Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 25 - Division of Provider Services and Quality Assurance › Rule 016.25.21-004 - Division of Provider Services and Quality Assurance (DPSQA) Manual Extension

Current through Register Vol. 49, No. 6, June, 2024
DPSQA COVID-19 RESPONSE
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OVERVIEW
201.000
Authority
The following rules are duly adopted and promulgated by the
				Division of Provider Services and Quality Assurance (DPSQA) of the Arkansas
				Department of Human Services (DHS) under the authority of Arkansas Code
				Annotated §§
									20-76-201,
				20-77-107,
				25-10-129,
				and
				20-10-203.
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Purpose
In response to the COVID-19 pandemic, DHS identified programs
				and services that required additional flexibility or changes to adapt to
				ensuring the health and safety of our clients. This manual details them so that
				DHS may render uninterrupted assistance and services to our clients.
203.000
Appeals
Appeal requests for the COVID-19 response policies must adhere
				to the policy set forth in the Medicaid Provider Manual Section 160.000
				Administrative Reconsideration and Appeals which can be accessed at
https://medicaid.mmis.arkansas.gov/Provider/Docs/all.aspx
.
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Severability
Each section of this manual is severable from all others. If
				any section of this manual is held to be invalid, illegal, or unenforceable,
				such determination shall not affect the validity of other sections in this
				manual and all such other sections shall remain in full force and effect. In
				such an event, all other sections shall be construed and enforced as if this
				section had not been included therein.
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PROVIDER
			 CERTIFICATION
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Pre-Admission Screening for Nursing Facility Residents Potentially
			 MI/DD
42 CFR §
										483.20(k) requires
				pre-admission screening for prospective nursing home residents to identify
				persons as potentially MI/DD. CMS granted an 1135 waiver for Arkansas waiving
				preadmission screening on April 2, 2020. CMS previously had issued a blanket
				waiver related to pre-admission screening on March 13th. Specifically, the
				approval of Federal Section 1135 Waiver requests stated:
* Section 1919 (e)(7) of the Act allows Level I and Level II
				assessments to be waived for 30 days. All new admissions can be treated like
				exempted hospital discharges. After 30 days, new admissions with mental illness
				(MI) or intellectual disability (ID) should receive a Resident Review as soon
				as resources become available.
* Per
				42
				C.F.R. §
										483.106(b)(4),
				new preadmission Level I and Level II screens are not required for residents
				who are being transferred between nursing facilities (NF). If the NF is not
				certain whether a Level I had been conducted at the resident's evacuating
				facility, a Level I can be conducted by the admitting facility during the first
				few days of admission as part of intake and transfers with positive Level I
				screens would require a Resident Review.
* The 7-9-day timeframe for Level II completion is an annual
				average for all preadmission screens, not individual assessments, and only
				applies to the preadmission screens (42 C.F.R.
				§
										483.112(c)) . There
				is not a set timeframe for when a Resident Review must be completed, but it
				should be conducted as resources become available.
The 1135 waiver is set to terminate "upon termination of the
				public health emergency, including any extensions."
These processes and procedures will be available until the
				termination of the federal public health emergency, including any extensions,
				or December 31, 2022, whichever occurs first.
I n response to this declaration and waiver, the Department of
				Human Services suspended parts of two rules of the Procedures for Determination
				of Medical Need for Nursing Home Services:
(1) Rule I to the extent it prohibits facilities from admitting
				individuals with diagnoses or other indicators of mental illness or
				developmental disability; and, (2) Rule II to the extent it requires the state
				to complete a Level 2 assessment for mental illness or developmental disability
				within seven (7) to nine (9) workdays from the date the mental illness or
				developmental disability is identified by the initial screening.
By suspending these rules, nursing homes are able to admit
				individuals with diagnoses or other indicators of mental illness or
				developmental disability without first getting an assessment and approval by
				the Division of Provider Services and Quality Assurance, Office of Long-term
				Care (OLTC), clearing such individuals for placement in the facility. However,
				prior to admission, the facility must review the individual's information to
				ensure the facility can meet the individual's medical and behavioral
				needs.
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Therapeutic Community Direct Service Requirements
DMS is suspending the rule related to Therapeutic Communities
				level of direct service requirements contained in the Therapeutic Communities
				Certification Manual.
The rules to be suspended are Therapeutic Community
				Certification Manual, Sections 113, 114, 115, 116, 118, 119, and 120.
DPSQA and DMS recommends that Therapeutic Communities offer as
				many direct service hours to beneficiaries as possible in response to COVID-19
				staffing issues. It is recommended that professional counseling services be
				reduced from ten (10) hours per week to three (3) encounters per week,
				physician services be reduced from two (2) encounters per month to one (1)
				encounter per month, and QBHP intervention services be reduced from forty-two
				(42) hours per week to eighteen (18) hours per week.
These services will be available until the termination of the
				federal public health emergency, including any extensions, or December 31,
				2022, whichever occurs first.