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COVID-19 Frequently Asked Questions

General Information (Last Revised August 13, 2021)

  1. Should DDD conduct in-person Support Coordination visits with members during the COVID-19 public health emergency (PHE)? (Added February 11, 2021)
    Planning meetings are still being held virtually as COVID-19 continues to impact Arizona. These meetings are important and necessary. Members should be involved in the meeting and on the video so their Support Coordinator can see them. Members who cannot attend online should tell their Support Coordinator so they can set up a phone call or in-person meeting with all team members. In-person meetings require safety measures including:
    •    All attendees wearing masks.
    •    Social distancing.
    •    Holding the meeting outdoors if possible.
     
  2. What kind of additional guidance/communication can we expect from DDD/AHCCCS? (Updated August 11, 2021)
    AHCCCS has an FAQ page and DDD has published a webpage that includes FAQs as well as other information related to COVID-19. This webpage is updated as new information becomes available.
     
  3. What is the process for notifying DDD of changes to service delivery or service location?
    Please refer to the Pandemic Performance Plan Service Delivery Changes  vendor announcement sent on March 12, 2020.
     
  4. What is the expected turnaround time for DDD staff to approve a request for a change in service delivery for a specific member or a change in service location when the request is sent to the [email protected] email as directed in DDD’s March 12, 2020, vendor announcement?
    We apologize for the delays providers have experienced in receiving responses.  You can expect to receive a response within 24-hours.
     
  5. What is the new process for Support Coordination planning meetings?
    Please refer to the COVID-19 Update vendor announcement sent out on March 17, 2020.
     
  6. If a member needs additional services or supports, can DDD respond quickly by approving additional services or supports? What if an individual cannot go to their day program, will DDD authorize attendant care or respite services they do not already have in their ISP so the member can receive services in the home? (Updated April 8, 2020)
    The Support Coordinator can assist with reassessment of a member’s needs at any time. Additionally, DDD has authorized Day Treatment services to be authorized in the home.  Please see 'Day Treatment Programs' section at the bottom of the FAQ for more information about the alternate service delivery option. 
     
  7. Can DDD members temporarily increase their home-based service hours as other services are being suspended or canceled and schools are closed?
    The Support Coordinator can assist with reassessment of a member’s needs at any time.
     
  8. What measures has DDD taken in relation to monitoring and licensing requirements? (Updated August 11, 2021)
    DDD On-Site Program Monitoring Visits and Life Safety Inspections of all service settings resumed the week of May 3, 2021. All visits are being conducted following CDC and ADHS COVID-19 protocols, including wearing masks and social distancing.
  1. What is happening with Program Review Committees?
    Beginning Thursday, March 19, 2020, all scheduled PRC meetings will take place through Paper Review. This means the Behavior Treatment Plan will be reviewed by the member’s team telephonically. Each plan will have careful consideration of the requirements and teaching methodology. When the committee has completed the review, the Disposition with Recommendations/Approvals will be sent to the Qualified Vendor/Provider and Support Coordinator. If you would like to request a Full Review rather than a Paper Review, please contact your District PRC Chair (see below) to request a telephonic Full Review.

    If there is an emergency review request, please send the request to your District PRC Chair and the DDD Behavioral Health Administration at [email protected]. 

  2. Is a signature required on a medication review when turning in a behavioral treatment plan (BTP) to the Program Review Committee (PRC) since behavioral health visits are often occurring via telehealth? (Added July 30, 2020)
    Although it is considered best practice to require signatures on medication reviews, there is no current policy that requires this. The intention of the medication review is to ensure and verify that there are no adverse medication side effects and that data is being reviewed with the prescribing physician to evaluate the need for a possible reduction of behavior modifying medication. In order to document this, the vendor should provide a copy of the medical notes/progress notes from the office visit (in-person or telehealth) from the prescribing physician. This will eliminate the need for agency-created forms and duplication of work by the prescriber and avoid the issue of prescribers being reluctant to complete outside forms.
     
  3. Do providers still need to conduct in-person supervisory visits of Direct Care Workers?
    DDD is suspending in-person supervisory visits. Supervisory review of case notes/charts should continue to the extent possible, as well as supervisory engagement with staff via available telephonic or other electronic means.
     
  4. Will DDD consider temporary changes to the Direct Care Worker (DCW) requirements for family members who reside with a member over age 18 to streamline hiring of family members in cases where there is no provider or where there are concerns of exposure due to providers coming into the home? (Updated August 11, 2021)
    As communicated on June 4, 2021, AHCCCS announced changes to several COVID-19 flexibilities that will impact DDD members and the professionals who support them. The Division has received clarification regarding the termination of the Direct Care Worker (DCW) training flexibility. Effective July 1, 2021, all DCWs will be required to complete their training requirements within 90days of their hire date. This means all agency employees providing Attendant Care services (ATC) or Housekeeping (HSK) must complete the mandatory Direct Care Worker training, including parents providing these services to their minor children. The target date for completion is September 30, 2021.

    Qualified Vendors that believe they will be unable to comply by this date may submit a compliance plan to the Division no later than August 30, 2021, documenting their plan to bring their employees into compliance and the anticipated date of compliance.
    Questions about this requirement and compliance plans should be submitted via email to [email protected].
     

  5. Are the requirements for keeping patient information private and secure different during the emergency?
    On March 17, 2020 the Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced, effective immediately, that it will exercise its enforcement discretion and will waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communication technologies during the COVID-19 nationwide public health emergency. More information can be found at the HHS Office of Civil Rights and SAMHSA.
     
  6. Has the Respite benefit limit been increased to 720 hours? (Updated August 11, 2021)
    The limit for respite hours was increased from 600 hours to 720 hours. That extension will revert to 600 hours per benefit year on October 1, 2021.
     
  7. How is DDD documenting signatures for the ISP, spending plan and other planning documents since DDD began completing virtual 90-day reviews on March 17, 2020? (Updated August 13, 2021)
    Support Coordinators are obtaining verbal consent for the plan during the virtual meeting (agree/ disagree) and documenting this consent in the member’s planning document. Within ten (10) days after the meeting, the DDD Support Coordinator sends the planning document to the member, qualified vendor(s) and other team members via secure email or US postal service as determined by the team member’s preference. Signatures are collected electronically unless the planning meeting is held in person.
     
  8. Is a parent or family member who is being paid to provide services for a DDD member required to report those payments as "wages earned" for unemployment insurance benefit eligibility? (Added July 30, 2020)
    Yes. Unemployment Insurance benefits are determined based on monetary and weekly eligibility criteria established by federal regulations and state law. When filing a weekly unemployment insurance claim all earnings must be reported and may impact unemployment benefits. More information can be found at https://des.az.gov/services/employment/unemployment-individual/weekly-unemployment-insurance-benefit-claims-reported-earnings.
     
  9. Can vendors be paid to provide care when a member needs support to access healthcare during an inpatient hospitalization during the COVID 19 emergency? (Added September 24, 2020)
    If the planning team has determined that the hospital does not have staff (often referred to as a "sitter") to offer support and the member does not have natural supports such as a parent, guardian, or a close family member; or if the support available is not enough to cover the level of support the member needs, the team may assess for and authorize attendant care to support the member during an inpatient hospital stay.
     
  10. If a member goes home from a residential setting with a family member to self-isolate and the parent wants to be employed by the agency, what service would this be under and are the parents exempt from needing fingerprint clearance? (August 11, 2021)
    The member’s planning team will assess needed services. The only service that exempts parent providers from the fingerprint requirement is Attendant Care. For all other services, parents are required to meet the fingerprint requirement.

Telehealth (Last Revised August 11, 2021)

  1. Which DDD services are authorized to be provided via telehealth? (Updated August 11, 2021)
    Effective for services delivered on or after March 17, 2020, DDD authorized the use of telehealth as outlined in AHCCCS Policy 320-I, https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/300/320-I.pdf. See AHCCCS COVID-19 Emergency Medical Coding Guidance and Telehealth Code Sets (Temporary) and Telehealth Code Set (Permanent).
     
  2. Do providers need to wait for a response from those staffing the [email protected] email before starting telehealth?
    No, any guidance given to the entire provider community may be executed upon notice via vendor announcements or posting on the DDD COVID-19 webpage.  DDD will be keeping track of the effective date of the decisions made on its webpage. 
     
  3. Will DDD reimburse at the same rate for services provided “in-person” and services provided via telehealth and/or telephonically? (Updated March 23, 2021)
    Yes, effective March 17, 2020, until the end of the COVID-19 emergency declaration, DDD will not discount rates for services provided via telehealth and telephonically as compared to contracted rates for “in-person” services. Please continue to use the member’s typical rate.
    For new members who do not have a typical or established rate, the vendors should use the clinic rate for teletherapy services.
     
  4. Can evaluations for therapy be done via telehealth? Most standardized assessments require specific testing materials, therefore cannot be administered via telehealth. Any guidance on evals for members needing them?  
    Vendors must ensure that their providers follow clinical best practice including testing standards and those set by their standards of their licensing boards and professional associations. Clinicians may determine that some members may not be best served by telehealth and some interventions may not be appropriate to deliver via telehealth.
     
  5. Is DDD considering DTA Virtual Learning/Instruction? (Updated April 14, 2020)
    Yes, the Division has posted guidance of service delivery (Delivering‌ ‌Employment‌ ‌and‌ ‌Habilitation‌ ‌via‌ ‌Telehealth‌ ‌During‌ ‌COVID) that provides details on how this can be utilized and in which settings they can be utilized.
     
  6. AHCCCS opened up the following codes (T2016, T2017, T2019, T2021, T2020) specific to the DDD Population.  What do those codes mean for DDD services? (Updated April 14, 2020)
    These codes are for habilitation services which are not typically used for telehealth services. The Division has posted guidance for service delivery (Delivering‌ ‌Employment‌ ‌and‌ ‌Habilitation‌ ‌via‌ ‌Telehealth‌ ‌During‌ ‌COVID that provides details on how these can be utilized and in which settings they can be utilized.
     
  7. Can DDD provide guidance on what providers should do if a family won't do teletherapy but have the means to do so?  (Updated April 7, 2020)
    Each clinician will need to assess if a particular member can make progress with telehealth. It may not be right for all members. If the clinician thinks that the service is clinically indicated via telehealth we will have SC reach out to the family to ensure they understand the issues/ risks and document this in a managed risk agreement (MRA). If the vendor's policy is that all visits must be telehealth, the SC can make every effort to locate an alternative vendor.
     
  8. Can a DDD vendor bill for attendant care at the same time the member is receiving employment telehealth services? (Added May 29, 2020)
    Yes, DDD will allow for both services to be billed at the same time. The understanding is these two services are different in delivery and do not duplicate. DDD recently updated U4 and U5 modifiers to be billed for telehealth services. Please ensure U codes are captured on TTE so that ATC can pay on the same day.
     
  9. During the COVID-19 emergency period, how do providers handle the informed consent requirements and treatment plan agreements/signatures and/or other documents that require a member or guardian's written consent, agreement and/or signature if they are providing services via telehealth or telephone? (Added January 12, 2021)
    During the COVID-19 emergency, providers delivering services through telehealth and telephonic means can obtain verbal consent and verbal treatment plan agreements and document the Member's/Guardian's verbal consent and verbal agreement in the Electronic Medical Record (EMR). It will not be necessary to gather retroactive signatures once the COVID-19 emergency period ends provided the documentation is in the EMR.
     
  10. For the authorized DDD telehealth services, can the a DCW (Direct Care Worker), therapist, or other provider deliver the service remotely from another State? (Updated March 23, 2021)
    Per AHCCCS policy 320-I Telehealth there are no geographic restrictions for providing authorized telehealth services as long as the telehealth provider agency is:

    1. AHCCCS registered,
    2. Not outside of the United States,
    3. Is individually licensed in the State of Arizona as applicable by provider type.

    There are no restrictions on telehealth as long as the individual telehealth provider meets all requirements set forth in the Qualified Vendor Agreement and the HCBS rules. Specifically, the Direct Care Worker (DCW) is AHCCCS registered through their Qualified Vendor agency and does not require an individual (professional) license. Individuals providing services requiring professional licensure like Therapy, are required to be individually licensed through the State of Arizona.

Billing (Last Revised August 11, 2021)

  1. How should vendors bill for approved telehealth services? (Updated August 11, 2021)

    Please note: The billing guidance below is meant to provide vendors with the appropriate telehealth modifiers, so that vendors can begin providing telehealth services without delay. DDD is currently making changes to its billing system and intends to have new modifiers added by April 8, 2020 for the initial batch of approved services. The rest will be added by the end of April.  Any claims using these new modifiers will deny if billed. Any claims billed before implementation of the new modifiers will assist DDD in tracking use of telehealth services and DDD Business Operations will work with vendors to re-bill.

    Vendor will complete the DDD Uniform Billing Template as usual, adding the appropriate Procedure Modifier under column Y, Z, or AA.  If the member is at home during the service, the POS is 12 under column X.

    For example: Service code STA [column F], POS 12 [column X], procedure modifier GT [column Y].

    Or complete the CMS 1500 or 837 as usual, adding the appropriate Procedure Modifier in Box 24 D-Modifier.  If the member is at home during the service, the POS is 12 under Box 24 B – Place of Service.
    Definitions: Place of Service - Place of service (POS) is the originating site which is the location of the AHCCCS member at the time the service is being furnished via telehealth or where the asynchronous service originates.  Many services can be provided when the member is at home.  Home is POS 12.
    Modifier GT [live] must be used depending on the type of telehealth services provided:

    GT: Via interactive “live” audio and video telecommunication systems- The use of telecommunications and information technology to provide access to health assessment diagnosis, intervention, consultation, supervision and information across distance.  Most DDD services will use this modifier.

    UD:  Via interactive "live" audio-only telecommunication systems. 

  2. How do Vendors submit claims for approved telehealth services if there is Third Party Liability (TPL)? (UPDATED March 24, 2020)
    If the member has TPL coverage, this should continue to be billed.  If you receive a clean denial you can submit the denial with the usual waiver request.  If for some reason the claim cannot be adjudicated for a clean denial due to the TPL not being set up to receive the Telemedicine modifiers and your claim gets rejected prior to adjudication, please do the following: Submit the Completed Waiver Request COBV Waiver Request Form with the Copy of the Billing Rejection. This method will be accepted for dates of service affected during the COVID-19 Crisis.  If the claims are adjudicated and denied for non-covered service for Telemedicine, this would be a clean denial reason and would be processed as usual through the waiver process.
     
  3. How frequently can a provider bill for services during this time period?
    DDD can process claims on a daily basis if necessary.  Providers can bill as frequently as  necessary.
     
  4. What other steps is DDD doing to help Vendors with Cash Flow? 
    DDD is enhancing its claims recycling where Vendors will receive hard denials for all claims that are not payable instead of the soft edit that assigned the claims to an internal pending status for recycling. Please see the additional FAQ document on the vendor announcement page for more information, Claim Recycling Frequently Asked Questions.
    .
  5. If providers are not able to provide transportation, but family members are willing to provide transportation, can DDD allow billing for GSE for individuals and job coaches (who are willing to continue to work) if their place of employment is still open?
    Yes.
     
  6. Will the Division create rates for different ratios for Employment Services? (Updated May 15, 2020)
    The Division updated the permanent rate book to include new ratios for Center-Based Employment and Transition to Employment services. The new ratios are effective April 1, 2020.

Training (Last Revised August 11, 2021)

  1. What are DDD’s expectations for Prevention & Support Training? (Updated August 11, 2021)
    In March 2020, the Division published guidance for Prevention & Support Training requiring only new employees assigned to members with Behavior Treatment Plans (in any setting), Functional Behavioral Assessments and/or who are receiving behavioral health treatment for a challenging behavior that may require physical intervention, to be certified in Prevention and Support before working with the member. Additionally, the Division allowed employees currently certified in Prevention and Support but have expired or are going to expire, to have a 90-day extension. These extensions were renewed in June 2020 and again in November 2020. All Qualified Vendor staff must become compliant with Prevention & Support training certification by September 30, 2021.
     
  2. What are DDD’s expectations for Article 9 Training? (Updated June 17, 2020)
    The Division has temporarily approved Article 9 training using live video conferencing.  We understand that conducting the assessment using the current process can be labor intensive for some training providers.  If your agency would like to try an alternative testing method during this time, you may submit your proposal to our training department via the statewide training mailbox: [email protected]. You must receive an email confirmation of approval before moving forward with your alternative testing method. A list of provider agencies conducting live video conferencing is available on our website https://des.az.gov/services/disabilities/developmental-disabilities/vendors-providers/actions_related_to_covid-19.  If you would like to be added to this list, please contact [email protected].
     
  3. What are DDD’s expectations for CPR/First Aid Training? (Updated August 11, 2020)
    Qualified Vendors are advised that staff with expired or expiring certifications must also become compliant with CPR/First Aid certification by September 30, 2021. Newly-hired employees not currently certified in CPR/First Aid, must continue to become certified using the standards outlined in the QVA before providing services without other certified staff present.
     
  4. Can CPR/First Aid classes be completed online? (Updated June 17, 2020)
    CPR/First Aid classes can be completed via a credible online/virtual format sponsored by a nationally-recognized organization with in-person evaluation occurring following the conclusion of the COVID-19 emergency.
     
  5. If in-person training is not available for Prevention and Support, will video training be authorized temporarily?  Can providers consider staff from other agencies not to be a new hire – in other words, can their training and credentials be portable to another agency so they can begin working right away and help fill in as needed? (Updated August 11, 2021)
    As indicated in the vendor announcements provided March 18, 2020, and June 17, 2020, only new members with Behavior Treatment Plans (in any setting), Functional Behavioral Assessments and/or who are receiving behavioral health treatment for a challenging behavior that may require physical intervention, must be certified in Prevention and Support before working with the member.
     

    The Division encourages Qualified Vendors to provide staff copies of their entire training record to facilitate their ability to work across vendors, if needed. Central Registry checks need to be completed anytime staff move between agencies as per current procedures

  6. What is DDD providing for Instructor Clinics for Article 9 and Prevention and Support? (Updated June 17, 2020)
    Article 9
    Article 9 Instructor Certification clinics will resume for NEW instructors only.  Class size will be limited to eight and will only be hosted in Phoenix, Arizona although applications statewide will be  considered.  Applications will be  processed in the order they are received and those that were submitted in February and March of this year, will be contacted.  Please contact Tim Payne at [email protected] for more information. 
     
    Article 9 instructors whose certifications have expired or are going to expire, will be given the option to be observed teaching the course on a day and time agreed upon by the instructor and Lead Instructor who will be observing them. Upon a passing observation, they will be given a renewal certificate.  
     
    Prevention and Support
    If you, or someone in your agency had previously attended the Prevention and Support New Instructor Clinic and were in the process of becoming certified, please contact Tim Payne at [email protected] for more information about how to continue the certification process. 
     
    Prevention and Support instructors whose certifications have expired or are going to expire, will be given the option to be observed teaching the skills portion of the course on a day and time agreed upon by the instructor and Lead Instructor who will be observing them.  Upon a passing observation, they will be given a renewal certificate.  Please contact Tim Payne at [email protected] to arrange for recertification.

  7. The American Red Cross website states that only compressions should be done in an emergency situation during the COVID-19 Pandemic. Per DDD contract requirements, are we required to perform rescue breaths and compressions regardless of the pandemic situation? Or are we only supposed to be doing compressions to reduce potential exposure? (Added September 18, 2020)
    During the pandemic, vendors and providers  should follow the Red Cross Guidance for First Aid/CPR/AED Care During COVID-19, https://www.redcross.org/take-a-class/coronavirus-information/first-aid-cpr-aed-care-during-covid-19.

  8. Is there any time I will have to bring staff training into traditional compliance (sooner than the end dates that DDD has provided as a COVID 19 flexibility)? (Added January 12, 2021)
    Yes. if your agency has an incident that requires that staff be re-trained as part of the remediation plan. The Division's Qualify Management Unit will tell you which specific staff and which training(s) will be required to be updated, based on the incident. 

Guidance for Residential Facilities and Congregate Settings (Last Revised August 11, 2021)

  1. What procedures should be used for ICFs and other Long-Term Care Facilities? (Updated August 11, 2021)
    Qualified Vendors providing services in ICFs and long-term care facilities should reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  2. What procedures should be used for congregate settings like DDD Group Homes and Developmental Homes? (Updated August 11, 2021)
    Qualified Vendors providing group home or developmental home services should reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  3. Are providers able to provide services to members in different locations like hotels or other non-licensed settings if the member tests positive? (Updated August 11, 2021) 
    Yes. AHCCCS has received this authority from CMS. DDD has guidance for alternative settings in the COVID-19 QVA Guidance for Congregate Settings (Group Homes / Developmental Homes) document. 

Developmental Home Specific (Last Revised April 14, 2022)

  1. Are quarterly visits to the provider’s home mandatory even if the member is highly immune-compromised or there are other concerns regardless if someone is ill? (Updated April 5, 2022)
    Beginning April 5, 2022, Qualified Vendors should resume in-person monthly monitoring as required by Provider Manual Chapter 51. During in-person visits, licensing staff are required to adhere to all COVID-19 pandemic protocols, including social distancing and wearing masks during the visit. If an in-home visit is unable to be completed due to COVID-19-like symptoms or exposure, a virtual visit may be completed and documented in the contacts screens in Quick Connect.
     
  2. What platform will be utilized for virtual visits?
    This will be up to your particular agency. The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has announced that during the COVID-19 national emergency it will exercise enforcement discretion and will not impose non-compliance penalties for HIPAA rules for covered providers for good faith provision of telehealth (virtual visits) services. HHS OCR has provided guidance that the following applications are approved and recommended: Apple FaceTime, Facebook Messenger video chat, GoogleHangouts video, Zoom, & Skype. HHS OCR further has, specifically, indicated that Facebook Live, Twitch, TikTok are not approved for telehealth (virtual visits) services. Additionally, the Division of Developmental Disabilities (DDD) has determined that telehealth using video shall not be used in any space that could compromise physical privacy (i.e. in a member’s bathroom).
     
  3. Does DDD’s temporary approval of parents of minors to be paid to provide care apply to foster parents? (Updated August 11, 2021)
    No. If they are a foster family home and they have a DD child who needs specialized care they need to speak to their licensing agency about becoming DD Certified through a DDD Qualified Vendor of Developmental Home services. They should contact their licensing agency or  OLCR for assistance, [email protected]. 
     
  4. Are all Developmental Home monitoring visits required to be completed in person during the COVID-19 public health emergency? (Rescinded April 5, 2022)
    As required by Provider Manual Chapter 51, developmental home licensing workers must conduct one in-person home visit per quarter (Jan-Mar, Apr-Jun, Jul-Sep, Oct-Dec) using DES Form LCR-1079A. Beginning January 17, 2022, all other monthly monitoring visits may be completed virtually using a video-conferencing platform. Licensing workers must still complete one unscheduled in-person visit per calendar year. During in-person visits, licensing staff are required to adhere to all COVID-19 pandemic protocols, including social distancing and wearing masks during the visit.

Group Home Specific (Last Revised August 11, 2021)

  1. DDD has asked us to screen staff and visitors for illness. Can we ask if group home staff and visitors have a fever instead of actually taking their temperatures?  (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  2. Are Vendors expected to purchase their own supplies i.e. alcohol, masks, etc.?
    Vendors are responsible for purchasing Personal Protective Equipment (PPE) and for sanitation. DES DDD has provided Value Based Payment to offset COVID 19 costs.
     
  3. Should we seek testing anytime we suspect someone may have COVID-19? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  4. What if a staff member is cleared by their doctor without a test or 14-days of quarantine? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  5. Are there guidelines on how staff can enter and exit an infected person's room without furthering the spread? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  6. Are group homes going to be allowed to provide day treatment services in the group home settings if members are choosing to remain at home?
    See DDD FAQ Day Treatment FAQ #5... When members live together the Vendor should consider if it can provide the services in a the member’s family home or developmental home at 1:2 or 1:3 rates. For members who live in a group home and can’t or don’t want to go to Day treatment programs, we will support a meaningful day with adjustments to the residential staffing schedules (DDD codes HAB, HPD), as needed, instead of with Day Treatment services.
     
  7. Nursing Supported Group Homes have concerns with the therapies being delivered by telehealth  in a residential setting:  
    • *Require an aide or nurse to be with the resident throughout the sessions.  
    • *Neither the aides nor the nurses are trained to do these therapies and there are safety concerns. *These therapies are taking staff away from their other responsibilities.
      If there's a particular member who might not be appropriate for telehealth, please elevate to the member’s planning team; however, nursing and direct care staff should be trained and be implementing the members' therapy programs.
       
  8. If a day treatment setting is used for quarantine and is currently licensed as a day treatment setting, would it need to be inspected before being used? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  9. Is there a way to expedite approval of staffing matrices (schedules) especially negotiated rates to avoid billing pressure on the Group home? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.
     
  10. Does the vendor need to hold a place in the group home or developmental home if a Member or family  temporarily moves out of a group home or developmental home to their family home due to group home or developmental home staffing issues or COVID 19 concerns/mitigation strategies? (Updated August 11, 2021)
    Yes. On August 3, 2021, Gthe CDC issued an eviction moratorium that runs through October 3, 2021, which prevents evictions in any county experiencing substantial or high levels of COVID-19 transmission. The Division will continue room and board authorizations for up to 30 days after the member temporarily moves home to their family home.  Please see Question # 18 on AHCCCS General COVID 19 questions which specifically addressed group homes during the COVID 19 emergency.

 
 

Day Treatment Programs (Last Revised August 11, 2021)

  1. Is the intent of the alternate delivery for Day Treatment announced on March 25, 2020, to allow for a 1:1 Day Treatment rate without the enhanced staffing justification? Is the intent to help families and developmental home providers who have no back up plans if the program closes (they must continue to work, for example)?  Will this only be offered to those with no other options as a last resort?
    The alternative delivery option was approved to provide more ways to flexibly support members who live in their family home or a developmental home. The intent is to try to provide consistency to the member by allowing a person who usually works with him/her to continue to do so. Enhanced rates (1:1 or 1:2 as published in the Division’s rate book) will not require prior approval during the period of emergency.

  2. Is the intent of the alternate delivery for Day Treatment announced on March 25, 2020, to convert all day programs to a one-on-one service model? The nature of the day programs is a group setting. As such, there will not be enough staff to work full days with each of the members on a one-on-one basis daily.
    No. This is simply an option for Day Treatment Vendors to consider during this emergency time period  Based on surveys that DDD has conducted with members, families, and providers, the supply of available Day Program staff is greater than the demand for in-home care in the family home or developmental home.

  3. Day Treatment programs are 7 to 8 hours per day. Under this alternate approach, how many hours per day are being considered? 
    Each member will be assessed based on his or her need for the service.

  4. If Day Treatment Programs are only providing Day Treatment for a few hours/day or week as determined by the families will the responsibility of running and tracking goals be waived? Also, can providers get permission to not run any DTA/HAH goals that require community involvement (shopping, learning to use mass transit, socialization, etc.), Or should providers document COVID-19 as a barrier?
    No. Day Treatment and Habilitation services will still require that member’s goals and outcomes be implemented. However, specific outcomes may need to be modified to accommodate social distancing or stay-at-home orders.

  5. Does DDD have guidelines on how providers should handle DTA participants who present with symptoms of colds or respiratory infections such as coughing, runny nose, etc? (Updated August 11, 2021)
    Please reference the COVID-19 QVA Guidance for Congregate Settings and Direct Care Workers document located in the Resources for Qualified Vendors and Providers section of the Actions Related to COVID-19 web page for the latest guidance.

  6. How does the alternate delivery for Day Treatment announced on March 25, 2020, work for members who live in a group home or developmental home and attend a Day Treatment by the same provider?
    When members live together the Vendor should consider if it can provide the services in a the member’s family home or developmental home at 1:2 or 1:3 rates. For members who live in a group home and can’t or don’t want to go to Day treatment programs, we will support a meaningful day with adjustments to the residential staffing schedules (DDD codes HAB, HPD), as needed, instead of with Day Treatment services.

  7. What will providers need to provide the Division with in order to begin providing the alternate delivery for Day Treatment announced on March 25, 2020?
    Vendors need to coordinate with the support coordinator and member teams, who will document in the member record.

  8. What verification will the Division require in order to bill the service? Will providers simply bill DTA or will there be a special code? Can billing for in-home DTA services be adjusted to reflect either half day or full day billing, as opposed to the current hourly billing?
    The Division will not require additional verification or approval to bill for Day Treatment in a member’s home or developmental home. Vendors must bill published rates and use the Place of Service Code (POS) 12.

  9. Can a developmental home provider be paid to provide 1:1 DTA to a member in their home?
    No. The purpose of allowing the flexibility for Day Treatment 1:1 in a developmental home is to provide habilitation and supervision to a member while a  developmental home provider is working outside the home. If the developmental home provider is available to provide habilitation to the member, then day treatment should not be assessed

Remote Learning (Last Revised October 20, 2020)

  1. What services can be assessed to help a child during remote learning? (Added September 8, 2020)
    Attendant Care and Nursing are the only two services that can be assessed to assist members with remote learning during school time. These services can only be delivered by agency providers. Parents cannot be paid caregivers to provide these services during school time.
     
  2. Can HAH be assessed to assist members with remote schooling? (Added September 8, 2020)
    No, the Code of Federal Regulations prohibits the delivery of Habilitation services during school time. “Services not included. The following services may not be included as habilitation services: Special education and related services (as defined in sections 602(16) and (17) of the Education of the Handicapped Act) (20 U.S.C. 1401 (16) and (17)) that are otherwise available to the individual through a local educational agency”.
     
  3. Can parents who under existing COVID-19 flexibilities are being paid to be direct care workers for their minor children and are providing Attendant Care continue to deliver that service for remote learning? (Added September 8, 2020)
    No, parents who have become paid direct care workers for their minor children during COVID-19 cannot be paid to provide care during remote learning time. Any assessed services for remote learning time must be provided by a non-parent direct care worker who is an employee and subcontractor of a Qualified Vendor or by an Independent Provider.
     
  4. Can parents who under existing COVID-19 flexibilities are being paid to be direct care workers for their minor children continue to be paid to deliver services? (Added September 8, 2020)
    Yes, as long as the services have not been assessed to provide remote support for educational time . Parents who qualify  may be paid to provide assessed medically necessary home and community based services during non-school time during the COVID-19 emergency. (see question 3).
     
  5. What should a Support Coordinator do if a parent who has been being paid to provide attendant care for their minor child disagrees with the new guidance prohibiting them from providing these services during school time? (Added September 8, 2020)
    The Support Coordinator should work with the parent to understand that The DDD Remote Learning Policy  prevents them from being paid to provide those services during school time, but those services can still be provided by provider employed by a Qualified Vendor or by and Independent provider so the member can continue to get the support they need. The parent can call the Customer Service Center to file a grievance they choose.
     
  6. Can the need for remote support be considered for either direct support activities or supervision within a virtual learning environment? (Added September 8, 2020)
    Yes, the assessment can consider either direct care or need for supervision for remote learning time based on the member’s needs.
     
  7. What about using Day Treatment Services for homework? (Added September 8, 2020)
    Day Treatment is a service that supports members' habilitative outcomes, not homework.
     
  8. What happens if a school offers to send a paraeducator to the family home for the school day but the family declines and would prefer to use the service option we have? (Added September 8, 2020)
    Members should avail themselves of available support from their school. The assessment for support during Remote learning requires a determination if there is available support to help a student engage in remote learning. Therefore, if a paraeducator is available, the Division would not fund support.
     
  9. Can service be assessed for members who participate in the  Empowerment Scholarship Account (ESA) Program? (Updated October 20, 2020)
    No, the ESA provides funds for families to provide educational options for qualified Arizona students. By opting out of the public-school system and accepting an ESA, applicants can seek a range of alternative educational services such as private schools, home-based education, tutoring, and educational therapies (for students with disabilities only) using state funds. The ESA program is not considered either a synchronous or asynchronous Remote Learning model related to the COVID-19 pandemic and therefore DDD services cannot be assessed for members participating in the ESA program. More information about the Empowerment Scholarship Account (ESA) program can be found at https://www.azed.gov/esa/frequently-asked-questions.
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