§ 42-66.4-4 Provision of long-term homehealth care program. – (a) When a long-term home health care program as defined under this chapter isavailable, the department of elderly affairs shall notify the eligible person,in writing, of the provisions of this chapter.
(b) If a person eligible to receive services under theprovisions of this title who requires care, treatment, maintenance, nursing orother services in a nursing home desires to remain and is deemed by his or herphysician able to remain in his or her own home or the home of a responsiblerelative or other responsible adult if the necessary services are provided,that person or that person's representative shall inform the department ofelderly affairs. If a long-term home health care program as defined under thischapter is provided, the department of elderly affairs shall authorize anassessment under the provisions of this chapter. If the results of theassessment indicate that the person can receive the appropriate level of careat home, the case manager shall prepare for that person a plan for theprovision of services comparable to those that would be rendered in a nursinghome. In developing this plan, the department shall consult with those personsperforming the assessment. The services shall be provided by certified homehealth agencies, home health aide/homemaker agencies, and adult day carecenters.
(c) At the time of the initial assessment, and at the time ofeach subsequent assessment, the case manager shall establish a monthly budgetin accordance with which he shall authorize payment for the services providedunder the plan. Total monthly expenditures made under this title for eachperson shall not exceed a maximum of one hundred percent (100%) or any lesserpercentage as may be determined by the director, of the average of the monthlyrates payable under this title for skilled nursing/intermediate care facilityservices as provided for in the department of human services principles ofreimbursement for skilled nursing/intermediate care facility services eligiblerequests of the medical assistance program. If an assessment of the person'sneeds demonstrates that he or she requires services, the payment for whichwould exceed the monthly maximum, but it can be reasonably anticipated thattotal expenditures for required services for that person will not exceed themaximum calculated over a one year period, the department of elderly affairsmay authorize payment for those services.
§ 42-66.4-4 Provision of long-term homehealth care program. – (a) When a long-term home health care program as defined under this chapter isavailable, the department of elderly affairs shall notify the eligible person,in writing, of the provisions of this chapter.
(b) If a person eligible to receive services under theprovisions of this title who requires care, treatment, maintenance, nursing orother services in a nursing home desires to remain and is deemed by his or herphysician able to remain in his or her own home or the home of a responsiblerelative or other responsible adult if the necessary services are provided,that person or that person's representative shall inform the department ofelderly affairs. If a long-term home health care program as defined under thischapter is provided, the department of elderly affairs shall authorize anassessment under the provisions of this chapter. If the results of theassessment indicate that the person can receive the appropriate level of careat home, the case manager shall prepare for that person a plan for theprovision of services comparable to those that would be rendered in a nursinghome. In developing this plan, the department shall consult with those personsperforming the assessment. The services shall be provided by certified homehealth agencies, home health aide/homemaker agencies, and adult day carecenters.
(c) At the time of the initial assessment, and at the time ofeach subsequent assessment, the case manager shall establish a monthly budgetin accordance with which he shall authorize payment for the services providedunder the plan. Total monthly expenditures made under this title for eachperson shall not exceed a maximum of one hundred percent (100%) or any lesserpercentage as may be determined by the director, of the average of the monthlyrates payable under this title for skilled nursing/intermediate care facilityservices as provided for in the department of human services principles ofreimbursement for skilled nursing/intermediate care facility services eligiblerequests of the medical assistance program. If an assessment of the person'sneeds demonstrates that he or she requires services, the payment for whichwould exceed the monthly maximum, but it can be reasonably anticipated thattotal expenditures for required services for that person will not exceed themaximum calculated over a one year period, the department of elderly affairsmay authorize payment for those services.
§ 42-66.4-4 Provision of long-term homehealth care program. – (a) When a long-term home health care program as defined under this chapter isavailable, the department of elderly affairs shall notify the eligible person,in writing, of the provisions of this chapter.
(b) If a person eligible to receive services under theprovisions of this title who requires care, treatment, maintenance, nursing orother services in a nursing home desires to remain and is deemed by his or herphysician able to remain in his or her own home or the home of a responsiblerelative or other responsible adult if the necessary services are provided,that person or that person's representative shall inform the department ofelderly affairs. If a long-term home health care program as defined under thischapter is provided, the department of elderly affairs shall authorize anassessment under the provisions of this chapter. If the results of theassessment indicate that the person can receive the appropriate level of careat home, the case manager shall prepare for that person a plan for theprovision of services comparable to those that would be rendered in a nursinghome. In developing this plan, the department shall consult with those personsperforming the assessment. The services shall be provided by certified homehealth agencies, home health aide/homemaker agencies, and adult day carecenters.
(c) At the time of the initial assessment, and at the time ofeach subsequent assessment, the case manager shall establish a monthly budgetin accordance with which he shall authorize payment for the services providedunder the plan. Total monthly expenditures made under this title for eachperson shall not exceed a maximum of one hundred percent (100%) or any lesserpercentage as may be determined by the director, of the average of the monthlyrates payable under this title for skilled nursing/intermediate care facilityservices as provided for in the department of human services principles ofreimbursement for skilled nursing/intermediate care facility services eligiblerequests of the medical assistance program. If an assessment of the person'sneeds demonstrates that he or she requires services, the payment for whichwould exceed the monthly maximum, but it can be reasonably anticipated thattotal expenditures for required services for that person will not exceed themaximum calculated over a one year period, the department of elderly affairsmay authorize payment for those services.
