Companion Care

Provider Requirements and Service Limitations
From The May 2010 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.

This service is not available to individuals enrolled on the DD Waiver – Tier Four.

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

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. if not licensed as a home health agency or a hospice.

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.