Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.07-012 - Division of Developmental Disabilities Alternative Community Service (DDS ACS) Transmittal Update 84

Current through Register Vol. 49, No. 6, June, 2024
201.200
Organized Health Care Delivery System Provider
The DDS Alternative Community Services (ACS) Waiver allows a
				provider who is licensed and certified as a DDS ACS case manager or a DDS ACS
				supportive living services provider to enroll in the Arkansas Medicaid Program
				as a DDS ACS organized health care delivery system (OHCDS) provider.
As long as the OHCDS provides at least one waiver service
				directly utilizing its own employees, an OHCDS provider may provide any other
				DDS ACS Waiver service via a sub-contract with an entity qualified to furnish
				the service.
The OHCDS provider furnishes the services as the individual's
				provider of choice as described in that individual's multi-agency plan of
				services (MAPS). The OHCDS provider must adhere to DDS ACS Waiver regulations
				as outlined in this provider manual. The OHCDS assumes all liability for
				services provided and/or performed by a sub-contracted entity.
211.000
Scope
The Arkansas Medical Assistance Program (Medicaid) offers
				certain home and community based services as an alternative to
				institutionalization. These services are available for eligible individuals
				with a developmental disability who would otherwise require an intermediate
				care facility for the mentally retarded (ICF/MR) level of care. The home and
				community based services to be provided through this waiver are described
				herein as the DDS Alternative Community Services Waiver Renewal, hereafter
				referred to as DDS ACS Waiver.
As stated in the DDS ACS Waiver, "waiver services will not be
				furnished to persons while they are inpatients of a hospital. Nursing Facility
				(NF), or Intermediate Care Facility for the Mentally Retarded (ICF/MR) unless
				payment to the hospital, NF, or ICF/MR is being made through private pay or
				private insurance."
A person may be placed in abeyance in three (3) month
				increments (with status report every month) for up to 12 months when a person
				is in a licensed/certified treatment program for purposes of behavior, physical
				or health treatment or stabilization. This is an option as long as the
				following conditions are met:
A. The
			 need for absence must be for the purposes of treatment in a licensed/certified
			 program for the purposes of behavior, physical or health treatment or
			 stabilization, loss of home or primary non-paid caregiver.
B. The request must be in writing with
			 supporting evidence included.
C.
			 The request must be prior approved by DDS to include applicable DDS
			 professionals' advisement.
Example: If the cause is behavior oriented, the request must be
				reviewed and recommended by DDS Psychological Team member.
D. A minimum of one (1) visit or one (1)
			 contact each month is required.
NOTE: Personal visit versus contact depends upon the
				circumstances of the abeyance. If the person is receiving treatment out of
				state or in a facility/hospital where a visit may not be an option, contact
				with applicable medical/social work personnel, the individual, and the legal
				representative is permissible. When/if the case management agency cannot be
				reimbursed, this function will be the responsibility of the DD
				specialist.
E.
			 Approval will be in 3-month increments with any/each request for continuance to
			 be submitted in writing
and sup
ported by evidence of
			 treatment status/progress. Request for continuance must be in advance and
			 timely to permit review and approval prior to abeyance expiration.
NOTE: This procedure does not stop closure of the
				Medicaid case relative to iVIedicaid income eiigibiiity. it simpiy hoids a siot
				in abeyance for the person's return. iVIedicaid income eligibility will be
				closed on the 60th day. If the person does not
				return to services within 60 days, IVIedicaid income eligibility must be
				re-determined once the person is released from treatment and ready to return to
				Waiver services.
F.
			 All requests for abeyance are to be faxed to the Program Director for Adult and
			 Waiver Services. Monthly status reports are required to be submitted to the DDS
			 Waiver Administration as long as the person is in abeyance.
In order for individuals to continue to be eligible for waiver
				services while they are in abeyance the following two requirements must be
				met:
A. It must be demonstrated that
			 an individual needs at least one waiver service as documented in their MAPS
			 Plan of Care.
B. Individuals must
			 receive at least one waiver service per month or monthly monitoring.
As stated in the Medicaid Service Manual, Section 1348, an
				individual living in a public institution is not eligible for Medicaid.
A. Public institutions include county jails,
			 state and federal penitentiaries, juvenile detention centers, and other
			 correctional or holding facilities.
B. Wilderness camps and boot camps are
			 considered a public institution if a governmental unit has any degree of
			 administrative control.
Thus, a person who is living in a public institution as defined
				above would be closed under Medicaid and also under the waiver program.
Services provided under this program are as follows:
A. Supportive Living
B. Community Experiences
C. Respite Care
D. Non-Medical Transportation
E. Supported Employment §. Adaptive
			 Equipment
G. Environmental
			 Modifications
H. Specialized
			 Medical Supplies
I. Supplemental
			 Support Service
J. Case Management
			 Services
K. Consultation Services
L. Crisis Intervention Services M.
			 Crisis Center