KRS § 205.528 — KY Code / Title XVII / Chapter 205 / Section 205.528
205.528 Hospital-to-Home Transition Program
Status: in_force

205.528 Hospital-to-Home Transition Program.

(1) The Department for Medicaid Services shall submit a waiver or waiver amendment

for approval to the Centers for Medicare and Medicaid Services in order to establish

the Hospital-to-Home Transition Program to provide coverage for services provided

by an approved Medicaid waiver provider to elderly and physically disabled persons

over the age of eighteen (18) years. The program shall provide coverage for up to

sixty (60) days for services not otherwise provided as part of the Medicaid essential

benefits coverage in order to assist waiver applicants while transitioning from an

institutional setting to their home or to a community setting.

(2) The Hospital-to-Home Transition Program shall provide nonmedical support

services to applicants, including but not limited to:

(a) Adult day-care services;

(b) Attendant services;

(c) Home-delivered meal services; and

(d) Transportation services.

(3) The daily cost of services covered by the Hospital-to-Home Transition Program

shall be less than the average daily Medicaid payment for a stay at a nursing facility.

(4) An applicant shall be eligible for the Hospital-to-Home Transition Program if the

applicant:

(a) Is determined to be functionally eligible for services in his or her home or

community setting; and

(b) Has a pending application for Medicaid waiver services, provided that he or

she complies with all other medical assistance application requirements.

(5) The cabinet shall develop a screening tool to determine whether an applicant meets

the eligibility criteria under subsection (4) of this section for the Hospital-to-Home

Transition Program. The screening tool shall include but not be limited to the

following:

(a) Procedures for determining whether an applicant is functionally able to live at

home or in a community setting;

(b) Procedures for determining financial eligibility;

(c) Procedures to address patient treatment preferences; and

(d) Procedures to address patient goals of care and family caregiver concerns.

(6) An applicant for the program shall:

(a) Sign a written agreement attesting to the accuracy of the financial and other

information that the applicant provides; and

(b) Complete a Medicaid application on the date the applicant is screened for

functional eligibility or not later than ten (10) days from the screening.

(7) The cabinet shall make the Medicaid level of care final determination of eligibility

for Medicaid and Medicaid waiver services by sixty (60) days following an eligible

applicant's discharge from an institutional setting to a home or community setting.

(8) The cabinet shall request funding to support the waiver program. Not later than July

1, 2016, subject to appropriations provided by the General Assembly and approval

of the waiver or waiver amendment from the Centers for Medicare and Medicaid

Services, the cabinet shall initiate the Hospital-to-Home Transition Program as

described in this section.

(9) The Department for Medicaid Services shall promulgate administrative regulations

to implement this section.