reglab/statecodes huggingface dataset:
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-3.0 - PROGRAM OVERVIEW - INDEPENDENT LIVING WAIVER (IL)

Current through June 25, 2024
Legal Basis
The statutory basis for this program is Section 1915 c (7) (B) of the Social Security Act.
Independent Living Waiver
The Independent Living Waiver (IL) program provides home and community-based services to individuals who have severe orthopedic and/or neurological impairments and who would qualify for nursing facility (NF) care.
The goal of the Independent Living Waiver program is to provide individuals with a meaningful choice regarding long-term care services. This goal is accomplished by facilitating the development and utilization of services that allow individuals to avoid premature nursing facility (NF) placement and provide current NF residents an opportunity to return to the home and community.
Individuals receive services though the IL Waiver and through other non-waiver service providers that are necessary to provide a safe alternative to nursing facility (NF) placement. The Independent Living Waiver allows Mississippi to provide services that are not available under the regular Medicaid State Plan program.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-3.1 - PROGRAM OVERVIEW TRAUMATIC BRAIN INURY/SPINAL CORD INJURY WAIVER (TBI/SCI)

Current through June 25, 2024
The Traumatic Brain Injury/Spinal Cord Injury Waiver provides individuals with an array of services as identified by the Case Management Team (OSDP Counselor and Registered Nurse) and identified on the Plan of Care (POC) necessary to allow the individuals with traumatic brain injury and/or spinal cord injury to remain in or return to a community setting.
Services are provided by MDRS/OSDP, providers/contractors/vendors for MDRS/OSDP and Division of Medicaid.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-3.2 - PROGRAM OVERVIEW - TRAUMATIC BRAIN INJURY/SPINAL CORD INJURY TRUST FUND (TBI/SCI)

Current through June 25, 2024
The goal of this program is to enable individuals severely disabled by a traumatic spinal cord injury or traumatic brain injury to resume the activities of daily living and reintegrate into the community with as much dignity and independence as possible. For those persons who cannot achieve complete independence, supportive services are needed in order for them to live as normally as possible.
The Trust Fund is the payer of last resort. An individual must seek the assistance from all available resources prior to the Trust Fund's participation.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-3.3 - PROGRAM OVERVIEW - FEDERAL INDEPENDENT LIVING GRANT INDEPENDENT LIVING SERVICES (TITLE VII)

Current through June 25, 2024
MDRS receives a federal grant from the Rehabilitation Services Administration (RSA) to assist individuals with the most severe disabilities to become more independent in their homes and communities. Although there are no age restrictions for this program, services provided must not duplicate services allowable under any other federal mandate.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-3.4 - PROGRAM OVERVIEW - STATE ATTENDANT CARE PROGRAM

Current through June 25, 2024
In 1985, the Mississippi Legislature created the State Attendant Care Fund. This state funded program provides personal care assistance services such as bathing, toileting, meal preparation, eating, and dressing to individuals with the most significant/severe disabilities. There are no age restrictions for this program; however, individuals must be able to direct their own care and must not be eligible for personal care assistance through any other program. The provision of a Personal Care Attendant allows an individual to function as independently as they can in the home and community.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-4.0 - INDEPENDENT LIVING WAIVER PROGRAM SERVICES

Current through June 25, 2024
The Independent Living Waiver provides individuals with severe orthopedic and/or neurological impairments an array of services as identified by the Case Management Team (OSDP Counselor and Registered Nurse) and identified on the Plan of Care (POC) necessary to allow the individual to remain in or return to a community setting.
Services are provided by MDRS/OSDP, providers/un-paid resources/vendors for MDRS/OSDP and Division of Medicaid.
Brief description of Independent Living Waiver services are:
1. Case Management
				activities that assist the consumer in gaining access to waiver services,
				non-waiver services from other resources or other OSDP Programs
2. Personal Care Attendant Services
				assistance a consumer receives with the performance of the activities of daily
				living and household chores necessary to maintain the home in a clean,
				sanitary, and safe environment.
3.
				Specialized Medical Equipment and Supplies devices, controls, appliances or
				medically necessary supplies that increase a consumer's ability to perform his
				activities of daily living; perceive, control, and communicate with the
				environment in which they live;
4.
				Transition Assistance Services assistance a consumer receives with
				transitioning from a nursing facility to the Independent Living Waiver
				program.
5. Environmental
				Accessibility Adaptations - services that assess the need for, arrange for, and
				provide modifications to an individual's home to enable him/her to reside in
				the home and to ensure safety, security, and accessibility.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-4.1 - TRAUMATIC BRAIN INJURY/SPINAL CORD INJURY WAIVER SERVICES

Current through June 25, 2024
Brief description of Traumatic Brain Injury/Spinal Cord Injury Waiver services are:
1.
				Case Management activities that assist the consumer in gaining access to waiver
				services, non-waiver services from other resources or other OSDP
				Programs
2. Personal Care Attendant
				Services assistance a consumer receives with the performance of the activities
				of daily living and household chores necessary to maintain the home in a clean,
				sanitary, and safe environment.
3.
				Specialized Medical Equipment and Supplies devices, controls, appliances or
				medically necessary supplies that increase a consumer's ability to perform his
				activities of daily living; perceive, control, and communicate with the
				environment in which they live;
4.
				Transition Assistance Services assistance a consumer receives with
				transitioning from a nursing facility to the Independent Living Waiver
				program.
5. Respite Services short
				term, temporary relief to the usual caregiver because of the absence or need
				for relief of the caregiver. Provides all the necessary care the usual
				caregiver would provide during that time period to the individual.
6. Environmental Accessibility Adaptations -
				services that assess the need for, arrange for, and provide modifications to an
				individual's home to enable them to reside in the home and to ensure safety,
				security, and accessibility.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-4.2 - TBI/SCI INJURY TRUST FUND SERVICES

Current through June 25, 2024
1. Transitional
				Personal Care Attendant Services
Attendant care services to assist an individual with physical
				  activities of daily living such as bathing and grooming or cognitive activities
				  such as planning daily schedules or participating in community reintegration
				  activities.
Limitation: Twelve-month limit on transitional
				  attendant care.
During this twelve-month lifetime period, the client and the
				  Counselor should make every effort to explore other attendant care
				  options.
Time allotments will range between two and four hours per day
				  except where unusual needs exist. Case file should be documented to support the
				  need for additional hours.
2. Durable Medical Equipment
An assessment/evaluation for this service will not be counted
				  towards an individual's lifetime cap.
3. Home Modifications
Follow the guidelines and procedures to purchasing Durable
				  Medical Equipment and Assistive Technology Services Section 13.
4. Vehicle Modifications
Follow the guidelines and procedures to purchasing Durable
				  Medical Equipment and Assistive Technology Services Section 13.
NOTE: Life CAP for Durable Medical Equipment, Home
				  Modifications and Vehicle Modifications combined is $35,000 per individual
				  lifetime.
5. Respite
				Services - A temporary, short-term furlough of a family member(s) or other
				caregiver from the responsibility of oversight and personal care for a survivor
				of spinal cord or brain injuries.
Limitation:
An individual is allowed a maximum of 288
				  respite hours per year which is scheduled at the discretion of the survivor and
				  regular caregiver.
6. Emergency Services Emergency services are
				services provided to the individuals that are of a short-term urgent nature and
				are considered critical for the individual's survival, general health, and
				welfare. There is a $1,000 lifetime cap limitation per individual.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-4.3 - STATE ATTENDANT CARE SERVICES

Current through June 25, 2024
Brief description of the State Attendant Care services is:
1. Case Management
				activities include monthly contacts with the client, annual assessments,
				certification of the Personal Care Assistant and check financial status of
				clients each year. Also provide access to other resources or other OSDP
				Programs.
2. Personal Care
				Attendant Services assistance a consumer receives with the performance of the
				activities of daily living and household chores necessary to maintain the home
				in a clean, sanitary, and safe environment.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-5.0 - APPLICATION FOR INDEPENDENT LIVING SERVICES (ILS)

Current through June 25, 2024
The Application for Services form and the Statement of Understanding form must be completed on all applicants who wish to apply for services under the Office of Special Disability Programs. Once completed, this form should be filed in the client case file in the appropriate tab. See Resource Guide for Application For Services Form and the Statement of Understanding Form.
The Application Documentation
The Application Documentation Page that is a part of the Application for Services is very important to the overall case process. This information lays the foundation of the entire casework process.
Documentation
Reasons for seeking services:
In this section, the Counselor should record information that they received during the initial application process regarding the individual's disability and their medical history to help the Counselor determine what medical or other information should be requested. The history of the individual's adjustment or lack of adjustment to their impairment is very important and their family support system.
Describe their independent living needs:
The Counselor should document the problems the applicant is having and what services they are requesting to enable them to function more independently in the home and community.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.0 - PRE-ADMISSION SCREENING (PAS) DETERMINATION REQUIREMENTS

Current through June 25, 2024
The new Pre-Admission Screening process became effective on October 1, 2007. All applicants/clients applying for Medicaid long term care on October 1, 2007 and beyond must complete a Pre-Admission Screening (PAS) for clinical eligibility determination. The PAS must be submitted within thirty (30) days of the physician's certification.
Individuals enrolled in Medicaid long term care must be recertified annually. Clients desiring continued waiver services must be recertified by submission of a new PAS at least ten (10) days, but no more than ninety (90) days, prior to the expiration of the current PAS. Failure to submit timely may result in a lapse in certification.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.1 - PAS QUALIFICATIONS AND RESPONSIBILITIES

Current through June 25, 2024
The PAS must be completed by the OSDP Case Manager and Registered Nurse.
The responsibilities for completing the PAS are as follows:
*
Conduct face to face interview with the applicant/client to the extent feasible, given the individual's physical and cognitive status;
*
Obtain information from caregiver(s) and/or designated representative, to the extent practicable;
*
Review medical records and other relevant medical documentation to verify medical conditions and services, to the extent practicable;
*
Provide information to the applicant/client and their responsible party/designated representative about available Medicaid program placement options, to facilitate informed decision making;
*
Provide information about alternative services/resources for individuals who may not be eligible for Medicaid long term care and
*
Provide information about the secondary review process and appeal rights for individuals who may not be eligible for Medicaid long term care.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.2 - PAS DOCUMENTATION OF INFORMED CHOICE

Current through June 25, 2024
When an individual is determined likely to require a home and community based waiver service, the individual or his or her legal representative will be:
*
Informed of any feasible alternatives under the waiver; and
*
Given the choice of either institutional or home and community based services.
The applicant/client, or legal representative, will initial their preference of placement on the Informed Choice section of the PAS Informed Choice form. The OSDP Case Manger must also sign an attestation that the applicant/client and/or the legal representative was informed of the identified DOM's long term care program options based on the results of the PAS and the applicant's/clients desired services. The Informed Choice document must be witnessed by a third party. The initial/signature page must be retained by the OSDP Case Manger for review by DOM, if requested.
(See Resource Guide for the PAS Informed Choice Form).
The consumer cannot receive services from:
* More than one Medicaid Waiver program at a time, including waivers that are not administered by the Department of Rehabilitation Services such as the Elderly and Disabled Waiver and the Assisted Living Waiver.
* A Medicaid institutional program such as nursing facility or hospice.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.3 - CONSUMER CHOICE AMONG SERVICES

Current through June 25, 2024
Non - Waiver Services
The Case Management Team must document any available benefits and services the consumer is receiving before waiver funds are used to meet the individual's needs. Example: If the consumer is eligible for Medicare and needs medical supplies/equipment, services available through Medicare must be used before use of medical supplies/equipment provided through the waiver.
The OSDP Counselor is responsible for assisting the consumer in applying for and using all available non-waiver services.
The OSDP Counselor must consider all third party resources including services provided by family members and other informal supports to reduce waiver expenditures. Non-waiver services must be considered in the development of the Plan of Care (POC) and must not duplicate IL Waiver or TBI/SCI Waiver Services.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.4 - SIGNATURE ON FILE

Current through June 25, 2024
Medicaid will follow Medicare policy and allow providers to obtain a lifetime authorization from the Medicaid applicant/client to submit Medicaid claims. This authorization must be signed at the time an application is taken. This authorization must be retained in the client's case file. Be sure the applicant/client signs his/her name. If the applicant/client cannot write his/her name, he/she should sign by a mark and a have a witness sign the applicant's/client's name and indicate by whom the name was entered. If the applicant/client is a minor or otherwise unable to sign, any responsible person such as a parent or guardian must enter the recipient's name and write "By," sign his/her own name and address in the space, show his/her relationship to the applicant/client and explain briefly why the applicant/client cannot sign.
See Resource Guide for Signature On File Form, (HCBS Resource Guide).
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.5 - APPLICANTS WITHOUT MEDICAID ELIGIBILITY › Section 32-1-6.5.1 - APPLICANTS WITH MEDICAID ELIGIBILITY COVERAGE

Current through June 25, 2024
At the time of the initial intake, information on the applicant's Medicaid and/or financial status will be obtained. OSDP staff handling the initial intake must determine if the applicant is currently on Medicaid and should check Envision to confirm the applicant's current status.
Applicant's who receive Supplemental Security Income (SSI) are already eligible for Medicaid and will not need to have a Medicaid eligibility decision.
It is the OSDP Counselor's responsibility to assist the individual in applying for Medicaid benefits.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.6 - APPLICATION PROCESS FOR MEDICAID ELIGIBILITY DETERMINATION

Current through June 25, 2024
If the individual does not have Medicaid coverage, their case record will be reviewed by the Division of Medicaid to determine if they meet the medical criteria for the waiver. If approved, the Division of Medicaid will forward notification to the Medicaid regional office that the applicant has met medical certification for participation and would like to apply for coverage under the Home and Community based services Special Income Category (300% of SSI).
Division of Medicaid, Home and Community Based Services Division, will forward a cover letter to the OSDP Counselor stating that the individual's application for waiver services has been determined to meet the medical criteria for the waiver and will be certified pending approval for Medicaid coverage.
The IL Counselor will inform the individual in writing or by phone that he/she will need to go to their Medicaid Regional Office within 10 days to apply for Medicaid eligibility through the Special Handicapped Coverage Group.
The HCBS Division will maintain a case record in a pending status for 60 days from the date it was processed. If the applicant and/or their representative do not initiate appropriate action to obtain eligibility process, failure to comply will result in closure of their case.
After the applicant completes the application at the Regional Office, they have 45 days to provide all requested information to complete the eligibility process. Failure to comply will result in closure of their case.
Medicaid will inform the IL Counselor that he/she client has been approved.
Examples:
Case record is approved 5/01/06, the applicant takes no action toward obtaining Medicaid eligibility by 07/01/06, case record will be disapproved and returned to the IL Counselor.
Case record approved 5/01/06, applicant waits until 06/29/06 to fill out application at the Regional Office, the "clock" restarts time allow applicant 45 days to complete the eligibility process.
No services can be initiated under the waiver program until eligibility has been established. The Division of Medicaid will send a cover letter with a certification date to the IL Counselor.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.7 - FAMILY MEMBERS AND INFORMAL SUPPORTS

Current through June 25, 2024
As part of the initial assessment, the Counselor determines the need for personal care services and the estimated hours necessary to meet those needs. The need for a particular task is determined based on the individual's functional impairment to complete that task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports. Personal Care Hours cannot be authorized if there is not a need for these services.
The Plan of Care (POC) should be developed considering the needs of the applicant and the stated intentions and willingness of the caregiver to provide unpaid care. The POC will reflect hours of those needed tasks that will not be provided by another source or the caregiver as unpaid care. The caregiver should be asked in all cases which services/tasks he will provide without payment.
Family members, except those legally responsible such as a spouse or parent of a minor, may be employed to be paid as Personal Care Attendants.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.8 - INFORMAL SUPPORT PROVIDING ASSISTANCE WITH ACTIVITIES OF DAILY LIVING

Current through June 25, 2024
Activities of daily living necessary for daily functioning include eating, toileting, transfer, dressing, bathing and meal preparation as identified in Section II A of the Long Term Care/Pre Admission Screening (PAS) Instrument. The activities of daily living are those tasks that do impact the consumer's health and safety.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.9 - ENSURING HEALTH AND SAFETY

Current through June 25, 2024
The OSDP Counselor and Nurse have the responsibility to ensure the consumer's health and safety and develop a Plan of Care (POC) that includes all necessary elements to adequately meet the consumer's needs. Use of informal supports, third party resources and other community resources are an integral part of the overall development of the POC. The use of third party resources ensures the most cost-effective and efficient use of funds to meet the individual's needs.
The Counselor must inform the family member or other non-paid supports of the importance of their contribution toward the Plan of Care.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.10 - INFORMING APPLICANTS/CLIENTS OF ESTATE RECOVERY › Section 32-1-6.10.1 - WHAT IS ESTATE RECOVERY?

Current through June 25, 2024
In order for Estate Recovery to apply, the applicant/client must be eligible for Medicaid and be
:
*
age 55 and older, and,
*
in a nursing facility or enrolled in a home and community based services waiver program at the time of death.
*
enrolled in hospice at the time of death.
The Estate Recovery law does not apply if at the time of death, the applicant/client has:
*
A surviving husband or wife, or
*
A surviving dependent child or children under 21 years of age, or
*
A surviving dependent child or children of any age who are blind or disabled, or
*
An undue hardship condition that causes Estate Recovery not to apply.
Estate property is made up of real and personal property that the applicant/client owns at the time of death:
*
Real property such as home, family business, farm or ranch;
*
Cash reserves, stocks, bonds, automobiles, recreational vehicles, mobile home;
*
Or any property with value owned by the beneficiary in full or in part
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.11 - PAS INSTRUMENT COMPONENTS

Current through June 25, 2024
The PAS consist of ten (10) sections, most of which have two (2) or more subsections. The table below lists the sections/subsections and identifies the populations for whom each subsection applies.
Section/Subsection
Applies to:
I Intake
All Applicants
II Functional Screen
IIA ADL's & IADL's
All Applicants
IIB Communication/Sensory
All Applicants
III Cognitive Screen
All applicants (caregiver response component applies only if caregiver is present)
IV Mood/Psychosocial & Behaviors
IVA Mood/Psychosocial
All Applicants
IVB Behaviors
All Applicants
V Medical Screen
VA Medical Conditions
All Applicants
VB Health-Related Services
All Applicants
VC Medications
All Applicants
VD Medical Stability
All Applicants
VE Medical Summary
All Applicants
VI Social Supports
VI.1 Primary Caregiver
All applicants with a primary caregiver
VI.2 Formal Agency Supports
All Applicants
VII Home Environment
All applicants except Nursing Home and other institutional residents not seeking community placement
VIII Informed Choice
VIII.1 Individual Strengths
All applicants except Nursing Home and other institutional residents not seeking community placement
VIII.2 Program Options & Desired Assistance
All Applicants
VIII.3 Individual Choice
All Applicants
IX Level II Determination (PASRR)
All applicants presented with Nursing Facility Placement as an option in Section VIII
X PAS Summary & Physician Certification
All Applicants
The PAS application may be reviewed in its entirety by logging on to:
www.dom.state.ms.us,
select Providers, select Envision. Enter your User ID and Password, select Provider, Long Term Care, PAS and Hardcopy PAS Application.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.12 - PAS CERTIFICATION PERIODS

Current through June 25, 2024
Clinical eligibility will be granted for a period of one year. HCBS waiver clients desiring continued waiver services must be recertified by submission of a new PAS at least ten (10) days (but no more than ninety (90) days) prior to date of expiration of the current PAS. Failure to submit the PAS timely may result in a lapse of certification.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-6.13 - PRE-ADMISSION SCREENING (PAS) RE-CERTIFICATION

Current through June 25, 2024
A re-assessment of an individual's functional limitations and functional capacities as they relate to activities of daily living and their impairment must be completed annually for individuals enrolled in the waiver. The re-certification re-assess' their need for services that will be developed on the Plan of Care to maintain them in his/her own home.
It is the responsibility of the OSDP Counselor and the Registered Nurse (Case Management Team) to complete the annual re-certification. It is performed in the home and again gives the case management team the opportunity to visually reassess if the person continues to meet the medical criteria for the waiver program.
In order to assure that the POC is reassessed annually as required by the waiver requirements, the Counselor must:
1. Begin the re-certification process no
				sooner than 90 days prior to the certification end date/expiration of the
				current POC;
2. Complete the
				development of the re-certification POC and verify all aspects of eligibility
				and;
3. Complete all necessary
				procedures no sooner that 90 days prior to the expiration of the current POC
				and submit all information to OSDP Administration no later than 60 days prior
				to the expiration of the current POC.
4. Enter information in OSDP Program Browse
				page to reflect the date of reassessment and the date of the Physician's 260.
In addition to the above, the Counselor must run their
				  tickler file from AACE which will ensure timely recertifications.
Note:
The DOM-HCBS 301 Plan of Care must be
				  completed at the same time as the re-certification assessment is completed.
				  Counselors must again make sure that the individual understands that all
				  services provided through the HCBS Waiver programs are subject to the approval
				  of the Division of Medicaid.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-7.0 - FUNCTIONAL ASSESSMENT FOR ATTENDANT CARE SERVICES

Current through June 25, 2024
If the client is requesting attendant care services through the State Attendant Care Program, a functional assessment must be completed. As part of the functional assessment, the Counselor determines the attendant care services the client needs and the estimated hours necessary to meet those needs. The need for the particular task is determined based on the client's functional impairment to complete the task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports. Attendant care hours should not be planned if there is not a need for these services. (See Resource Guide for the Functional Assessment Form).
The ILP should be developed and updated annually considering the needs of the client, stated intentions and willingness of the caregiver to provide unpaid care. Family members, except spouses and those legally responsible, may be employed as the attendant under the State Attendant Care Program.
Upon completion of the functional assessment, update the OSDP program browse page by entering the functional assessment date, start and end date and the number of PCA hours authorized.
The OSDP Counselor is required to make monthly contacts with clients receiving State Attendant Care with a face to face visit annually at the end of each state fiscal year.
The OSDP Counselor must make attempts to assist the client in accessing other resources for this service (i.e. Medicaid waiver programs) for those individuals requiring long term care.
Although the number of hours needed is determined during the functional assessment process, the number of hours an individual receives via the State Attendant Care Program may be affected by the availability of state funds. Any additional hours given above what has been approved must be approved by OSDP State Office Administration.
The functional assessment may be completed by the OSDP Counselor and does not require a Registered Nurse to be present.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-7.1 - FUNCTIONAL ASSESSMENT FOR TRANSITIONAL ATTENDANT CARE SERVICES

Current through June 25, 2024
If the client is requesting transitional attendant care services through the TBI/SCI Trust Fund Program, a functional assessment must be completed. As part of the functional assessment, the Counselor determines the attendant care services the client needs and the estimated hours necessary to meet those needs. The need for the particular task is determined based on the client's functional impairment to complete the task and if that task will be completed by other sources including unpaid caregivers, such as family members or other informal supports. Transitional attendant care hours should not be planned if there is not a need for these services. (See Resource Guide for the Functional Assessment Form).
The ILP should be developed and updated annually considering the needs of the client, stated intentions and willingness of the caregiver to provide unpaid care. Family members, except spouses and those legally responsible, may be employed as the attendant under the TBI/SCI Trust Fund Program.
Upon completion of the functional assessment, update the OSDP program browse page by entering the functional assessment date, start and end date and the number of PCA hours authorized.
The OSDP Counselor is required to make monthly contacts with clients receiving transitional attendant care services.
The OSDP Counselor must make attempts to assist the client in accessing other resources for this service (i.e. Medicaid waiver programs) for those individuals requiring long term care.
There is a twelve-month time limit on transitional attendant care services. During this time, the client or family members will be assisted with seeking other attendant care options.
In addition to the functional assessment, the TBI/SCI Verification form must be completed by the treating physician. (See Resource Guide for TBI/SCI Verification form).
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-8.0 - DETERMINING THE APPLICANT'S DISABILITY

Current through June 25, 2024
Determining the client's disability is the first major step in the process. This process begins with the Counselor's recording of medical history obtained from the consumer during the application process. Information regarding their impairment, and illnesses including dates and types of treatments or services provided should be recorded. The names and addresses of physicians who have treated them, as well as, hospitals and clinics where they may have been a patient are important so that the Counselor may request, if needed, pertinent medical records. As much as possible, the Counselor should try to determine the client's primary care physician for the impairment they are reporting.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-8.1 - MEDICAL INFORMATION TO ESTABLISH ELIGIBILITY AND FOR THE PROVISION OF SERVICES

Current through June 25, 2024
When an individual is in Application status, medical reports/examination, etc., are necessary to make a determination. When medical information is used as a basis to establish eligibility, the following guidelines shall be followed:
1. If a
				disability is reported and may be documented by medical Records but does not
				cause substantial functional limitations to activities of daily living or the
				condition is stable, this impairment does not have to be recorded on the
				Certificate of Eligibility. The Counselor's knowledge of this impairment and
				its stability, and the fact that it is not a factor to the rehabilitation
				process should be documented in Case notes or in the other section of the
				Certificate of Eligibility.
2.
				Medical information does not have to be signed if the diagnostician, medical
				groups, or clinic is clearly identified in the information. DDS reports,
				hospital/VA records data on letterhead stationery, faxes to Counselors, copies
				of letter to other physicians, and letters to Counselors are
				acceptable
3. Medical data not
				readily identifiable, handwritten notes, office/clinic notes, or pages from
				charts would all require a signature if the physician or office is not
				identified.
4. Patients name must
				be on all medical data to ensure that there is no question concerning the
				identification of the consumer/client.
5. Medical information, if used to help
				determine eligibility, must contain an actual diagnosis.
6. Medical documentation must be in the file
				and dated on or before the date of the certificate of eligibility.
7. Medical reports completed by a Family
				Nurse Practitioner (FNP) or Physicians Assistant must be co-signed by a
				physician to be acceptable.
8.
				Medical reports completed/signed by the physician's office staff (i.e.
				secretary, nurse, etc.) are never acceptable.
A disability will generally be considered stable if the
				  answer is "no" to all the following questions:
1. Has the client's condition changed in the
				past year?
2. Has the client been
				hospitalized during the past year as a result of his/her condition?
3. Has the client's medication or therapy
				been changed in the past year?
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-8.2 - MEDICAL CONSULTATION

Current through June 25, 2024
Each MDRS District has a Medical Consultant that can be utilized by the OSDP staff. The medical consultants help Counselors interpret medical data and advise them regarding impairments.
It is important to remember that Counselors make all decisions regarding a client's eligibility for services.
Medical Consultation is required for the following situations:
* When there is conflicting medical information or recommendations for treatment.
* When multiple disabilities complicate the provision of services;
* To certify the acceptability of medical reports;
* To help interpret medical information received and provide information regarding the functional limitations that are not always clearly stated in medical reports.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-8.3 - DOCUMENTING ELIGIBILITY FOR SERVICES

Current through June 25, 2024
At a minimum, the case file for each individual determined eligible for services must include the following information supporting the determination of eligibility:
*
The medical, psychological, and other information supporting the presence of a most significant or significant physical or mental disability;
*
The Certificate of Eligibility that records the impairment, justification analysis of a severe (serious) limitation in their ability in to function, continue functioning or move towards functioning independently in the family or community or to continue in employment.
The existence of a DISABILITY must be based upon medical, psychiatric, and/or psychological reports.
The IL Counselor may utilize other staff members (case reviews) and medical consultants in making eligibility decision. The final eligibility decision must be made and certified by the IL Counselor the case is assigned to.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-8.4 - ELIGIBILITY DETERMINATION EXTENSION

Current through June 25, 2024
A determination of eligibility shall be made within 60 days from the date of application.
The 60 day period is considered to be consecutive calendar days and is counted in this manner. The 60 day period begins on the date the consumer or his/her representative signs the application for services.
A delay in determining eligibility for services may be extended if exceptional or unforeseen circumstances beyond the control of the Agency preclude making the eligibility determination within 60 days, and the Agency and the individual agree to a specified extension of time.
This agreement and extension must be documented as an eligibility determination extension. The extension must reflect the reason for the extension, the date in which the eligibility determination will be made, and that the individual agrees with the extension. Extensions cannot be more than 60 additional calendar days.
Under unusual circumstances, the Counselor Assistant can complete and sign the extension. The reason must be documented.
It is the sole responsibility of the Office of Special Disability Programs, Mississippi Department of Rehabilitation Services to determine if an individual is eligible for services and to determine the nature and scope of the services to be provided.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-9.0 - STATE ATTENDANT CARE ELIGIBILITY

Current through June 25, 2024
The State Attendant Care Program is a special program created by the Mississippi Legislature in 1985 to provide personal care services to persons who have severe disabilities. The intent of the State Attendant Care Program is to provide a means for securing attendants for those not able to access personal care services under other programs.
Eligibility Criteria:
In order for an individual to be served under the State Attendant Care Program, the following eligibility criteria must be met:
* The presence of a significant mental or physical disability;
* The presence of a severe limitation in ability to function independently in the family or community, and
* A reasonable expectation that independent living rehabilitation services will significantly assist in their ability to function more independently in the home or community.
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-9.1 - ELIGIBILITY CRITERIA FOR THE TRAUMATIC BRAIN INJURY/SPINAL CORD INJURY TRUST FUND PROGRAM

Current through June 25, 2024
In order for an individual to be served under the TBI/SCI Trust Fund program, the following eligibility criteria must be met:
1. Must have a certified traumatic brain or
				spinal cord injury. See Spinal Cord/Traumatic Brain Injury Verification Form.
				(Resource Guide)
*
Traumatic brain injury is defined as an insult
				  to the skull, brain or its covering after birth, resulting from external trauma
				  which produces an altered state of consciousness or anatomic motor, sensory, or
				  cognitive/behavioral deficits. (This
excludes
any birth
				  trauma.)
Note: Birth trauma is defined as a physical injury
				  sustained by an infant during birth; and
Birth is defined as the entire separation of the infant
				  from the maternal body (after cutting of the umbilical cord).
*
Spinal cord injury is defined as a traumatic
				  injury to the spinal cord or the cauda equina with evidence of motor deficit,
				  sensory deficit, and/or bowel and bladder dysfunction. The lesions must have
				  significant involvement with two of the above three.
******This
excludes
brain injury and spinal cord
				  injury
trauma
that results intentionally or unintentionally from
				  medical intervention.
2.
				Must be certified as medically stable by the primary care physician. Medical
				stability is defined as the absence of the following:
A. An active, life threatening condition
				(e.g. sepsis, respiratory, or other condition requiring systematic therapeutic
				measures);
B. IV drip to control or
				support blood pressure;
C.
				Intracranial pressure or arterial monitoring
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-10.1 - TRAUMATIC BRAIN INJURY/SPINAL CORD INJURY WAIVER

Current through June 25, 2024
The Traumatic Brain Injury (TBI)/Spinal Cord Injury (SCI) waiver provides services to clients who, but for the provision of such services, would require the level of care found in a nursing facility. The TBI/SCI Waiver is a Medicaid home and community-based waiver operated jointly with the Division of Medicaid.
Eligibility Criteria
1. Must have a certified traumatic brain or
				spinal cord injury. See Spinal Cord/Traumatic Brain Injury Verification Form.
				(Resource Guide)
*
Traumatic brain injury is defined as an insult
				  to the skull, brain or its covering resulting from external trauma, which
				  produces an altered state of consciousness or anatomic motor, sensory, or
				  cognitive/behavioral deficit.
*
Spinal cord injury is defined as a traumatic
				  injury to the spinal cord or the cauda equina with evidence of motor deficit,
				  sensory deficit, and/or bowel and bladder dysfunction. The lesions must have
				  significant involvement with two of the above three.
2. Must be certified as medically stable by
				the primary care physician.
Medical stability is defined as the absence of the
				  following:
A. An active, life
				threatening condition (e.g. sepsis, respiratory, or other condition requiring
				systematic therapeutic measures);
B. IV drip to control or support blood
				pressure;
C. Intracranial pressure
				or arterial monitoring
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-10.2 - THE TRAUMATIC BRAIN INJURY/SPINAL CORD INJURY PHYSICIAN VERIFICATION FORM

Current through June 25, 2024
The Traumatic Brain Injury/Spinal Cord Injury Physician Verification form must be completed by the physician certifying that the client's injury was due to trauma and that their condition is medically stable.
The original copy of the TBI/SCI Verification form should be kept in your file and a copy submitted to the DOM with the pre-admission screening application.
It is necessary to use the Verification form that is in the actual TBI/SCI Waiver.
(See Resource Guide for a copy of the TBI/SCI Verification form)
Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-10.3 - PRE-ADMISSION SCREENING APPEALS

Current through June 25, 2024
Applicants/clients have the right to appeal long term care eligibility denials. If an individual files an appeal and the case has not already been subject to the secondary review process, it will be handled in the manner described in Section 10.4. If the secondary review has already occurred, the case will be reviewed again by a supervisory level clinician who has not previously reviewed the case. Appeals will be processed in accordance with existing state policies.