Transitional Living Program: Functional Skills Training

The need for and benefit from functional skills training is to be determined as part of the assessment described in 130 CMR 422.438(A). At a minimum, each service agreement must contain provisions and a schedule for functional skills training in the four areas in 130 CMR 422.437(A) through (D). (A) PCA Training. PCA training must instruct the member and the member’s surrogate, if any, in the functions and scheduling of PCAs in relation to the member’s needs. (B) PCA Management. The member and the member’s surrogate, if any, will be instructed in (1) hiring of PCAs, including identification of local resources, advertising for PCAs, and interviewing techniques; (2) use of activity forms and schedules in documenting the use of PCAs and meeting the requirements for reimbursement; (3) methods for evaluating PCA competence and effectiveness and requesting assistance in dealing with training or other issues as necessary; and (4) firing and replacing PCAs, including maintenance of a backup system as necessary. (C) Personal Health Care Maintenance. The transitional living provider must instruct the member and the member’s surrogate, if any, in the respective roles of the member, the PCAs, and others who assist the member in meeting personal health care needs and the respective abilities of each to (1) identify, understand, and describe medical conditions, problems, and susceptibilities; and (2) identify, understand, and describe routines and treatments, including medication schedules and dosages, nutritional planning, bowel and bladder routine, and exercise/range-of-motion routine. (D) Emergency Management. The transitional living provider must instruct the member and the member’s surrogate, if any, to develop and review procedures to (1) describe how and when to use a physician and a local hospital emergency room; (2) identify and respond to the signs of an emergency; (3) understand the appropriate treatment, equipment, or action for dealing with an emergency; and (4) maintain a list of emergency telephone numbers and procedures for use by the member, the member’s surrogate, if necessary, and PCAs.