Specialized Consultation Services provide expertise, training and technical assistance in a specialty area to assist family members, support staff and other natural supports in assisting individuals with developmental disabilities and behavioral issues. It is a service covered by NC Medicaid for those on the Innovations (Medicaid C) Waiver to live as independently as desired and able in his or her home and community, remaining out of institutional care. The current service definition can be found on page 101 of the NC Clinical Coverage Policy 8-P found here.

With Specialized Consultation Services, family members and other paid/unpaid caregivers are trained by a master’s level, licensed professional to carry out therapeutic interventions, consistent with the Individualized Support Plan (ISP)/Member Care Plan. The focus of the service is more so on the care team members by providing recommendations, guidance, training, etc. The role of Specialized Consultation Services are to equip and empower the caregivers to help the individual they serve decrease negative and harmful behaviors and develop more positive ones for healthy, productive and independent living.

Activities that ARE included under this service:

  • Observing the individual to determine needs
  • Assessing any current interventions for effectiveness
  • Developing written intervention plan recommendations, which may include preventative strategies, behavioral interventions and strategies. Recommendations will clearly delineate the interventions, activities and expected outcomes to be carried out by his/her care team
  • Training of relevant persons to implement specific interventions/support techniques to include observation, collecting recorded data and monitoring implementation of support strategies
  • Reviewing documentation and evaluating the activities and revising written recommendations as needed to assure progress toward achievement of outcomes
  • Participating in team meetings and/or
  • Tele-consultation through use of two-way, real-time interactive audio and video between places of lesser and greater clinical expertise to provide behavioral consultation when distance separates the care from the individual

Activities that are NOT included under this service:

  • Individual therapy, behavioral intervention or skill development directly with the individual
  • Family therapy with or without the individual (should be met through referral for individual and/or family therapy billable to Medicaid B or primary insurance)
  • Crisis intervention (should be provided by IDD Clinical Home or Innovations Crisis Services provider)
  • General caregiver and/or provider education on IDD services and standard interventions (should be provided by Innovations Natural Supports Education provider)