ModifiedConnecticut Insurance DepartmentPolicy N/A

Appendix K Temporary Service-Delivery Modifications

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Temporary delivery, setting, provider, personal-care, duration, and unwind requirements for specified Connecticut developmental-disability waiver services.

Policy Summary

PayerConnecticut Insurance Department

PolicyAppendix K Temporary Service-Delivery Modifications

Policy CodePolicy N/A

Change TypeModified

Effective DateN/A

Next Review DateN/A

Key ActionProviders must use only the service-specific temporary settings and modalities, comply with HIPAA requirements for telephonic or electronic face-to-face delivery, and return services to pre-pandemic delivery after the public health emergency.

SourceLink

POLICY UPDATE CHANGES

Temporary modifications expand delivery settings to include out-of-state locations, facilities, small or larger groups, individual homes, telephonic delivery, and HIPAA-compliant electronic face-to-face delivery for specified services.

Several services may temporarily include an increased amount of personal care or assistance, but personal care or assistance may not comprise the entirety of the service.

Transitional Employment and Prevocational services may temporarily be extended beyond the three-year durational limit.

The previously available option to provide specified services through a qualified provider or self-hire in a neighboring state is no longer available.

At the end of the public health emergency, services must return to pre-pandemic service delivery.

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ModifiedConnecticut Insurance DepartmentPolicy N/A

Appendix K Temporary Service-Delivery Modifications

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Temporary delivery, setting, provider, personal-care, duration, and unwind requirements for specified Connecticut developmental-disability waiver services.

Policy Summary

PayerConnecticut Insurance Department

PolicyAppendix K Temporary Service-Delivery Modifications

Policy CodePolicy N/A

Change TypeModified

Effective DateN/A

Next Review DateN/A

SourceLink

POLICY UPDATE CHANGES

Several services may temporarily include an increased amount of personal care or assistance, but personal care or assistance may not comprise the entirety of the service.

Transitional Employment and Prevocational services may temporarily be extended beyond the three-year durational limit.

The previously available option to provide specified services through a qualified provider or self-hire in a neighboring state is no longer available.

At the end of the public health emergency, services must return to pre-pandemic service delivery.

Services eligible for temporary out-of-state delivery

HIPAATelephonic or electronic delivery requirement

3 yearsTemporary durational limit extension

Not availableNeighboring-state provider or self-hire option

Pre-pandemicPost-emergency delivery standard

Temporary Service-Delivery Criteria

Temporary delivery eligibility

A listed service may use the applicable temporary modification only within the service-specific settings and modalities described, subject to HIPAA compliance where telephonic or electronic face-to-face delivery is used.

ALL of the following

Service is one of the services identified in the Appendix K temporary modifications.
Delivery uses only the settings or modalities authorized for that service.
Telephonic or electronic face-to-face delivery complies with HIPAA requirements when applicable.

Personal-care limitation

Where a temporary increase in personal care or assistance is permitted, the personal care or assistance cannot comprise the entirety of the service.

ALL of the following

Personal care or assistance is ancillary to the covered service.
Personal care or assistance does not comprise the entire service.

Temporary duration extension

Transitional Employment and Prevocational services may receive a temporary duration extension.

ALL of the following

Service is Transitional Employment or Prevocational.
A temporary extension beyond the three-year durational limit is authorized.

Neighboring-state option no longer available

The former neighboring-state provider or self-hire option is not available under the unwind update.

ALL of the following

Do not use the former option to deliver the listed services through a provider or self-hire in a neighboring state.

Duration and Service Parameters

Temporary Duration Extension

Covered servicesTransitional Employment and Prevocational services

Temporary durationMay be extended past the three-year durational limit

After the extensionServices must return to pre-pandemic delivery

Service-Specific Delivery and Provider Requirements

Note

Individualized Home: Temporary Delivery

Individualized Home may temporarily be delivered out of state or, to maintain health and safety, in a facility, in a small group, or through telephonic or electronic face-to-face means in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery; Individualized Home Supports may be provided through virtual or electronic face-to-face means as permitted by the DDS waivers.

Note

Individualized Home: Provider Eligibility

Individualized Home may be provided by an eligible individual or agency, including the specified employee and legally responsible person arrangements.

Eligible provider types: individual or agency.
Permitted arrangements include an agency employee, self-hire employee, or legally responsible person.

Delivery Terms and End-of-Emergency Requirements

Telephonic or Electronic Face-to-Face Delivery

Delivery methodTelephonic or electronic face-to-face communication

Permitted useA temporary service-delivery method for specified services

Compliance requirementDelivery must be in accordance with HIPAA requirements

Return to Pre-Pandemic Service Delivery

When it appliesAt the end of the public health emergency

Required actionServices must return to pre-pandemic service delivery

Scope

Policy Summary

PayerConnecticut Insurance Department

PolicyAppendix K Temporary Service-Delivery Modifications

Policy CodePolicy N/A

Change TypeModified

Effective DateN/A

Next Review DateN/A

SourceLink

On This Page

Note

Personal Supports: Temporary Delivery

Personal Supports may temporarily be delivered out of state, in a group setting, telephonically, or by electronic face-to-face means in accordance with HIPAA requirements.

A temporary increase in personal care or assistance through verbal cues or prompts is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Personal Supports: Provider Eligibility

Personal Supports may be provided by an eligible individual or agency through the permitted employee arrangements.

Eligible provider types: individual or agency.
Permitted arrangements include an agency employee or self-hire employee.

Note

Behavioral Support: Temporary Delivery

Behavioral Support may temporarily be delivered out of state, with expanded authorized settings that include virtual and telephonic methods in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Behavioral Support: Provider Eligibility

Behavioral Support may be provided by an eligible individual or agency provider qualified by the Department of Developmental Services.

Provider must be qualified by DDS.

Note

Individualized Day: Temporary Delivery

Individualized Day may temporarily be provided out of state or, to maintain health and safety, in a facility, in a small group, or through telephonic or electronic face-to-face means in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Individualized Day may be provided through virtual or electronic face-to-face means as articulated in the DDS waivers.
Services must return to pre-pandemic delivery.

Note

Individualized Day: Provider Eligibility

Individualized Day may be provided by an eligible individual or agency through the specified employee, self-hire, and legally responsible person arrangements.

Eligible provider types: individual or agency.
Permitted arrangements include an agency employee, self-hire employee, legally responsible person, or legal guardian.

Note

Individualized Supported Employment: Temporary Delivery

Individualized Supported Employment may temporarily be delivered in expanded settings, including virtual and telephonic methods in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Individualized Supported Employment: Provider Eligibility

Individualized Supported Employment may be provided by an eligible individual or agency through an agency employee or self-hired employee.

Eligible provider types: individual or agency.
Permitted arrangements include an agency employee or self-hired employee.

Note

Group Day Support: Temporary Delivery

Group Day Support may temporarily be delivered in the individual's home, in a one-to-one setting, telephonically, or by electronic face-to-face means in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Group Day Support: Provider Eligibility

Group Day Support is provided by an agency, specifically a private agency.

Provider type: agency.
The provider must be a private agency.

Note

Senior Supports: Temporary Delivery

Senior Supports may temporarily be delivered in expanded settings, including virtual and telephonic methods in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Senior Supports: Provider Eligibility

Senior Supports may be provided by an eligible individual or agency, including an agency employee.

Eligible provider types: individual or agency.
An agency employee may provide the service.

Note

Group Supported Employment: Temporary Delivery

Group Supported Employment may temporarily be delivered in the individual's home, in a larger group, telephonically, or by electronic face-to-face means in accordance with HIPAA requirements.

Delivery may include transferable skills and support services not specifically related to job-skill training that support community integration, workplace integration, and social interaction with people without disabilities.
A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
Services must return to pre-pandemic delivery.

Note

Group Supported Employment: Provider Eligibility

Group Supported Employment is provided by an agency through an agency employee.

Provider type: agency.
The service must be delivered by an agency employee.

Note

Transitional Employment: Temporary Delivery and Duration

Transitional Employment may temporarily be delivered in the individual's home, in a one-to-one setting, telephonically, or by electronic face-to-face means in accordance with HIPAA requirements.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
The service may temporarily be extended past the three-year durational limit.
Services must return to pre-pandemic delivery.

Note

Transitional Employment: Provider Eligibility

Transitional Employment is provided by an agency through an agency employee.

Provider type: agency.
The service must be delivered by an agency employee.

Note

Prevocational: Temporary Delivery and Duration

Prevocational services may temporarily use HIPAA-compliant electronic face-to-face or other permitted delivery methods.

A temporary increase in personal care or assistance is permitted, but personal care or assistance may not comprise the entirety of the service.
The service may temporarily be extended past the three-year durational limit.
Services must return to pre-pandemic delivery.

Note

Prevocational: Provider Eligibility

Prevocational services are provided by an agency through an agency employee.

Provider type: agency.
The service must be delivered by an agency employee.

Billing Rule

Out-of-State Delivery: Unwind Update

The temporary out-of-state delivery option is no longer available following the end of the public health emergency.

The former option applied to CLA, CRS, Individual Home Supports, Individualized Day Supports, Personal Supports, Individualized Supported Employment, and Behavioral Support Services.
Providers must no longer use the temporary out-of-state delivery authority for these services.

Billing Rule

Neighboring-State Qualification: Current Status

The former neighboring-state qualification pathway required a provider or self-hire in a neighboring state to be determined by the Department of Developmental Services to meet Connecticut provider or self-hire qualifications.

That DDS determination requirement applied to the listed services delivered temporarily in a neighboring state.
The neighboring-state option is no longer available; do not rely on the former qualification pathway for current delivery.

Applies to services using temporary Appendix K modifications

Neighboring-State Provider/Self-Hire Option

Former arrangementA provider or self-hire operating in a neighboring state

Qualification requirementThe Department of Developmental Services had determined that the provider or self-hire met Connecticut provider or self-hire qualifications for the applicable service

Current availabilityThe neighboring-state provider or self-hire option is no longer available