The requirements for a traditional provider to hire a family member or legal guardian to provide COMP/NOW waiver services are strictly regulated and require demonstrating specific extenuating circumstances.
Basic Rules and Prohibitions
- Representatives are excluded: Under no circumstances can a provider hire an individual waiver participant’s Identified Representative or backup representative to provide services.
- Legally responsible persons: Payment for services provided by legally responsible relatives (such as spouses or parents of minor children) is prohibited if the services are those they are already legally obligated to provide. If the family member is going to support a minor child, the hire can only be approved for care over and above what a legally responsible person would ordinarily provide.
- Eligible relatives: With proper approval, allowed family members include parents of adult participants, grandparents, great-grandparents, siblings, children, grandchildren, aunts/uncles, nieces/nephews, cousins, and legal guardians.
- Background checks: A fingerprint criminal background clearance must be obtained for the proposed family hire.
Eligible Services
Traditional family hires may only be approved and reimbursed for the following specific services:
- Community Access
- Community Living Supports (CLS)
- Supported Employment
- Respite In-Home
- Transportation
Extenuating Circumstances Requirements
To be approved, the request must clearly document that the situation meets at least two of the following three criteria:
- Lack of available, qualified employees in the area where the individual lives. This requires documentation of current agency vacancies, recent unsuccessful attempts to hire, and challenges specific to the individual (e.g., geographic location, unique individual needs).
- Extraordinary and specialized skills, education, or knowledge of the proposed family hire. The provider must submit documented proof of these skills, education, or experience working with the individual or population served.
- Most cost-effective and efficient means: A clear demonstration that compensating the family member is the most cost-effective and efficient way to provide services compared to the cost and service delays of continuing to seek unrelated staff.
Approval and Renewal Process
- Submission: The provider must complete a specific family hire request form detailing demographic information, the relationship, and documentation of the extenuating circumstances. This application must be submitted to the Intake and Evaluation Manager at the appropriate DBHDD Regional Field Office.
- Annual Renewal: Family hire approvals must be renewed annually. The individual or representative must re-apply to the regional field office at least 60 days before the Individual Service Plan (ISP) start date.
- Transitions: A new request must be submitted if the family moves to a different DBHDD region or if the individual changes to a new provider who wishes to continue employing the family member.
If a family hire request is denied by the Intake and Evaluation Manager, the individual or representative has the right to initiate a multi-level appeal process.
