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iBudget Provider COVID-19: Frequently Asked QuestionsMarch 31, 2020TopicVisitationQuestionAre there restrictions onvisitors entering facilities?VisitationCan Waiver ServiceCoordinators (WSC) minimizeface to face contacts?VisitationCommunityIntegrationSite VisitsFlexibility ofWaiverServicesAre family members able to visit theirloved one receiving services in afacility setting? What if the familymember wants to take their lovedone home or for an outing during thispublic health emergency?Can a companion worker take aresident of a group home into thecommunity?Will APD staff still be conductingmonthly monitoring visits in APDlicensed foster/group homes?Will APD work with providers onstaffing levels required by licensureif they experience asignificant shortage in staff due toillness.AnswerYes. To protect the health and safety of residents in a long-term care facility,group home setting, or Institutional Care Facility (ICF), visitation in these livingsettings has been suspended with few exceptions. See Emergency Order DEM20-006 more information.Yes. Providers should employ alternative forms of communication such astelephonic or video conferencing in lieu of in-person visits. Please refer to theMarch 13, 2020 waiver support coordinator (WSC) Advisory for nsumer%20Contact%20Requirements.pdf.In addition, support plans and waiver eligibility worksheets can be completedtelephonically temporarily. Once the in-person visits are re- instated, WSCsshould conduct a visit in recipients’ homes to assess the safety of the livingenvironment.Emergency Order DEM 20-006 allows family visits in the facility only in the caseof end of life situations. If the family wants to take their family member home orfor an outing during this time, they may do so. However, it is stronglydiscouraged. Prior to being allowed to reenter the group home or ICF, theperson must pass the pre-screening questionnaire.This is strongly discouraged. Prior to being allowed to reenter the grouphome after a community outing, the resident must pass the pre-screeningquestionnaire.Yes. The APD monitoring staff will continue to conduct monthly monitoringvisits unless otherwise advised.APD and AHCA are requesting flexibility with federal requirements toaddress this.

iBudget Provider COVID-19: Frequently Asked QuestionsMarch 31, 2020TopicFlexibility ofWaiverServicesFlexibility ofWaiverServicesQuestionFor group/foster home residentsunder the age of 21 who are out ofschool, can companion services beprovided in the licensed home whileout of school?Can a therapist do telehealth visits forMedicaid waiver clients or CDC ? If so,would they charge the same rate orwhat would the rate be? Will theprovider need an authorizationmodifying it as a telehealth visit?AnswerNo. At this time companion services can only be authorized for individuals ifthey are 22 or older.iBudget Waiver providers should deliver telemedicine iBudget waiver or CDC services following the same guidance regarding telemedicine as was sent out byAHCA in the Medicaid Provider Alerts on March 18, 2020 and can be found onAHCA’s COVID-19 webpage. Providers should deliver waiver services in the homewhenever possible and only utilize telemedicine if: Services cannot be delivered because the center is closed (when servicesare delivered in the center) and home-based care is not an option; orThe provider and/or the recipient meet one or more of the self-screeningcriteria for COVID-19 in accordance with the Department of Healthguidelines and services cannot be delivered in the home.Additional prior authorization is not required for transitioning a service to atelemedicine modality. Services provided via telemedicine will be paid at thecurrent service rate.Flexibility ofWaiverServicesSince behavioral services require that75% of their time be face-to-face, canthis be waived or reduced so morefrequent phone calls can be madebetween behavioral staff andGH/PS/SLC staff?iBudget Waiver providers should deliver waiver services via telemedicine followingthe same guidance that was sent out by the AHCA in the Medicaid Provider Alertson March 18, 2020 and can be found on AHCA’s COVID-19 webpage. We areasking providers to provide waiver services in the home whenever possible andonly utilize telemedicine if: Services cannot be delivered because the center is closed (when servicesare delivered in the center) and home-based care is not an option; orThe provider and/or the recipient meet one or more of the self-screeningcriteria for COVID-19 in accordance with the Department of Healthguidelines and services cannot be delivered in the home.

iBudget Provider COVID-19: Frequently Asked QuestionsMarch 31, 2020TopicFlexibility ofWaiverServicesQuestionWill background screeningrequirements be lifted during thepandemic to allow providers tomaintain staffing ratios? Some LiveScan facilities are closing.AnswerProviders MUST perform all service components designated in the iBudget WaiverHandbook for the procedure code billed and be appropriately reflected in theindividual service plan.AHCA released guidance on March 28, 2020 that provides information onflexibilities surrounding background screening. When a criminal background checkis required, a provider must first review the Clearinghouse Results Website toverify if the candidate has a current Level 2 screening. If the candidate does nothave a current Level 2 screening or the provider is not able to initiate an AgencyReview or Resubmission on the candidate in the Clearinghouse Results Website,then the provider must make every effort to find a Livescan Service Provider thatwill process fingerprints for a Level 2 screening. The alert also describes theprocess providers should use to handle cases where the candidate is not in theClearinghouse and they are unable to initiate Level 2 screening due to the inabilityto access a Livescan site to be fingerprinted.This information can be found on AHCA’s COVID-19 webpage athttp://ahca.myflorida.com/covid-19 alerts.shtml. Under “Facility Information,” itis titled “Health Care Provider Background Screening.” The web page provides themost up-to-date information about the flexibilities we are enacting to ensure ourrecipients continue to receive services and the ways the Agency is responding tothe needs of the community.Flexibility ofWaiverServicesFlexibility ofWaiverServicesSince many ADTs have closed, will theresidential habilitation providers beable to bill at an enhanced rate orwould they have to have a serviceauthorization for ADT?There is a concern about the timelinefor implementation plans and this is arecoupment issue. Will support plansbe issued during this time period? If so,Residential habilitation is considered a 24-hour a day service. Residentialhabilitation providers will not be paid at an enhanced rate for individualsremaining in the home in lieu of attending ADT. However, ADT providers mayrender the ADT service at an alternate setting such as a group home.The State will allow for the use of telephonic support plan development for anyplans that expire during the emergency period. If telephonic or video conferencingis unavailable, extensions will be granted. Upon receipt of the support plan, the

iBudget Provider COVID-19: Frequently Asked QuestionsMarch 31, 2020TopicFlexibility ofWaiverServicesFlexibility ofWaiverServicesADTsADTsADTsADTsQuestionwill implementation plans have to beimplemented within 30 days ofreceipt?Will timelines for quarterly and annualreports be waived or extended duringthis time period?Answerexpectation is the implementation plan would be developed using similarmethods, if required, within the established timeframes.APD offices around the state areclosing but some are still planning forthe BCBA to hold LRC? Can the reviewsbe extended?Will APD require ADTs providingservices to more than 10individuals to close?All LRC meetings are being held telephonically for the duration of the emergency.It is strongly recommended that each provider contact their LRC Chairperson toclarify proper submission of documents (including behavior plans and data) withinHIPAA encryption requirements.Not at this time. If ADT providers are required to close, we will allow ADTservices to be provided in other settings.What are ADT's to do if a person getssick while at the ADT and the grouphome refuses to pick them up citingno staff to work during ADT hours?If ADT programs are closing and theperson will be remaining in his/herown home with personal supports,how could additional hoursbe authorized?If ADT programs wish totemporarily close to reduce thepotential spread of the virus, arethey required to give a 30-daynotice?Yes. The State has requested federal flexibility on waiver reporting requirements.Providers should consult with APD to determine which reporting deadlines havebeen waived or extended.AHCA will be making advanced Medicaid payments to ADT providers to helpaddress the financial hardship sustained during this state of emergency.Please refer to the iBudget Provider Payment Flexibility provider alertdistributed by the Agency dated March 18, 2020 for more information.Group homes are required to have adequate staffing to meet client needs.Notify the APD Regional Operations Manager immediately for incidents of thisnature.The provider should work with the client’s waiver support coordinator to shiftany available unallocated funds to cover the additional hours needed.No. ADT programs who wish to temporarily close do not need to give a 30- daynotice. However, the ADT should work with the individuals’ WSCs so thatalternative services can be arranged.

iBudget Provider COVID-19: Frequently Asked QuestionsMarch 31, pSuppliesSafetyProtocolsQuestionCan closed ADT programs beconsidered as possible quarantinesites for group home residents whobecome infected with COVID-19?Can providers offer offsite ADT, virtualADT, or have staff work at homeproviding client oversight and stillcount this as ADT services provided?If facility programs are required toclose,providers indicate their business riskinsurance will likely not cover theexpenses they will incur.Can providers bill more frequentlythan once per month? This wouldassist with cash flow to handleadditional protective and infectioncontrol costs and other supportservices that may be needed.When will assistance be available toassist providers in obtainingprotective and cleaning suppliesconsidering these items are beingrationed and in some cases such asbarrier gowns are not available?If a client is exposed to or contractsCOVID-19 what protocol should thefacility take before the person isable to return?AnswerThis may be considered as an option should that become necessary.ADT may be provided off site but cannot be provided via telemedicine. ADT mayalso be rendered in alternative settings, including in the group home or theindividual’s own home.The State of Florida is exploring potential options for affected businesses.Providers are encouraged to complete the Business Damage AssessmentSurvey at www.floridajobs.org.Services that can be billed more frequently include quarter hour and dailyservices. Services must be billed in accordance with the approved serviceauthorization.The entire country is struggling with an extreme shortage of personal protectiveequipment (PPE), including masks. Please attempt to use your existing supplychain to order any needed masks and other PPE. The County EmergencyOperations Center (EOC) is a resource to obtain necessary supplies in anemergency. Although counties do not have excess supplies at this time, if youhave not submitted a request already, you can submit a request to your CountyEOC. This will help to inform the statewide prioritization of supplies as theyarrive in Florida.Providers should follow the CDC guidelines and protocols published by theDepartment of Health. They are providing the most up-to date information asthe situation evolves.