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Companion

Provider Requirements and Service Limitations

From The July 2007 Florida Medicaid Provider Handbook

Companion - Requirements To Receive

Description

Companion services consist of non-medical care, supervision and socialization
activities provided to an adult on a one-on-one basis or in groups not to exceed three
recipients. This service must be provided in direct relation to the achievement of the
recipient’s goals per his support plan. A companion provider may also assist the
recipient with such tasks as self-care needs, meal preparation, laundry and shopping;
however, these activities shall not be performed as discrete services. This service
does not entail hands-on medical care. Providers may also perform light
housekeeping tasks, incidental to the care and supervision of the recipient. The
service provides access to community-based activities that cannot be provided by
natural or other unpaid supports, and should be defined as activities most likely to
result in increased ability to access community resources without paid support.
Companion services may be scheduled on a regular, long-term basis.
Companion services are not merely diversional in nature, but are related to a specific
outcome or goal(s) of the recipient. Examples of acceptable companion activities are
volunteer activities performed by the recipient as a pre-work activity; going to the
library, getting a library card, learning how to use the library and checking out books or
videos for personal use; shopping for groceries; or going to an animal shelter to learn
about animals, and volunteering or assisting at the animal shelter.

Limitations

Providers of companion services are limited to the amount, duration, and scope
of the services described on the recipient’s support plan and current approved
cost plan. A recipient shall receive no more than six hours or 24-quarter hour
units of these services per day. A unit is defined as a 15-minute time period or a
portion thereof.
A recipient is limited to no more than 30 hours a week of companion services.
The unit value is 15 minutes. Companion services are used to provide a
meaningful day activity for a recipient. A recipient may not receive a
combination of ADT, companion or supported employment services that exceeds
30 hours per week. A recipient may not receive more than a total of 30 hours a
week of a paid support, or combination of paid supports designed to be used as
a meaningful day activity. The companion rate shall be based on one to three
recipients receiving the service during the same time interval. The rate ratio is
determined by what is the usual and customary service delivery pattern and
does not fluctuate with incidental absences of one or more recipients included in
the rate ratio.
Companion services are limited to adults only (21 or older). Recipients may not
receive this service in the provider’s home. This service cannot be provided
concurrently (at the same time) with adult day training, personal care assistance,
in-home support services (quarter hour), supported employment and residential
habilitation services.

Documentation Requirements
Reimbursement* and monitoring documentation to be maintained by the
provider:
1. *Copy of claim(s) submitted for payment;
2. *Copy of service log.
The provider must submit a copy of service log, monthly, to the waiver support
coordinator.
If the provider plans to transport the recipient in his private vehicle, at the time of
enrollment, the provider must be able to show proof of valid: 1) driver’s license,
2) car registration, and 3) insurance. Subsequent to enrollment, the provider is
responsible for keeping this documentation up-to-date.
*Indicates reimbursement documentation.
Place of Service Companion services may be provided in the recipient’s own home or family
home, or while a recipient who lives in his own home, family home or licensed
facility is engaged in a community activity. Companion services provided to a
recipient living in a licensed group or foster home must be performed in the
community, not the licensed living environment. No service may be provided or
received in the provider’s home.

Special Considerations
Companion services are provided in accordance with an outcome on the
recipient’s support plan and are not merely a diversion.
If the provider plans to transport the recipient in his private vehicle, at the time of
enrollment, the provider must be able to show proof of valid: 1) driver’s license, 2)
car registration, and 3) insurance. Subsequent to enrollment, the provider is
responsible for keeping this documentation up-to-date.
Companion services providers are not reimbursed separately for transportation
and travel costs. These costs are integral components of companion services and
are included in the basic rate.

Companion Provider Requirements


Companion Provider Requirements
Provider Qualifications Providers of companion services may be home health or hospice agencies
licensed in accordance with Chapter 400, parts III and IV, F.S. If providing
this service as an agency or group provider, using more than one employee
to provide companion services and billing for their services, the provider
must be registered as a sitter or companion provider in accordance with
section 400.509, F.S.
Independent vendors are not required to be licensed, certified, or registered
if they bill for and are reimbursed only for services personally rendered.
Minimum qualifications for a companion include: be at least 18 years of age
and have one year of experience working in a medical, psychiatric, nursing
or child care setting, or in working with recipients having developmental
disabilities. College, vocational or technical training from an accredited
institution can substitute at the rate of 30 semester, 45 quarter or 720
classroom hours for the required experience.
Training Requirements Proof of training in the areas of Cardiopulmonary Resuscitation (CPR),
HIV/AIDS and infection control is required within 30 days of initially
providing companion services. Proof of annual or required updated training
shall be maintained on file for review. The provider is responsible for all
training requirements outlined in the Core Assurances.
Note: Refer to the Core Assurances in Appendix A for the provider training
requirements.