1. Recreational Therapist

1.1. Description

1.1.1. The nature of the job as a Recreational Therapist is to provide 1:1 care to individuals with developmental disabilities in home and community-based settings.

1.1.2. The nature of the job is to provide a systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illnesses and/or disabling conditions, as a means to psychological and physical health, recovery and well-being. Further, "Recreational Therapy” means a treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restrictions to participation in life situations caused by an illness or disabling condition.

1.1.3. Recreational Therapy supports are supports provided under the Indiana Division of Disability and Rehabilitative Supports (DDRS) consisting of a medically approved recreational program to restore, remediate, or rehabilitate an individual in order to

1.1.3.1. Improve the individual’s functioning and independence

1.1.3.2. Reduce or eliminate the effects of an individual’s disability

1.2. Benefits

1.2.1. The following benefits are available to eligible full-time Recreational Therapist staff:

1.2.1.1. Paid hourly wages

1.2.1.2. Paid mileage when transporting an individual receiving supports, taking into consideration how far the Recreational Therapist is willing to drive (also available to part-time employees)

1.2.1.2.1. The Recreational Therapist has the following options for mileage reimbursement:

1.2.1.2.1.1. $0.35 per mile paid by Assisted Independence, LLC. bi-monthly when any individual supported is transported, or

1.2.1.2.1.2. the Internal Revenue Service (IRS) tax write-off current mileage reimbursement rate (2020 rate is $0.58.5 per mile) for annual income tax filing, including all miles driven for work purposes [excludes miles driving to and from personal home] *documentation of mileage required

1.2.1.3. Health Insurance following one month of employment

1.2.1.4. 401k Enrollment with a 1% match by Assisted Independence

1.2.1.5. One-year membership every five years to Smart CEU’s Hub

1.2.1.6. Flexible work schedules

1.3. Prequalification

1.3.1. All Recreational Therapist staff must submit to the Human Resource Manager of Assisted Independence proof of the following prior to employment and prior to the expiration of any document:

1.3.1.1. Application (available online)

1.3.1.2. Resume

1.3.1.3. Cardiopulmonary Resuscitation (CPR) certification

1.3.1.4. First Aid Certification

1.3.1.5. Negative Tuberculin Skin Test

1.3.1.6. Driver’s License

1.3.1.7. Vehicle Registration

1.3.1.8. Automobile Insurance

1.3.1.9. Acceptance notice of the position offered with a minimum one-year commitment

1.3.2. Additionally, Recreational Therapist must provide an active certification from the National Council on Therapeutic Recreation Certification (NCTRC), along with:

1.3.2.1. a bachelor’s degree in Therapeutic Recreation or related field and/or

1.3.2.2. 18 earned credit hours in the study of therapeutic recreation

1.3.2.3. 5 years of full-time experience as a Recreational Therapist. Note: this only applies to those who have taken the National Council on Therapeutic Recreation Certification (NCTRC) equivalency Path A and did NOT earn a bachelor’s degree.

1.3.3. Additionally, Recreational Therapist staff must meet the following criteria prior to employment:

1.3.3.1. Free of Felony Convictions

1.3.3.2. Inspector General’s Exclusion from Federally Funded Healthcare Organization

1.3.4. All Recreational Therapy staff working with individuals shall meet the following requirements:

1.3.4.1.1. Be at least eighteen (18) years of age.

1.3.4.1.2. Demonstrate an interest in and empathy for individuals

1.3.4.1.3. Demonstrate the ability to communicate adequately in order to:

1.3.4.1.3.1. complete required forms and reports of visits; and follow oral or written instructions.

1.3.4.1.3.2. Demonstrate the ability to provide supports according to the individual's Person-Centered Individualized Support Plan (PCISP).

1.3.4.1.3.3. Demonstrate willingness to accept supervision.

1.3.5. Recreational Therapist staff must complete the following forms after receiving an offer of employment, but prior to providing service to an individual, submitting to the Human Resource Manager:

1.3.5.1. Indiana Form I-9

1.3.5.2. Indiana Form W4

1.3.5.3. Indiana Form WH-4

1.3.5.4. Employee Authorization of Direct Deposit

1.3.5.5. Hepatitis B Consent / Declination Form

1.3.6. Recreational Therapist staff must complete the following trainings, and once annually, prior to providing supports to an individual:

1.3.6.1. Respecting the Dignity of an Individual (if the Recreational Therapist has documentation of trainings on this topic within the last year, the trainings can be submitted to the Human Resource Manager)

1.3.6.2. Providing a Healthy and Safe Environment (if the Recreational Therapist has documentation of trainings on this topic within the last year, the trainings can be submitted to the Human Resource Manager)

1.3.6.3. Protecting an Individual from Abuse, Neglect, and Exploitation (if the Recreational Therapist has documentation of trainings on this topic within the last year, the trainings can be submitted to the Human Resource Manager)

1.3.6.4. Person Centered Planning

1.3.6.5. Incident Reporting

1.3.6.6. Behavior Support Plan (BSP) Training (as applicable)

1.3.6.6.1. Upon review of each Person-Centered Individualized Support Plan (PCISP), the Recreational Therapist must contact the Behavior Consultant (B.C., Behavioral Manager, Behavioral Therapist) of each individual supported to schedule a one-hour training

1.3.6.7. 30 minute phone call walk-through of AccelTrax online documentation software with the Human Resource Manager

1.3.7. Recreational Therapists will be provided with:

1.3.7.1. Letter of Employment

1.3.7.2. Business Cards

1.3.7.3. Email Address

1.3.7.4. AccelTrax online software username and password

1.3.7.5. Division of Disability and Rehabilitative Supports (DDRS) Portal online access for cloud-storage of documentation

1.3.7.6. Assessment Copies

1.3.7.7. Assessment and activity tote

1.3.7.8. Professional headshot photograph to be uploaded to the Recreational Therapists personal LinkedIn profile, which lists the occupation with Assisted Independence, LLC.

1.1. Job Duties

1.1.1. All Recreational Therapist staff must abide by the Policies and Procedures of Assisted Independence, LLC.

1.1.2. All Recreational Therapist staff must adhere to the rules and regulations set forth in Indiana Administrative Code (IAC) 460-6.

1.1.3. All Recreational Therapist staff must adhere to the rules and regulations set forth by the Division of Disability and Rehabilitative Supports (DDRS), Bureau of Developmental Disabilities Supports (BDDS), and the Bureau of Quality Improvement Supports (BQIS).

1.1.4. All Recreational Therapist staff must abide by the requirements set forth by the Council of Quality and Leadership (CQL), our accrediting body

1.1.5. All Recreational Therapist staff shall be eligible to provide the following supports:

1.1.5.1. Recreational Therapy

1.1.5.2. Transportation

1.1.6. All Recreational Therapist staff must assist the individual to which is being supported with one of the following:

1.1.6.1. Self-care

1.1.6.2. Self-direction

1.1.6.3. Expressive or receptive language

1.1.6.4. Ambulation or mobility

1.1.6.5. Activities of Daily Living (ADL’s)

1.1.6.6. Learning

1.1.6.7. Independent Living

1.1.6.8. Economic Self-Sufficiency

1.1.6.9. Physical Activity

1.1.6.10. Community Participation

1.1.7. All Recreational Therapist staff will assist a Medicaid recipient or Medicaid recipients already determined that meet at least one of the following criteria set forth by the Division of Disability and Rehabilitative Supports (DDRS):

1.1.7.1. SSI (MASI)

1.1.7.2. Aged (MA A)

1.1.7.3. Blind (MA B)

1.1.7.4. Disabled (MA D)

1.1.7.5. MED Works (MADW, MADI)

1.1.7.6. Low-income Caretakers (MAGF)

1.1.7.7. Foster Care (MA 15)

1.1.7.8. Foster Care Independence (MA14)

1.1.7.9. Children under Age 1 (MA Y)

1.1.7.10. Children Age 1-5 (MA Z)

1.1.7.11. Children Age 1-18 (MA 2, MA 9)

1.1.7.12. Transitional Medical Assistance (MA F)

1.1.7.13. IV-E FC Foster Care children (MA 4)

1.1.7.14. Children in the Adoption Assistance Program (MA 8)

1.1.8. Scheduling

1.1.8.1. All Recreational Therapist staff will be responsible for scheduling times to provide supports with the individual receiving supports, the individuals parent and/or guardians, and/or other team members by scheduling in-person, through the phone, via email, or the preferred method of communication by the individual supported.

1.1.8.2. Recreational Therapist staff must inform the Director of Recreational Therapy of dates when and when not available to provide supports.

1.1.8.3. All Recreational Therapist staff may not cancel a scheduled work time without permission from the Director of Recreational Therapy, unless the individual supported cancels the scheduled time. Based on the discretion of the Corporate Compliance Officer (CCO), all Recreational Therapist staff must submit supporting documentation (doctor’s notes, Certificate of Death, etc.) for missed work.

1.1.8.4. All Recreational Therapist planning to discontinue employment with Assisted Independence, LLC. shall provide the Director of Recreational Therapy written notice six-weeks prior to the last day of employment. Recreational Therapist are recommended to continue employment until the replacement Recreational Therapist is permitted to provide Recreational Therapy supports.

1.1.8.5. Meet and Greet: Recreational Therapists are permitted to meet the individual seeking recreational therapy supports for 30 minutes prior to being approved to provide recreational therapy supports to the individual. The purpose of the Meet and Greet is to allow the individual and/or family to determine if the recreational therapist will be a good fit.

1.1.9. Prior to providing recreational therapy supports to an individual, the following is required:

1.1.9.1. Notice of Action (NOA) providing the amount of time the individual is eligible for recreational therapy within the current timeframe. Recreational Therapist must fulfill 90% of the total units listed on the Notice of Action (NOA) within the given timeframe.

1.1.9.1.1. In the event the Notice of Action (NOA) is not present, the individual seeking recreational therapy supports must contact their Case Manager, requesting recreational therapy supports to be added to their Notice of Action (NOA). The recreational therapist will need to inform the individual to contact their case manager.

1.1.9.2. Person-Centered Individualized Support Plan (PCISP)

1.1.10. All Recreational Therapist staff will complete the following:

1.1.10.1. Assessment conducted initially and once annually.

1.1.10.1.1. Completion of an Individual Intake Form for each person supported in recreational therapy that has NOT previously received supports from Assisted Independence. The Individual Intake form is due upon completion of the first meeting the individual and/or their family.

1.1.10.1.2. Completion of a Functional Assessment of Characteristics for Therapeutic Recreation-Revised (FACTR-R) Assessment for all individuals supported over the age of 10 years-old. The assessment is to be completed within thirty (30) days of the first initial session. Upon completion of the assessment, the scoring sheet must be uploaded (via scanner or photograph converted into PDF format) to the Division of Disability and Rehabilitative Supports (DDRS) Portal online at https://cmportal.fssa.in.gov/DDRSCMS/Account/login?returnUrl=%2fDDRSCMS%2f

1.1.10.1.2.1. The Functional Assessment of Characteristics for Therapeutic Recreation-Revised (FACTR-R) Assessment cannot be printed and/or copied without consent Idyll Arbor, Inc. Each Recreational Therapist will be provided with blank assessments from the Director of Recreational Therapy.

1.1.10.1.3. Completion of the General Recreational Screening Tool (GRST) Assessment for any individual supported under the age of 10 years old. The assessment is to be completed within thirty (30) days of the first initial session. Upon completion of the assessment, the scoring sheet must be uploaded (via scanner or photograph converted into PDF format) to the Division of Disability and Rehabilitative Supports (DDRS) Portal online at https://cmportal.fssa.in.gov/DDRSCMS/Account/login?returnUrl=%2fDDRSCMS%2f

1.1.10.1.3.1. The General Recreational Screening Tool (GRST) Assessment cannot be printed and/or copied without consent Idyll Arbor, Inc. Each Recreational Therapist will be provided with blank assessments from the Director of Recreational Therapy.

1.1.10.1.4. Rights Assessment

1.1.10.1.5. Mini Mental State-Examination (MMSE) – Optional

1.1.10.2. Planning

1.1.10.2.1. Development of a Treatment Plan within fourteen (14) days after the completion of the Assessment, using the Assisted Independence, LLC. treatment plan template, including:

1.1.10.2.1.1. An assessment write-up, including scores

1.1.10.2.1.2. Priority needs of the individual

1.1.10.2.1.3. Measurable goals and objectives containing content, condition, and criterion

1.1.10.2.1.4. Recommended treatment modalities and activities

1.1.10.2.1.5. Two evidence-based peer reviewed journals or meta-analysis citing why the course of treatment is proven to be effective

1.1.10.2.1.6. Signature and credentials of the Recreational Therapist

1.1.10.2.2. The treatment plan must be updated once annually, including new assessment scores

1.1.10.2.3. The treatment plan must be saved as both a Microsoft Word and PDF document with the file name “First4ofLastNameFirst 3ofFirstName Tx. Plan DD/MM/YEAR” (Example: John Smith = SmitJoh Tx. Plan 01/01/2020)

1.1.10.3. Implementation

1.1.10.3.1. Organizing and directing home and/or community-based activities for the individual supported. These activities may include adaptive sports, dramatics, arts and crafts, social activities, volunteer opportunities, and other recreational supports designed to restore, remediate, or rehabilitate

1.1.10.3.2. Transporting individuals supported to community locations, including, but not limited to, gymnasiums, parks, athletic facilities, outdoors, museums, sporting events, children’s playhouses, community centers, amusement parks, sightseeing locations, monuments, educational facilities, or any potential place or resources where recreational therapy can be conducted.

1.1.10.3.3. All Recreational Therapist staff are required to provide one-on-one supports to the individuals. Group sessions may occur when the ratio of persons supported to Recreational Therapist are 1:1.

1.1.10.4. Evaluation

1.1.10.4.1. After each session conducted, the Recreational Therapists are to document the session using narrative notes online at https://assistedind.accelcon.com/AccelTrax/Login

1.1.10.4.1.1. For every 45 minutes of recreational therapy support provided, the Recreational Therapist has 15 minutes to complete necessary documentation (notetaking, assessments, treatment plans, etc.)

1.1.10.4.1.2. Medical abbreviations and terminology are not required for narrative notetaking

1.1.10.4.1.3. The individuals name may be spelled while completing documentation

1.1.10.4.2. Mandatory attendance of all quarterly meetings consisting of each person supported Individualized Support Team (IST). The quarterly meetings are set three months in advance. During the quarterly meeting, Recreational Therapists should document who is in attendance, medication changes, changes in behavior, reports or recommendations from team members, reports about school as applicable, incident reports, home life, extracurricular activities, health status, education towards rights, or any other pertinent information to the holistic well-being of the individual supported.

1.1.10.4.2.1. Recreational Therapists may request an Individualized Support Team (IST) meeting in the event an incident has occurred to the individual supported, or as deemed necessary by the Recreational Therapist.

1.1.11. Scheduling

1.1.11.1. All Recreational Therapist staff will be responsible for scheduling times to provide supports with the individual receiving supports, the individuals parent and/or guardians, and/or other team members by scheduling in-person, through the phone, via email, or the preferred method of communication by the individual supported.

1.1.11.2. Recreational Therapist staff must inform the Director of Recreational Therapy of dates when and when not available to provide supports.

1.1.11.3. All Recreational Therapist staff may not cancel a scheduled work time without permission from the Director of Recreational Therapy, unless the individual supported cancels the scheduled time.

1.1.11.4. All Recreational Therapist staff must submit supporting documentation (doctor’s notes, Certificate of Death, etc.) for missed work.

1.1.11.5. All Recreational Therapist planning to discontinue employment with Assisted Independence, LLC. shall provide the Director of Recreational Therapy written notice six-weeks prior to the last day of employment. Recreational Therapist are recommended to continue employment until the replacement Recreational Therapist is permitted to provide Recreational Therapy supports.

1.1.12. Activities Not Permissible

1.1.12.1. Payment for the cost of the recreational activities, registrations, memberships, or admission fees associated with the activities being planned, organized, or directed. The individual supported is required to pay for the cost of the recreational activities, registrations, memberships, or admission fees associated with the activities being planned, organized, or directed. Recreational Therapist should inform families in advance of potential costly activities. The course of treatment should consider the financial abilities of the individual supported. Under no circumstances, should a lack of financial ability prevent the individual from receiving recreational therapy supports. All expenses paid by the individual or the individual’s parent(s) or guardian(s) should be approved by the individual or the individual’s parent(s) or guardian(s) prior to the transaction. Receipts must be requested from the vendor and given to the individual or the individuals parent(s) or guardian(s).

1.1.12.2. Any supports that are reimbursable through the Medicaid State Plan

1.1.12.3. Therapy supports furnished to the participant within the educational/school setting or as a component of the participant’s school day

1.1.12.4. Solicitation to any potential individual receiving or seeking supports on behalf of any home and community-based support provider in the State of Indiana.

1.1.13. Incident Reporting

1.1.13.1. All Recreational Therapist staff are to submit an Incident Report through AccelTrax for any of the following incidents, or knowledge of any of the following incidents:

1.1.13.1.1. Alleged, suspected, or actual abuse, neglect, or exploitation occurs,

1.1.13.1.2. Anytime injury occurs,

1.1.13.1.3. Anytime death occurs,

1.1.13.1.4. Anytime structural or environmental problems threaten the health and safety of an individual

1.1.13.1.5. Anytime a fire occurs at the site of service delivery

1.1.13.1.6. Anytime a person goes away without telling somebody

1.1.13.1.7. Anytime alleged, suspected, or actual criminal activity by an employee of Assisted Independence occurs

1.1.13.1.8. Anytime a medication error occurs

1.1.13.1.9. Anytime a physical or mechanical restraint is used

1.1.13.1.10. Anytime a client has a fall

1.1.13.1.11. Any unusual incident that may affect the health, wellness, and functioning of a client

1.1.13.2. Incident Reports must include the following:

1.1.13.2.1. Employee first and last name

1.1.13.2.2. Client first and last name

1.1.13.2.3. Date in MM/DD/YEAR format

1.1.13.2.4. Time the incident began in 00:00AM format

1.1.13.2.5. Time the incident end in 00:00AM format

1.1.13.2.6. Description of the events immediately before, during, and following the event

1.1.13.2.7. All individuals involved in the event

1.1.13.2.8. Description of response to the event

1.1.13.3. Incident Reports are to be submitted to the Assisted Independence office within 24 hours of the incident occurring.

1.1.13.4. All Recreational Therapist staff must notify the Director of Recreational Therapy immediately following the incident, or immediately after receiving knowledge of the incident.

1.1.14. Recreational Therapist Review

1.1.14.1. Recreational Therapists must meet for one hour with the Director of Recreational Therapy after:

1.1.14.1.1. 30 days employment

1.1.14.1.2. 90 days employment

1.1.14.1.3. 180 days employment

1.1.14.1.4. One-year employment, including a training

1.1.14.1.5. Annually following one year of employment, including a training

1.1.14.2. The Recreational Therapists will have the opportunity to provide feedback about:

1.1.14.2.1. Scheduling

1.1.14.2.2. Caseloads

1.1.14.2.3. Supplies / Equipment / Resources

1.1.14.2.4. Job satisfaction

1.1.14.2.5. Input for ways to improve the Recreational Therapy department

1.1.14.2.6. Complaint / Grievance filing anonymously or not anonymously

1.1.14.3. The Recreational Therapist will complete an employee evaluation with the Director of Recreational Therapy, including, but not limited to:

1.1.14.3.1. Results from the Annual Survey Individual Satisfaction

1.1.14.3.2. Results from any complaints or investigations

1.1.14.3.3. Competency, including progress toward earning Continuing Education Units (CEU’s)

1.1.14.3.4. Assessment Scoring

1.1.14.3.5. Treatment Plan Writings

1.1.14.3.6. Any other pertinent documentations

1.1.14.3.7. Professional Behavior

1.1.14.3.8. Organizational Participation

1.1.14.3.9. Supporting Good Health

1.1.14.3.10. Strengths

1.1.14.3.11. Areas for Improvement

1.1.14.3.12. Safety

1.1.14.3.13. Plan for Employee Development

1.2. Ongoing Recruitment

1.2.1. All Recreational Therapists are expected to represent and speak about Assisted Independence, LLC. in a positive manner. Recreational Therapists are encouraged to aid in the recruitment and retention of employment at Assisted Independence, LLC.

(Revised on: 10/27/2022, Nathan Red, President)