reglab/statecodes huggingface dataset:
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-506 - Short-term Registration of an Interpreter

Current through Register Vol. 30, No. 28, July 12, 2024
A. To register with the Commission to provide
				interpreting in Arizona in a non-legal situation for fewer than 20 days in a
				year, an interpreter shall submit the following information in writing to the
				Commission:
1. Interpreter's name;
2. Interpreter's residential and e-mail
				addresses;
3. Interpreter's mobile
				telephone number;
4. Dates on which
				interpreting will be provided;
5.
				Name, address, and contact information of the person or event for which
				interpreting services will be provided; and
6. Date of most recent
				short-term registration with the Commission, if any.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-508 - Fees and Charges

Current through Register Vol. 30, No. 28, July 12, 2024
A. Under the
				authority provided by A.R.S. §§
									36-1973(A)
				 and
				36-1974(C),
				the Commission establishes and shall collect the following fees, which are not
				refundable unless A.R.S. §
									41-1077
				applies:
1. Generalist or legal license
				application fee, $125;
2.
				Generalist or legal license renewal application fee, $50;
3. Provisional license application fee,
				$25;
4. Provisional license renewal
				application fee, $25; and
5.
				Penalty for late license renewal, $100
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-509 - Procedures for Processing Applications; Time Frames

Current through Register Vol. 30, No. 28, July 12, 2024
A. For the purpose of A.R.S. §
									41-1073,
				the Commission establishes the following licensing time frames:
1. Administrative completeness review time
				frame: 30 days;
2. Substantive
				review time frame: 60 days; and
3.
				Overall time frame: 90 days.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-510 - Continuing Education Requirement; Waiver; Extension of Time to Complete

Current through Register Vol. 30, No. 28, July 12, 2024
A. Continuing
				education is required as a condition of licensure renewal.
1. A generalist interpreter shall complete
				continuing education required by NAD, RID, or BEI to maintain certification by
				NAD, RID, or BEI. If the certification of a generalist interpreter is suspended
				or revoked by NAD, RID, or BEI because the generalist interpreter failed to
				complete the required continuing education, the Commission shall initiate
				proceedings under Article 3 against the generalist interpreter's
				license.
2. A Class A legal
				interpreter shall complete continuing education required by NAD, RID, or BEI to
				maintain legal certification by NAD, RID, or BEI. If the certification of a
				Class A legal interpreter is suspended or revoked by NAD, RID, or BEI because
				the Class A legal interpreter failed to complete the required continuing
				education, the Commission shall initiate proceedings under Article 3 against
				the legal interpreter's license.
3.
				A Class C or D legal interpreter shall complete continuing education required
				by NAD, RID, or BEI to maintain certification by NAD, RID, or BEI including at
				least 20 hours of legal training. If the certification of a Class C or D legal
				interpreter is suspended or revoked by NAD, RID, or BEI because the Class C or
				D legal interpreter failed to complete the required continuing education or if
				the Class C or D legal interpreter fails to complete the required hours of
				legal training, the Commission shall initiate proceedings under Article 3
				against the legal interpreter's license.
4. When renewing a license under
				R9-26-507(B),
				a provisional interpreter shall submit the evidence required under subsection
				(B) showing completion of 12 hours of continuing education. The Commission
				shall accept continuing education:
a. Designed
				to enhance the provisional licensee's skill and ability to provide quality
				interpreting to the deaf and hard-of-hearing community;
b. Approved by RID, NAD, or BEI, as
				applicable, for certification maintenance;
c. Provided by an accredited institution of
				higher education; or
d. Provided by
				an entity involved with the deaf and hard-of-hearing community.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-511 - Video Remote Interpreting

Current through Register Vol. 30, No. 28, July 12, 2024
A. An
				interpreter who is licensed under A.R.S. Title 36, Chapter 17.1 and this
				Article is authorized to provide VRI only for individuals who are located in
				Arizona.
B. An interpreter who is
				licensed under A.R.S. Title 36, Chapter 17.1 and this Article and provides VRI
				shall comply fully with the requirements of this Article.
C. An interpreter who is located outside of
				Arizona shall not provide VRI for an individual located in Arizona before being
				licensed under A.R.S. Title 36, Chapter 17.1 and this Article.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-515 - Identification Badge Required

Current through Register Vol. 30, No. 28, July 12, 2024
A. To
				protect the public, a licensee shall have and present on request, an
				identification badge issued by the Commission whenever the licensee provides
				interpreting services.
B. A
				licensee who loses or damages the identification badge required under
				subsection (A) may obtain a replacement identification badge by submitting a
				request to the Commission and paying the charge specified under
				R9-26-508.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 26 - COMMISSION FOR THE DEAF AND THE HARD OF HEARING › Article 5 - INTERPRETER LICENSURE AND REGULATION › Section R9-26-518 - Required Notices to the Commission

Current through Register Vol. 30, No. 28, July 12, 2024
A. If a licensee's certification by RID, NAD,
				BEI, or other acceptable certifying entity is suspended, revoked, or subject to
				other disciplinary action by RID, NAD, BEI, or the other acceptable certifying
				entity, the licensee shall provide immediate written notice of the disciplinary
				action to the Commission. Failure to provide the notice required under this
				subsection is unprofessional conduct.
B. If a licensee's state-issued certification
				submitted as qualification for a Class B provisional license is suspended,
				revoked, or subject to other disciplinary action by the state that issued the
				certification, the licensee shall provide immediate written notice of the
				disciplinary action to the Commission. Failure to provide the notice required
				under this sub- section is unprofessional conduct.
C. The Commission shall communicate with a
				licensee or applicant using the name and address provided to the Commission by
				the licensee or applicant. To ensure timely receipt of communication from the
				Commission, a licensee or applicant shall notify the Commission of any change
				in the licensee's or applicant's name or address.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 1 - DEFINITIONS › Section R9-28-102 - Covered Services Related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. The following words and phrases, in addition to
				  definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  and 9 A.A.C. 22, Article 1, have the following meanings unless the context of
				  the Chapter explicitly requires another meaning:
"Bed hold" means a 24 hour per day unit of service that is
				  authorized by an ALTCS case manager or designee during a period of short-term
				  hospitalization or therapeutic leave that meets the requirement specified in
				  42 CFR
				  483.12.
"Behavior intervention" means the planned interruption of a
				  member's inappropriate behavior using techniques such as reinforcement,
				  training, behavior modification, and other systematic procedures intended to
				  result in more acceptable behavior.
"Respite care" means a short-term service provided in a NF or
				  a home and community based service setting to an individual if necessary to
				  relieve a family member or other person caring for the individual.
"Room and board" means lodging and meals.
"Scope of services" means the covered, limited, and excluded
				  services under Articles 2 and 12 of this Chapter.
"Ventilator dependent," for purposes of ALTCS eligibility,
				  means an individual is medically dependent on a ventilator for life support at
				  least six hours per day and has been dependent on ventilator support as an
				  inpatient in a hospital, NF, or ICF-MR for at least 30 consecutive days.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 1 - DEFINITIONS › Section R9-28-103 - Preadmission Screening Related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. The following words and phrases, in addition to
				  definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  and 9 A.A.C. 22, Article 1, have the following meanings unless the context of
				  the Chapter explicitly requires another meaning:
"Developmental disability" is defined in A.R.S. §
									36-551.
"PAS" means preadmission screening, which is the process of
				  determining an individual's risk of institutionalization at a NF or ICF-MR
				  level of care, as specified in Article 3 of this Chapter.
"Reassessment" means the process of redetermining PAS
				  eligibility for ALTCS services as appropriate, for all members.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 1 - DEFINITIONS › Section R9-28-106 - Request for Proposals and Contract Process Related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. The following words and phrases, in addition to
				  definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  and 9 A.A.C. 22 Article 1, have the following meanings unless the context of
				  the Chapter explicitly requires another meaning: "Interested Party" means an
				  actual or prospective offeror whose economic interest may be affected
				  substantially and directly by the issuance of a request for proposals, the
				  award of a contract, or the failure to award a contract.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 1 - DEFINITIONS › Section R9-28-111 - Behavioral Health Services Related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. The words and phrases in this Chapter, in
				  addition to definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  have the same meaning as specified in 9 A.A.C. 22, Article 1.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-201 - General Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
In addition to the exclusions and limitations specified in
				  this Article, services provided to a member are covered services if:
1. Medically necessary, cost effective, and
				federally reimbursable;
2.
				Coordinated by a case manager in accordance with requirements specified in
				R9-28-510;
3. The provider obtains
				prior authorization as required by a member's program contractor or by the
				Administration:
a. Failure of the provider to
				obtain prior authorization is cause for denial.
b. Services provided during prior period
				coverage are exempt from prior authorization requirements;
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-202 - Scope of Services

Current through Register Vol. 30, No. 28, July 12, 2024
A.The
				Administration or a contractor shall cover medical services specified in 9
				AA.C. 22, Article 2 for a member, subject to the limitations and exclusions
				specified in Article 2, unless otherwise specified in this Chapter.
B. In addition, for members living in an HCBS
				setting, incontinence briefs for a member 21 years of age and older, including
				pull-ups, are covered in order to:
1. Treat a
				medical condition; and
2. Prevent
				skin breakdown when all the following are met:
a. The member is incontinent due to a
				documented medical condition that causes incontinence of bowel and/or
				bladder.
b. The PCP or attending
				physician has issued a prescription ordering the incontinence briefs.
c. Incontinence briefs do not exceed 180
				briefs per month unless the prescribing physician presents evidence of medical
				necessity for more than 180 briefs per month.
d. The member obtains incontinence briefs
				from vendors within the Contractor's network, and
e. Prior authorization has been obtained if
				required by the Administration. Contractor, or Contractor's designee, as
				appropriate. Contractors shall not require prior authorization more frequently
				than every twelve months.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-203 - Coverage for CRS Services

Current through Register Vol. 30, No. 28, July 12, 2024
ABeginning October 1, 2013, ALTCS DD members
				who need active treatment for one or more of the qualifying medical
				condition(s) in A.A.C
				R9-22-1303
				shall receive CRS services through the CRS contractor as described under
				Chapter 22, Article 13.
BBeginning
				October 1, 2013, AHCCCS ALTCS EPD members who need active treatment for one or
				more of the qualifying medical conditions in A.A.C
				R9-22-1303
				shall not receive CRS services through the CRS contractor as described under
				Chapter 22, Article 13. These members shall receive treatment for those
				conditions through their assigned ALTCS EPD contractor. However, an American
				Indian member with a CRS condition(s) who is enrolled with a tribal contractor
				or Native American Community Health (NACH) shall obtain CRS services through
				the CRS contractor.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-204 - Institutional Services

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				Institutional services are provided in:
1. A
				NF;
2. An ICF-MR; or
3. A facility identified in
				R9-28-1105(A)(1)(b), (B), or (C).
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-205 - Home and Community Based Services (HCBS)

Current through Register Vol. 30, No. 28, July 12, 2024
A. Subject to the availability of federal
				funds, HCBS are covered services if provided to a member residing in the
				member's own home or an alternative residential setting. Room and board
				services are not covered in a HCBS setting.
B. The case manager shall authorize and
				specify in a case management plan any additions, deletions, or changes in home
				and community based services provided to a member or in accordance with
				R9-28-510.
C. Home and community
				based services include the following:
1. Home
				health services provided on a part-time or intermittent basis. These services
				include:
a. Nursing care;
b. Home health aide;
c. Medical supplies, equipment, and
				appliances;
d. Physical
				therapy;
e. Occupational
				therapy;
f. Respiratory therapy;
				and
g. Speech and audiology
				services;
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 2 - COVERED SERVICES › Section R9-28-206 - ALTCS Services That May be Provided to a Member Residing in Either an Institutional or HCBS Setting

Current through Register Vol. 30, No. 28, July 12, 2024
The Administration shall cover the following services if the
				  services are provided to a member within the limitations listed:
1. Occupational and physical therapies,
				speech and audiology services, and respiratory therapy:
a. The duration, scope, and frequency of each
				therapeutic modality or service is prescribed by the member's primary care
				provider or attending physician;
b.
				The therapy or service is authorized by the member's contractor or the
				Administration; and
c. The therapy
				or service is included in the members case management plan;
d. AHCCCS will not cover more than 15
				outpatient physical therapy visits for the contract year with the exception of
				the required Medicare coinsurance and deductible payment as described in 9
				A.A.C. 29, Article 3.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-302 - General Provisions

Current through Register Vol. 30, No. 28, July 12, 2024
To qualify for services described in A.R.S. §
									36-2939:
1. An applicant shall meet the financial
				criteria described in Article 4, and
2. AHCCCS shall determine that the applicant
				is at immediate risk of institutionalization under the PAS assessment as
				specified in this Article.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-303 - Preadmission Screening (PAS) Process

Current through Register Vol. 30, No. 28, July 12, 2024
A. The assessor shall use the PAS instrument
				to determine whether the following applicants or members are at immediate risk
				of institutionalization:
1. The assessor
				shall use the PAS instrument prescribed in
				R9-28-304
				to assess an applicant or member who is EPD.
2. The assessor shall use the age-specific
				PAS instrument prescribed in
				R9-28-305
				to assess an applicant or member who is physically disabled and less than 6
				years old. After assessing the child, the assessor shall refer the child for
				physician consultant review under subsections (G) through (J).
3. The assessor shall use the PAS instrument
				prescribed in
				R9-28-305
				to assess an applicant or member who is DD, except as specified in subsection
				(A)(4) for an applicant or member who is DD and residing in a NF. After
				assessing a child who is DD and less than 6 months of age, the assessor shall
				refer the child for physician consultant review under subsections (G) through
				(J).
4. The assessor shall use the
				PAS instrument prescribed in
				R9-28-304
				for an applicant or a member who is DD and residing in a NF.
5. The assessor shall use the PAS instrument
				prescribed in
				R9-28-304
				or
				R9-28-305,
				whichever is applicable, to assess an applicant or member who is classified as
				ventilator-dependent, under Section 1902(e)(9) of the Social Security
				Act.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-304 - Preadmission Screening Criteria for an Applicant or Member who is Elderly or Physically Disabled (EPD)

Current through Register Vol. 30, No. 28, July 12, 2024
A. The
				PAS instrument for an applicant or member who is EPD includes the following
				categories:
1. Intake information category.
				The assessor solicits intake information category information on an applicant's
				or member's demographic background. The components of the intake information
				category are not included in the calculated PAS score.
2. Functional assessment category. The
				assessor solicits functional assessment category information on an applicant's
				or member's:
a. Need for assistance with
				activities of daily living, including:
i.
				Bathing,
ii. Dressing,
iii. Grooming,
iv. Eating,
v. Mobility,
vi. Transferring, and
vii. Toileting in the residential environment
				or other routine setting;
b. Communication and sensory skills,
				including hearing, expressive communication, and vision; and
c. Continence, including bowel and bladder
				functioning.
3. Emotional
				and cognitive functioning category. The assessor solicits emotional and
				cognitive functioning category information on an applicant's or member's:
a. Orientation to person, place, and time. In
				soliciting this information, the assessor shall also take into account the
				caregiver's judgment; and
b.
				Behavior, including:
i. Wandering
ii. Self-injurious behavior,
iii. Aggression,
iv. Resistiveness, and
v. Disruptive behavior.
4. Medical assessment category.
				The assessor solicits medical assessment category information on an applicant's
				or member's:
a. Medical conditions that have
				an impact on the applicant's or member's functional ability in relation to
				activities of daily living, continence, and vision;
b. Medical condition that requires medical or
				nursing service and treatment;
c.
				Medication, treatment, and allergies;
d. Specific services and treatments that the
				applicant or member is currently receiving; and
e. Physical measurements, hospitalization
				history, and ventilator dependency.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-305 - Preadmission Screening Criteria for an Applicant or Member who is Developmentally Disabled (DD)

Current through Register Vol. 30, No. 28, July 12, 2024
A. The
				Administration shall conduct a PAS assessment of an applicant or member who is
				DD using one of three PAS instruments specifically designed to assess an
				applicant or member in the following age groups:
1. Twelve years of age and older,
2. Six through 11 years of age, and
3. Birth through 5 years of
				age.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-306 - Reassessments

Current through Register Vol. 30, No. 28, July 12, 2024
A. An assessor
				shall reassess an ALTCS member to determine continued eligibility:
1. In connection with a routine audit of the
				PAS assessment by AHCCCS;
2. In
				connection with a request by a provider, program contractor, case manager, or
				other party, if AHCCCS determines that continued eligibility is uncertain due
				to substantial evidence of a change in the member's circumstances or error in
				the PAS assessment; or
3. Annually
				when part of a population group identified by the Director in a written report
				as having an increased likelihood of becoming ineligible.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 3 - PREADMISSION SCREENING (PAS) › Section R9-28-307 - The ALTCS Transitional Program for a Member who is Elderly and or Physically Disabled (EPD) or Developmentally Disabled (DD)

Current through Register Vol. 30, No. 28, July 12, 2024
A. The ALTCS transitional program serves
				members enrolled in the ALTCS program who, at the time of reassessment as
				described in
				R9-28-306, no
				longer meet the threshold specified in
				R9-28-304
				for EPD or in
				R9-28-305
				for DD but do meet all other ALTCS eligibility criteria. The Administration
				shall compare the member's PAS assessment to a scoring methodology for
				eligibility in the ALTCS transitional program as defined in subsections (B) and
				(C).
B. The Administration shall
				transfer a member who is DD from the ALTCS program to the ALTCS transitional
				program if, at the time of a reassessment, the total PAS score is less than the
				threshold described in
				R9-28-305
				but is at least 30, or the member is diagnosed with moderate, severe, or
				profound mental retardation.
C. The
				Administration shall transfer a member who is EPD from the ALTCS program to the
				ALTCS transitional program if, at the time of a reassessment, the PAS score is
				less than the threshold described in
				R9-28-304
				but is at least 40.
D. For a member
				residing in a NF or ICF-IID, the program contractor or the Administration shall
				ensure that the member is moved to an approved home- and community-based
				setting within 90 continuous days from the enrollment date of the member's
				eligibility for the ALTCS transitional program.
E. A member in the ALTCS transitional program
				shall continue to receive all medically necessary covered services as specified
				in Article 2.
F. A member in the
				ALTCS transitional program is eligible to receive up to 90 continuous days per
				NF or ICF-IID admission when the member's condition worsens to the extent that
				an admission is medically necessary.
G. For a member requiring medically necessary
				NF or ICF-IID services for longer than 90 days, the program contractor shall
				request the Administration to conduct a reassessment under
				R9-28-306.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-401.01 - General

Current through Register Vol. 30, No. 28, July 12, 2024
A. Application for
				ALTCS coverage.
1. The Administration shall
				provide a person the opportunity to apply for ALTCS as described under Chapter
				22, Article 3, unless specified otherwise in this Section.
2. To
				apply for ALTCS, a person shall submit an application to an ALTCS eligibility
				office.
a. The application shall contain the
				applicant's name and address.
b.
				Before the application is approved, a person listed in A.A.C.
				R9-22-302(2)
				 shall sign the application.
c. A witness shall also sign the application
				if an applicant signs the application with a mark.
d. The date of application is the date the
				application is received by the Administration or its designee as described in
				R9-22-302.
3. Except as provided in
				R9-22-306,
				the Administration shall determine eligibility within 45 days from the date of
				application.
4. An applicant or representative who files an ALTCS
				application may withdraw the application for ALTCS coverage either orally or in
				writing to the ALTCS eligibility office where the application was filed. The
				Administration shall provide the applicant with a denial notice under
				subsection (E).
5. If an applicant dies while an application is
				pending, the Administration shall complete an eligibility determination for the
				deceased applicant.
6. If a person dies before an application is filed,
				the Administration shall complete an eligibility determination on an
				application filed on behalf of the deceased applicant, if the application is
				filed in the month of the person's death.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-406 - ALTCS Living Arrangements

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				Long-term care living arrangements. A person may be eligible for ALTCS
				services, under Article 2, while living in one of the following settings:
1. Institutional settings:
a. A Nursing Facility (NF) defined in
				42 U.S.C.
				1396 r(a),
b. An Institution for Mental Diseases (IMD)
				for a person who is either under age 21 or age 65 or older ,
c. An Intermediate Care Facility for the
				Mentally Retarded (ICF-MR) for a person with developmental
				disabilities,
d. A hospice
				(free-standing, hospital, or nursing facility subcontracted beds) defined in
				A.R.S. §
											36-401;
				or
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-407 - Resource Criteria for Eligibility

Current through Register Vol. 30, No. 28, July 12, 2024
A. The following Medicaid-eligible persons
				shall be deemed to meet the resource requirements for ALTCS eligibility unless
				ineligible due to federal and state laws regarding trusts.
1. A person receiving Supplemental Security
				Income (SSI);
2. A person receiving
				Title IV-E Foster Care Maintenance payment; or
3. A person receiving a Title IV-E Adoption
				Assistance.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-408 - Income Criteria for Eligibility

Current through Register Vol. 30, No. 28, July 12, 2024
A. The following Medicaid-eligible persons
				shall be deemed to meet the income requirements for ALTCS eligibility unless
				ineligible due to federal and state laws regarding trusts.
1. A person receiving Supplemental Security
				Income (SSI);
2. A person receiving
				Title IV-E Foster Care Maintenance Payments; or
3. A person receiving Title IV-E Adoption
				Assistance.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-410 - Community Spouse

Current through Register Vol. 30, No. 28, July 12, 2024
A. The
				methodology in this Section applies to an institutionalized person who has a
				community spouse.
B. If the
				institutionalized person's most current period of continuous
				institutionalization began on or after September 30, 1989, the Administration
				shall use the methodology for the treatment of resources under
				42
				U.S.C. 1396r-5(c).
1. The following resource criteria shall be
				used in addition to the criteria specified in
				R9-28-407
				to be eligible:
a. Resources owned by a
				couple at the beginning of the first continuous period of institutionalization
				from and after September 30, 1989, shall be computed from the first day of
				institutionalization. The total value of resources owned by the
				institutionalized spouse and the community spouse, and a spousal share equal to
				one-half of the total value, are computed under
				42 U.S.C.
				1396 r - 5(c)(1).
b. The Community Spouse Resource Deduction
				(CSRD) is calculated under
				42 U.S.C.
				1396 r - 5(f)(2).
c. The CSRD is subtracted from the total
				resources of the couple to determine the amount of the couple's resources
				considered available to the institutionalized spouse at the time of application
				under
				42 U.S.C.
				1396 r - 5(c)(2).
i. Resources in excess of the CSRD must be
				equal to or less than the standard for a person specified in
				R9-28-407.
ii. The CSRD is allowed as a deduction for 12
				consecutive months beginning with the first month in which the
				institutionalized spouse is eligible for ALTCS benefits. Beginning with the
				13th month, the separate property of the institutionalized spouse must be
				within the resource standard for a person specified in
				R9-28-407.
iii. If a person who was previously eligible
				for ALTCS as an institutionalized person with a community spouse reapplies for
				ALTCS after a break in institutionalization of more than 30 days, the CSRD will
				be allowed as a deduction from resources for a 12-month period in addition to
				the period in subsection (c)(ii).
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-411 - Changes, Redeterminations, and Notices

Current through Register Vol. 30, No. 28, July 12, 2024
A. Reporting and verifying changes.
1. A person shall report to the ALTCS
				eligibility office the following changes for a person, a person's spouse, or a
				person's dependent children under
				42 CFR
				435.916:
a.
				A change of address;
b. An
				admission to or discharge from a medical facility, public institution, or
				private institution;
c. A change in
				the household's composition;
d. A
				change in income;
e. A change in
				resources;
f. A determination of
				eligibility for other benefits;
g.
				A death;
h. A change in marital
				status;
i. An improvement in the
				person's medical condition;
j. A
				change in school attendance;
k. A
				change in Arizona state residency;
l. A change in citizenship or alien
				status;
m. Receipt of an SSN under
				R9-22-305;
n. A transfer of assets
				under
				R9-28-409;
o. A change in trust income and disbursements
				in accordance with state and federal law;
p. A change in first- or third-party
				liability that may be responsible for payment of all or a portion of the
				person's medical costs;
q. A change
				in first-party medical insurance premiums;
r. A change in the household expenses used to
				calculate the community spouse monthly income allowance described in
				R9-28-410;
s. A change in the amount of the community
				spouse monthly income allowance that is provided to the community spouse by the
				institutionalized spouse under
				R9-28-410;
				and
t. Any other change that may
				affect the person's eligibility or share-of-cost.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-412 - General Enrollment

Current through Register Vol. 30, No. 28, July 12, 2024
A. Program
				contractors. The Administration shall enroll each ALTCS member with:
1. An elderly and physically disabled (EPD)
				program contractor,
2. The
				developmentally disabled (DD) program contractor,
3. A tribal program contractor, or
4. The AHCCCS fee-for-service
				program.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-413 - Enrollment with an Elderly and Physically Disabled (EPD) Program Contractor

Current through Register Vol. 30, No. 28, July 12, 2024
A. A
				member's enrollment with an EPD program contractor. The Administration shall
				enroll an ALTCS elderly or physically disabled member with an EPD program
				contractor assigned to that GSA.
B.
				New member makes a choice of an EPD program contractor. The Administration
				shall provide a new member an opportunity to choose an EPD program contractor,
				if an ALTCS member is elderly or physically disabled, and lives in a GSA served
				by more than one EPD program contractor.
C. New member who makes no choice of an EPD
				program contractor . The Administration shall enroll an elderly or physically
				disabled new member that lives in a GSA with more than one EPD program
				contractor and who makes no choice of an EPD program contractor under the
				following:
1. Criteria. The Administration
				will prioritize enrollment based on continuity of care and enroll a member with
				an EPD program contractor chosen under the following criteria, including but
				not limited to:
a. A member's living
				arrangement, and
b. A member's
				primary care practitioner.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-414 - Enrollment with the DD Program Contractor

Current through Register Vol. 30, No. 28, July 12, 2024
A
				  member's DD program contractor. The Administration shall enroll a member
				  including an American Indian with the DES Division of Developmental
				  Disabilities as specified in A.R.S. §
									36-2940,
				  if the ALTCS member is eligible for services for the developmentally disabled
				  .
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-415 - Enrollment with a Tribal Program Contractor

Current through Register Vol. 30, No. 28, July 12, 2024
A. On-reservation. Notwithstanding
				R9-28-412, the
				Administration shall enroll an American Indian ALTCS member who is elderly or
				physically disabled with the ALTCS tribal program contractor as specified in
				A.R.S. §
									36-2932
				if the person:
1. Lives on-reservation of a
				tribe participating as an ALTCS tribal program contractor, or
2. Lived on-reservation of a tribe
				participating as an ALTCS tribal program contractor immediately prior to
				placement in an off-reservation NF or alternative HCBS setting.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-416 - Enrollment with the Fee-for-service (FFS) Program

Current through Register Vol. 30, No. 28, July 12, 2024
A. No tribal or EPD program contractor in
				GSA. The Administration shall enroll an ALTCS elderly or physically disabled
				member who resides in an area with no ALTCS tribal program contractor or EPD
				program contractor in the AHCCCS
FFS program under A.R.S. §
										36-2945.
B. Prior period coverage. The
				Administration shall enroll a member in AHCCCS fee-for-service program if a
				member is eligible for ALTCS services only during prior period
				coverage.
C. The Administration
				shall enroll a member in AHCCCS fee-for-service program if the member is
				eligible for ALTCS services during the prior quarter period.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-417 - Notification Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
A.
				Administration responsibilities. The Administration shall notify a member's
				program contractor when a member is enrolled or disenrolled from the ALTCS
				program. The Administration shall include the following in the notification:
1. The member's name,
2. The member's identification
				number,
3. The member's effective
				date of enrollment or disenrollment, and
4. The member's share-of-cost on a monthly
				enrollment roster.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-418 - Disenrollment

Current through Register Vol. 30, No. 28, July 12, 2024
The Administration shall disenroll an ALTCS member on the
				  last day of the month following receipt of appropriate notification under
				  R9-28-411
				  except:
1. The Administration shall
				disenroll an ALTCS member who dies. A member's last day of enrollment shall be
				the date of death.
2. The
				Administration shall disenroll a member immediately when the member voluntarily
				withdraws from the ALTCS program.
3. If ALTCS benefits have been continued
				pending an eligibility appeal decision and the discontinuance is upheld as
				specified in 9 A.A.C. 34, the Administration shall disenroll a member effective
				on the date of the hearing decision.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-501 - Program Contractor and Provider Standards - Related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. The following words and phrases, in addition to
				  definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  and 9 A.A.C. 22, Article 1, have the following meanings unless the context of
				  the Chapter explicitly requires another meaning:
"Certification" means a voluntary process by which a federal
				  or state regulatory entity grants recognition to a person, facility, or
				  organization that has met certain qualifications specified by the regulatory
				  entity, allowing the person, facility, or organization to use the word
				  "certified" in a title or designation.
"Therapeutic leave" means that a member leaves an
				  institutional facility for a period that does not exceed nine days per contract
				  year.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-501.01 - Pre-existing Conditions

Current through Register Vol. 30, No. 28, July 12, 2024
A program contractor shall comply with the pre-existing
				  condition requirements in A.A.C.
				  R9-22-502.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-502 - Long-term Care Provider Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
A. A provider shall obtain any necessary
				authorization from the program contractor or the Administration for services
				provided to a member.
B. A provider
				shall maintain and make available to a program contractor and to the
				Administration, financial, and medical records for not less than five years
				from the date of final payment, or for records relating to costs and expenses
				to which the Administration has taken exception, five years after the date of
				final disposition or resolution of the exception. The provider shall maintain
				records that meet uniform accounting standards and generally accepted practices
				for maintenance of medical records, including detailed specification of all
				patient services delivered, the rationale for delivery, and the service date.
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-503 - Licensure and Certification for Long-term Care Institutional Facilities

Current through Register Vol. 30, No. 28, July 12, 2024
A. A nursing
				facility shall not provide services to a member unless the facility is licensed
				by Arizona Department of Health Services, Medicare- and Medicaid-certified, and
				meets the requirements in 42 CFR 442, as of October 1, 2004, and 42 CFR 483, as
				of October 1, 2004, incorporated by reference, on file with the Administration,
				and available from the U.S. Government Printing Office, 732 N. Capitol St.,
				N.W., Washington, D.C. 20401. This incorporation by reference contains no
				future editions or amendments.
B.
				An ICF-MR shall not provide services to a member unless the ICF-MR is
				Medicaid-certified and meets the requirements in A.R.S. § 36-2939(B)(1)
				and 42 CFR 442, Subpart C, as of October 1, 2004, and 42 CFR 483, as of October
				1, 2004, incorporated by reference, on file with the Administration and
				available from the U.S. Government Printing Office, 732 N. Capitol St., N.W.,
				Washington, D.C. 20401. This incorporation by reference contains no future
				editions or amendments.
C. A
				nursing facility or ICF-MR that provides services to a member shall register as
				a provider with the Administration to receive reimbursement. The Administration
				shall not register a provider unless the provider meets the licensure and
				certification requirements of subsection (A) or (B).
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-505 - Standards, Licensure, and Certification for Providers of Hospital and Medical Services

Current through Register Vol. 30, No. 28, July 12, 2024
A provider shall not provide hospital services to a member
				  unless the hospital is licensed by the Arizona Department of Health Services,
				  and meets the requirements in 42 CFR 441 and 482, as of October 1, 2004, and 42
				  CFR 456, Subpart C, as of October 1, 2004, incorporated by reference, on file
				  with the Administration and available from the U.S. Government Printing Office,
				  732 N. Capitol St., N.W., Washington, D.C. 20401. This incorporation contains
				  no future editions or amendments. An Indian Health Service (IHS) hospital and a
				  Veterans Administration hospital shall not provide services to a member unless
				  accredited by the Joint Commission on Accreditation of Healthcare Organizations
				  (JCAHO).
Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 5 - PROGRAM CONTRACTOR AND PROVIDER STANDARDS › Section R9-28-506 - Requirements for Spouse as Paid Caregiver

Current through Register Vol. 30, No. 28, July 12, 2024
A. For purposes of this Section, the
				following definitions apply:
1.
				"Extraordinary care" means care that exceeds the range of activities that a
				spouse would ordinarily perform in the household on behalf of the ALTCS member
				if the member did not have a disability or chronic illness, and that is
				necessary to ensure the health and welfare of the member and avoid
				institutionalization.
2. "Personal
				care or similar services" means assistance provided to an ALTCS member with a
				disability or chronic illness to enable the member to perform Activities of
				Daily Living (ADL) or Instrumental Activities of Daily Living (IADL) that the
				member would normally perform for himself or herself if the member did not have
				a disability or chronic illness. Assistance may involve performing a personal
				care task for the member or cuing the member so that the member performs the
				task for himself or herself.