 200% of the federal poverty level, as well as any applicable community spouse’s or family allowance, and amounts for incurred medical or remedial care expenses not subject to payment by a thirdparty, as specified in 42 CFR 435.726. (c) The programmatic requirements for eligibility are as follows: An individual shall: (1) Be between the ages of 18 and 64 at the time the application is completed; (2) Have an ABI, as defined in section 17b-260a-3(1) of the Regulations of Connecticut State Agencies; (3) Meet the criteria for one of the level-of-care categories described in subsection 17b-260a-9(d) of the Regulations of Connecticut State Agencies; (4) Have the cognitive abilityto actively participate in the development of the individual’s service plan or, absent such ability, have a legal representative who acts on the individual’s behalf to perform these tasks. Participation includes, but is not limited to, selection, hiring, direction, and termination of providers; (5) Voluntarily choose to live in the community by participating in the ABI waiver program; (6) Wish to utilize ABI waiver services; (7) Develop, in consultation with the person-centered team, a serviceplan that providesassistance that reasonably addresses and mitigates identified risks; (8) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that there are risks inherent in living in the community; that the individual’s safety cannot be guaranteed; and that the individual acceptsfull responsibility if the individual chooses to live in the community, thereby absolving the department from any liability for any and all consequences that may result from this choice; (9) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that the individual is the employer of any household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut StateAgencies, and shallsign a written document accepting full responsibility as the employer of such providers; (10) Maintain eligibility for Medicaid; (11) Need waiverservices, which means that the individual needs a minimumof two waiver services, on at least a monthly basis; (12) Have a total serviceplan cost that does not cause the ABI waiverprogram’s expenditures to exceed total appropriated funding limits for the ABI waiver program; (13) Have a total serviceplan cost that does not exceed the individual cap that appliesto the individual, as set forth in sections 17b-260a-10(a) and (b); and (14) Agree to pay, if applicable, any applied income toward the cost of services renderedunder the waiver, as required under section 17b-260a-11(b). (d) Not with standing subsections (a), (b) and (c) of this section,an individual shallnot be eligible for ABI waiver program services if: (1) The individual: (A) Receives services under any other Medicaid waiver program; (B) Has received and benefited from ABI waiver services, no longer requires the services, no longer meets level-of-care criteria, and can continueto reside in the community without the support of ABI waiver program services; (C) Has a cognitive or behavioral dysfunction due solely to an intellectual disability or chronic mental illness, rather than an ABI, as determined by a licensed medical professional; (D) Requires inpatient care in an acute care hospital, NF,ABI NF, ICF-IID or CDH, or who is otherwise institutionalized for a period of ninety days or more,provided, however, such durational limitation may be extended for an additional thirty days upon submission of documentation from a medical professional indicating that the applicant’s discharge is expected within thirty days; (E) Demonstrates consistent and extreme physical, verbal, or sexual aggression toward others; (F) Demonstrates behaviors that violate the law or are contraryto community integrated living; (G) Is currentlyincarcerated, and not expected to be returnedto the community within ninety days; (H) Lacks mental capacity to participate in the program; (I) Refuses servicesthat are vital to health,welfare, and safety;or (J) Behaves in ways that are detrimental to the individual’s health, welfare, and safety, which includes, but is not limited to: (i) Participating in illegal or criminal activity; (ii) Using, or threatening to use, weapons,chemicals, or firearmsfor the purposeof causing harm or injury to self or others; or (iii) Compromising the safety of caregivers, staff, and others in the home or community. (2) The conditions at the individual’s home or on the grounds of the home are hazardous due to: (A) Illegal or criminal activity; (B) The presenceof animals that are dangerous or not properly secured or maintained; (C) Poor sanitation; or (D) Violations of local or state fire,zoning, or housing that pose a risk to the health, welfare, and safety of the individual or providers; or (3) Persons who either reside in, or have regular access, the individual’s home are: (A) Engaging in illegal or criminal activity; (B) Behaving in a manner that is dangerous or jeopardizes the safety, health,or well-being of the individual, providers, or others; (C) Interfering with the provider’s delivery, or the individual’s receipt,of services or acting in any way that affects a provider’s access to the individual; or (D) Threatening the individual verbally, physically, or sexually; or (4) In the opinion of the department, a service plan that is both cost-effective and reasonably ensures the health, welfare, and safety of the individual cannot be developed or implemented. (e) Individuals who are actively participating program in the ABI waiverprogram and who turn 65 years of age shall be offered the choice of (1) remaining on the ABI waiver program; (2) accessing institutional placement; or (3) transitioning to the Connecticut Home Care Program for Elders. (NEW) Sec. 17b-260a-6. Person-centered planning process (a) The service plan shall be developed based on a person-centered planning model, as described in 42 CFR 441.301(c), as amended from time to time. The individual shall lead planning processaddition to the planningprocess where possible, and in accordance with section 17b-260a-11(a) of the Regulations of Connecticut State Agencies. (b) In additionto being led by the individual receiving services and supportlead planning, the person-centered planning process shall: (1) Include people chosen by the individual, providedthe inclusion of such personsis not otherwise prohibited herein; (2) Provide necessary information and supportto ensure that the individual directs the planning process to the maximum extent possible, and is able to make informed choices and decisions; (3) Be timely and occur at dates, times, and locations of convenience to the individual; (4) Be conducted in a manner that reflects cultural considerations of the individual; provides information in plainlanguage; and is accessible to the individual and persons with limited English proficiency; (5) Include strategies for conflict-resolution or solving disagreements within the process,including clear conflict-of-interest guidelines for all participants; (6) Prohibit providers of waiver servicesfor the individual, or those who have an interest in or are employed by a provider of waiver services for the individual, from providing care management or participating in the development of the person-centered service plan; (7) Offer informedchoices to the individual regarding the types and providers of services and supports that are available; (8) Include a method for the individual to request updates to the plan as needed; and (9) Record the alternative home andcommunity-based settings that the individual considered. (NEW) Sec. 17b-260a-7. Home and community-based setting requirements (a) Prior to an individual accessing any services under the ABI waiver program, the department shall assess each home and community-based settingin the service plan to determine whethersuch setting complies with 42 CFR 441.301(c)(4)-(5), as amended from time to time. (b) If, upon initial assessment of the individual’s service plan, or any time thereafter, the department determines that a settingdoes not comply with 42 CFR 441.301(c)(4)-(5), the department shall inform the individual that the setting does not comply, and inform the individual of alternative settings that complywith these requirements. If the individual elects to remainin, or receive services at, a setting that does not meet these requirements, and the provider has not complied with the department’s corrective action plan for meeting such requirements, the individual shall not remain eligible to receive services under the ABI waiver program. (c) The department shall assess compliance with 42 CFR 441.301(c)(4)-(5) as part of its process for credentialing and re-credentialing providers. (NEW) Sec. 17b-260a-8. Home and community-based services available under the ABI waiver program (a) General principles (1) ABI waiver services shall be furnished under a written service plan that is based on a person- centered planning process,as described in section 17b-260a-6 of the Regulations of Connecticut State Agencies, and subject to approval by the department. (2) Except as set forth in subsection (b) of this section, ABI waiver services may be provided alone or in combination with other services, in accordance with the specificfunctional needs of the individual. (3) The ABI waiver services provided at any given time, in combination with other available medical and community-based services,constitute the individual’s service plan. The need for each specific ABI waiver service shall be documented in the service plan. (4) The ABI waiver services documented in the service plan may be purchased from agency providers, household employees, or self-employed providers that the department’s fiscal intermediary has determined are eligible to participate in the Medicaid program, are enrolled with the department as a provider, and agree to accept Medicaidpayment as paymentin full for services authorized and performed under the program. (5) The department shall not pay for ABI waiver servicesprovided by the individual’s conservator, power of attorney, or a family member of such conservator or power of attorney, or an agency provider owned by the individual’s conservator or power of attorney. (6) The department shall pay only for ABI waiver servicesthat are providedin settings that meet the requirements of 42 CFR 441.301(c)(4), as amended from time to time. (7) Payments for ABI waiverservices shall not exceed the rates, or maximum limits,the department establishes for the provision of such services. (8) The rate paid to service providers does not includepayment for transportation services, unless specified in subsection (b) of this section. (9) The department’s fiscal intermediary, priorto the start of servicesand bi-annually thereafter, shall verify that providers are qualified to provide services. (b) The following services and supplies may be covered under the ABI waiver program: (1) ABI Group Day Habilitation Services , which are services and supports that: lead to the acquisition, improvement, or retention of skills and abilities necessary for an individual to maintain health, wellness, and self-care; preparean individual for work or community participation; or support meaningful socialization and leisure activities. ABI Group Day Habilitation services shall be provided only: (A) By an agency provideror a rehabilitation hospital outpatient department that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; and (B) For a time period that does not exceed eight hours per day. (2) ABI Recovery Assistant I Services , which are services to promote the individual’s strengths and abilities to maintain and foster community living skills, in accordance with therapeutic goals outlined in the individual’s service plan. Services may include improvement of socialization, self- advocacy, and the development of natural supports. Services also include communication and coordination with service providers and others who support the individual. Although not a primary function, a providerperforming ABI RecoveryAssistant I servicesmay provide assistance with ADLs and cueing with respect to medications with support of a medication box. (A) This service shallbe provided only to individuals on ABI Waiver II; and (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (3) ABI Recovery Assistant II Services , which are non-medical and safety monitoring servicesto assist an individual with activities of daily living(both hands-on and cueing) and integration into the community. (A) This serviceshall be providedonly to individuals on ABI WaiverII; (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (4) Adult Day Health Services , which are services provided in a group setting that include a variety of health and social services, including, but not limited to: personal care, health care, recreation, socialization, nursingservices, transportation services, and hot meals and snacksthat meet the individual’s nutritional needs and dietary restrictions. Adult Day Health services shall: (A) Be provided only to individuals on ABI WaiverII; (B) Be providedby an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (C) Be providedone or more days per week, four or more hours per day, on a regularly scheduled basis; and (D) Include transportation to and from theAdult Day Health Center, a meal, and snacks. (5) Care Management Services , which are services provided to assist the individual to implement the service plan and to assure on-going effective coordination, communication, and cooperation among all sources of support and services to the individual. Care management services include, but are not limited to, the following: assistance identifying the individual’s home and community-based service needs; promotion of participation in activities that may increase the individual’s independence, inclusion in the community and life satisfaction; arrangement of daily living supports and services to be delivered to the individual; assistance identifying and accessing entitlements and other possible funding sources; advocacy for the individual when necessary to ensure the receipt of needed services; and referral for crisis intervention services and monitoring, as necessary and appropriate. Care management services shall be provided by a care manager that meets all the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements, and that: (A) Does not provide any other home and community-based services to the individual; and (B) Does not have an interest in, or is not employed by, a provider of home and community-based services for the individual. (6) Chore Services , which are services needed to maintain the individual’s home in a clean, sanitary, and safe condition. Chore services include, but are not limited to, heavy household chores, such as washing floors,windows, and walls,and moving heavyitems of furniture in order to provide safe access and egress. (A) Chore services shall be providedby an agency provider or household employeewho meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Chore services shall not be covered if: (i) The individual or anyone else living in the household is capable of performing or paying for the services; (ii) A relative, caretaker, community agencyor other entityis capable of, or responsible for, providing the services; or (iii) In the case of rental properties, condominiums, or co-ops,a specific choreservice is the responsibility of the landlord or the landlord’s designee, as evidenced in the lease or any other agreement. (7) Cognitive-Behavioral Services , which are individual interventions designed to increase an individual’s cognitive and behavioral capabilities and to further the individual’s adjustment to successful community engagement. These services include, but are not limited to: comprehensive assessment of cognitive strengths and liabilities, quality of adjustment, and behavioral functioning; development and implementation of cognitive and behavioral strategies; development of a structured cognitive-behavioral intervention plan; ongoing or periodic consultation with the individual and the person-centered planning team concerning cognitive and behavioral strategies and interventions specified in the cognitive-behavioral intervention plan; ongoing or periodic assistance with training of the individual and person-centered planning team concerning cognitive and behavioral strategies and interventions; and periodic reassessment and revision, as needed, of the cognitive-behavioral intervention plan. (A) Cognitive-behavioral services may be provided in the individual’s home or in the community, and shall be performed by an agency provider or a self-employed provider who is a licensed psychologist, physical therapist, speech therapist, or occupational therapist, a qualified neuropsychologist, or another type of provider authorized to perform cognitive-behavioral services under the ABI waiver program,and who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Intervention plans shall be updated at least annually,or more frequently as clinically indicated. Intervention plans shall include the following components: (i) Long-term, measurable goals mutually agreed upon by the individual, or the individual’s legal representative, and the provider; (ii) Shorter-term, measurable objectives to reach those goals; (iii) The individual’s strengths and challenges, and a description of how strengths are to be used in achieving goals; (iv) Skills or tasks that need to be developed by the individual or the family; (v) Input by the individual into the intervention plan commensurate with the levelat which the individual is able to participate; and (vi) A description of how positive reinforcement, rather than punitive measures, will be used to support the individual. (C) Providers of cognitive-behavioral services shall be paid for face-to-face encounters and also for non-face-to-face encounters. (i) Face-to-face (in-person) encounters are in-personmeetings with the individual, and meetings with the individual’s family, supporters, or providers, even when the individual is not present. The provider must have an in-person meeting with the individual at least quarterly. (ii) Non-face-to-face (not in-person) encounters are telephonic or other secure electronic forms of communication, including videotelephony services such as Skype. A provider may also be paid at the non-face-to-face rate for activities such as reviewing the individual’s record and writing the plan of care, even if the individual is not present. (8) Community Living Support Services , which are support services that provide supervised living in the individual’s residence for up to 24 hours per day, including overnight supervision, to a minimum of two, or a maximum of three, individuals at once who require supportand supervision, in a supervised community residential setting for either a half-day (12 hours) or full day (24 hours). (A) Community living support servicesinclude, but are not limitedto, supervision and assistance with the following skills: (i) Self-care; (ii) Medication management; (iii) Interpersonal communication; (iv) Socialization; (v) Sensory and motor skills; (vi) Mobility; (vii) Utilizing transportation services; (viii) Problem-solving; (ix) Money management; and (x) Household management. (B) Assessment and training servicesare provided as part of this service. (C) Room and board is not included as part of this service. (D) The providershall develop a plan that demonstrates the provider’s abilityto work with the individual and to provideservices that are consistent with the therapeutic goals of the individual’s service plan. (E) Upon the individual’s request or improvement in the individual’s ability to live more independently, the providerand the care manager shallwork together, with the individual, to develop and implement a plan to transition the individual to greater independence in the community. (F) Community living support services shall be provided by anagency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (9) Companion Services , which are nonmedical services that are provided in accordance with a therapeutic goal includedin the service plan, includingthe following: supervision and socialization services; assistance with or supervision of meal preparation; assistance with laundry that is being performed by the individual; and light housekeeping tasks that are incidental to the care of the individual. (A) Companion services shall be provided by an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Companion servicesshall not entailthe provision of hands-on care or household management tasks, as these tasks are provided by personal care assistants and chore services providers, respectively, in accordance with subdivisions (6) and (15) of this subsection. (10) Consultation Services , which are services provided to assist a team and individuals to address service-implementation issues that have presented a barrier to resolution. This service aids in the development of individual interventions designed to decrease an individual’s severe maladaptive behaviors, which jeopardize the individual’s ability to remain integrated in the community. (A) Consultation services shall be provided: (i) Only to individuals on ABI Waiver II; (ii) In a team meeting at the individual’s home or community location; and (iii) By an agency or self-employed provider who is a licensed psychologist, clinical social worker, speech pathologist, speech therapist, occupational therapist, physical therapist, registered nurse, or dietician/nutritionist, a qualified neuropsychologist, or a certifiedrehabilitation counselor or substance abuse specialist, and who meet the requirements of subsection (a) of this section and all applicable training, state licensure, or certification requirements. (11) Environmental Accessibility Adaptation (“EAA”) Services,which are physicalchanges made to an individual’s home that are necessary to ensure the health, welfare, and safety of the individual, or enhance and promote greater independence, without which the individual would require institutionalization. (A) EAA services include,but are not limited to, the following: (i) Installation of ramps; (ii) Widening of doorways; (iii) Modifications to meet egressrequirements; (iv) Modification of bathroom facilities; and (v) Addition of specialized electrical and plumbing devices. (B) All EAA services shall be providedby agency providers or private contractors or businesses in accordance with applicable state and local building codes. (C) EAA services do not include: carpeting; central air conditioning; roof repair; house adaptations that add to the squarefootage of the home; or any otherphysical improvement to the home not of direct benefit to the individual’s health, welfare, and safety, or ability to live independently. (D) EAA servicesshall not be provided to adapt units that are owned or leased by providers of waiver services. (12) Homemaker Services , which are generalhousehold activities, includingmeal preparation and routine household chores. (A) The department shall pay for homemaker serviceswhen the personregularly responsible for homemaking activities is temporarily absent or unable to manage the home and care for the individual or others in the home, or when the individual is unable to learn such skills. (B) Homemaker services shall be provided by an agency provider or a household employee that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements.Homemaker services shall not be provided by a member of the individual’s family, the individual’s conservator, or a member of the conservator’s family. (13) Home-Delivered Meals , which is the preparation and delivery of one or two meals per day to an individual who is unable to prepare or obtain nourishing meals on the individual’s own, or for an individual who normallyhas someone who is responsible for preparing and delivering meals,but that person is temporarily absent or unable to perform this service. (14) Independent Living Skills Training (“ ILST ”), which is a training service designed for, and delivered to, an individual to improve that individual’s abilityto live independently in the community and to carry out strategies developed in cognitive/behavioral programs. (A) ILST may include, but is not limited to, teaching the individual the following skills: (i) Self-care; (ii) Medication management; (iii) Task completion; (iv) Interpersonal communication skills; (v) Socialization skills; (vi) Sensory/motor skills; (vii) Mobility and community transportation skills; (viii) Problem solving skills; (ix) Money management skills; and (x) Household management skills. (B) ILST shall be providedby an agency provider or household employeethat meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (15) Personal Care Assistant services , which are services that provide the individual with assistance with the following: eating, bathing, dressing, personal hygiene, and other activities of daily living that are performed by a provider in the individual’s home or community; or supervision and cueing of theseactivities without actualhands-on assistance. Personalcare assistant servicesshall be provided only: (A) If the individual’s physicalability to performactivities of daily living is impaired, or if the individual’s cognitive or behavioral impairments interfere with the individual’s ability to perform these tasks; (B) To individuals on ABI WaiverII; and (C) By an agency that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (16) Personal Emergency Response System (“PERS”),which is an electronic device connected to an individual’s telephone that enables an individual at high risk of institutionalization to secure help in an emergency. (A) A PERS is available only to an individual who: (i) Lives alone; (ii) Is alone for significant parts of the day and who does not have providers; or (iii) Would otherwiserequire extensive routinesupervision. (B) A PERS shall be provided by an agencyprovider that sells and installsPERS equipment. (17) Prevocational Services , which are time-limited services that provide learning and work experience, including volunteerwork, where the individual can develop generalnon-job-task-specific strengths and skillsthat contribute to employability in paid employment in an integrated work setting. Services are intended to develop and teach general skills, such as the ability to: communicate effectively with supervisors, co-workers, and customers; comply with generally accepted community workplace conduct and dress; follow directions; attend to tasks; develop strategies to solve problems at the workplace; and comply with general workplace safety and mobility training. Prevocational services are designed to be a pre-cursor to integrated employment. (A) The following time limits shall apply to prevocational services: (i) For individuals enrolled in ABI Waiver I, effective December1, 2015, a two-year time limit for thisservice shall be applied prospectively. This two-year limit may be extended up to a maximum of four years upon a determination by the department that additional time is needed for an individual to achieve the person-centered goal of attaining supported employment. Annual redeterminations of eligibility for such services shall be made after an initial two years of such services. (ii) For individuals enrolled in ABI Waiver II, this serviceis limited to two years.Upon strong justification of progress towardemployment goals, the department may authorize the service for a maximum total of three years. (iii) This serviceis limited to 40 hours per week. (B) Services shall be providedin the individual’s home or in an integrated work setting, based on the individual’s needs and preferences. (C) The individual shall have employment-related goals in theperson-centered service plan; (D) Prevocational services shall be provided by an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (18) Respite Care Services, whichare services providedto individuals who are unableto care for themselves, and when the person normally performing such services is absent or in need of relief. (A) Services shall be furnished on a short-term basis in the individual’s home. (B) Services shall be providedby an agency or household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (19) Specialized Medical Equipment and Supplies , which include devices, controls, or appliances that enable an individual to increase the individual’s ability to perform ADLs, or to cognitively perceive, control, or communicate in the individual’s environment within the community; items necessary for life supportand those ancillary supplies and equipment that are necessary for the proper functioning of such items; and durable and non-durable medical equipment that is not available as a covered medical service under the Medicaid state plan. (A) Specialized medical equipment and supplies paid for under the ABI waiver program shall be of direct medical or remedial benefit to the individual; meet all applicable standards of manufacture, design and installation; and be in addition to any medicalequipment and suppliesfurnished under the Medicaid state plan. (B) Specialized medicalequipment and suppliesshall be providedby a medical equipment vendor, durable medical equipment provider, or pharmacy that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (20) Substance Abuse Program Services , which are individually designed interventions to reduce or eliminate the individual’s use or abuseof alcohol or drugs when such use or abuseinterferes with the individual’s ability to remain in the community. (A) Substance abuse program services shall include, but are not limited to, the following services: (i) Performing an in-depth assessment of the relationship between the individual’s use or abuse of alcohol or drugs and the individual’s brain injury; (ii) Performing a learning and behavioral assessment; (iii) Developing and implementing a structured treatment plan; (iv) Providing ongoingeducation and trainingof the individual, family members,and other service providers concerning support needs of the individual; (v) Developing individualized strategies to avoid relapse; (vi) Conducting periodic reassessment of the treatment plan; and (vii) Providing ongoing support to the individual. (B) Substance abuseprogram services shall be providedon an outpatient basis in a congregate setting or the individual’s community. (C) Substance abuseprogram services shall be providedby either agencyproviders (i.e, substance abuse diagnostic and treatment centers, or rehabilitation hospitals) or individual providers (i.e., self- employed providers, licensed psychologists, or certified drug and alcohol counselors) that meet the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (D) The individual’s structured treatment plan may include both group and individual interventions and shall reflect the use of curricula and materials adoptedfrom substance abuse programs designed to meet the needs of individuals with cognitive impairment. (E) The individual’s treatment plan shallinclude linkages to existing community-based, self-help or support groups, such as Alcoholics Anonymous and organizations that promote and support sobriety. (F) With the individual’s consent,the substance abuse program providershall communicate with the individual’s other service providers concerning the individual’s treatment regimens. (21) Supported Employment services, which are services provided to individuals who, because of their disabilities, need intensive on-going support to perform in a work setting. The intended outcome of this serviceis sustained paid employment or self-employment in the generalworkforce in a job that: (1) meets the individual’s personal and career goals; (2) pays a wage level at or above the minimum wage; and (3) pays at a wage and benefit levelthat is not less than the customary wage and benefit level paid by an employer for the same or similar work performed by individuals without disabilities. (A) Supported employment services may be conducted in a variety of settings, including work sites where persons without disabilities are employed. When supported employment services are provided in such integrated work settings, paymentsshall be made only for adaptations, supervision and training needed by the individual, and shall not include payment for any modifications or activities rendered or required within the normal business setting. (B) Supported employment services shall not otherwise be available under a programfunded under the Rehabilitation Act of 1973, 20 USC 1401 et seq., or Education forAll Handicapped Children Act, Pub. L. No. 94- 142. (C) Transportation betweenthe individual’s residence and supported employment site is required as a supported employment service, and is included in the rate paid to the provider. (D) Supportive employment services shall be provided by agency providers that meet the requirements of subsection (a) of this section, and all applicable training and statelicensure, or certification requirements. (22) Transitional Living Services , which are short-term, individualized, residential services providing support to an individual transitioning into a community livingsituation. These services and supports are designed to improve the individual’s skills and ability to live in the community. (A) Transitional living services: (i) Are availableonly to individuals on ABI Waiver I; (ii) Shall be provided for only one transitional period; (iii) May be provided up to 24 hours per day; (iv) Shall be provided only when the individual is unable to be supported in a permanent residence and is in need of intensive clinical interventions provided by this service; and (v) Shall be provided by an agency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Prior to discharge from transitional living services, the provider shall work with the individual and the care manager to develop a plan of care. Upon discharge, other ABI services shall become available to the individual in accordance with the plan of care. (C) ABI waiverfunds shall not be used to pay for the room and board component of transitional living services. (D) Transitional living services shall not be provided with any ABI services other than care management, environmental modifications, specialized medical equipment and vehicle modifications. (23) Transportation Services , which are services offered in accordance with the individual’s service plan to allow the individual to access servicesthat do not qualify for non-emergency medical transportation under 42 CFR §440.170(a). (A) Transportation services shall not be provided when public transportation is available or when friends, family, neighbors, or community agencies are able to provide transportation free of charge. (B) All reasonable alternatives shall be explored and exhausted priorto receiving approvalfor transportation services. (C) Transportation servicesshall be providedby a livery service or individual providerlicensed by the State of Connecticut, with a valid Connecticut driver’s license and evidence of automobile insurance. (24) Vehicle modification services , which are alterationsto a vehicle when such alterations are necessary to improve the individual’s independence and inclusion in the community, and to enable the individual to avoid institutionalization. (A) The vehicle shall be the individual’s primarymeans of transportation. (B) The vehicleshall be ownedby the individual, a relativewith whom the individual lives or has consistent and ongoing contact, or a non-relative who provides primary long-term support to the individual and is not a paid provider of such services. (C) All modifications and adaptations shall be providedin accordance with applicable federaland state vehicle codes. (D) Vehicle modification services do not include: adaptations or improvements to a vehicle that are of general utility and not of direct medicalor remedial benefitto the individual; payments for the purchase or lease of a vehicle; or regularly scheduled upkeep and maintenance of a vehicle, except for upkeep and maintenance of the modifications. (E) The total individual cost limit for vehicle modifications is $10,000.00. (F) Vehicle modification services shall be provided by a providerapproved by the State of Connecticut as a vehicle modification vendor. (NEW) Sec. 17b-260a-9. Pre-screen, waiting list and assessment (a) The department shall review completedapplications that it receives in the orderin which they are received. Acceptance to the ABI waiver program shall be on a first-come, first-served basis, except that individuals transitioning from the Money Follows the Person program or Department of Mental Health and Addiction Services Acquired Brain Injury Services to the ABI waiver program shall have priority for reserved spaces. (b) The department shall conduct a pre-screen of the applicant following the receipt of the application, and prior to placing the applicant’s name on the waiting list, to determine whether the applicant (1) meets the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut State Agencies, and (2) requires one of the level-of-care categories described in subsection (d) of this section. (c) Applications shall be pre-screened based upon the information contained in the completed application, as well as information obtained from: the individual; a neuropsychological examination report prepared by a qualified neuropsychologist; and any other clinical personnel who are familiar with the individual’s case and history.In order to be considered, the neuropsychological examination report must have been completed no more than two years prior to the application date, provided, however, that the department retains the discretion to increase this time limitation on a case-by-case basis. The neuropsychological examination report shall be submitted to the department no later than six months followingthe application date,except that the department may extend this deadline for an additional 90 days if a neuropsychological examination appointment has been scheduled. Failure by the individual to meet this deadline shall result in the denial of the application. (d) To qualifyfor services under the ABI waiver program,the individual shall meet one of the following institutional level-of-care categories: (1) Category I (NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a NF. The individual is considered to require care in a NF if the individual residesin such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, including, but not limited to, eating, bathing, dressing, toileting, and transferring; (2) Category II (ABI NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in an ABI NF. The individual is considered to require care in an ABI NF if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facilitybut has impaired cognition, impairedbehavior requiring daily supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, and a mental illness that manifested itself before the brain injury occurred; (3) Category III (ICF-IID level of care): If the individual were not receiving services under the ABI waiver program,the individual wouldrequire care in an ICF-IID.The individual is considered to require care in an ICF-IID if the individual resides in such a facility and the department or its agent determines that the individual currently requires such levelof care, or if the individual does not reside in such a facility but has impaired cognition, an ABI that occurred before the age of 22 and, due to physical deficits, requires physical assistance with two or more ADLs; or (4) Category IV (CDH level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a CDH. The individual is considered to require care in a CDH if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and impaired or abnormal behavior, and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b- 260a-3(46) of the Regulations of Connecticut StateAgencies, with two or more ADLs. For purposes of this category, “impaired or abnormal behavior” means that one or more behaviors is consistently severely impaired or abnormal, and requires the availability of intensive and ongoing behavior intervention to the extent that the individual would require care in a CDH if the individual were not receiving services under the ABI waiver program. Behaviors that may meet this definition include: engaging in inappropriate sexual activity; causing injury to others or self, or damage to property; demonstrating physical or verbal aggression; demonstrating a consistent ongoing pattern of wandering or elopement; engaging in socially offensive behavior; demonstrating withdrawal, susceptibility to victimization, impulsivity, intrusiveness, agitation or pica; or engaging in criminal activity after the brain injury occurred. (e) The applicant shall be placed on the waiting list if the applicant is determined by the department, based on the information provided during the pre-screening, including the neuropsychological examination report, to meet the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut StateAgencies and the applicant requires one of the levels of care described in subsection (d) of this section. (f) The department shall notify the applicant in writing when, based on the applicant’s waitlist position, an opening is reasonably expected to become available to the applicant within 90 days. Once notified, a care managershall meet with the individual, complete a comprehensive assessment of the individual’s needs, including the level of care, and develop a proposed service plan. A care manager and the individual, in conjunction with the person-centered team, shall then develop, if feasible, a cost-effective service plan as determined pursuant to section 17b-260a-10(d). Services shall not be authorized until the department determines that the individual’s Medicaid coverage is active. (g) The department shall re-evaluate the level of care for each individual at least annually. (NEW) Sec. 17b-260a-10. Development of the service plan and evaluating cost-effectiveness (a) Applicants enrolledin ABI Waiver I shall have a total individual service plan cost limit no greater than 200% of the annualized alternative institutional care cost. (b) Applicants enrolledin ABI Waiver II shall have a total individual service plan cost limit no greater than 150% of the annualized alternative institutional care cost. (c) The department shall not approvea total individual service plan that exceeds the individual service plan cost caps or funding limitations established in the approved waiver. (d) To determine the cost-effectiveness of the individual’s service plan, the department shall: (1) Obtain the annualized alternative institutionalized care costs for the individual. For each level of care listed in subsection (d) of section 17a-260a-9 of the Regulations of Connecticut State Agencies, the annualized alternative institutional care cost is equal to the state’s weighted average cost for the specified facilitytype, as annuallydeveloped and published by the department, minus the average applied income; (2) Determine the individual’s total service cost by aggregating each of the following costs: (A) The annualized cost of each covered servicethat will be provided to the individual, based on the department’s established rates for such services; (B) The annualized cost of the ABI waiver home and community-based services, as described in section 17b- 260a-8 of the Regulations of Connecticut StateAgencies, to be provided to the individual under the proposed service plan; (C) The annualized cost of any other medical services covered by Medicaid, as described in section 17b- 260a- 3(37) of the Regulations of Connecticut StateAgencies, provided in the individual’s home that the individual may require in order to live in the community, to be calculated by multiplying the expected frequency of utilization of these services by the Medicaid rates established by the department for such services; and (D) The annualized cost of any other community-based services, as describedin section 17b-260a- 3(36) of the Regulations of Connecticut State Agencies, that the individual may require in order to live in the community; and (3) Compare the individual’s total service cost to the applicable individual limit set in subsections (a) and (b) of this section to determine if the total service cost exceeds the applicable individual limit. (e) To promote cost neutrality in accordance with 42 USC1396n (b), every reasonable effort shall be made to provide services below the maximum dollar amount level, and in the most cost-effective manner possible. The department shallnot exceed the funding limitations established in the approved waiver when determining whether an individual can be accepted into the program. (NEW) Sec. 17b-260a-11. Responsibilities of the individual (a) Person-Centered Planning and Selecting Providers (1) To the extent feasible, the individual shall lead the person-centered planning process. If the individual has a legal representative, the legal representative may participate in the planning process, making decisions for the individual, as necessary to ensure the best interests of the individual. The department may seek assistance from a court of probate if: (A) The department determines that the legal representative is not acting in the best interests of the individual and is hindering the person-centered planning process; or (B) There is a conflict between the individual and the legal representative. (2) The individual or the individual’s legal representative, or both, shall: (A) Choose the team to participate in the person-centered planning process; (B) Collaborate with the person-centered team; (C) Select, from a list of providers, the providers who will deliver the services specified in the service plan; (D) Supervise the services that are provided to the individual in accordance with the service plan; (E) Notify the department if a provider is not performing satisfactorily; (F) Terminate the employment of a household employee or the services of a self-employed provider, as necessary; and (G) Select new providers, as necessary. (b) Financial Responsibilities (1) An individual whose gross income exceeds shall be 200% of the federal poverty level shallbe required to contribute toward the cost of services rendered under the waiver. The amount contributed shall be calculated according to section 5035 of the Uniform Policy Manual, or any other applicable law or policy of the department. (2) The individual shall agree to pay directly to the department’s fiscal intermediary the portion of income calculated to be contributed to the individual’s cost of care. This agreement shall be documented in the individual’s service plan. (c) Responsibilities of the Individual as the Employer of Household Employees An individual who is the employer of household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut State Agencies, shall be responsible for: (1) Compliance with all applicable state and federal requirements, including, but not limited to, those related to workers’ compensation, unemployment compensation, minimum wage rates, and income tax withholding; and (2) Hiring and termination of the employment of household employees, as necessary. (d) Critical Incident Reporting (1) The individual, or the individual’s legal representative, shall comply with the department’s critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-12. Department responsibilities " CT DSS " The department or its agent shall: (a) Inform eligible individuals that they have the choice whether to community-based reprogram by community-based services through the ABI waiver program, or to receive institutional care; (b) Establish eligibility for the ABI waiver programby performing an assessment of the individual’s needs; (c) Coordinate the development of a service plan designed to deinstitutionalize or divert the individual from institutional placement; (d) Assist with implementation of an approved service plan by coordinating services provided to the individual; (e) Review with the individual, on a regular basis, the effectiveness of the service plan and make appropriate and cost-effective revisions to the plan, as required, based on achievement of the expected outcomes, the individual’s degree of satisfaction with the services and providers, the individual’s changing capabilities, and the ongoing availability of home and community-based services; (f) Review and reassess, at least every 12 months, and whenever there is a significant change in the individual’s ability to function in the community, the individual’s service plan and level of care; (g) Lead team meetings in conjunction with the individual; (h) Maintain records for at least 7 years. (i) Advise the individual of the individual’s right to an administrative hearing in accordance with sections 17b-60 and 17b-61of the Connecticut General Statutes if the individual is aggrieved by the department’s decision with respect to the individual’s application or eligibility for the ABI waiver program, or if services are reduced, denied or terminated; (j) Maintain a waiting list of individuals who have applied for and been pre-screened for ABI services; (k) Establish provider qualifications and, through maintain its fiscal intermediary, establish and maintain a directory of providers; (l) Establish payment rates for all services offer under or delivered the ABI waiver program; (m) Pay for approved ABI waiver services health or delivered by providers on behalf of the individual; and (n) Maintain, and comply with, a critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s healthor welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-13. Provider Responsibilities (a) All providers shall: (1) Comply with any critical incident reporting protocols developed by the department for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (2) Report their arrest, or any arrest of an employee, to the department within 10 business days. The failure of a provider to report any such arrest may result in termination of the provider from the ABI waiver program. (3) Complete a state and federal criminal background check, at the expense of the applicant or provider. (4) Accept payment only for services that were actually provided to the individual and that do not violate the rules, regulations, standards, or laws governing the Medicaid program in accordance with sections 17-83k-1 to 17-83k-7, inclusive, of the Regulations of Connecticut State Agencies. A provider may be suspended or terminated from participation in the program for accepting payment for services not provided or for violating the rules, regulations, standards, or laws governing the program. (b) Agencies that employ providers shall: (1) Ensure that all staff, volunteers, interns or other persons employed by, supervised by, or representing the agency who may have direct contact with individuals receiving ABI waiver funding, meet and maintain all criminal background standards and requirements as set forth in subsection (a)(3) of this section. (2) Have policies in place regarding the provision of language services to individuals while receiving ABI waiver services, and shall not rely on the assistance of individuals’ friends, family or others. (3) Deliver training to staff members regarding the provision of services that are person-centered and culturally competent. (4) Have policies and procedures in place regarding employee standards of conduct. Such policies and procedures shall include, but are not limited to, the following topics: (A) The need for providing person-centered services; (B) The importance of respecting individuals’ rights, including privacy and self-determination; (C) The prohibition against neglect, abuse, and harassment of individuals; (D) The prohibition of the use of drugs or alcohol, or of being under the influence of drugs or alcohol, while providing services to individuals; (E) The laws covering confidentiality of all participant information collected, used or maintained; and (F) Critical incident reporting requirements. (5) Establish a quality assurance plan. Such plan is subject to the approval by the department and shall include random checks of staff performance. (NEW) Sec. 17b-260a-14. Provider participation (a) It shallbe a certification requirement of the department for all servicespecialties that, in order to participate in the ABI waiver program and receive payment from the department, all providers: (1) Enroll with the department as a provider in the Medicaid program and sign the Medicaid Provider Enrollment Agreement, as directed by the department, which agreement may include addenda specific to the ABI waiver program and may be amended from time to time; (2) Comply with all applicable state and federal statutes and regulations, including, but not limited to, sections 17b-262-522 et seq. of the Regulations of Connecticut State Agencies, the Medicaid Provider Enrollment Agreement and any applicable addenda, and all departmental policies, as amended from time to time (3) Comply with all of the provisions and requirements of applicable Medicaid waivers, as amended from time to time; (4) Deliver, document, and bill only for those services that are outlined in the individual’s service plan; and (5) Comply with the requirements of any corrective action plan imposed by the department. (b) The commissioner shall have the discretion to refuse to list a provider in the provider directory, remove the provider’s name from the provider directory, or refuse payments to a provider, if the provider performing the services poses a threat to the health or safety of individuals participating in the ABI waiver program, or has been convicted in this state or any other state of a felony, as defined in section 53a-25 of the Connecticut General Statutes, involving: forgery under sections 53a-137 of the Connecticut General Statutes; robbery undersection 53a-133 of the Connecticut General Statutes; larceny under sections, 53a-119, 53a-122, 53a-123, and 53a-124 of the Connecticut General Statutes; sexual assault under sections 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a, 53a-72b, 53a-73a of the Connecticut General Statutes; or assault under sections 53a-59, 53a-59a, 53a-60, 53a-60a, 53a-60b, and 53a-60c of the Connecticut General Statutes; or has been convicted in this state or any other state of an offense, as defined in section 53a-24 of the Connecticut General Statutes, involving: cruelty to persons under section 53-20 of the Connecticut General Statutes; vendor fraud under sections 53a- 290 to 53a-296, inclusive, of the Connecticut General Statutes; or the abuse of an elderly, blind or disabled person, or a person with intellectual disability under sections 53a-320 to 53a-323, inclusive, of the Connecticut General Statutes. (NEW) Sec. 17b-260a-15. Corrective action and provider cooperation (a) If a provider fails to comply with sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or MedicaidProvider Enrollment Agreement, the department may require the provider to comply with a corrective action plan. (b) The provider shall cooperate fully with any department, state, or federal audit or investigation, and shall correct any deficiencies identified in the course of such audit or investigation. (NEW) Sec. 17b-260a-16. Provider fiscal responsibility (a) For purposes of this section: (1) “Fraud” means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to that person or some other person. It includes any act that constitutes fraud under applicable federal or state law. (2) “Abuse” means practices that are inconsistent with generally acceptedfiscal or business practices and result in unnecessary cost to the ABI waiver program. (b) The provider shall not engage in or commit fraud or abuse, including, but not limited to: (1) Billing for services not rendered; (2) Billing for services not in the service plan; (3) Billing for services not medically necessary; (4) Falsely identifying the person who actually performed a service, including billing for services performed by an individual who is not credentialed; (5) Failing to adequately document all servicesthat are billed; (6) Billing for services for ABI participants services that who are institutionalized at the time in which the service has been billed as having been rendered; or (7) Violating Medicaid policies, procedures, rules, regulations, or statutes. (NEW) Sec. 17b-260a-17. Client documentation and provider reporting (a) Providers shall retain records to document services submitted for Medicaid reimbursement for at least seven years from the date the service or item was provided. Documentation shall include the following: (1) Provider’s name and signature; (2) Dates of service; (3) Start time for each visit; (4) End time for each visit; (5) A description of duties performed or items provided; (6) Client goals and documentation of progress toward meeting those goals; and (7) Unless otherwise described in the provider’s applicable Medicaid Provider Enrollment Agreement and any addenda thereto,the individual’s name and the signature of the individual or the individual’s legal representative. (b) Upon written request presented to the provider, the department or its authorized agent shall be given immediate access to, and permitted to review and copy, any and all records and documentation used to support claims billed to Medicaid. For purposes of this subsection, “immediate access” means access to records at the time the written request is presented to the provider. (c) The provider shall submit written reports on the individual’s status and progress for each of the first three months of the individual’s participation in the program, and quarterly thereafter, to the care manager in a manner that is set forth by the department. (NEW) Sec. 17b-260a-18. Provider termination, suspension or disqualification (a) Failure to comply with any requirements in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or Medicaid Provider Enrollment Agreement, may result in the nonpayment of services, suspension or termination from participation in the ABI waiver program, or any other sanction available under state or federal law. (b) The department may suspend or terminate the provider from participation in the ABI waiver program immediately and withoutprior notice if it has reason to believe that a providerposes a threat to, or has acted in a manner that posed a threat to, the health, safety or welfare of an individual participating in the ABI waiver program, or has engaged in fraudulent or abusive program practices.

"These programs are funded by the Federal Medicaid Program and are available to residents of Connecticut and other states. The Connecticut Department of Social Services is responsible for overseeing and ensuring the quality of the services provided for the CT programs." Connecticut Regulations of CT DSS Department of Social Services Concerning The Acquired Brain Injury Waiver Programs 1 and 2 The Regulations of Connecticut State Agencies are amendedby adding sections17b-260a-1 to 17b- 260a-18, inclusive, as follows: (NEW) Sec. 17b-260a-1. Purpose The Acquired Brain Injury (ABI) waiver program is established pursuant to sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes and 42 USC 1396n(c). The ABI waiverprogram provides, within the limitations described in sections 17b-260a-2 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, a range of nonmedical, home and community-based services to individuals 18 years of age or older with an ABI who, without such services, would otherwise require placement in a hospital, nursing facility (NF), or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The intention of the ABI waiver program is to enable such individuals, through person-centered planning, to receive home and community-based services necessary to allow such individuals to live in the community and avoid institutionalization. (NEW) Sec. 17b-260a-2. Scope Sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut StateAgencies set forth the requirements for eligibility and payment of services to eligible individuals participating in the ABI waiver program. These regulations also describe program requirements; services available; service requirements; department, provider and individual responsibilities; residential setting requirements; and limitations under the ABI waiver program. (NEW) Sec. 17b-260a-3. Definitions As used in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies: (1) “ Acquired brain injury ” or “ABI” means the combination of focal and diffuse central nervous system dysfunctions, immediate or delayed, at the brainstem level or above.These dysfunctions may be acquired through physical trauma, oxygen deprivation, infection, or a discrete incident that is toxic, surgical, or vascular in nature. The term “ABI” does not include disorders that are congenital, developmental, degenerative, associated with aging, or that meet the definition of intellectual disability as defined in section 1-1g of the Connecticut General Statutes; (2) “ Acquired braininjury nursing facility ” or “ABI NF” means a type of nursing facilitythat provides specialized programs for persons with an acquired brain injury; (3) “ Acquired Brain Injury waiver program ” or “ABI waiver program” or “the program” means the programsadministered by the Department of Social Servicesand established pursuantto sections 17b-260a(a) and 17b-260a(b) of the Connecticut General Statutes, as described in Medicaid waivers approved by the Secretary of the United States Department of Health and Human Services pursuant to 42 USC 1396n as amended from time to time, for the provision of home and community-based services to individuals with acquired brain injury; (4) “ ABI Waiver I ” " ABI Waiver Program One 1 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(a) of the Connecticut General Statutes and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of January 1, 1999; (5) “ ABI Waiver II ” " ABI Waiver Program Two 2 " means the Acquired Brain Injury waiver administered by the Department of Social Services, as authorized by section 17b-260a(b) of the Connecticut General Statutes, and approved by the Secretary of the United States Department of Health and Human Services with an initial effective date of December 1, 2014; (6) “ Acquired Brain Injury waiver services ” or “ABI waiver services” means all or some of the services provided to individuals in the ABI waiver program; (7) “ Activity of daily living ”or “ADL” means an activity or task that is essential to an individual’s health, welfare, and safety, including, but not limited to, bathing, dressing, eating, transfers, and bowel and bladder care; (8) “ Agency provider ” means a provider employed by an agency, who provides ABI waiver services to individuals participating in the ABI waiver program; (9) “ Alternative institutional care costs ” means the costs of institutional care that the individual would otherwise incur, but for the support of waiver services; (10) “ Applicant ” means an individual who, directly or through a representative, completes an ABI waiver program application form and submits it to the department; (11) “ Applied income ” means the portion of the individual’s income that remains after all deductions and disregards are subtracted and that may be appliedto the cost of waiverservices; (12) “ Assessment ” means a comprehensive, multidimensional written evaluation conducted by nonmedical department personnel or agents, using a standard assessment form that is used to determine whether an individual meets the level-of-care criteria to participate in the ABI waiver program; (13) “ Chronic disease hospital " or “CDH” means a long-term hospitalhaving facilities, medical staff, and necessary personnel for the diagnosis, care, and treatment of a wide range of chronic diseases; (14) “ Commissioner ” means the Commissioner of Social Services; (15) “ Cost-effective ” or “ cost-effectiveness ” means the department’s determination that payments for the individual’s total service costs do not exceed either the individual caps or available funding for the ABI waiver program; (16) “ Countable income ” means all sources of income not excluded under the Medicaid program; (17) “ Department ” or “ DSS ” means the stateof Connecticut Department of Social Services or its agent; (18) “ Family member ”means a person who is related to the individual by blood, adoption, or marriage; (19) “ Fiscal intermediary ” means an agent or agents under contract with the department that is responsible for: paying providers for services delivered; registering providers; providingtraining and outreach to individuals and providers of services under the ABI waiver program; and performing other administrative functions requested by the department; (20) “ Hands-on care ” means assistance with ADLs provided most often, but not exclusively, by home health aides. Hands-oncare includes the prompting and cueing necessary for an individual to perform ADLs; (21) “ Home and community-based services ” means Medicaid servicesprovided to an individual in that individual’s own home or other community-based setting; (22) “ Home and community-based setting ” has the same meaning as provided in 42 CFR 441.301(c)(4)-(5), as amended from time to time; (23) “ Hospital ” has the samemeaning as provided in 42 CFR 440.10, as amended from time to time; (24) “ Household employee ” means a provider who performs ABI recovery assistant I, ABI recovery assistant II, chore, companion, homemaker, independent livingskills training, or respite services, and who is employed by the individual and not an agency; (25) “ Individual ” means a person with an acquired brain injury who is applying for, or actively participating in, the ABI waiver program; (26) “ Individual cap ” meansthe maximum allowabletotal cost of the individual’s service plan; (27) “ Integrated work setting ” means a work setting wherepeople with disabilities work alongside people without disabilities, for at least minimum wage. (28) “ Intermediate care facility for individuals with intellectual disabilities ” or “ICF-IID” has the same meaning as provided in 42 CFR 440.150, as amended from time to time, and is a facility licensed by the Connecticut Department of Developmental Services for the care and treatment of persons with intellectual disabilities; (29) “ Intervention plan ” means a document developed by a cognitive behaviorist that identifies the treatment goals and interventions for the individual and team; (30) “ Legal representative ” means a guardian, conservator, or an individual holding a power of attorney appointed to act on the individual’s behalf; (31) “ Level of care ” means the type of facility, as determined by a care manager or designated agent of the department, neededto care for an individual if the individual were not receiving services under the ABI waiver program. The types of facilities include: a nursing facility, ABI NF, CDH, or ICF-IID; (32) “ Medicaid ” or “ Medicaid program ”means medical and health-related servicesadministered by the state of Connecticut Department of Social Services pursuant to Title XIX of the Social SecurityAct; (33) “ Medicaid Provider Enrollment Agreement ” has the same meaning as provided in section 17b-262-523(23) of the Regulations of Connecticut StateAgencies, except that such agreement may include addenda specific to the ABI waiver program; (34) “ Neuropsychological evaluation ” has the same meaning as provided in section 17b-262- 468(17) of the Regulations of Connecticut State Agencies; (35) “ Nursing facility ” or “NF” has the same meaning as provided in 42 CFR 440.40 and 42 CFR 440.155, as amended from time to time; (36) “ Other community-based services ” means servicesprovided by programsadministered by the department that are not part of the ABI waiver program, or services provided by programs administered by other state or local agencies that are necessary to maintain the individual in the community; (37) “ Other medical services ” means services that are normally included in the department’s payments to NFs, ABI NFs, CDHs, and ICF-IIDs, and that the individual requires,in addition to ABI waiver services, to live in the community. Other medical servicesinclude: home health care; nursing services; physical therapy; speech therapy; and occupational therapy; (38) “ Person-centered plan ” means a service plan developed by the person-centered team that meets the requirements of 42 CFR 441.301(c)(1)-(3), inclusive, as amended from time to time; (39) “ Person-centered team ” means an interdisciplinary group of people organized to assist the individual to develop and implement a service plan. The planning team consists of a care manager, the individual, the legal representative (if applicable), a cognitive behaviorist, any interested family members, or other relevant participants; (40) “ Provider ” means an agency provider, household employee or self-employed provider who meets the qualifications established by the department to provide home and community-based services under the ABI waiver program, has signed the Medicaid Provider Enrollment Agreement, and is enrolled in the ABI waiver program; (41) “ Qualified neuropsychologist ” means a psychologist who meets the qualifications of section 17b-262-468(16) of the Regulations of Connecticut State Agencies; (42) “ Rehabilitation hospital ” means a facilityperforming rehabilitative outpatient hospital services in accordance with the provisions of 42 CFR 440.20(a). (43) “ Representative ” means a personwho is not a legalrepresentative, and who is actingin support of an individual; (44) “ Self-employed provider ”means a person who does not work for an agency, is not a household employee, and meets the qualifications listed in 17b-260a-8 of the Regulations of Connecticut State Agencies to provide certain services under the ABI waiver program; (45) “ Service plan ” means an individualized written plan developed through person-centered planning that documents the medicaland home and community-based servicesthat are necessary to enable the individual to live in the community instead of an institution. The service plan includes measurable goals, objectives, and documentation of total service costs; (46) “ Supervision or cueing ” means daily support such as monitoring, observing, verbal or gestural prompting, verbalcoaching and gesturalor pictorial cueing that is required in order for the individual to accomplish an ADL. Supervision and cueing must be required on a contemporaneous basis with the performance of the ADL, and does not include a reminder or request to perform an ADL when the individual does not need support beyond such reminder or request in order to accomplish the ADL. (47) “ Total service costs ” means the annualized cost of ABI waiver services, other medical services, and other community-based services included in an individual’s service plan that are required in order for the individual to live in the community instead of an institution; and (48) “ Waiting list ” means a record maintained by the department that includes the names, and dates of completed ABI waiver applications, of all individuals who have submitted completed applications for ABI waiver services and whoseapplications have been screened and found to be functionally eligible for the program. (NEW) Sec. 17b-260a-4. Not an Entitlement The ABI waiver program is not an entitlement program. Services, waiver slots and access to services under the ABI waiver program may be limited based on available funding and program capacity. (NEW) Sec. 17b-260a-5. Eligibility (a) An applicant may be eligible to receive coverage for the cost of the services specified in section 17b-260a-8 of the Regulations of Connecticut State Agencies, through the department’s ABI waiver program, if: (1) The applicant’s countable income is less than 300% of the benefit amount that would be payable under the federal Supplemental Security Income programto an applicant who lives in the applicant’s own home and has no income or resources; (2) The applicant is otherwise eligible to participate in the department’s Medicaid program, including any applicable asset requirements, under either the working disabledor long-term care eligibility criteria; (3) The applicant meets the programmatic requirements of subsection (c) of this section; and (4) The applicant is not ineligible for coverage under subsections (d) or (e) of this section. (b) The financial requirements for eligibility are as follows: (1) The applicant’s countable income and assets for purposes of eligibility are determined using the same methodologies the department employsin determining the countable incomeand assets of an institutionalized applicantfor Medicaid, including, but not limitedto, the spousal impoverishment rules and spousal post-eligibility rules under section 1924 of the Social Security Act, 42 U.S.C. § 1396r-5, for individuals with a community spouse. (2) Income eligibility determination for ABI waiver services under this section is based solely on the applicant’s countable income and does not involve consideration of the incurredmedical expenses or any other liabilities that may have been incurred by the applicant. (3) Payment for ABI waiver services is reduced by the individual’s applied income, which is calculated by determining the amount of the applicant’s countable income remaining after the deduction of an allowance for the personal needs of the individual equal to 200% of the federal poverty level, as well as any applicable community spouse’s or family allowance, and amounts for incurred medical or remedial care expenses not subject to payment by a thirdparty, as specified in 42 CFR 435.726. (c) The programmatic requirements for eligibility are as follows: An individual shall: (1) Be between the ages of 18 and 64 at the time the application is completed; (2) Have an ABI, as defined in section 17b-260a-3(1) of the Regulations of Connecticut State Agencies; (3) Meet the criteria for one of the level-of-care categories described in subsection 17b-260a-9(d) of the Regulations of Connecticut State Agencies; (4) Have the cognitive abilityto actively participate in the development of the individual’s service plan or, absent such ability, have a legal representative who acts on the individual’s behalf to perform these tasks. Participation includes, but is not limited to, selection, hiring, direction, and termination of providers; (5) Voluntarily choose to live in the community by participating in the ABI waiver program; (6) Wish to utilize ABI waiver services; (7) Develop, in consultation with the person-centered team, a serviceplan that providesassistance that reasonably addresses and mitigates identified risks; (8) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that there are risks inherent in living in the community; that the individual’s safety cannot be guaranteed; and that the individual acceptsfull responsibility if the individual chooses to live in the community, thereby absolving the department from any liability for any and all consequences that may result from this choice; (9) Understand and acknowledge, or the individual’s legal representative shall understand and acknowledge, that the individual is the employer of any household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut StateAgencies, and shallsign a written document accepting full responsibility as the employer of such providers; (10) Maintain eligibility for Medicaid; (11) Need waiverservices, which means that the individual needs a minimumof two waiver services, on at least a monthly basis; (12) Have a total serviceplan cost that does not cause the ABI waiverprogram’s expenditures to exceed total appropriated funding limits for the ABI waiver program; (13) Have a total serviceplan cost that does not exceed the individual cap that appliesto the individual, as set forth in sections 17b-260a-10(a) and (b); and (14) Agree to pay, if applicable, any applied income toward the cost of services renderedunder the waiver, as required under section 17b-260a-11(b). (d) Not with standing subsections (a), (b) and (c) of this section,an individual shallnot be eligible for ABI waiver program services if: (1) The individual: (A) Receives services under any other Medicaid waiver program; (B) Has received and benefited from ABI waiver services, no longer requires the services, no longer meets level-of-care criteria, and can continueto reside in the community without the support of ABI waiver program services; (C) Has a cognitive or behavioral dysfunction due solely to an intellectual disability or chronic mental illness, rather than an ABI, as determined by a licensed medical professional; (D) Requires inpatient care in an acute care hospital, NF,ABI NF, ICF-IID or CDH, or who is otherwise institutionalized for a period of ninety days or more,provided, however, such durational limitation may be extended for an additional thirty days upon submission of documentation from a medical professional indicating that the applicant’s discharge is expected within thirty days; (E) Demonstrates consistent and extreme physical, verbal, or sexual aggression toward others; (F) Demonstrates behaviors that violate the law or are contraryto community integrated living; (G) Is currentlyincarcerated, and not expected to be returnedto the community within ninety days; (H) Lacks mental capacity to participate in the program; (I) Refuses servicesthat are vital to health,welfare, and safety;or (J) Behaves in ways that are detrimental to the individual’s health, welfare, and safety, which includes, but is not limited to: (i) Participating in illegal or criminal activity; (ii) Using, or threatening to use, weapons,chemicals, or firearmsfor the purposeof causing harm or injury to self or others; or (iii) Compromising the safety of caregivers, staff, and others in the home or community. (2) The conditions at the individual’s home or on the grounds of the home are hazardous due to: (A) Illegal or criminal activity; (B) The presenceof animals that are dangerous or not properly secured or maintained; (C) Poor sanitation; or (D) Violations of local or state fire,zoning, or housing that pose a risk to the health, welfare, and safety of the individual or providers; or (3) Persons who either reside in, or have regular access, the individual’s home are: (A) Engaging in illegal or criminal activity; (B) Behaving in a manner that is dangerous or jeopardizes the safety, health,or well-being of the individual, providers, or others; (C) Interfering with the provider’s delivery, or the individual’s receipt,of services or acting in any way that affects a provider’s access to the individual; or (D) Threatening the individual verbally, physically, or sexually; or (4) In the opinion of the department, a service plan that is both cost-effective and reasonably ensures the health, welfare, and safety of the individual cannot be developed or implemented. (e) Individuals who are actively participating program in the ABI waiverprogram and who turn 65 years of age shall be offered the choice of (1) remaining on the ABI waiver program; (2) accessing institutional placement; or (3) transitioning to the Connecticut Home Care Program for Elders. (NEW) Sec. 17b-260a-6. Person-centered planning process (a) The service plan shall be developed based on a person-centered planning model, as described in 42 CFR 441.301(c), as amended from time to time. The individual shall lead planning processaddition to the planningprocess where possible, and in accordance with section 17b-260a-11(a) of the Regulations of Connecticut State Agencies. (b) In additionto being led by the individual receiving services and supportlead planning, the person-centered planning process shall: (1) Include people chosen by the individual, providedthe inclusion of such personsis not otherwise prohibited herein; (2) Provide necessary information and supportto ensure that the individual directs the planning process to the maximum extent possible, and is able to make informed choices and decisions; (3) Be timely and occur at dates, times, and locations of convenience to the individual; (4) Be conducted in a manner that reflects cultural considerations of the individual; provides information in plainlanguage; and is accessible to the individual and persons with limited English proficiency; (5) Include strategies for conflict-resolution or solving disagreements within the process,including clear conflict-of-interest guidelines for all participants; (6) Prohibit providers of waiver servicesfor the individual, or those who have an interest in or are employed by a provider of waiver services for the individual, from providing care management or participating in the development of the person-centered service plan; (7) Offer informedchoices to the individual regarding the types and providers of services and supports that are available; (8) Include a method for the individual to request updates to the plan as needed; and (9) Record the alternative home andcommunity-based settings that the individual considered. (NEW) Sec. 17b-260a-7. Home and community-based setting requirements (a) Prior to an individual accessing any services under the ABI waiver program, the department shall assess each home and community-based settingin the service plan to determine whethersuch setting complies with 42 CFR 441.301(c)(4)-(5), as amended from time to time. (b) If, upon initial assessment of the individual’s service plan, or any time thereafter, the department determines that a settingdoes not comply with 42 CFR 441.301(c)(4)-(5), the department shall inform the individual that the setting does not comply, and inform the individual of alternative settings that complywith these requirements. If the individual elects to remainin, or receive services at, a setting that does not meet these requirements, and the provider has not complied with the department’s corrective action plan for meeting such requirements, the individual shall not remain eligible to receive services under the ABI waiver program. (c) The department shall assess compliance with 42 CFR 441.301(c)(4)-(5) as part of its process for credentialing and re-credentialing providers. (NEW) Sec. 17b-260a-8. Home and community-based services available under the ABI waiver program (a) General principles (1) ABI waiver services shall be furnished under a written service plan that is based on a person- centered planning process,as described in section 17b-260a-6 of the Regulations of Connecticut State Agencies, and subject to approval by the department. (2) Except as set forth in subsection (b) of this section, ABI waiver services may be provided alone or in combination with other services, in accordance with the specificfunctional needs of the individual. (3) The ABI waiver services provided at any given time, in combination with other available medical and community-based services,constitute the individual’s service plan. The need for each specific ABI waiver service shall be documented in the service plan. (4) The ABI waiver services documented in the service plan may be purchased from agency providers, household employees, or self-employed providers that the department’s fiscal intermediary has determined are eligible to participate in the Medicaid program, are enrolled with the department as a provider, and agree to accept Medicaidpayment as paymentin full for services authorized and performed under the program. (5) The department shall not pay for ABI waiver servicesprovided by the individual’s conservator, power of attorney, or a family member of such conservator or power of attorney, or an agency provider owned by the individual’s conservator or power of attorney. (6) The department shall pay only for ABI waiver servicesthat are providedin settings that meet the requirements of 42 CFR 441.301(c)(4), as amended from time to time. (7) Payments for ABI waiverservices shall not exceed the rates, or maximum limits,the department establishes for the provision of such services. (8) The rate paid to service providers does not includepayment for transportation services, unless specified in subsection (b) of this section. (9) The department’s fiscal intermediary, priorto the start of servicesand bi-annually thereafter, shall verify that providers are qualified to provide services. (b) The following services and supplies may be covered under the ABI waiver program: (1) ABI Group Day Habilitation Services , which are services and supports that: lead to the acquisition, improvement, or retention of skills and abilities necessary for an individual to maintain health, wellness, and self-care; preparean individual for work or community participation; or support meaningful socialization and leisure activities. ABI Group Day Habilitation services shall be provided only: (A) By an agency provideror a rehabilitation hospital outpatient department that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; and (B) For a time period that does not exceed eight hours per day. (2) ABI Recovery Assistant I Services , which are services to promote the individual’s strengths and abilities to maintain and foster community living skills, in accordance with therapeutic goals outlined in the individual’s service plan. Services may include improvement of socialization, self- advocacy, and the development of natural supports. Services also include communication and coordination with service providers and others who support the individual. Although not a primary function, a providerperforming ABI RecoveryAssistant I servicesmay provide assistance with ADLs and cueing with respect to medications with support of a medication box. (A) This service shallbe provided only to individuals on ABI Waiver II; and (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (3) ABI Recovery Assistant II Services , which are non-medical and safety monitoring servicesto assist an individual with activities of daily living(both hands-on and cueing) and integration into the community. (A) This serviceshall be providedonly to individuals on ABI WaiverII; (B) This serviceshall be providedby an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (4) Adult Day Health Services , which are services provided in a group setting that include a variety of health and social services, including, but not limited to: personal care, health care, recreation, socialization, nursingservices, transportation services, and hot meals and snacksthat meet the individual’s nutritional needs and dietary restrictions. Adult Day Health services shall: (A) Be provided only to individuals on ABI WaiverII; (B) Be providedby an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (C) Be providedone or more days per week, four or more hours per day, on a regularly scheduled basis; and (D) Include transportation to and from theAdult Day Health Center, a meal, and snacks. (5) Care Management Services , which are services provided to assist the individual to implement the service plan and to assure on-going effective coordination, communication, and cooperation among all sources of support and services to the individual. Care management services include, but are not limited to, the following: assistance identifying the individual’s home and community-based service needs; promotion of participation in activities that may increase the individual’s independence, inclusion in the community and life satisfaction; arrangement of daily living supports and services to be delivered to the individual; assistance identifying and accessing entitlements and other possible funding sources; advocacy for the individual when necessary to ensure the receipt of needed services; and referral for crisis intervention services and monitoring, as necessary and appropriate. Care management services shall be provided by a care manager that meets all the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements, and that: (A) Does not provide any other home and community-based services to the individual; and (B) Does not have an interest in, or is not employed by, a provider of home and community-based services for the individual. (6) Chore Services , which are services needed to maintain the individual’s home in a clean, sanitary, and safe condition. Chore services include, but are not limited to, heavy household chores, such as washing floors,windows, and walls,and moving heavyitems of furniture in order to provide safe access and egress. (A) Chore services shall be providedby an agency provider or household employeewho meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Chore services shall not be covered if: (i) The individual or anyone else living in the household is capable of performing or paying for the services; (ii) A relative, caretaker, community agencyor other entityis capable of, or responsible for, providing the services; or (iii) In the case of rental properties, condominiums, or co-ops,a specific choreservice is the responsibility of the landlord or the landlord’s designee, as evidenced in the lease or any other agreement. (7) Cognitive-Behavioral Services , which are individual interventions designed to increase an individual’s cognitive and behavioral capabilities and to further the individual’s adjustment to successful community engagement. These services include, but are not limited to: comprehensive assessment of cognitive strengths and liabilities, quality of adjustment, and behavioral functioning; development and implementation of cognitive and behavioral strategies; development of a structured cognitive-behavioral intervention plan; ongoing or periodic consultation with the individual and the person-centered planning team concerning cognitive and behavioral strategies and interventions specified in the cognitive-behavioral intervention plan; ongoing or periodic assistance with training of the individual and person-centered planning team concerning cognitive and behavioral strategies and interventions; and periodic reassessment and revision, as needed, of the cognitive-behavioral intervention plan. (A) Cognitive-behavioral services may be provided in the individual’s home or in the community, and shall be performed by an agency provider or a self-employed provider who is a licensed psychologist, physical therapist, speech therapist, or occupational therapist, a qualified neuropsychologist, or another type of provider authorized to perform cognitive-behavioral services under the ABI waiver program,and who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Intervention plans shall be updated at least annually,or more frequently as clinically indicated. Intervention plans shall include the following components: (i) Long-term, measurable goals mutually agreed upon by the individual, or the individual’s legal representative, and the provider; (ii) Shorter-term, measurable objectives to reach those goals; (iii) The individual’s strengths and challenges, and a description of how strengths are to be used in achieving goals; (iv) Skills or tasks that need to be developed by the individual or the family; (v) Input by the individual into the intervention plan commensurate with the levelat which the individual is able to participate; and (vi) A description of how positive reinforcement, rather than punitive measures, will be used to support the individual. (C) Providers of cognitive-behavioral services shall be paid for face-to-face encounters and also for non-face-to-face encounters. (i) Face-to-face (in-person) encounters are in-personmeetings with the individual, and meetings with the individual’s family, supporters, or providers, even when the individual is not present. The provider must have an in-person meeting with the individual at least quarterly. (ii) Non-face-to-face (not in-person) encounters are telephonic or other secure electronic forms of communication, including videotelephony services such as Skype. A provider may also be paid at the non-face-to-face rate for activities such as reviewing the individual’s record and writing the plan of care, even if the individual is not present. (8) Community Living Support Services , which are support services that provide supervised living in the individual’s residence for up to 24 hours per day, including overnight supervision, to a minimum of two, or a maximum of three, individuals at once who require supportand supervision, in a supervised community residential setting for either a half-day (12 hours) or full day (24 hours). (A) Community living support servicesinclude, but are not limitedto, supervision and assistance with the following skills: (i) Self-care; (ii) Medication management; (iii) Interpersonal communication; (iv) Socialization; (v) Sensory and motor skills; (vi) Mobility; (vii) Utilizing transportation services; (viii) Problem-solving; (ix) Money management; and (x) Household management. (B) Assessment and training servicesare provided as part of this service. (C) Room and board is not included as part of this service. (D) The providershall develop a plan that demonstrates the provider’s abilityto work with the individual and to provideservices that are consistent with the therapeutic goals of the individual’s service plan. (E) Upon the individual’s request or improvement in the individual’s ability to live more independently, the providerand the care manager shallwork together, with the individual, to develop and implement a plan to transition the individual to greater independence in the community. (F) Community living support services shall be provided by anagency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (9) Companion Services , which are nonmedical services that are provided in accordance with a therapeutic goal includedin the service plan, includingthe following: supervision and socialization services; assistance with or supervision of meal preparation; assistance with laundry that is being performed by the individual; and light housekeeping tasks that are incidental to the care of the individual. (A) Companion services shall be provided by an agency provider or a household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (B) Companion servicesshall not entailthe provision of hands-on care or household management tasks, as these tasks are provided by personal care assistants and chore services providers, respectively, in accordance with subdivisions (6) and (15) of this subsection. (10) Consultation Services , which are services provided to assist a team and individuals to address service-implementation issues that have presented a barrier to resolution. This service aids in the development of individual interventions designed to decrease an individual’s severe maladaptive behaviors, which jeopardize the individual’s ability to remain integrated in the community. (A) Consultation services shall be provided: (i) Only to individuals on ABI Waiver II; (ii) In a team meeting at the individual’s home or community location; and (iii) By an agency or self-employed provider who is a licensed psychologist, clinical social worker, speech pathologist, speech therapist, occupational therapist, physical therapist, registered nurse, or dietician/nutritionist, a qualified neuropsychologist, or a certifiedrehabilitation counselor or substance abuse specialist, and who meet the requirements of subsection (a) of this section and all applicable training, state licensure, or certification requirements. (11) Environmental Accessibility Adaptation (“EAA”) Services,which are physicalchanges made to an individual’s home that are necessary to ensure the health, welfare, and safety of the individual, or enhance and promote greater independence, without which the individual would require institutionalization. (A) EAA services include,but are not limited to, the following: (i) Installation of ramps; (ii) Widening of doorways; (iii) Modifications to meet egressrequirements; (iv) Modification of bathroom facilities; and (v) Addition of specialized electrical and plumbing devices. (B) All EAA services shall be providedby agency providers or private contractors or businesses in accordance with applicable state and local building codes. (C) EAA services do not include: carpeting; central air conditioning; roof repair; house adaptations that add to the squarefootage of the home; or any otherphysical improvement to the home not of direct benefit to the individual’s health, welfare, and safety, or ability to live independently. (D) EAA servicesshall not be provided to adapt units that are owned or leased by providers of waiver services. (12) Homemaker Services , which are generalhousehold activities, includingmeal preparation and routine household chores. (A) The department shall pay for homemaker serviceswhen the personregularly responsible for homemaking activities is temporarily absent or unable to manage the home and care for the individual or others in the home, or when the individual is unable to learn such skills. (B) Homemaker services shall be provided by an agency provider or a household employee that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements.Homemaker services shall not be provided by a member of the individual’s family, the individual’s conservator, or a member of the conservator’s family. (13) Home-Delivered Meals , which is the preparation and delivery of one or two meals per day to an individual who is unable to prepare or obtain nourishing meals on the individual’s own, or for an individual who normallyhas someone who is responsible for preparing and delivering meals,but that person is temporarily absent or unable to perform this service. (14) Independent Living Skills Training (“ ILST ”), which is a training service designed for, and delivered to, an individual to improve that individual’s abilityto live independently in the community and to carry out strategies developed in cognitive/behavioral programs. (A) ILST may include, but is not limited to, teaching the individual the following skills: (i) Self-care; (ii) Medication management; (iii) Task completion; (iv) Interpersonal communication skills; (v) Socialization skills; (vi) Sensory/motor skills; (vii) Mobility and community transportation skills; (viii) Problem solving skills; (ix) Money management skills; and (x) Household management skills. (B) ILST shall be providedby an agency provider or household employeethat meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (15) Personal Care Assistant services , which are services that provide the individual with assistance with the following: eating, bathing, dressing, personal hygiene, and other activities of daily living that are performed by a provider in the individual’s home or community; or supervision and cueing of theseactivities without actualhands-on assistance. Personalcare assistant servicesshall be provided only: (A) If the individual’s physicalability to performactivities of daily living is impaired, or if the individual’s cognitive or behavioral impairments interfere with the individual’s ability to perform these tasks; (B) To individuals on ABI WaiverII; and (C) By an agency that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (16) Personal Emergency Response System (“PERS”),which is an electronic device connected to an individual’s telephone that enables an individual at high risk of institutionalization to secure help in an emergency. (A) A PERS is available only to an individual who: (i) Lives alone; (ii) Is alone for significant parts of the day and who does not have providers; or (iii) Would otherwiserequire extensive routinesupervision. (B) A PERS shall be provided by an agencyprovider that sells and installsPERS equipment. (17) Prevocational Services , which are time-limited services that provide learning and work experience, including volunteerwork, where the individual can develop generalnon-job-task-specific strengths and skillsthat contribute to employability in paid employment in an integrated work setting. Services are intended to develop and teach general skills, such as the ability to: communicate effectively with supervisors, co-workers, and customers; comply with generally accepted community workplace conduct and dress; follow directions; attend to tasks; develop strategies to solve problems at the workplace; and comply with general workplace safety and mobility training. Prevocational services are designed to be a pre-cursor to integrated employment. (A) The following time limits shall apply to prevocational services: (i) For individuals enrolled in ABI Waiver I, effective December1, 2015, a two-year time limit for thisservice shall be applied prospectively. This two-year limit may be extended up to a maximum of four years upon a determination by the department that additional time is needed for an individual to achieve the person-centered goal of attaining supported employment. Annual redeterminations of eligibility for such services shall be made after an initial two years of such services. (ii) For individuals enrolled in ABI Waiver II, this serviceis limited to two years.Upon strong justification of progress towardemployment goals, the department may authorize the service for a maximum total of three years. (iii) This serviceis limited to 40 hours per week. (B) Services shall be providedin the individual’s home or in an integrated work setting, based on the individual’s needs and preferences. (C) The individual shall have employment-related goals in theperson-centered service plan; (D) Prevocational services shall be provided by an agency provider that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (18) Respite Care Services, whichare services providedto individuals who are unableto care for themselves, and when the person normally performing such services is absent or in need of relief. (A) Services shall be furnished on a short-term basis in the individual’s home. (B) Services shall be providedby an agency or household employee who meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (19) Specialized Medical Equipment and Supplies , which include devices, controls, or appliances that enable an individual to increase the individual’s ability to perform ADLs, or to cognitively perceive, control, or communicate in the individual’s environment within the community; items necessary for life supportand those ancillary supplies and equipment that are necessary for the proper functioning of such items; and durable and non-durable medical equipment that is not available as a covered medical service under the Medicaid state plan. (A) Specialized medical equipment and supplies paid for under the ABI waiver program shall be of direct medical or remedial benefit to the individual; meet all applicable standards of manufacture, design and installation; and be in addition to any medicalequipment and suppliesfurnished under the Medicaid state plan. (B) Specialized medicalequipment and suppliesshall be providedby a medical equipment vendor, durable medical equipment provider, or pharmacy that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (20) Substance Abuse Program Services , which are individually designed interventions to reduce or eliminate the individual’s use or abuseof alcohol or drugs when such use or abuseinterferes with the individual’s ability to remain in the community. (A) Substance abuse program services shall include, but are not limited to, the following services: (i) Performing an in-depth assessment of the relationship between the individual’s use or abuse of alcohol or drugs and the individual’s brain injury; (ii) Performing a learning and behavioral assessment; (iii) Developing and implementing a structured treatment plan; (iv) Providing ongoingeducation and trainingof the individual, family members,and other service providers concerning support needs of the individual; (v) Developing individualized strategies to avoid relapse; (vi) Conducting periodic reassessment of the treatment plan; and (vii) Providing ongoing support to the individual. (B) Substance abuseprogram services shall be providedon an outpatient basis in a congregate setting or the individual’s community. (C) Substance abuseprogram services shall be providedby either agencyproviders (i.e, substance abuse diagnostic and treatment centers, or rehabilitation hospitals) or individual providers (i.e., self- employed providers, licensed psychologists, or certified drug and alcohol counselors) that meet the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements. (D) The individual’s structured treatment plan may include both group and individual interventions and shall reflect the use of curricula and materials adoptedfrom substance abuse programs designed to meet the needs of individuals with cognitive impairment. (E) The individual’s treatment plan shallinclude linkages to existing community-based, self-help or support groups, such as Alcoholics Anonymous and organizations that promote and support sobriety. (F) With the individual’s consent,the substance abuse program providershall communicate with the individual’s other service providers concerning the individual’s treatment regimens. (21) Supported Employment services, which are services provided to individuals who, because of their disabilities, need intensive on-going support to perform in a work setting. The intended outcome of this serviceis sustained paid employment or self-employment in the generalworkforce in a job that: (1) meets the individual’s personal and career goals; (2) pays a wage level at or above the minimum wage; and (3) pays at a wage and benefit levelthat is not less than the customary wage and benefit level paid by an employer for the same or similar work performed by individuals without disabilities. (A) Supported employment services may be conducted in a variety of settings, including work sites where persons without disabilities are employed. When supported employment services are provided in such integrated work settings, paymentsshall be made only for adaptations, supervision and training needed by the individual, and shall not include payment for any modifications or activities rendered or required within the normal business setting. (B) Supported employment services shall not otherwise be available under a programfunded under the Rehabilitation Act of 1973, 20 USC 1401 et seq., or Education forAll Handicapped Children Act, Pub. L. No. 94- 142. (C) Transportation betweenthe individual’s residence and supported employment site is required as a supported employment service, and is included in the rate paid to the provider. (D) Supportive employment services shall be provided by agency providers that meet the requirements of subsection (a) of this section, and all applicable training and statelicensure, or certification requirements. (22) Transitional Living Services , which are short-term, individualized, residential services providing support to an individual transitioning into a community livingsituation. These services and supports are designed to improve the individual’s skills and ability to live in the community. (A) Transitional living services: (i) Are availableonly to individuals on ABI Waiver I; (ii) Shall be provided for only one transitional period; (iii) May be provided up to 24 hours per day; (iv) Shall be provided only when the individual is unable to be supported in a permanent residence and is in need of intensive clinical interventions provided by this service; and (v) Shall be provided by an agency provider or rehabilitation hospital that meets the requirements of subsection (a) of this section, and all applicable training, state licensure, or certification requirements; (B) Prior to discharge from transitional living services, the provider shall work with the individual and the care manager to develop a plan of care. Upon discharge, other ABI services shall become available to the individual in accordance with the plan of care. (C) ABI waiverfunds shall not be used to pay for the room and board component of transitional living services. (D) Transitional living services shall not be provided with any ABI services other than care management, environmental modifications, specialized medical equipment and vehicle modifications. (23) Transportation Services , which are services offered in accordance with the individual’s service plan to allow the individual to access servicesthat do not qualify for non-emergency medical transportation under 42 CFR §440.170(a). (A) Transportation services shall not be provided when public transportation is available or when friends, family, neighbors, or community agencies are able to provide transportation free of charge. (B) All reasonable alternatives shall be explored and exhausted priorto receiving approvalfor transportation services. (C) Transportation servicesshall be providedby a livery service or individual providerlicensed by the State of Connecticut, with a valid Connecticut driver’s license and evidence of automobile insurance. (24) Vehicle modification services , which are alterationsto a vehicle when such alterations are necessary to improve the individual’s independence and inclusion in the community, and to enable the individual to avoid institutionalization. (A) The vehicle shall be the individual’s primarymeans of transportation. (B) The vehicleshall be ownedby the individual, a relativewith whom the individual lives or has consistent and ongoing contact, or a non-relative who provides primary long-term support to the individual and is not a paid provider of such services. (C) All modifications and adaptations shall be providedin accordance with applicable federaland state vehicle codes. (D) Vehicle modification services do not include: adaptations or improvements to a vehicle that are of general utility and not of direct medicalor remedial benefitto the individual; payments for the purchase or lease of a vehicle; or regularly scheduled upkeep and maintenance of a vehicle, except for upkeep and maintenance of the modifications. (E) The total individual cost limit for vehicle modifications is $10,000.00. (F) Vehicle modification services shall be provided by a providerapproved by the State of Connecticut as a vehicle modification vendor. (NEW) Sec. 17b-260a-9. Pre-screen, waiting list and assessment (a) The department shall review completedapplications that it receives in the orderin which they are received. Acceptance to the ABI waiver program shall be on a first-come, first-served basis, except that individuals transitioning from the Money Follows the Person program or Department of Mental Health and Addiction Services Acquired Brain Injury Services to the ABI waiver program shall have priority for reserved spaces. (b) The department shall conduct a pre-screen of the applicant following the receipt of the application, and prior to placing the applicant’s name on the waiting list, to determine whether the applicant (1) meets the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut State Agencies, and (2) requires one of the level-of-care categories described in subsection (d) of this section. (c) Applications shall be pre-screened based upon the information contained in the completed application, as well as information obtained from: the individual; a neuropsychological examination report prepared by a qualified neuropsychologist; and any other clinical personnel who are familiar with the individual’s case and history.In order to be considered, the neuropsychological examination report must have been completed no more than two years prior to the application date, provided, however, that the department retains the discretion to increase this time limitation on a case-by-case basis. The neuropsychological examination report shall be submitted to the department no later than six months followingthe application date,except that the department may extend this deadline for an additional 90 days if a neuropsychological examination appointment has been scheduled. Failure by the individual to meet this deadline shall result in the denial of the application. (d) To qualifyfor services under the ABI waiver program,the individual shall meet one of the following institutional level-of-care categories: (1) Category I (NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a NF. The individual is considered to require care in a NF if the individual residesin such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, including, but not limited to, eating, bathing, dressing, toileting, and transferring; (2) Category II (ABI NF level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in an ABI NF. The individual is considered to require care in an ABI NF if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facilitybut has impaired cognition, impairedbehavior requiring daily supervision or cueing, as described in section 17b-260a-3(46) of the Regulations of Connecticut State Agencies, with two or more ADLs, and a mental illness that manifested itself before the brain injury occurred; (3) Category III (ICF-IID level of care): If the individual were not receiving services under the ABI waiver program,the individual wouldrequire care in an ICF-IID.The individual is considered to require care in an ICF-IID if the individual resides in such a facility and the department or its agent determines that the individual currently requires such levelof care, or if the individual does not reside in such a facility but has impaired cognition, an ABI that occurred before the age of 22 and, due to physical deficits, requires physical assistance with two or more ADLs; or (4) Category IV (CDH level of care): If the individual were not receiving services under the ABI waiver program, the individual would require care in a CDH. The individual is considered to require care in a CDH if the individual resides in such a facility and the department or its agent determines that the individual currently requires such level of care, or if the individual does not reside in such a facility but has impaired cognition and impaired or abnormal behavior, and, due to physical or cognitive deficits, requires physical assistance, supervision or cueing, as described in section 17b- 260a-3(46) of the Regulations of Connecticut StateAgencies, with two or more ADLs. For purposes of this category, “impaired or abnormal behavior” means that one or more behaviors is consistently severely impaired or abnormal, and requires the availability of intensive and ongoing behavior intervention to the extent that the individual would require care in a CDH if the individual were not receiving services under the ABI waiver program. Behaviors that may meet this definition include: engaging in inappropriate sexual activity; causing injury to others or self, or damage to property; demonstrating physical or verbal aggression; demonstrating a consistent ongoing pattern of wandering or elopement; engaging in socially offensive behavior; demonstrating withdrawal, susceptibility to victimization, impulsivity, intrusiveness, agitation or pica; or engaging in criminal activity after the brain injury occurred. (e) The applicant shall be placed on the waiting list if the applicant is determined by the department, based on the information provided during the pre-screening, including the neuropsychological examination report, to meet the financial and programmatic requirements described in section17b-260a-5 of the Regulations of Connecticut StateAgencies and the applicant requires one of the levels of care described in subsection (d) of this section. (f) The department shall notify the applicant in writing when, based on the applicant’s waitlist position, an opening is reasonably expected to become available to the applicant within 90 days. Once notified, a care managershall meet with the individual, complete a comprehensive assessment of the individual’s needs, including the level of care, and develop a proposed service plan. A care manager and the individual, in conjunction with the person-centered team, shall then develop, if feasible, a cost-effective service plan as determined pursuant to section 17b-260a-10(d). Services shall not be authorized until the department determines that the individual’s Medicaid coverage is active. (g) The department shall re-evaluate the level of care for each individual at least annually. (NEW) Sec. 17b-260a-10. Development of the service plan and evaluating cost-effectiveness (a) Applicants enrolledin ABI Waiver I shall have a total individual service plan cost limit no greater than 200% of the annualized alternative institutional care cost. (b) Applicants enrolledin ABI Waiver II shall have a total individual service plan cost limit no greater than 150% of the annualized alternative institutional care cost. (c) The department shall not approvea total individual service plan that exceeds the individual service plan cost caps or funding limitations established in the approved waiver. (d) To determine the cost-effectiveness of the individual’s service plan, the department shall: (1) Obtain the annualized alternative institutionalized care costs for the individual. For each level of care listed in subsection (d) of section 17a-260a-9 of the Regulations of Connecticut State Agencies, the annualized alternative institutional care cost is equal to the state’s weighted average cost for the specified facilitytype, as annuallydeveloped and published by the department, minus the average applied income; (2) Determine the individual’s total service cost by aggregating each of the following costs: (A) The annualized cost of each covered servicethat will be provided to the individual, based on the department’s established rates for such services; (B) The annualized cost of the ABI waiver home and community-based services, as described in section 17b- 260a-8 of the Regulations of Connecticut StateAgencies, to be provided to the individual under the proposed service plan; (C) The annualized cost of any other medical services covered by Medicaid, as described in section 17b- 260a- 3(37) of the Regulations of Connecticut StateAgencies, provided in the individual’s home that the individual may require in order to live in the community, to be calculated by multiplying the expected frequency of utilization of these services by the Medicaid rates established by the department for such services; and (D) The annualized cost of any other community-based services, as describedin section 17b-260a- 3(36) of the Regulations of Connecticut State Agencies, that the individual may require in order to live in the community; and (3) Compare the individual’s total service cost to the applicable individual limit set in subsections (a) and (b) of this section to determine if the total service cost exceeds the applicable individual limit. (e) To promote cost neutrality in accordance with 42 USC1396n (b), every reasonable effort shall be made to provide services below the maximum dollar amount level, and in the most cost-effective manner possible. The department shallnot exceed the funding limitations established in the approved waiver when determining whether an individual can be accepted into the program. (NEW) Sec. 17b-260a-11. Responsibilities of the individual (a) Person-Centered Planning and Selecting Providers (1) To the extent feasible, the individual shall lead the person-centered planning process. If the individual has a legal representative, the legal representative may participate in the planning process, making decisions for the individual, as necessary to ensure the best interests of the individual. The department may seek assistance from a court of probate if: (A) The department determines that the legal representative is not acting in the best interests of the individual and is hindering the person-centered planning process; or (B) There is a conflict between the individual and the legal representative. (2) The individual or the individual’s legal representative, or both, shall: (A) Choose the team to participate in the person-centered planning process; (B) Collaborate with the person-centered team; (C) Select, from a list of providers, the providers who will deliver the services specified in the service plan; (D) Supervise the services that are provided to the individual in accordance with the service plan; (E) Notify the department if a provider is not performing satisfactorily; (F) Terminate the employment of a household employee or the services of a self-employed provider, as necessary; and (G) Select new providers, as necessary. (b) Financial Responsibilities (1) An individual whose gross income exceeds shall be 200% of the federal poverty level shallbe required to contribute toward the cost of services rendered under the waiver. The amount contributed shall be calculated according to section 5035 of the Uniform Policy Manual, or any other applicable law or policy of the department. (2) The individual shall agree to pay directly to the department’s fiscal intermediary the portion of income calculated to be contributed to the individual’s cost of care. This agreement shall be documented in the individual’s service plan. (c) Responsibilities of the Individual as the Employer of Household Employees An individual who is the employer of household employees, as defined in section 17b-260a-3(24) of the Regulations of Connecticut State Agencies, shall be responsible for: (1) Compliance with all applicable state and federal requirements, including, but not limited to, those related to workers’ compensation, unemployment compensation, minimum wage rates, and income tax withholding; and (2) Hiring and termination of the employment of household employees, as necessary. (d) Critical Incident Reporting (1) The individual, or the individual’s legal representative, shall comply with the department’s critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-12. Department responsibilities " CT DSS " The department or its agent shall: (a) Inform eligible individuals that they have the choice whether to community-based reprogram by community-based services through the ABI waiver program, or to receive institutional care; (b) Establish eligibility for the ABI waiver programby performing an assessment of the individual’s needs; (c) Coordinate the development of a service plan designed to deinstitutionalize or divert the individual from institutional placement; (d) Assist with implementation of an approved service plan by coordinating services provided to the individual; (e) Review with the individual, on a regular basis, the effectiveness of the service plan and make appropriate and cost-effective revisions to the plan, as required, based on achievement of the expected outcomes, the individual’s degree of satisfaction with the services and providers, the individual’s changing capabilities, and the ongoing availability of home and community-based services; (f) Review and reassess, at least every 12 months, and whenever there is a significant change in the individual’s ability to function in the community, the individual’s service plan and level of care; (g) Lead team meetings in conjunction with the individual; (h) Maintain records for at least 7 years. (i) Advise the individual of the individual’s right to an administrative hearing in accordance with sections 17b-60 and 17b-61of the Connecticut General Statutes if the individual is aggrieved by the department’s decision with respect to the individual’s application or eligibility for the ABI waiver program, or if services are reduced, denied or terminated; (j) Maintain a waiting list of individuals who have applied for and been pre-screened for ABI services; (k) Establish provider qualifications and, through maintain its fiscal intermediary, establish and maintain a directory of providers; (l) Establish payment rates for all services offer under or delivered the ABI waiver program; (m) Pay for approved ABI waiver services health or delivered by providers on behalf of the individual; and (n) Maintain, and comply with, a critical incident reporting protocol for instances where an individual experiences a perceived or actual threat to the individual’s healthor welfare, or to the individual’s ability to remain in the community. (NEW) Sec. 17b-260a-13. Provider Responsibilities (a) All providers shall: (1) Comply with any critical incident reporting protocols developed by the department for instances where an individual experiences a perceived or actual threat to the individual’s health or welfare, or to the individual’s ability to remain in the community. (2) Report their arrest, or any arrest of an employee, to the department within 10 business days. The failure of a provider to report any such arrest may result in termination of the provider from the ABI waiver program. (3) Complete a state and federal criminal background check, at the expense of the applicant or provider. (4) Accept payment only for services that were actually provided to the individual and that do not violate the rules, regulations, standards, or laws governing the Medicaid program in accordance with sections 17-83k-1 to 17-83k-7, inclusive, of the Regulations of Connecticut State Agencies. A provider may be suspended or terminated from participation in the program for accepting payment for services not provided or for violating the rules, regulations, standards, or laws governing the program. (b) Agencies that employ providers shall: (1) Ensure that all staff, volunteers, interns or other persons employed by, supervised by, or representing the agency who may have direct contact with individuals receiving ABI waiver funding, meet and maintain all criminal background standards and requirements as set forth in subsection (a)(3) of this section. (2) Have policies in place regarding the provision of language services to individuals while receiving ABI waiver services, and shall not rely on the assistance of individuals’ friends, family or others. (3) Deliver training to staff members regarding the provision of services that are person-centered and culturally competent. (4) Have policies and procedures in place regarding employee standards of conduct. Such policies and procedures shall include, but are not limited to, the following topics: (A) The need for providing person-centered services; (B) The importance of respecting individuals’ rights, including privacy and self-determination; (C) The prohibition against neglect, abuse, and harassment of individuals; (D) The prohibition of the use of drugs or alcohol, or of being under the influence of drugs or alcohol, while providing services to individuals; (E) The laws covering confidentiality of all participant information collected, used or maintained; and (F) Critical incident reporting requirements. (5) Establish a quality assurance plan. Such plan is subject to the approval by the department and shall include random checks of staff performance. (NEW) Sec. 17b-260a-14. Provider participation (a) It shallbe a certification requirement of the department for all servicespecialties that, in order to participate in the ABI waiver program and receive payment from the department, all providers: (1) Enroll with the department as a provider in the Medicaid program and sign the Medicaid Provider Enrollment Agreement, as directed by the department, which agreement may include addenda specific to the ABI waiver program and may be amended from time to time; (2) Comply with all applicable state and federal statutes and regulations, including, but not limited to, sections 17b-262-522 et seq. of the Regulations of Connecticut State Agencies, the Medicaid Provider Enrollment Agreement and any applicable addenda, and all departmental policies, as amended from time to time (3) Comply with all of the provisions and requirements of applicable Medicaid waivers, as amended from time to time; (4) Deliver, document, and bill only for those services that are outlined in the individual’s service plan; and (5) Comply with the requirements of any corrective action plan imposed by the department. (b) The commissioner shall have the discretion to refuse to list a provider in the provider directory, remove the provider’s name from the provider directory, or refuse payments to a provider, if the provider performing the services poses a threat to the health or safety of individuals participating in the ABI waiver program, or has been convicted in this state or any other state of a felony, as defined in section 53a-25 of the Connecticut General Statutes, involving: forgery under sections 53a-137 of the Connecticut General Statutes; robbery undersection 53a-133 of the Connecticut General Statutes; larceny under sections, 53a-119, 53a-122, 53a-123, and 53a-124 of the Connecticut General Statutes; sexual assault under sections 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a, 53a-72b, 53a-73a of the Connecticut General Statutes; or assault under sections 53a-59, 53a-59a, 53a-60, 53a-60a, 53a-60b, and 53a-60c of the Connecticut General Statutes; or has been convicted in this state or any other state of an offense, as defined in section 53a-24 of the Connecticut General Statutes, involving: cruelty to persons under section 53-20 of the Connecticut General Statutes; vendor fraud under sections 53a- 290 to 53a-296, inclusive, of the Connecticut General Statutes; or the abuse of an elderly, blind or disabled person, or a person with intellectual disability under sections 53a-320 to 53a-323, inclusive, of the Connecticut General Statutes. (NEW) Sec. 17b-260a-15. Corrective action and provider cooperation (a) If a provider fails to comply with sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or MedicaidProvider Enrollment Agreement, the department may require the provider to comply with a corrective action plan. (b) The provider shall cooperate fully with any department, state, or federal audit or investigation, and shall correct any deficiencies identified in the course of such audit or investigation. (NEW) Sec. 17b-260a-16. Provider fiscal responsibility (a) For purposes of this section: (1) “Fraud” means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to that person or some other person. It includes any act that constitutes fraud under applicable federal or state law. (2) “Abuse” means practices that are inconsistent with generally acceptedfiscal or business practices and result in unnecessary cost to the ABI waiver program. (b) The provider shall not engage in or commit fraud or abuse, including, but not limited to: (1) Billing for services not rendered; (2) Billing for services not in the service plan; (3) Billing for services not medically necessary; (4) Falsely identifying the person who actually performed a service, including billing for services performed by an individual who is not credentialed; (5) Failing to adequately document all servicesthat are billed; (6) Billing for services for ABI participants services that who are institutionalized at the time in which the service has been billed as having been rendered; or (7) Violating Medicaid policies, procedures, rules, regulations, or statutes. (NEW) Sec. 17b-260a-17. Client documentation and provider reporting (a) Providers shall retain records to document services submitted for Medicaid reimbursement for at least seven years from the date the service or item was provided. Documentation shall include the following: (1) Provider’s name and signature; (2) Dates of service; (3) Start time for each visit; (4) End time for each visit; (5) A description of duties performed or items provided; (6) Client goals and documentation of progress toward meeting those goals; and (7) Unless otherwise described in the provider’s applicable Medicaid Provider Enrollment Agreement and any addenda thereto,the individual’s name and the signature of the individual or the individual’s legal representative. (b) Upon written request presented to the provider, the department or its authorized agent shall be given immediate access to, and permitted to review and copy, any and all records and documentation used to support claims billed to Medicaid. For purposes of this subsection, “immediate access” means access to records at the time the written request is presented to the provider. (c) The provider shall submit written reports on the individual’s status and progress for each of the first three months of the individual’s participation in the program, and quarterly thereafter, to the care manager in a manner that is set forth by the department. (NEW) Sec. 17b-260a-18. Provider termination, suspension or disqualification (a) Failure to comply with any requirements in sections 17b-260a-1 to 17b-260a-18, inclusive, of the Regulations of Connecticut State Agencies, other applicable state or federal statute or regulation, or any provision of the Medicaid waivers or Medicaid Provider Enrollment Agreement, may result in the nonpayment of services, suspension or termination from participation in the ABI waiver program, or any other sanction available under state or federal law. (b) The department may suspend or terminate the provider from participation in the ABI waiver program immediately and withoutprior notice if it has reason to believe that a providerposes a threat to, or has acted in a manner that posed a threat to, the health, safety or welfare of an individual participating in the ABI waiver program, or has engaged in fraudulent or abusive program practices.

Connecticut's Call to Action: Urgent Housing and Service Regulation Reforms Needed in Federally Funded Programs In the heart of New England, Connecticut stands at a pivotal moment. The need for comprehensive reform in agency housing and service regulations within its federally funded programs has never been more urgent. ABI Resources, a beacon of commitment and care in Connecticut, is at the forefront of this critical change, proactively engaging with Governor Ned Lamont and influential representatives in both the Senate and the House. The voices of Senator Richard Blumenthal, Senator Chris Murphy, Representative John Larson, Representative Joe Courtney, Representative Rosa DeLauro, Representative Jim Himes, and Representative Jahana Hayes are instrumental in driving this change forward. As constituents and concerned citizens, your voice is not just important; it's crucial. The collective call for fair and equitable treatment for all resonates deeply in our communities. This is not just a matter of policy - it's a matter of justice and humanity. The Role of ABI Resources: A Beacon of Hope and Excellence ABI Resources, a renowned organization in Connecticut, exemplifies dedication and excellence in supporting individuals and families. Their collaborative approach with government and community service providers like the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services, sets a standard for others to follow. Their partnerships with leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford showcase their commitment to high-quality, personalized care. ABI Resources' involvement in vital programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver demonstrates their pivotal role in enhancing the lives of those they serve. The Need for Reform: A Glimpse into the Current Scenario The current state of agency housing and service regulations in Connecticut's federally funded programs reveals significant gaps. These gaps affect not just the quality of care but also the dignity and rights of individuals relying on these services. It's a scenario that demands immediate attention and action. Your Role: A Vital Piece of the Puzzle As a member of the Connecticut community, your support and voice are invaluable. Engaging with your representatives, spreading awareness, and voicing your concerns are powerful actions that can lead to real change. When the community unites for a cause, the impact is profound. Unite for the Cause: A Future of Fairness and Quality Care Imagine a Connecticut where every individual receives the care and support they deserve, where regulations are not just guidelines but pathways to a better life for all. This vision is achievable, but it requires the collective effort of every one of us. Call to Action Connecticut is at a crossroads, and the path we choose now will define our future. Let's unite for this cause. Reach out to Governor Ned Lamont and your representatives. Share your stories, express your concerns, and demand the change we desperately need. Together, we can build a Connecticut that upholds the values of fairness, dignity, and exceptional care for everyone. Call to Action! Connecticut urgently needs to reform agency housing and service regulations in its federally funded programs. ABI Resources is proactively engaging Governor Ned Lamont and key representatives in the Senate (Richard Blumenthal, Chris Murphy) and the House (John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, Jahana Hayes) to drive this change. Your voice is crucial in ensuring fair and equitable treatment for all. Let's unite for this cause. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. "Action Required: ABI Resources Calls for Community Support in Major CT Housing Reform!" "Don't Miss Out: Be Part of Connecticut's Historic Shift in Federally Funded Housing Programs" "Alert: How Connecticut's Housing Policy Could Change Forever – And Why You Should Care" "Governor Lamont's Next Big Challenge: ABI Resources Advocates for Urgent Housing Reforms" "Critical Update: How ABI Resources is Revolutionizing Housing and Services in Connecticut" "Connecticut Residents: Your Chance to Influence Major Housing Policy Changes is Here!" "New Era in Housing: Join ABI Resources in Pioneering Change for Connecticut's Community" "Make a Difference: Your Role in Steering Connecticut Towards Equitable Housing Solutions" "Breaking: ABI Resources Leads Monumental Push for Housing Regulation Overhaul in CT" "Connecticut's Turning Point: How You Can Help Shape the Future of Housing and Services" "A Call to Action: Join Forces with ABI Resources for Groundbreaking Housing Reforms" "Major Alert: Connecticut's Housing System on the Brink of Revolution with Your Help" "Governor Lamont, Senators, and You: A United Front for Connecticut's Housing Reforms" "Urgent Community Call: ABI Resources Driving Change in CT's Housing Regulations" "Your Voice Matters: Impacting Connecticut's Housing Policies with ABI Resources" "Time to Act: ABI Resources Urges Public Support for Critical Housing Reforms in CT" "Empower Change: How Connecticut Citizens Can Shape Housing Policies for the Better" "Connecticut's Housing Crisis: Why ABI Resources Needs Your Support Now More Than Ever" "Revolutionize CT's Housing: How Your Involvement Can Make a Real Difference" "Exclusive: Inside ABI Resources' Campaign for Transforming Connecticut's Housing Landscape"

"Advocating for Change: Uncovering the Critical Needs in Connecticut’s Medicaid ABI Waiver Program" Introduction: Welcome to our in-depth discussion that shines a spotlight on the crucial challenges faced by disabled consumers under the Medicaid ABI Waiver Program in Connecticut. We are honored to have a representative from ABI Resources, a trailblazer in advocating for individuals with disabilities, join us today. This conversation aims to dissect the issues at hand and propose actionable solutions that can make a real difference. Unveiling the Challenges: Our journey begins with understanding the core obstacles these consumers face. Misleading practices are rampant, often diverting individuals from their true rehabilitation needs. Coupled with managerial misdirection, the quality of services provided has seen a significant decline. But perhaps most alarming is the coercive nature of service utilization, leading to financial manipulation and trapping consumers in a cycle of dependency. This lack of transparency and limited consumer choice paints a troubling picture of the current state of affairs. The Mental Health Impact: The consequences of these challenges are not just physical – they deeply impact mental health. Consumers are often left feeling stressed, anxious, and helpless. This psychological turmoil can severely hinder recovery and rehabilitation, undermining the primary goal of fostering independence and improving the quality of life. The Role of Federal Intervention: In this complex landscape, federal intervention emerges as a beacon of hope. It has the power to enforce ethical standards, implement stringent oversight, and mandate transparency in service provision. Such actions could realign the program with its intended purpose, placing consumer needs at its heart. Proposing a Path Forward: ABI Resources champions a comprehensive policy overhaul, emphasizing enhanced training for care managers and clearer communication of consumer rights. Advocating for direct involvement of disabled individuals in policy-making and service design is crucial to ensure their voices are not just heard but are influential in driving change. Amplifying Consumer Voices: The key to real transformation lies in amplifying the voices of disabled consumers in decision-making. This can be achieved through their active involvement in advisory boards and decision-making committees, complemented by regular feedback mechanisms and a transparent grievance redressal system. Conclusion: Our conversation today with ABI Resources not only sheds light on the pressing need for systemic reform in Connecticut's Medicaid ABI Waiver Program but also serves as a call to action. By advocating for federal oversight and focusing on consumer-centric solutions, we edge closer to a system that genuinely supports and empowers individuals with disabilities. Join us in this pivotal discussion and be part of a movement towards a more inclusive and effective care system. Empowering Communication: Transparent communication stands as a pillar in this endeavor, especially for families and caregivers. It's essential for them to be fully informed about the services available, the rights of the consumers, and the mechanisms in place for feedback and grievances. Empowered with information, they can make informed decisions and advocate effectively for their loved ones. Harnessing Technology: In an era where technology is a game-changer, its potential to enhance services for disabled consumers is immense. From facilitating communication to providing accessible educational resources, and enabling remote consultations, technology paves the way for more efficient and personalized service delivery. Tailored Solutions for Unique Needs: Addressing the needs of consumers with brain injuries requires a specialized approach. It calls for training care providers specifically for these challenges, creating individualized care plans, and ensuring access to resources dedicated to brain injury rehabilitation. Aligning Services with Goals: Service plans must be aligned with individual rehabilitation goals, developed collaboratively with consumers, their families, and healthcare professionals. Regular reviews and adjustments are vital to keep these plans relevant and effective. Governmental Support for Independence: The role of state and federal governments in supporting initiatives that promote independence and self-sufficiency for disabled consumers cannot be overstated. Funding programs focused on skill development, employment training, and community integration are critical steps towards this goal. The Central Role of Medical Professionals: Medical professionals must be at the forefront of overseeing and guiding services for disabled individuals. Their expertise is instrumental in developing appropriate care plans and ensuring services align with medical and rehabilitation needs. Fostering Policy Inclusion: Finally, to ensure that disabled consumers have a significant voice in policy-making and service design, their involvement in advisory roles and consultation processes is imperative. Their experiences and insights are invaluable in crafting services that truly resonate with their needs. "Shocking Truths Unveiled: How Connecticut's Medicaid Program Fails Disabled Consumers" "Experts Reveal: Major Flaws in Disability Care System in Connecticut" "Breaking News: ABI Resources Exposes Deep Flaws in Medicaid ABI Waiver Program" "Connecticut's Hidden Crisis: ABI Resources Sheds Light on Disabled Care Failings" "Scandal in Healthcare: How Connecticut's System Fails Its Disabled Citizens" "Urgent Reform Needed: ABI Resources Calls Out Flaws in Medicaid Program" "Alarming Insights: The Harsh Reality of Disability Services in Connecticut" "Connecticut's Shame: How Medicaid Fails Those With Disabilities" "Exclusive! ABI Resources Exposes Connecticut's Disability Care Scandal" "Disability Advocacy Shakeup: ABI Resources' Revealing Take on Medicaid Woes" "Connecticut's Disability Dilemma: Inside Look with ABI Resources" "A System in Crisis: Uncovering Connecticut's Disability Service Flaws" "Medicaid’s Dark Side: ABI Resources Reveals What Needs to Change Now" "The Untold Story of Disability Neglect in Connecticut's Healthcare System" "Breaking Barriers: ABI Resources' Crusade Against Disability Injustice" "Connecticut's Disability Service Failures: An Insider's Shocking Revelation" "The Battle for Better Care: How ABI Resources is Challenging Connecticut's System" "Connecticut's Alarming Disability Care Gap: What You Need to Know" "Disability Rights Crisis: ABI Resources Uncovers Shocking Facts" "Advocacy Alert: ABI Resources Exposes Connecticut's Failing Disability Services" Introduction: To Governor Ned Lamont, Senators Richard Blumenthal and Chris Murphy, and House Representatives John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, and Jahana Hayes, As a collective of deeply concerned citizens, we write to you today with a matter of utmost urgency and gravity. Our focus is the Connecticut Department of Social Services (CT DSS), an institution that should stand as a bastion of support and empowerment for individuals with disabilities but is currently falling distressingly short of its mandate. Concerns and Allegations: Recent reports and allegations paint a troubling picture of the CT DSS. Claims of housing and service entrapment, operation of sheltered workshops, and involvement in unethical kickback incentive programs and bribery schemes have surfaced. These practices not only tarnish the reputation of the CT DSS but also grossly infringe upon the rights of people with disabilities. A particularly disheartening tactic is the “what they don’t know won’t hurt them” approach, which only serves to perpetuate discrimination and further marginalize our disabled community members. Transparency and Accountability Issues: Equally concerning is the reported lack of avenues for individuals to document and voice their challenges and grievances. This opaque veil over the operations of the CT DSS hinders the crucial process of identifying, acknowledging, and rectifying these grave issues. Call to Action: We call upon you, our elected officials, to take immediate and decisive action. While we acknowledge and appreciate the commitment of ABI Resources in addressing these issues, the role and intervention of governmental authorities like yourselves are indispensable for enacting meaningful and systemic reform. Proposed Reforms: We urge you to implement reforms in agency housing and service regulations, particularly in programs that are federally funded. These reforms should ensure fair and equitable treatment of all citizens, with a specific focus on safeguarding the rights and well-being of individuals with disabilities. Role of ABI Resources: ABI Resources has been a commendable ally, offering exemplary support to individuals and families in Connecticut. Their collaborative efforts with various government and community service providers, including CT DSS, are noteworthy. Their involvement in Medicaid MFP, ABI Waiver Program, and PCA Waiver has been crucial in enhancing the lives of those they serve. Conclusion: We stand united in our call for justice, equity, and respect for the rights of people with disabilities. Your prompt and decisive response to these pressing issues is not just anticipated; it is imperative for the betterment of our Connecticut community. We await your action and leadership on this critical matter. Respectfully,To the Esteemed Governor Ned Lamont, Senators Richard Blumenthal and Chris Murphy, and House Representatives John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, and Jahana Hayes, We, a collective of concerned citizens, are writing to express our profound concern regarding the urgent need for reform and regulation within the Connecticut Department of Social Services (CT DSS). We believe there is a systemic issue of disability rights violations that cannot be overlooked. It is alarming that the CT DSS, an entity meant to protect and empower individuals with disabilities, is reportedly engaged in practices that severely hinder self-advocacy and propagate discrimination. The alleged instances of housing and service entrapment, along with the operation of sheltered workshops, and engagement in kickback incentive programs and bribery, are deeply troubling. These practices not only undermine the ethical standards expected of such a department but also flagrantly violate the rights of people with disabilities. The approach of "what they don't know won't hurt them" is especially concerning as it perpetuates discrimination and further marginalizes those with disabilities. Moreover, it is disconcerting that the CT DSS is accused of creating barriers that make it difficult for individuals to document their concerns or challenges. This lack of transparency and accountability obstructs the necessary process of identifying and rectifying these critical issues. We urge you, as our elected officials and representatives, to take decisive action in addressing these allegations. The commitment of ABI Resources in this matter is noteworthy, but the involvement and decisive actions of government officials such as yourselves are paramount in ensuring meaningful reform. Immediate action is necessary to reform agency housing and service regulations in federally funded programs, ensuring fair and equitable treatment for all citizens, particularly those with disabilities. The people of Connecticut look to your leadership in safeguarding the rights and voices of individuals with disabilities. We stand united in this cause, calling for justice, equity, and the upholding of the rights of people with disabilities. Your prompt and decisive response to these concerns is not only anticipated but necessary for the betterment of our community. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. Connecticut's Call to Action: Urgent Housing and Service Regulation Reforms Needed in Federally Funded Programs In the heart of New England, Connecticut stands at a pivotal moment. The need for comprehensive reform in agency housing and service regulations within its federally funded programs has never been more urgent. ABI Resources, a beacon of commitment and care in Connecticut, is at the forefront of this critical change, proactively engaging with Governor Ned Lamont and influential representatives in both the Senate and the House. The voices of Senator Richard Blumenthal, Senator Chris Murphy, Representative John Larson, Representative Joe Courtney, Representative Rosa DeLauro, Representative Jim Himes, and Representative Jahana Hayes are instrumental in driving this change forward. As constituents and concerned citizens, your voice is not just important; it's crucial. The collective call for fair and equitable treatment for all resonates deeply in our communities. This is not just a matter of policy - it's a matter of justice and humanity. The Role of ABI Resources: A Beacon of Hope and Excellence ABI Resources, a renowned organization in Connecticut, exemplifies dedication and excellence in supporting individuals and families. Their collaborative approach with government and community service providers like the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services, sets a standard for others to follow. Their partnerships with leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford showcase their commitment to high-quality, personalized care. ABI Resources' involvement in vital programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver demonstrates their pivotal role in enhancing the lives of those they serve. The Need for Reform: A Glimpse into the Current Scenario The current state of agency housing and service regulations in Connecticut's federally funded programs reveals significant gaps. These gaps affect not just the quality of care but also the dignity and rights of individuals relying on these services. It's a scenario that demands immediate attention and action. Your Role: A Vital Piece of the Puzzle As a member of the Connecticut community, your support and voice are invaluable. Engaging with your representatives, spreading awareness, and voicing your concerns are powerful actions that can lead to real change. When the community unites for a cause, the impact is profound. Unite for the Cause: A Future of Fairness and Quality Care Imagine a Connecticut where every individual receives the care and support they deserve, where regulations are not just guidelines but pathways to a better life for all. This vision is achievable, but it requires the collective effort of every one of us. Call to Action Connecticut is at a crossroads, and the path we choose now will define our future. Let's unite for this cause. Reach out to Governor Ned Lamont and your representatives. Share your stories, express your concerns, and demand the change we desperately need. Together, we can build a Connecticut that upholds the values of fairness, dignity, and exceptional care for everyone. Call to Action! Connecticut urgently needs to reform agency housing and service regulations in its federally funded programs. ABI Resources is proactively engaging Governor Ned Lamont and key representatives in the Senate (Richard Blumenthal, Chris Murphy) and the House (John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, Jahana Hayes) to drive this change. Your voice is crucial in ensuring fair and equitable treatment for all. Let's unite for this cause. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. "Shocking Revelations: The Dark Side of Connecticut's DSS Exposed!" "Urgent Alert: CT's Disability Rights Crisis Demands Immediate Action!" "Breaking News: Alarming Practices in CT DSS Put Disability Rights at Risk!" "Connecticut's Hidden Scandal: Disability Discrimination in DSS Uncovered!" "Governor Lamont, Your Immediate Attention Required on DSS Disability Failures!" "A Call for Justice: The Urgent Need to Reform Connecticut's DSS Now!" "Exposed: How CT DSS Fails Our Disabled Community - Action Needed!" "Unbelievable! CT DSS Accused of Violating Disability Rights!" "Connecticut's DSS Under Fire: A Plea for Disability Rights Protection!" "Revealed: The Shocking Truth About Disability Rights Violations in CT DSS!" "Citizens Outraged: CT DSS's Unethical Practices Against Disabled Individuals!" "A Cry for Help: Urgent Reform Needed in Connecticut's DSS for Disability Rights!" "Connecticut in Crisis: Urgent Reform Demanded for DSS Disability Rights Violations!" "Disability Rights at Risk: The Alarming Truth Behind Connecticut's DSS!" "Time for Change: The Battle Against Disability Discrimination in CT DSS!" "Governor Lamont's Urgent Challenge: Reforming CT DSS for Disability Justice!" "Connecticut's Shame: Uncovering the Dark Practices of DSS Against the Disabled!" "Act Now! The Dire State of Disability Rights in Connecticut's DSS Revealed!" "Explosive Report: CT DSS's Discriminatory Practices Against the Disabled!" "A State in Urgent Need: The Critical Fight for Disability Rights in Connecticut's DSS!""Action Required: ABI Resources Calls for Community Support in Major CT Housing Reform!" "Don't Miss Out: Be Part of Connecticut's Historic Shift in Federally Funded Housing Programs" "Alert: How Connecticut's Housing Policy Could Change Forever – And Why You Should Care" "Governor Lamont's Next Big Challenge: ABI Resources Advocates for Urgent Housing Reforms" "Critical Update: How ABI Resources is Revolutionizing Housing and Services in Connecticut" "Connecticut Residents: Your Chance to Influence Major Housing Policy Changes is Here!" "New Era in Housing: Join ABI Resources in Pioneering Change for Connecticut's Community" "Make a Difference: Your Role in Steering Connecticut Towards Equitable Housing Solutions" "Breaking: ABI Resources Leads Monumental Push for Housing Regulation Overhaul in CT" "Connecticut's Turning Point: How You Can Help Shape the Future of Housing and Services" "A Call to Action: Join Forces with ABI Resources for Groundbreaking Housing Reforms" "Major Alert: Connecticut's Housing System on the Brink of Revolution with Your Help" "Governor Lamont, Senators, and You: A United Front for Connecticut's Housing Reforms" "Urgent Community Call: ABI Resources Driving Change in CT's Housing Regulations" "Your Voice Matters: Impacting Connecticut's Housing Policies with ABI Resources" "Time to Act: ABI Resources Urges Public Support for Critical Housing Reforms in CT" "Empower Change: How Connecticut Citizens Can Shape Housing Policies for the Better" "Connecticut's Housing Crisis: Why ABI Resources Needs Your Support Now More Than Ever" "Revolutionize CT's Housing: How Your Involvement Can Make a Real Difference" "Exclusive: Inside ABI Resources' Campaign for Transforming Connecticut's Housing Landscape"

Navigating Home Support Services for Brain Injury Survivors: A Guide to Empowered Living Introduction: For survivors of brain injuries and their loved ones, selecting the right home support services is more than just a necessity—it's a crucial step towards regaining independence and improving quality of life. The path, however, is often fraught with complexities, from deciphering the maze of service options to finding genuinely empathetic care. This guide aims to navigate these challenges, emphasizing the need for informed decision-making and celebrating the role of organizations like ABI Resources in providing tailored, respectful, and empowering support. Understanding the Unique Needs of Brain Injury Survivors: Tailored Support in a Complex Landscape Brain injury survivors face distinct challenges and needs in home support. A generic approach simply doesn't suffice. Every survivor's journey is unique, with varying degrees of support required. We will explore the significance of understanding these needs, the necessity of personalized care plans, and the drawbacks of a one-size-fits-all service model. This knowledge is essential in securing services that truly align with the specific needs and goals of each survivor. The Importance of Informed Choices and Rights: Your Journey, Your Decision In the world of home support services, being well-informed is not just beneficial—it's imperative. This segment delves into the criticality of understanding available options and recognizing tactics some providers may employ that could hinder autonomy. We'll discuss the rights of brain injury survivors and the intricacies involved in selecting a support service, emphasizing the need for survivors to maintain control over their recovery and everyday lives. ABI Resources – A Beacon of Hope and Respect: Empowering Brain Injury Survivors through Compassionate Care ABI Resources exemplifies the ideal in home support services, particularly for brain injury survivors. This section will showcase their approach, which includes respect for individual choices, fostering independence, and providing support attuned to the unique challenges of brain injury survivors. We'll examine their commitment to creating an environment that is both understanding and supportive, illustrating how they set the benchmark for compassionate care. Making Empowered Decisions in Choosing Support Services: Finding the Right Fit for Your Needs The decision to choose the right home support service is one that should be approached with diligence and careful thought. This part of the guide offers practical advice for brain injury survivors and their families on how to select the best service. It covers evaluating compatibility, recognizing individual needs, and the importance of seeking input from various sources. Our goal is to empower you with the knowledge and tools needed to make a decision that best suits your specific situation, leading to a more satisfying and effective support experience. Conclusion: Navigating home support services for brain injury survivors is a journey of empowerment, understanding, and careful selection. By being well-informed and considering organizations like ABI Resources that prioritize tailored, respectful care, survivors and their families can make choices that significantly enhance their daily lives and recovery paths. Remember, the right support can transform the challenge of a brain injury into an opportunity for growth and regained independence. Useful Contacts: The commissioner of the Connecticut Department of Social Services (DSS) is Andrea Barton Reeves. Her email address is commis.dss@ct.gov "Discover Life-Changing Home Support for Brain Injury: You Won't Believe the Difference!" "Revolutionary Guide to Choosing Brain Injury Care: Empowerment Awaits!" "Shocking Secrets to Finding the Best Brain Injury Home Support Revealed!" "Brain Injury Recovery: Uncover the Ultimate Home Care Solutions!" "Transform Your Care: Insider Tips for Brain Injury Survivors!" "The Home Support Guide Every Brain Injury Survivor Must Read!" "Brain Injury Care Exposed: The Truth About Home Support Services!" "Empower Your Recovery: The Best Home Care Choices for Brain Injury!" "Breaking the Mold: Innovative Home Support for Brain Injury Survivors!" "Unbelievable Ways to Optimize Home Care for Brain Injury Recovery!" "Maximize Your Independence: Surprising Home Support Tips for Brain Injury!" "The Empowering Path to Brain Injury Recovery: Home Care Secrets Unveiled!" "Expert's Guide to Choosing Home Support After a Brain Injury: A Must-Read!" "Reimagining Brain Injury Care: Home Support Strategies That Actually Work!" "Navigate Brain Injury Recovery Like a Pro: The Home Support Edition!" "Brain Injury Care Revolution: Home Support Strategies You Never Knew!" "Unveiling the Best Home Support Tactics for Brain Injury Triumph!" "Brain Injury Recovery: Home Support Tips That Will Change Your Life!" "The Ultimate Home Support Blueprint for Brain Injury Survivors!" "Mastering Home Care for Brain Injury: Insider Strategies Revealed!" "Unlock the Secret to Selecting the Best Care Manager for Your Life!" "Experts Reveal: How to Choose a Care Manager Who Puts You First!" "Life-Changing Tips for Finding the Perfect Care Manager!" "Exclusive Insider Advice: Picking a Care Manager Who Understands You!" "Transform Your Care Experience with the Right Manager: Find Out How!" "Master the Art of Choosing a Care Manager That Values Your Choices!" "Your Life, Your Choice: Selecting a Care Manager Who Respects That!" "Top Professional Strategies for Picking a Care Manager Who Cares!" "Revolutionize Your Care with the Perfect Manager: Expert Tips Revealed!" "Empower Your Life: Expert Guide to Choosing the Right Care Manager!" "Breakthrough Advice: Selecting a Care Manager Who Aligns with Your Needs!" "Your Guide to Finding a Care Manager Who Truly Listens and Cares!" "Pro Tips: Choosing a Care Manager Who Advocates for Your Best Life!" "Make the Right Choice: Expert Insights into Selecting Your Care Manager!" "Personalized Care Starts Here: How to Pick Your Ideal Care Manager!" "Navigating the Care Manager Maze: Expert Advice for the Best Choice!" "Your Needs Matter: Find a Care Manager Who Puts You First!" "The Ultimate Guide: Selecting a Care Manager Who Respects Your Choices!" "Change Your Life with the Right Care Manager: Here's How!" "Expert Blueprint: Choosing a Care Manager Who Champions Your Choices!" "Advocating for Change: Uncovering the Critical Needs in Connecticut’s Medicaid ABI Waiver Program" Introduction: Welcome to our in-depth discussion that shines a spotlight on the crucial challenges faced by disabled consumers under the Medicaid ABI Waiver Program in Connecticut. We are honored to have a representative from ABI Resources, a trailblazer in advocating for individuals with disabilities, join us today. This conversation aims to dissect the issues at hand and propose actionable solutions that can make a real difference. Unveiling the Challenges: Our journey begins with understanding the core obstacles these consumers face. Misleading practices are rampant, often diverting individuals from their true rehabilitation needs. Coupled with managerial misdirection, the quality of services provided has seen a significant decline. But perhaps most alarming is the coercive nature of service utilization, leading to financial manipulation and trapping consumers in a cycle of dependency. This lack of transparency and limited consumer choice paints a troubling picture of the current state of affairs. The Mental Health Impact: The consequences of these challenges are not just physical – they deeply impact mental health. Consumers are often left feeling stressed, anxious, and helpless. This psychological turmoil can severely hinder recovery and rehabilitation, undermining the primary goal of fostering independence and improving the quality of life. The Role of Federal Intervention: In this complex landscape, federal intervention emerges as a beacon of hope. It has the power to enforce ethical standards, implement stringent oversight, and mandate transparency in service provision. Such actions could realign the program with its intended purpose, placing consumer needs at its heart. Proposing a Path Forward: ABI Resources champions a comprehensive policy overhaul, emphasizing enhanced training for care managers and clearer communication of consumer rights. Advocating for direct involvement of disabled individuals in policy-making and service design is crucial to ensure their voices are not just heard but are influential in driving change. Amplifying Consumer Voices: The key to real transformation lies in amplifying the voices of disabled consumers in decision-making. This can be achieved through their active involvement in advisory boards and decision-making committees, complemented by regular feedback mechanisms and a transparent grievance redressal system. Conclusion: Our conversation today with ABI Resources not only sheds light on the pressing need for systemic reform in Connecticut's Medicaid ABI Waiver Program but also serves as a call to action. By advocating for federal oversight and focusing on consumer-centric solutions, we edge closer to a system that genuinely supports and empowers individuals with disabilities. Join us in this pivotal discussion and be part of a movement towards a more inclusive and effective care system. Empowering Communication: Transparent communication stands as a pillar in this endeavor, especially for families and caregivers. It's essential for them to be fully informed about the services available, the rights of the consumers, and the mechanisms in place for feedback and grievances. Empowered with information, they can make informed decisions and advocate effectively for their loved ones. Harnessing Technology: In an era where technology is a game-changer, its potential to enhance services for disabled consumers is immense. From facilitating communication to providing accessible educational resources, and enabling remote consultations, technology paves the way for more efficient and personalized service delivery. Tailored Solutions for Unique Needs: Addressing the needs of consumers with brain injuries requires a specialized approach. It calls for training care providers specifically for these challenges, creating individualized care plans, and ensuring access to resources dedicated to brain injury rehabilitation. Aligning Services with Goals: Service plans must be aligned with individual rehabilitation goals, developed collaboratively with consumers, their families, and healthcare professionals. Regular reviews and adjustments are vital to keep these plans relevant and effective. Governmental Support for Independence: The role of state and federal governments in supporting initiatives that promote independence and self-sufficiency for disabled consumers cannot be overstated. Funding programs focused on skill development, employment training, and community integration are critical steps towards this goal. The Central Role of Medical Professionals: Medical professionals must be at the forefront of overseeing and guiding services for disabled individuals. Their expertise is instrumental in developing appropriate care plans and ensuring services align with medical and rehabilitation needs. Fostering Policy Inclusion: Finally, to ensure that disabled consumers have a significant voice in policy-making and service design, their involvement in advisory roles and consultation processes is imperative. Their experiences and insights are invaluable in crafting services that truly resonate with their needs. "Shocking Truths Unveiled: How Connecticut's Medicaid Program Fails Disabled Consumers" "Experts Reveal: Major Flaws in Disability Care System in Connecticut" "Breaking News: ABI Resources Exposes Deep Flaws in Medicaid ABI Waiver Program" "Connecticut's Hidden Crisis: ABI Resources Sheds Light on Disabled Care Failings" "Scandal in Healthcare: How Connecticut's System Fails Its Disabled Citizens" "Urgent Reform Needed: ABI Resources Calls Out Flaws in Medicaid Program" "Alarming Insights: The Harsh Reality of Disability Services in Connecticut" "Connecticut's Shame: How Medicaid Fails Those With Disabilities" "Exclusive! ABI Resources Exposes Connecticut's Disability Care Scandal" "Disability Advocacy Shakeup: ABI Resources' Revealing Take on Medicaid Woes" "Connecticut's Disability Dilemma: Inside Look with ABI Resources" "A System in Crisis: Uncovering Connecticut's Disability Service Flaws" "Medicaid’s Dark Side: ABI Resources Reveals What Needs to Change Now" "The Untold Story of Disability Neglect in Connecticut's Healthcare System" "Breaking Barriers: ABI Resources' Crusade Against Disability Injustice" "Connecticut's Disability Service Failures: An Insider's Shocking Revelation" "The Battle for Better Care: How ABI Resources is Challenging Connecticut's System" "Connecticut's Alarming Disability Care Gap: What You Need to Know" "Disability Rights Crisis: ABI Resources Uncovers Shocking Facts" "Advocacy Alert: ABI Resources Exposes Connecticut's Failing Disability Services" Introduction: To Governor Ned Lamont, Senators Richard Blumenthal and Chris Murphy, and House Representatives John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, and Jahana Hayes, As a collective of deeply concerned citizens, we write to you today with a matter of utmost urgency and gravity. Our focus is the Connecticut Department of Social Services (CT DSS), an institution that should stand as a bastion of support and empowerment for individuals with disabilities but is currently falling distressingly short of its mandate. Concerns and Allegations: Recent reports and allegations paint a troubling picture of the CT DSS. Claims of housing and service entrapment, operation of sheltered workshops, and involvement in unethical kickback incentive programs and bribery schemes have surfaced. These practices not only tarnish the reputation of the CT DSS but also grossly infringe upon the rights of people with disabilities. A particularly disheartening tactic is the “what they don’t know won’t hurt them” approach, which only serves to perpetuate discrimination and further marginalize our disabled community members. Transparency and Accountability Issues: Equally concerning is the reported lack of avenues for individuals to document and voice their challenges and grievances. This opaque veil over the operations of the CT DSS hinders the crucial process of identifying, acknowledging, and rectifying these grave issues. Call to Action: We call upon you, our elected officials, to take immediate and decisive action. While we acknowledge and appreciate the commitment of ABI Resources in addressing these issues, the role and intervention of governmental authorities like yourselves are indispensable for enacting meaningful and systemic reform. Proposed Reforms: We urge you to implement reforms in agency housing and service regulations, particularly in programs that are federally funded. These reforms should ensure fair and equitable treatment of all citizens, with a specific focus on safeguarding the rights and well-being of individuals with disabilities. Role of ABI Resources: ABI Resources has been a commendable ally, offering exemplary support to individuals and families in Connecticut. Their collaborative efforts with various government and community service providers, including CT DSS, are noteworthy. Their involvement in Medicaid MFP, ABI Waiver Program, and PCA Waiver has been crucial in enhancing the lives of those they serve. Conclusion: We stand united in our call for justice, equity, and respect for the rights of people with disabilities. Your prompt and decisive response to these pressing issues is not just anticipated; it is imperative for the betterment of our Connecticut community. We await your action and leadership on this critical matter. Respectfully,To the Esteemed Governor Ned Lamont, Senators Richard Blumenthal and Chris Murphy, and House Representatives John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, and Jahana Hayes, We, a collective of concerned citizens, are writing to express our profound concern regarding the urgent need for reform and regulation within the Connecticut Department of Social Services (CT DSS). We believe there is a systemic issue of disability rights violations that cannot be overlooked. It is alarming that the CT DSS, an entity meant to protect and empower individuals with disabilities, is reportedly engaged in practices that severely hinder self-advocacy and propagate discrimination. The alleged instances of housing and service entrapment, along with the operation of sheltered workshops, and engagement in kickback incentive programs and bribery, are deeply troubling. These practices not only undermine the ethical standards expected of such a department but also flagrantly violate the rights of people with disabilities. The approach of "what they don't know won't hurt them" is especially concerning as it perpetuates discrimination and further marginalizes those with disabilities. Moreover, it is disconcerting that the CT DSS is accused of creating barriers that make it difficult for individuals to document their concerns or challenges. This lack of transparency and accountability obstructs the necessary process of identifying and rectifying these critical issues. We urge you, as our elected officials and representatives, to take decisive action in addressing these allegations. The commitment of ABI Resources in this matter is noteworthy, but the involvement and decisive actions of government officials such as yourselves are paramount in ensuring meaningful reform. Immediate action is necessary to reform agency housing and service regulations in federally funded programs, ensuring fair and equitable treatment for all citizens, particularly those with disabilities. The people of Connecticut look to your leadership in safeguarding the rights and voices of individuals with disabilities. We stand united in this cause, calling for justice, equity, and the upholding of the rights of people with disabilities. Your prompt and decisive response to these concerns is not only anticipated but necessary for the betterment of our community. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. Connecticut's Call to Action: Urgent Housing and Service Regulation Reforms Needed in Federally Funded Programs In the heart of New England, Connecticut stands at a pivotal moment. The need for comprehensive reform in agency housing and service regulations within its federally funded programs has never been more urgent. ABI Resources, a beacon of commitment and care in Connecticut, is at the forefront of this critical change, proactively engaging with Governor Ned Lamont and influential representatives in both the Senate and the House. The voices of Senator Richard Blumenthal, Senator Chris Murphy, Representative John Larson, Representative Joe Courtney, Representative Rosa DeLauro, Representative Jim Himes, and Representative Jahana Hayes are instrumental in driving this change forward. As constituents and concerned citizens, your voice is not just important; it's crucial. The collective call for fair and equitable treatment for all resonates deeply in our communities. This is not just a matter of policy - it's a matter of justice and humanity. The Role of ABI Resources: A Beacon of Hope and Excellence ABI Resources, a renowned organization in Connecticut, exemplifies dedication and excellence in supporting individuals and families. Their collaborative approach with government and community service providers like the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services, sets a standard for others to follow. Their partnerships with leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford showcase their commitment to high-quality, personalized care. ABI Resources' involvement in vital programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver demonstrates their pivotal role in enhancing the lives of those they serve. The Need for Reform: A Glimpse into the Current Scenario The current state of agency housing and service regulations in Connecticut's federally funded programs reveals significant gaps. These gaps affect not just the quality of care but also the dignity and rights of individuals relying on these services. It's a scenario that demands immediate attention and action. Your Role: A Vital Piece of the Puzzle As a member of the Connecticut community, your support and voice are invaluable. Engaging with your representatives, spreading awareness, and voicing your concerns are powerful actions that can lead to real change. When the community unites for a cause, the impact is profound. Unite for the Cause: A Future of Fairness and Quality Care Imagine a Connecticut where every individual receives the care and support they deserve, where regulations are not just guidelines but pathways to a better life for all. This vision is achievable, but it requires the collective effort of every one of us. Call to Action Connecticut is at a crossroads, and the path we choose now will define our future. Let's unite for this cause. Reach out to Governor Ned Lamont and your representatives. Share your stories, express your concerns, and demand the change we desperately need. Together, we can build a Connecticut that upholds the values of fairness, dignity, and exceptional care for everyone. Call to Action! Connecticut urgently needs to reform agency housing and service regulations in its federally funded programs. ABI Resources is proactively engaging Governor Ned Lamont and key representatives in the Senate (Richard Blumenthal, Chris Murphy) and the House (John Larson, Joe Courtney, Rosa DeLauro, Jim Himes, Jahana Hayes) to drive this change. Your voice is crucial in ensuring fair and equitable treatment for all. Let's unite for this cause. ABI Resources is a renowned organization in Connecticut, committed to delivering outstanding support to individuals and families. They work collaboratively with several government and community service providers, such as the Connecticut Department of Social Services (DSS), Community Options (COU), the Department of Mental Health and Addiction Services (DMHAS), Connecticut Community Care (CCC/CCCI), Area Agencies on Aging (SWCAA, WCAAA), Allied Community Resources (ACR), Access Health, and United Services. ABI Resources works alongside leading institutions like HFSC, Gaylord, UCONN, Yale, and Hartford, emphasizing high-quality, personalized care. They play a key role in programs like Medicaid MFP (Money Follows the Person), ABI Waiver Program, and PCA Waiver, enhancing the lives of those they serve. ABI Resources Connecticut home-based and community supported living. "Shocking Revelations: The Dark Side of Connecticut's DSS Exposed!" "Urgent Alert: CT's Disability Rights Crisis Demands Immediate Action!" "Breaking News: Alarming Practices in CT DSS Put Disability Rights at Risk!" "Connecticut's Hidden Scandal: Disability Discrimination in DSS Uncovered!" "Governor Lamont, Your Immediate Attention Required on DSS Disability Failures!" "A Call for Justice: The Urgent Need to Reform Connecticut's DSS Now!" "Exposed: How CT DSS Fails Our Disabled Community - Action Needed!" "Unbelievable! CT DSS Accused of Violating Disability Rights!" "Connecticut's DSS Under Fire: A Plea for Disability Rights Protection!" "Revealed: The Shocking Truth About Disability Rights Violations in CT DSS!" "Citizens Outraged: CT DSS's Unethical Practices Against Disabled Individuals!" "A Cry for Help: Urgent Reform Needed in Connecticut's DSS for Disability Rights!" "Connecticut in Crisis: Urgent Reform Demanded for DSS Disability Rights Violations!" "Disability Rights at Risk: The Alarming Truth Behind Connecticut's DSS!" "Time for Change: The Battle Against Disability Discrimination in CT DSS!" "Governor Lamont's Urgent Challenge: Reforming CT DSS for Disability Justice!" "Connecticut's Shame: Uncovering the Dark Practices of DSS Against the Disabled!" "Act Now! The Dire State of Disability Rights in Connecticut's DSS Revealed!" "Explosive Report: CT DSS's Discriminatory Practices Against the Disabled!" "A State in Urgent Need: The Critical Fight for Disability Rights in Connecticut's DSS!""Action Required: ABI Resources Calls for Community Support in Major CT Housing Reform!" "Don't Miss Out: Be Part of Connecticut's Historic Shift in Federally Funded Housing Programs" "Alert: How Connecticut's Housing Policy Could Change Forever – And Why You Should Care" "Governor Lamont's Next Big Challenge: ABI Resources Advocates for Urgent Housing Reforms" "Critical Update: How ABI Resources is Revolutionizing Housing and Services in Connecticut" "Connecticut Residents: Your Chance to Influence Major Housing Policy Changes is Here!" "New Era in Housing: Join ABI Resources in Pioneering Change for Connecticut's Community" "Make a Difference: Your Role in Steering Connecticut Towards Equitable Housing Solutions" "Breaking: ABI Resources Leads Monumental Push for Housing Regulation Overhaul in CT" "Connecticut's Turning Point: How You Can Help Shape the Future of Housing and Services" "A Call to Action: Join Forces with ABI Resources for Groundbreaking Housing Reforms" "Major Alert: Connecticut's Housing System on the Brink of Revolution with Your Help" "Governor Lamont, Senators, and You: A United Front for Connecticut's Housing Reforms" "Urgent Community Call: ABI Resources Driving Change in CT's Housing Regulations" "Your Voice Matters: Impacting Connecticut's Housing Policies with ABI Resources" "Time to Act: ABI Resources Urges Public Support for Critical Housing Reforms in CT" "Empower Change: How Connecticut Citizens Can Shape Housing Policies for the Better" "Connecticut's Housing Crisis: Why ABI Resources Needs Your Support Now More Than Ever" "Revolutionize CT's Housing: How Your Involvement Can Make a Real Difference" "Exclusive: Inside ABI Resources' Campaign for Transforming Connecticut's Housing Landscape"

Title: High Demand for Specialized Professionals in Connecticut's Brain Injury Home and Community Programs Subtitle: Cognitive behaviorists, occupational therapists, educational psychologists, speech therapists, physical therapists, behavior analysts, psychologists, and neuropsychologists are essential to support individuals with brain injuries. The state of Connecticut is currently experiencing a high demand for specialized professionals in the field of brain injury home and community programs. These professionals, including cognitive behaviorists, occupational therapists, educational psychologists, speech therapists, physical therapists, behavior analysts, psychologists, and neuropsychologists, play a crucial role in providing comprehensive support and care for individuals with brain injuries. Their expertise is critical in designing and implementing personalized interventions that help individuals overcome challenges and reintegrate into their communities. Service Description: Individual Interventions At the core of Connecticut's brain injury home and community programs are individual interventions specifically tailored to address each person's unique needs. These interventions focus on decreasing severe maladaptive behaviors that jeopardize an individual's ability to remain integrated within their community. Key components of these services include: Comprehensive assessment of deficient cognition and maladaptive behavior(s). Development of a structured cognitive/behavioral intervention plan, prioritizing the teaching of socially appropriate behaviors. Elimination of maladaptive behaviors through the development and implementation of cognitive compensatory strategies. Implementation of the intervention plan. Ongoing or periodic supervision of the waiver participant, family members, and caregivers concerning treatment regimens, cognitive and behavioral strategies, and interventions, as well as the use of equipment specified in the plan of care. Periodic reassessment of the intervention plan. Assistance to providers in implementing participant-specific interventions. Collaborative Approach: Person-centered Team These services are performed within the context of each individual's person-centered team, working in collaboration with the Department of Social Services (DSS) social worker who acts as an administrative case manager. This collaborative approach ensures that all parties are involved in the decision-making process and that interventions are designed to best support the individual's unique needs. Flexible Service Delivery: Home and Community Settings Cognitive/behavioral programs may be provided in the individual's home or community to reinforce the training in a real-life situation. This flexible service delivery model enables professionals to address challenges in the environments where they are most likely to occur, promoting greater success in the individual's reintegration process. Conclusion As the demand for specialized professionals in Connecticut's brain injury home and community programs continues to grow, it is crucial for cognitive behaviorists, occupational therapists, educational psychologists, speech therapists, physical therapists, behavior analysts, psychologists, and neuropsychologists to be aware of the opportunities available to them. These professionals play a critical role in supporting individuals with brain injuries, helping them overcome challenges, and ensuring their successful reintegration into their communities. _________________________ Connecticut, cognitive behaviorists, brain injury, home and community programs, occupational therapists, educational psychologists, speech therapists, physical therapists, behavior analysts, psychologists, neuropsychologists, high demand, specialized professionals, individual interventions, maladaptive behaviors, cognitive compensatory strategies, person-centered team, Department of Social Services, DSS, social worker, case manager, flexible service delivery, reintegration, comprehensive assessment, deficient cognition, structured intervention plan, socially appropriate behaviors, treatment regimens, supervision, family members, caregivers, equipment, reassessment, assistance, providers, participant-specific interventions, collaboration, real-life situations, challenges, opportunities, support, care, expertise, personalized interventions, collaborative approach, decision-making process, environments, rehabilitation, therapeutic services, cognitive therapy, behavioral therapy, community integration, adaptive skills, brain injury recovery, traumatic brain injury, TBI, acquired brain injury, ABI, neurological disorders, stroke, concussion, cognitive rehabilitation, behavioral management, functional independence, quality of life, mental health, communication skills, motor skills, sensory processing, vocational training, life skills, case coordination, disability services, special needs, interdisciplinary team, family support, evidence-based practices, patient-centered care, goal setting, progress monitoring, resource coordination, community resources, clinical services, home-based care, coping strategies, emotional regulation, cognitive training, behavior modification, therapeutic interventions, neuropsychological assessment, psychosocial support, disability management, recovery planning, care coordination, cognitive-behavioral therapy, CBT, assistive technology.

Connecticut Care managers are the unsung heroes of home healthcare. working tirelessly behind the scenes to ensure that people receive the best possible care. These healthcare professionals coordinate care across providers, advocate for patients' needs, and navigate complex insurance policies, state and federal regulations and reimbursement guidelines. Despite the critical role that care managers play in the home healthcare system, they are often underpaid and overwhelmed. they often face significant challenges that can lead to burnout, job dissatisfaction and overwelm. As a community, we must prioritize the well-being of care managers and provide them with the support they need to thrive. By doing so, we can empower these healthcare heroes to deliver high-quality, patient-centered care while also promoting their own professional fulfillment and personal well-being. Here are some strategies for supporting Connecticut's care managers: Increasing resources and tailored trainings: Care managers need access to the latest information and training to stay up-to-date on the best practices and changes in the healthcare industry. Organizations can provide access to training programs, professional development opportunities, and relevant resources to help care managers build their skills and knowledge. Support with Streamlining administrative tasks: Care managers often spend a significant amount of time on administrative tasks such as documentation and scheduling. By reducing administrative burdens, organizations can help care, managers, focus more on person-centered care. Investing in technology to streamline administrative tasks or hiring additional administrative staff can be an effective solution. Increased collaboration and communication systems: Care managers need to work closely with healthcare providers, patients, and family members to deliver effective care. Organizations can encourage collaboration and communication by providing opportunities for care managers to meet with other healthcare professionals, use telemedicine or virtual visits, and communicate regularly with patients and their families. Addressing workload and staffing concerns: Care managers may feel overwhelmed by their workload, especially in cases where patient demand exceeds staffing capacity. Organizations can address workload and staffing concerns by monitoring caseloads, providing additional staff as needed, and using data to inform staffing decisions. Prioritize self-care and work-life balance: Care managers may experience burnout due to the demands of their job. Organizations can promote self-care and work-life balance by encouraging employees to take breaks, providing access to mental health resources, and implementing flexible scheduling policies. By supporting care managers, we can build a healthcare system that prioritizes the well-being of patients and healthcare professionals alike. Empowering care managers to deliver high-quality, patient-centered care while also promoting their own professional fulfillment and personal well-being is a win-win for everyone involved. Let's come together as a community to understand and invest in our care managers and build a brighter future for healthcare in Connecticut. Together, we can make a difference and create a system that truly cares for those who care for us. care managers health care heroes patient care care coordination healthcare advocacy healthcare professionals patient advocacy wellbeing self-care work-life balance professional development mental health support health tech administrative tasks staffing concerns

The Mirrors of Our Hearts Imagine a world where every interaction is a mirror reflecting the deepest parts of ourselves back to us. There are extraordinary people among us who do just that—they become the mirrors of our hearts. Through their compassion, empathy, and unconditional acceptance, they reveal the depth of love and goodness within us. It is as if by loving us, they allow us to see our own capacity to love and be loved, illuminating the path to self-discovery and growth. Lead and uplift those around you through acts of kindness, gratitude and encouragement. By embodying these principles, you not only enrich your own journey but also light the way for others to follow. ABI RESOURCES Connecticut's Supported Living Leaders