Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.14-027 - Discontinuing of the DAAS-IC-20 Form

Current through Register Vol. 49, No. 6, June, 2024
Section
			 II
IndependentChoices
202.300
Enrollment
The Division of Aging and Adult Services (DAAS) is the point of
				entry for all enrollment activity for IndependentChoices. The program is
				limited based on an approved number through the Medicaid State Plan.
The individual or their designee will first call the
				IndependentChoices toll-free number at 888-682-0044 or 866-710-0456.
				Information about the program is provided to the individual and verification
				made that the individual is currently enrolled in a Medicaid category that
				covers personal assistance services. If the individual is currently enrolled in
				an appropriate Medicaid category and has an assessed physical dependency need
				for "hands on" assistance with personal care needs, DAAS will enter the
				participant's information into a DAAS database. If the individual is not
				currently enrolled in an appropriate Medicaid category, the individual will be
				referred to the DHS County Office for eligibility determination.
The IndependentChoices counselor, nurse and fiscal agent will
				then work with the individual to complete the enrollment forms either by mail
				and telephone contact or by a face-to-face meeting. The individual will be
				provided with a program manual, which explains the individual's
				responsibilities regarding enrollment and continuing participation. The
				individual must complete the forms in the Enrollment Packet, which consists of
				the Participant Responsibilities and Agreement, the Backup Personal Assistant
				and the Authorization to Disclose Health Information. The individual must also
				complete the forms in the Employer Packet, which includes the Limited Power of
				Attorney, IRS and direct deposit forms related to being a household employer.
				Each personal assistant must complete the forms in the Employee Packet which
				include the standard tax withholding forms normally completed by an employee,
				the Employment Eligibility Verification Form (I-9), a Participant/Personal
				Assistant Agreement, Employment Application and a Provider Agreement. Each
				packet includes step-by-step instructions on how to complete the above forms.
				Assistance is available to the individual, Decision-Making
				Partner/Communications Manager and the personal assistant to help complete the
				forms and answer any questions.
As part of the enrollment process, the DAAS RN will complete an
				assessment using the Home and Community Based Services (HCBS) Level of Care
				Assessment Tool. The DAAS RN will determine, through the completed assessment
				and professional judgment, the level of medical necessity. This determination
				creates the budget for self-directed services. Eligibility for personal care
				services is based on the same criteria as state plan personal care services.
NOTE:
For ElderChoices beneficiaries, the DAAS RN will determine
				the need for personal care, Adult Companion Services and Homemaker hours
				needed. The ElderChoices plan of care will reflect that the beneficiary chooses
				IndependentChoices as the provider. DAAS-HCBS staff will obtain physician
				authorization for persons not receiving either ElderChoices or Alternatives for
				Adults with Physical Disabilities waiver services.
After the in-home assessment, the DAAS RN will complete the
				paperwork and coordinate with the IndependentChoices counselor. The counselor
				will process all of the completed enrollment forms. The assessment is sent to
				the beneficiary's physician for authorization if the beneficiary is not
				authorized for services through a waiver plan of care for ElderChoices or
				Alternatives for Adults with Physical Disabilities. State and IRS tax forms
				will be retained by the fiscal agent. Disbursement of funds to a beneficiary or
				their employee will not occur until all required forms are accurately completed
				and in the possession of the fiscal agent.
Personal care assessments for beneficiaries aged 21 years or
				older and authorized by the beneficiary's physician in excess of 14.75 hours
				per week are forwarded to DAAS for coordination with Utilization Review in the
				Division of Medical Services for approval. View or print Utilization Review
				contact information.For beneficiaries under age 21, all personal care hours
				must be authorized through Medicaid's contracted Quality Improvement
				Organization (QIO), QSource of Arkansas. View or print QSource of Arkansas
				contact information.
IndependentChoices follows the rules and regulations found in
				the Arkansas Medicaid Personal Care Provider Manual in determining and
				authorizing personal care hours. The initial authorization for personal
				assistance services may not begin until the beneficiary's primary care
				physician or an advanced practice nurse enrolled in the Arkansas Medicaid APN
				program seeing patients in an Arkansas Medicaid enrolled Rural Health Clinic or
				Federally Qualified Health Center signs and dates the Home and Community Based
				Services (HCBS) Level of Care Assessment Tool. For beneficiaries receiving
				services through the ElderChoices or Alternatives for Adults with Physical
				Disabilities waiver program, the APN or physician's signature is not required.
				The signature of the DAAS RN is sufficient to authorize personal care services.
				After the service plan is authorized, the actual day services begin is
				dependent upon all of the following conditions:
A. DAAS issues a seven-day notice to
			 discontinue service to any agency personal care, adult companion services or
			 homemaker provider currently providing services to the individual.
B. The date the beneficiary's worker is able
			 to begin providing the necessary care. It can be no earlier than the date the
			 physician authorized the service plan for the non-waiver eligible participant,
			 if an agency provider is not providing the personal care services.
C. The fiscal agent is in possession of all
			 required employer and employee documents.
If the beneficiary is not a recipient of ElderChoices or
				Alternatives for Adults with Physical Disabilities services, then continuation
				of personal assistance services requires reauthorization prior to the end of
				the current service plan end date.
When required for non-waiver beneficiaries, the earlier of the
				two following conditions will suffice for the face-to-face visit required sixty
				days prior to the begin date of the new service plan:
A. The beneficiary's primary care physician
			 or eligible nurse practitioner (as described in this manual) signature on the
			 HCBS Level of Care Assessment Tool attests that he or she has examined the
			 patient within the past 60 days.
B.
			 The beneficiary has a face-to-face visit with their primary care physician or
			 eligible nurse practitioner 60 days prior to the service plan begin date.
When the approval by Utilization Review is received, or the
				beneficiary needs 14.75 hours or less per week, the IndependentChoices
				Counselor will contact the beneficiary or Decision-Making
				Partner/Communications Manager to develop the cash expenditure plan. The
				Medicaid beneficiary as the employer and the counselor will determine when
				IndependentChoices services can begin, but may not commence prior to the date
				authorized by the physician. The beneficiary is required to have a face-to-face
				visit with their physician within 60 days of the date that the physician signs
				the Assessment Tool or 60 days prior to the service plan begin date and each
				subsequent reassessment. At no time will services begin prior to the first day
				of the previous month unless authorized by the Division of Aging and Adult
				Services.