Rule 24-2-30.1 - Supervised Living Services for Intellectual/Developmental Disabilities Service ComponentsA. Supervised Living Services provide individually tailored supports which assist with the acquisition, retention, or improvement in skills related to living in the community. Learning and instruction are coupled with the elements of support, supervision, and engaging participation to reflect the natural flow of learning, practice of skills, and other activities as they occur during the course of a person's day. Activities must support meaningful days for each person. Activities are to be designed to promote independence, yet provide necessary support and assistance. Agency providers should focus on working with the person to gain maximum independence and opportunity in all life activities. Agency providers must ensure each person's rights, as outlined in Chapter 14. Services must optimize, but not regiment, a person's initiative, autonomy, and independence in making life choices, including, but not limited to, daily activities, physical environment, and with whom to interact.B. Supervised Living Services must include the following supports as appropriate to each person's needs: 1. Direct personal care assistance activities such as:2. Instrumental activities of daily living which include:(a) Assistance with planning and preparing meals;(d) Assistance with mobility both at home and in the community;(e) Supervision of the person's safety and security;(i) Facilitation of the person's participation in community activities;(j) Use of natural supports and typical community services available to everyone;(l) Participation in leisure activities;(m) Development of socially valued behaviors; and(n) Assistance with scheduling and attending appointments.3. Methods for assisting people arranging and accessing routine and emergency medical care and monitoring their health and/or physical condition. Documentation of the following must be maintained in each person's record:(a) Assistance with making doctor/dentist/optical appointments;(b) Transporting and accompanying people to such appointments; and(c) Conversations with the medical professional if the person gives consent.4. Transporting people to and from community activities, other places of the person's choice, work, and other sites as documented in the Activity Support Plan and the Plan of Services and Supports.5. Employees the person invites to the Plan of Services and Supports meeting must be allowed to attend and participate in the development and review of the person's Plan of Services and Supports.6. If Supervised Living Services personnel were unable to participate in the development of the person's Plan of Services and Supports, employees must be trained regarding the person's plan prior to beginning work with the person. This training must be documented, in a manner as defined by DMH.7. Orientation of the person to Supervised Living Services, to include but not limited to: (a) Familiarization of the person with the living arrangement and neighborhood;(b) Introduction to support personnel and other people living in the home (if appropriate);(c) Description of the written materials provided upon admission; and(d) Description of the process for informing people/parent(s)/legal representative(s) of their rights, responsibilities, and any agency provider policies prior to or at the time of admission.C. Meals must be provided at least three (3) times per day, and snacks must be provided throughout the day. Documentation of meal planning must be available for review, and documentation must include development of a menu with input from people living in the residence that includes varied, nutritious meals and snacks and a description of how/when meals and snacks will be made available.1. People must have access to food at any time. Any restrictions must be documented in their Plan of Services and Supports and/or Activity Support Plan.2. People must have choices of the food they eat. Any restrictions must be documented in their Plan of Services and Supports and/or Activity Support Plan.3. People must have choices about when and with whom they eat.D. People receiving services are prohibited from having friends, family members, etc., living with them who are not also receiving services as part of Supervised Living Services.E. In living arrangements in which people pay rent and/or room and board to the agency provider, there must be a written financial agreement which addresses, at a minimum, the following:1. Procedures for setting and collecting fees and/or room and board (in accordance with Chapter 10).2. A detailed description of the basic charges agreed upon (e.g., rent [if applicable], utilities, food, etc.).3. The time period covered by each charge (must be reviewed at least annually or at any time charges change).4. The service(s) for which special charge(s) are made (e.g., internet, cable, etc.).5. The written financial agreement must be explained to and reviewed with the person/legal representative(s) prior to or at the time of admission and at least annually thereafter or whenever fees are changed. The agreement should be developed to ensure the person's/legal representative's ability to control their own resources to the greatest extent possible.6. A requirement that the person's record contains a copy of each written financial agreement which is signed and dated by the person/legal representative(s) indicating the contents of the agreement were explained and the person/legal representative(s) is in agreement with the contents. A copy must also be given to the person/legal representative(s).7. The written financial agreement must include language specifying the conditions, if any, under which a person might be evicted from the living setting that ensures that the agency provider will collaborate with Support Coordination to arrange an appropriate replacement living option to prevent the person from becoming homeless as a result of discharge/termination from the Supervised Living Services provider.8. People must be afforded the rights outlined in the Landlord/Tenant laws of the State of Mississippi.F. People must be 18 years or older to participate in Supervised Living Services.G. There must be at least one (1) employee in the same dwelling as people receiving services at all times who is able to respond immediately to the requests/needs for assistance from the people in the dwelling. Employees must be awake 24 hours a day, seven (7) days a week.H. Newly certified service locations can have no more than four (4) people residing in the home. Existing certified service locations with more than four (4) persons cannot increase capacity.I. The setting is selected by the person from setting options including non-disability specific settings and the option of having a private unit, to the degree allowed by personal finances, in the residential setting. This selection must be documented in the person's record.J. People have freedom and support to control their own schedules and activities.1. People cannot be made to attend day services.2. Employees must be available to support a person's choice.K. For ID/DD Waiver Supervised Living Services, there must be a Supervised Living Services Supervisor for a maximum of four (4) supervised living homes. The Supervised Living Services Supervisor must meet the qualifications in Rule 11.4.C. Waiver Supervised Living Services Supervisors may be limited to supervise less than four (4) homes if deemed necessary by DMH. 1. The Supervised Living Services Supervisor is responsible for providing weekly supervision and monitoring at all four (4) homes.2. Unannounced visits on all shifts, on a rotating basis must take place monthly.3. All supervision activities must be documented and available for DMH review. Supervision activities include, but are not limited to, review of daily service notes to determine if outcomes identified on a person's Plan of Services and Supports are being met; review of meals, meal plans and food availability; review of purchasing; review of people's finances and budgeting; and review of each person's satisfaction with services, staff, environment, etc.L. People must have control over their personal resources. Agency providers cannot restrict access to personal resources. Agency providers must offer informed choice of the consequences/risks of unrestricted access to personal resources. There must be documentation in each person's record regarding all income received and expenses incurred, as well as how and when income and expenses are reviewed with the person.M. Nursing services must be provided as a component of Supervised Living Services and must be provided in accordance with the applicable scope of practice per the applicable licensure board. Nursing services must be provided on an as-needed basis. Only activities within the nurse's scope of practice can be provided. (Refer to Chapter 13). Services a nurse may provide include, but are not limited to, monitoring vital signs, monitoring blood sugar, administration of medication, weight monitoring, and accompanying people on medical appointments. For requirements regarding assistance with medication usage by non-licensed personnel, refer to Chapter 13.N. The amount of employee supervision someone receives is based on tiered levels of support determined by a person's score on the Inventory for Client and Agency Planning (ICAP) and risk reflected in the Plan of Services and Supports and the Activity Support Plan. The DMH-approved staffing spreadsheet should be used.O. Each person must have an Activity Support Plan, developed with the person based on their Plan of Services and Supports.P. Behavior Support may be provided in the Supervised Living Services home to provide direct services as well as modify the environment and train employees on implementation of the Behavior Support Plan.Q. Crisis Intervention Services may be provided in the Supervised Living Services home to intervene in and mitigate an identified crisis situation. Crisis intervention personnel may remain in the home with the person until the crisis is resolved. This could be in 24-hour increments (daily) or less than 24-hour increments (episodic), depending on each person's need for support.R. Visiting hours cannot be restricted unless associated with an assessed risk and documented in the person's Plan of Services and Supports.S. People have choices about housemates and with whom they share a room. Documentation of each person's choice(s) must be included in each person's record.T. People may share bedrooms based on their choices. Individual rooms are preferred, but no more than two (2) people may share a bedroom.