††††† 910 KAR 1:270. Hart-supported living services.

 

††††† RELATES TO: KRS 210.770-210.795

††††† STATUTORY AUTHORITY: KRS 210.780(3), 210.795(3)

††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 210.780(3) authorizes the State Supported Living Council to recommend necessary administrative regulations to carry out the purposes of KRS 210.770 to 210.795. KRS 210.795(3) requires the Department for Mental Health and Mental Retardation Services in concert with the State Supported Living Council to promulgate administrative regulations to establish the methods of awarding Hart-supported Living Program grants, monitoring the quality of service delivery, and providing for administrative appeals of decisions. This administrative regulation establishes, the grant application and award procedures, the standards to monitor the quality of service delivery and the appellate procedure.

 

††††† Section 1. Definitions. (1) "Adaptive and therapeutic equipment" means an item recommended by a physician, or therapist which promotes the recipient's independent functioning and communication.

††††† (2) "Applicant" means a person who is eligible for Hart-supported living funds and submits a completed application to the regional supported living coordinator employed by the mental health and mental retardation board located in the region where the applicant chooses to reside by the deadline established in the application.

††††† (3) "Application" means a written request for supported living services which must be completed and submitted in accordance with Section 3 of this administrative regulation to the regional Hart-supported living coordinator.

††††† (4) "Community resource developer" means a person who coordinates and assists a recipient to develop friendships, opportunities, and networks in the community on an individualized basis.

††††† (5) "Council" means State Supported Living Council as described by KRS 210.775.

††††† (6) "Department" means the Department for Mental Health and Mental Retardation Services.

††††† (7) "Duplicative service" is a support or service received through the Hart-Supported Living Program which an individual is entitled to receive from another agency or program.

††††† (8) "Eligibility for services" means meeting the eligibility criteria in KRS 210.790.

††††† (9) "Hart-supported living grant" means an award of funds for a fiscal year to an applicant.

††††† (10) "Hart-supported living program" is defined by KRS 210.770(5) and (6).

††††† (11) "Home modifications" means an architectural change, ramp, widening of doors, or other adaptation which need to be made to the recipient's place of residence to accommodate that person's disability.

††††† (12) "Homemaker services" means cooking, cleaning, shopping, laundry, housekeeping, and practical assistance in maintaining the recipient's household.

††††† (13) "Impairment" means "mental impairment" as defined by stated at KRS 210.770(1) and "physical impairment" as defined by KRS 210.770(3).

††††† (14) "One-time support" means a nonrenewable grant for start-up costs, home modifications, assistive technology, or other support awarded for no longer than one fiscal year.

††††† (15) "Ongoing supports" means a renewable grant for supports or services which will likely be required on a continuing basis.

††††† (16) "Personal care services" means assistance with feeding, bathing, dressing, transferring, turning, repositioning, activities of daily living, and if necessary, ambulation and emergency procedures.

††††† (17) "Recipient" means a person who has applied and been approved for a supported living grant.

††††† (18) "Regional supported living coordinator" means a person who is responsible for fiscal and programmatic oversight of supported living funds and plans.

††††† (19) "Request for reconsideration" means the process to be followed if a recipient disagrees with a decision made by the regional supported living coordinator, review team, or council.

††††† (20) "Review team" means a team designated by the Department and Council to review applications, make funding recommendations, and review requests for amendments from recipients as described in Section 6 of this administrative regulation.

††††† (21) "Start-up grants" means an award of funds to a recipient for one (1) time expenses limited to a security deposit, down payment not to exceed ten (10) percent of the purchase price, closing costs for a home, purchase of furniture, home furnishings, or equipment.

††††† (22) "Substantial limitation of a major life activity" means as stated at KRS 210.770(4).

††††† (23) "Supported living plan" means the document developed between the regional Hart-supported living coordinator and the recipient to account for the services to be provided and funds awarded as a Hart-supported living grant.

††††† (24) "Supported living plan amendment" means a written, documented change in a supported living plan in the same fiscal year.

††††† (25) "Transportation" means a service or mileage reimbursement for a person or provider who transports the recipient to work or community activities.

 

††††† Section 2. State Supported Living Council Operating Procedures. (1) A State Supported Living Council member shall:

††††† (a) Adhere to applicable laws and regulations concerning confidentiality;

††††† (b) Disclose any relationship to any person receiving Hart-supported living services, including themselves; and

††††† (c) Adhere to the bylaws. If a member fails to act in accordance with the bylaws, the chair of the State Supported Living Council shall recommend the dismissal of that member to the governor.

††††† (2) A State Supported Living Council member shall not:

††††† (a) Influence, discuss, deliberate, or vote on a decision if the member has a conflict of interest that is:

††††† 1. Personal;

††††† 2. Professional; or

††††† 3. Financial;

††††† (b) Be physically present in a meeting or portion of a meeting in which the matter with respect to which a conflict of interest exists is discussed or voted on;

††††† (c) Assist another individual, regardless of where the person resides, to complete an application for supported living services, except as provided in subsection (3) of this section.

††††† (3) A State Supported Living Council member may assist in the completion of an application for Hart-supported living services for himself, if eligible, or an eligible family member.

 

††††† Section 3. Applicant Responsibilities. (1) The applicant shall submit a completed application to the regional Hart-supported living coordinator where the applicant chooses to reside. The application shall be submitted:

††††† (a) On the current Hart-supported living application with all required sections completed; and

††††† (b) By the annual deadline, April 1.

††††† (2) A Hart-supported living grant shall not be funded for:

††††† (a) On-going rent or mortgage payments;

††††† (b) Payment of a medical insurance premium or unpaid medical bill;

††††† (c) Supplementation of wages for staff in other publicly-funded programs;

††††† (d) Modifications costing over $3,500 to rental property;

††††† (e) A home improvement not related to a person's disability;

††††† (f) Rental of a vehicle for more than thirty (30) days in a fiscal year;

††††† (g) Purchase of a vehicle;

††††† (h) Supports or services for individuals in living arrangements that include more than three (3) people who are eligible for Hart-supported living unless all are related legally or biologically as a family unit;

††††† (i) Equipment or service which is obtainable from another program for which the applicant qualifies;

††††† (j) Tuition, transportation costs, or fees for a program or activity lasting more than thirty (30) days if during that fiscal year a majority of participants are individuals with disabilities as defined by the Americans with Disabilities Act (ADA) of 1990;

††††† (k) Support or service which is duplicative of a support or service which is obtainable from another program for which the individual qualifies; or

††††† (l) Furniture or home furnishings not related to a start-up grant or a personís disability.

 

††††† Section 4. Eligibility. An applicant must meet the eligibility requirements set forth in KRS 210.790

 

††††† Section 5. Application Evaluation Criteria. (1)The following criteria shall be used by the review team to recommend funding for a Hart-supported living grant:

††††† (1) Adherence to principles of the Hart-supported Living Program as shown by the following factors:

††††† (a) The ability of the applicant to exercise choice and autonomy in the supported living arrangement;

††††† (b) The involvement of people, in addition to the applicant and paid staff, who are committed to supporting the arrangement; and

††††† (c) Opportunities for the applicant to be present and participate in family and community activities.

††††† (2) Potential for success as shown by the following factors:

††††† (a) The applicant has clearly indicated the reason for requesting funds and what he will do if granted the funds;

††††† (b) The applicant has identified a place to live; and

††††† (c) Additional resources available to the applicant have been identified that may include:

††††† 1. Family;

††††† 2. Friend; or

††††† 3. Another service provider who can support the situation.

††††† (d) The application indicates that the applicant is planning for his future.

††††† (3) Need as shown by the following factors:

††††† (a) Services have been designed around the specific needs of the applicant;

††††† (b) The applicant or his family is experiencing a crisis situation; and

††††† (c) The applicant's multiple disabilities create barriers to developing and sustaining supports.

††††† (4) Accountability as shown by the following factors:

††††† (a) The applicant has identified a prospective service provider;

††††† (b) The capability of the applicant, and the people supporting the applicant, to manage the resources and arrange for the requested services; and

††††† (c) The applicant has demonstrated a reasonable effort to secure funds from other sources, if appropriate.

††††† (5) Overall purpose of the application as shown by whether the supported living resources will be used to promote and improve a positive quality of life for the applicant.

 

††††† Section 6. Review Teams. (1) A review team shall:

††††† (a) Evaluate applications in accordance with the criteria in Section 5 of this administrative regulation;

††††† (b) Make funding recommendations for each fiscal year, not to exceed regional allocations; and

††††† (c) Review requests for plan amendments.

††††† (2) Funding recommendations shall be made in the following order:

††††† (a) Current recipients requesting the same amount or less for on-going supports;

††††† (b) Current recipients requesting additional funding in order to ensure the continuation of their current plan. Additional funding may be granted for the following:

††††† 1. An increase in the pay rate of a provider for services currently in the plan;

††††† 2. An increase in employer taxes for services currently in the plan;

††††† 3. An increase in workerís compensation rates; or

††††† 4. Payment to a provider to compute required employer taxes and withholdings.

††††† (c) Applicants denied funding from the previous fiscal year and approved for funding by the reconsideration or administrative hearing process as outlined in Sections 11 and 12 of this administrative regulation; and

††††† (d) New applicants and current recipients requesting additions to their plans.

††††† (3) A review team shall be designated by the department and council and shall be made up of a minimum of three (3) individuals and a maximum of six (6) individuals as follows:

††††† (a) A minimum of one (1) and maximum of two (2) employees of the department; and

††††† (b) A minimum of two (2) and maximum of four (4) regional supported living coordinators.

††††† (4) A review team shall not include:

††††† (a) The regional coordinator representing an applicant; or

††††† (b) An employee of a supported living contracted agency for the applicantís choice of residence.

 

††††† Section 7. Recipient Responsibilities. (1) A recipient of a supported living grant shall:

††††† (a) Participate in the development of a supported living plan with the Hart-supported living coordinator;

††††† (b) Adhere to the supported living plan and request a plan amendment for a desired change; and

††††† (c) Negotiate the services to be provided by:

††††† 1. A service providing agency; or

††††† 2. An individual who provides services, as an employee or independent contractor.

††††† (2) A recipient of a Hart-supported living grant who is an employer shall:

††††† (a) Be responsible for the computation, payment, and reporting of employee payroll, withholdings, workers' compensation, unemployment, and taxes;

††††† (b) Establish terms of employment for an employee, to include time, duties and responsibilities. This shall be in the form of a signed agreement;

††††† (c) Establish terms for an independent contract to include services to be provided and compensation. This shall be in the form of a signed agreement.

††††† (3) A recipient of a Hart-supported living grant shall not sell or donate equipment or another item purchased with supported living funds without the written consent of the council.

††††† (4) A recipient of a Hart-supported living grant shall comply with standards as set forth in KRS 210.795.

††††† (5) A recipient shall immediately notify the regional coordinator upon the receipt of additional supports or services.

††††† (6) A recipient shall be responsible for submitting documentation that a support or service approved on a plan has been provided when requesting payment.

††††† (7) A recipient of an ongoing grant shall submit a request for continued or increased funding by April 1 for funding for the fiscal year beginning July 1.

 

††††† Section 8. Reduction of a Hart-supported Living Grant. (1) The grant shall be reduced by any amount received for a service which duplicates a support or service on the supported living plan.

††††† (2) The grant shall be reduced if:

††††† (a) The support does not comply with the principles and definition of the Hart-supported living program in KRS 210.770(5) and (6) and 210.795; or

††††† (b) The recipient no longer needs a support or service in whole or in part.

 

††††† Section 9. Termination of a Hart-supported Living Grant. A Hart-supported living grant shall be terminated if the recipient:

††††† (1) Does not use the funds in accordance with the principles and definition of supported living in KRS 210.770, 210.795, and this administrative regulation;

††††† (2) Does not comply with employer responsibilities if applicable;

††††† (3) Takes up residence outside of Kentucky;

††††† (4) Requests termination of the Hart-supported living grant; or

††††† (5) Dies.

 

††††† Section 10. Nonfunded Supported Living Applications. (1) Applications that will exceed the regional allocation of supported living funds shall not be approved unless funding for that application becomes available within the fiscal year for which the application was made.

††††† (2) The council may recommend funding for an application when it is determined through the reconsideration process that the review team did not comply with Sections 5 and 6 of this administrative regulation.

 

††††† Section 11. Reconsideration Process. (1) A recipient or applicant who disagrees with a decision by the regional Hart-supported living coordinator or review team may request reconsideration, in writing, or alternative format within thirty (30) days following the notification by the regional supported living coordinator of the decision. Reconsideration may be requested regarding:

††††† (a) A supported living plan;

††††† (b) A plan amendment;

††††† (c) The reduction of a grant;

††††† (d) The termination of a grant; or

††††† (e) A nonfunded application.

††††† (2) A request for reconsideration shall:

††††† (a) Be submitted to the regional Hart-supported living coordinator for review by the council; and

††††† (b) Contain the following information:

††††† 1. Name;

††††† 2. Address;

††††† 3. Telephone number;

††††† 4. A decision to be reconsidered;

††††† 5. A reason for a decision to be reconsidered;

††††† 6. Documentation supporting request for reconsideration; and

††††† 7. Signature of person requesting reconsideration.

††††† (3) A meeting for reconsideration shall be scheduled and include:

††††† (a) Three (3) members of the council, one (1) of whom shall be the chairman or his designee;

††††† (b) The recipient or his designee;

††††† (c) One (1) member of the review team; and

††††† (d) The regional Hart-supported living coordinator.

††††† (4) The meeting for reconsideration shall be conducted at a time and place convenient to the parties and may be conducted in person, by videoconference, or by telephone conference.

††††† (5) The council shall make the final decision and issue a written response to the recipient with an explanation for the decision within thirty (30) days.

††††† (6) If a recipient or applicant disagrees with the determination made by the council, the recipient may request an administrative hearing.

††††† (7) No currently funded recipient shall have his grant reduced or terminated to fund a plan or grant approved through the reconsideration process.

 

††††† Section 12. Request for Administrative Hearing. (1) An applicant or recipient who disagrees with the reconsideration decision may request an administrative hearing within thirty (30) days of receipt of notification.

††††† (2) The applicant or recipient requesting an administrative hearing shall:

††††† (a) Submit a written request for an administrative hearing to the Commissioner of the Department for Mental Health and Mental Retardation Services, 100 Fair Oaks Lane, Frankfort, Kentucky 40621; and

††††† (b) Include with the request the same information required in Section 11(2)(b) of this administrative regulation.

††††† (3) The administrative hearing process shall be in accordance with KRS Chapter 13B.

 

††††† Section 13. Regional Hart-supported Living Coordinator Responsibilities. The regional Hart-supported living coordinator shall:

††††† (1) Participate as required in review team responsibilities as outlined in Section 6(1) of this administrative regulation;

††††† (2) Disseminate applications for the Hart-supported Living Program which include the evaluation criteria;

††††† (3) Provide assistance in the completion of supported living applications upon request by an eligible applicant or individual on the applicant's behalf;

††††† (4) Receive supported living applications, document date received, send notice of receipt of application;

††††† (5) Prescreen applications to determine completeness, compliance with the instructions, and conformity with KRS 210.770(5) and (6);

††††† (6) Maintain a database of expenditures and activities of unfunded applicants and funded recipients for each fiscal year. Criteria for the database information shall be established by the council and the department;

††††† (7) Notify all applicants of the status of their applications within fifteen (15) days of the completion of the initial funding recommendations, but no later than June 15 of each fiscal year;

††††† (8) Upon recommendation for funding, meet with the recipient to finalize a supported living plan within thirty (30) days of the recommendation. Initial plans shall follow the funding recommendations and be specific to approved supports and services;

††††† (9) Educate the recipient on their responsibilities as outlined in Section 7 of this administrative regulation;

††††† (10) Arrange for payments for currently funded supported living plans that includes:

††††† (a) Receiving bills or other documentation that a service has been provided;

††††† (b) Verifying the service as a part of the established plan;

††††† (c) Approving payment; and

††††† (d) Keeping a record of payment.

††††† (11) Arrange for billing and payment directly to a vendor for one (1) time expenditures or to an agency as requested by a grant recipient;

††††† (12) Monitor to ensure compliance with regulations and the successful implementation of plans.

††††† (a) Monitoring shall be by home visit or site visit where the services are received with home modifications requiring a home visit.

††††† (b) Monitoring reports shall be completed for each recipient as follows:

††††† 1. Within three (3) months of completion of the service for one (1) time services received by a recipient; and

††††† 2. within the first three (3) months of the initiation of the supported living plan and annually thereafter for on-going services received by a recipient.

††††† (c) Reports of monitoring visits shall be documented in a manner and format approved by the council.

††††† (d) Monitoring reports shall be a permanent part of the recipientís record.

††††† (13) Attend trainings and meetings as required by the council; and

††††† (14) Submit database information as outlined in this section to the Division of Mental Retardation Services.

 

††††† Section 14. Contract Agency Responsibilities. The contract agency for supported living funds shall:

††††† (1) Implement the Hart-supported living program in accordance with KRS 210.770, 210.790, and 210.795.

††††† (2) Assume fiscal accountability for the state funds designated for the program.

††††† (3) Provide necessary personnel within the contract agency office.

††††† (4) Establish a cost center and record staff costs for administering the Hart-supported Living Program.

††††† (5) Maintain files and records that include:

††††† (a) Applications;

††††† (b) Requests for continued funding;

††††† (c) Applications that were not funded retained for the length of time required by the Health Insurance Portability and Accountability Act of 1996, 45 C.F.R. 164.530, for seven (7) years after the fiscal year in which application was not funded;

††††† (d) Records regarding recipients whose funding was terminated retained for the length of time required by the Health Insurance Portability and Accountability Act of 1996, 45 C.F.R. 164.530, for seven (7) years or for seven (7) years past majority;

††††† (e) Currently-funded recipients;

††††† (f) Recipient plans;

††††† (g) Amendments to plans;

††††† (h) Financial records; and

††††† (1) Recipient monitoring reports.

 

††††† Section 15. Department Responsibilities. The Department shall:

††††† (1) In cooperation with the council, establish deadlines, budgets, and priorities for supported living funds;

††††† (2) Maintain aggregate financial and programmatic data;

††††† (3) Advocate for program expansion;

††††† (4) Provide staff support, technical assistance, and training for the Hart-supported Living Program; and

††††† (5) Provide monitoring of the Hart-supported Living Program.

 

††††† Section 16. Incorporation by Reference. (1) The following material is incorporated by reference:

††††† (a) "Hart-Supported Living Grant Application", July 2006 edition; and

††††† (b) "Request for Renewal", July 2006 edition.

††††† (2) This material may be inspected, copied, or obtained,. subject to applicable copyright law, at the Department for Mental Health and Mental Retardation Services, Division of Mental Retardation Services, 100 Fair Oaks Lane, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. through 4:30 p.m. (24 Ky.R. 2043; Am. 2729; 25 Ky.R. 346; eff. 8-17-98; 33 Ky.R. 1737; 2324; eff. 3-9-2007; Recodified from 908 KAR 2:190; eff. 6-19-2009.)