In-Home and Community Support

In-Home and Community Support is a direct service provided in home and community settings to participants aged 0–120 years. This service assists participants in acquiring, maintaining, and improving the skills necessary to live in the community, live more independently, and participate meaningfully in community life. To the extent that In-Home and Community Support is provided in community settings, the settings must be inclusive rather than segregated.

The services consist of assistance, support, and guidance, which may include physical assistance, instruction, prompting, modeling, and positive reinforcement. These are provided in general areas such as self-care, health maintenance, decision-making, home management, managing personal resources, communication, mobility and transportation, relationship development and socialization, personal adjustment, participation in community functions and activities, and use of community resources.

The type and amount of assistance, support, and guidance are informed by the assessed need for physical, psychological, and emotional assistance established through the assessment and person-centered planning processes. Assistance is delivered to enhance the autonomy of the participant, align with their personal preferences, and achieve their desired outcomes. The In-Home and Community Support provider must ensure the necessary level of services to enable the participant to meet these outcomes.

The assistance, support, and guidance provided may include the following areas:

1. Carrying out activities of daily living such as personal grooming and hygiene, dressing, making meals, and maintaining a clean environment
2. Learning and developing practices that promote good health and wellness, including nutritious meal planning, regular exercise, carrying through prescribed therapies and exercises, awareness and avoidance of risks (such as environmental risks, exploitation, and abuse), responding to emergencies in the home and community (such as fire or injury), and knowing how and when to seek assistance
3. Managing medical care, which includes scheduling and attending medical appointments, filling prescriptions self-administering medications, and keeping health logs and records. This may also include assistance, support, and guidance in administering medications in accordance with applicable regulatory guidance, positioning the participant, taking vital statistics, performing a range of motion exercises as directed by a licensed professional, applying prescribed treatments, and monitoring for seizure activity
4. Managing mental health diagnoses and emotional wellness, which includes self-management of emotions such as disappointment, frustration, anxiety, anger, and depression. This also involves applying trauma-informed care principles and practices, accessing mental health services, implementing the Behavior Support component of the plan, the Crisis Intervention component of the plan, and/or the Skill Building component of the plan. It may also involve collecting and recording data necessary to evaluate progress and the need for revisions to the plan
5. Participating in the development and implementation of the service plan and directing the person-centered planning process, including identifying who should attend and what the desired outcomes are
6. Managing the home, which includes locating a private home, arranging for utility services, paying bills, performing routine home maintenance, and ensuring home safety
7. Achieving financial stability through activities such as managing personal resources, general banking and balancing accounts, record keeping, managing savings accounts, and utilizing programs such as ABLE accounts