Source: http://register.dls.virginia.gov/details.aspx?id=7304
Timestamp: 2019-03-22 16:42:16
Document Index: 253862473

Matched Legal Cases: ['§ 63', '§ 22', '§ 63', '§ 37', '§ 51', '§ 37']

Vol. 35 Iss. 10 (Final Regulation) 22VAC30-80, Auxiliary Grants Program January 07, 2019
The amendments (i) add supportive housing, which is a new living arrangement that individuals who receive auxiliary grant payments may choose, as a third setting in which individuals may receive the auxiliary grant; (ii) define requirements to participate in the supportive housing setting; (iii) clarify providers' responsibilities for each setting; and (iv) update terminology and guidelines for the Auxiliary Grant Program.
"Assisted living facility" or "ALF" means [ , as defined in § 63.2-100 of the Code of Virginia, ] any congregate residential setting that provides or coordinates personal and health care services, 24-hour supervision, and assistance (scheduled and unscheduled) for the maintenance or care of four or more adults who are aged, infirm or disabled and who are cared for in a primarily residential setting, except (i) a facility or portion of a facility licensed by the State Board of Health or the Department of Behavioral Health and Developmental Services, but including any portion of such facility not so licensed; (ii) the home or residence of an individual who cares for or maintains only persons related to him by blood or marriage; (iii) a facility or portion of a facility serving infirm or disabled persons between the ages of 18 and 21, or 22 if enrolled in an educational program for the handicapped pursuant to § 22.1-214 of the Code of Virginia, when such facility is licensed by the [ department Virginia Department of Social Services ] as a children's residential facility under Chapter 17 (§ 63.2-1700 et seq.) of Title 63.2 of the Code of Virginia, but including any portion of the facility not so licensed; and (iv) any housing project for persons 62 years of age or older or the disabled that provides no more than basic coordination of care services and is funded by the U.S. Department of Housing and Urban Development, by the U.S. Department of Agriculture, or by the Virginia Housing Development Authority. Included in this definition are any two or more places, establishments or institutions owned or operated by a single entity and providing maintenance or care to a combined total of four or more aged, infirm or disabled adults. Maintenance or care means the protection, general supervision and oversight of the physical and mental well-being of an aged, infirm or disabled individual. [ Assuming responsibility for the well-being of individuals residing in an ALF, either directly or through contracted agents, is considered "general supervision and oversight." ]
"Auxiliary Grants Program" or [ "AG Program" "AG" ] means a state and locally funded assistance program to supplement income of an individual receiving Supplemental Security Income (SSI) or adult who would be eligible for SSI except for excess income, who resides in an ALF or in, an AFC home, or a supportive housing setting with an established rate. The total number of individuals within the Commonwealth of Virginia eligible to receive AG in a supportive housing setting shall not exceed the number designated in the signed agreement between the department and the Social Security Administration.
[ "Program" means the Auxiliary Grant AG Program. ]
"Provider" means an ALF that is licensed by the [ Virginia ] Department of Social Services or an AFC provider that is approved by a local department of social services or a supportive housing provider as defined in § 37.2-421.1 of the Code of Virginia.
"Provider agreement" means a document written agreement that the ALF [ ALFs ALF ] and supportive housing providers must complete and submit to the department when requesting to be approved for admitting approval to admit individuals receiving AG.
"Third-party payment" means a payment made by a third party to an ALF or, an AFC home, or supportive housing provider on behalf of an AG recipient for goods or services other than for food, shelter, or specific goods or services required to be provided by the ALF or, an AFC home, or a supportive housing provider as a condition of participation in the Auxiliary Grants AG [ Program ] in accordance with 22VAC30-80-45.
A. In order to receive payment from the [ program AG ] for care in an ALF or [ in an ] AFC home, an individual applying for AG shall have been assessed by a qualified assessor using the UAI in accordance with 22VAC30-110 and determined to need residential or assisted living care or AFC.
B. As a condition of eligibility for the [ program AG ], a UAI shall be completed on an individual prior to admission, except for an emergency placement as documented and approved by a Virginia adult protective services worker; at least once annually; and whenever there is a significant change in the individual's level of care, and a determination is made that the individual needs residential or assisted living care in an ALF or AFC home.
D. In order to receive payment from the AG [ program ] for care in the SH setting, an individual shall be evaluated by a qualified assessor in accordance with § 51.5-160 E of the Code of Virginia. Eligible individuals shall be notified of the SH setting option and the availability of approved SH providers at the time of their annual level of care assessment. The individual may select SH or ALF at any time after the first or any subsequent annual reassessment as long as the individual meets the criteria for residential or assisted living level of care and subject to the availability of the selected housing option.
A. The rate established under the [ program AG ] for the ALF setting shall cover the following services:
A. The rate established under the [ program AG ] for SH, as defined in 22VAC30-80-10, shall cover a residential setting with access to SH services that include:
B. The residential setting covered under the [ program AG ] for SH, as defined in 22VAC30-80-10, shall be the least restrictive and most integrated setting practicable for the individual and shall:
1. As a condition of participation in the [ program AG ], the ALF provider is required to complete and submit to the department a signed provider agreement as stipulated in subdivision 2 of this subsection in this section. The agreement is to be submitted prior to the ALF accepting AG payment for qualified individuals. A copy of the ALF's current license must be submitted with the provider agreement.
2. The ALF provider shall agree to the following conditions in the provider agreement to participate in the [ program AG ]:
B. As a condition of participation in the [ program AG ], the AFC provider shall be approved by a local department of social services and comply with the requirements set forth in 22VAC30-120.
1. As a condition of participating in the AG [ program ], the SH provider shall enter an agreement with DBHDS pursuant to § 37.2-421.1 of the Code of Virginia.
2. The SH provider shall submit a copy of the executed agreement and a copy of its current DBHDS license prior to the SH provider receiving payments from the AG [ program ] on behalf of qualified individuals.
3. For specific goods or services provided to the individual other than food, shelter, or other specific goods or services required to be provided by the ALF or, AFC home, or SH provider as a condition of participation in the AG [ program ].
C. Providers who do not comply with the requirements of this chapter may be subject to adverse action, which may include suspension of new AG program [ Program ] admissions or termination of provider agreements.
Auxiliary Grant Certification, Reporting Period July 1, 2016, to June 30, 2017, 032-02-0745-10-eng (rev. 7/2017)
VA.R. Doc. No. R17-4816; Filed December 13, 2018, 11:21 a.m.