Section 47.07.045. Home and community-based services.

   (a) The department may provide home and community-based services under a waiver in accordance with 42 U.S.C. 1396 - 1396p (Title XIX, Social Security Act), this chapter, and regulations adopted under this chapter, if the department has received approval from the federal government and the department has appropriations allocated for the purpose. To supplement the standards in (b) of this section, the department shall establish in regulation additional standards for eligibility and payment for the services.
   (b) Before the department may terminate payment for services provided under (a) of this section
        (1) the recipient must have had an annual assessment to determine whether the recipient continues to meet the standards under (a) of this section;
        (2) the annual assessment must have been reviewed by an independent qualified health care professional under contract with the department; for purposes of this paragraph, "independent qualified health care professional" means,
             (A) for a waiver based on intellectual or developmental disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified intellectual disability professional;
             (B) for other allowable waivers, a registered or advanced practice registered nurse licensed under AS 08.68 who is qualified to assess children with complex medical conditions, older Alaskans, and adults with physical disabilities for medical assistance waivers; and
        (3) the annual assessment must find that the recipient's condition has materially improved since the previous assessment; for purposes of this paragraph, "materially improved" means that a recipient who has previously qualified for a waiver for
             (A) a child with complex medical conditions, no longer needs technical assistance for a life-threatening condition, and is expected to be placed in a skilled nursing facility for less than 30 days each year;
             (B) intellectual or developmental disability, no longer needs the level of care provided by an intermediate care facility for persons with intellectual and developmental disabilities either because the qualifying diagnosis has changed or the recipient is able to demonstrate the ability to function in a home setting without the need for waiver services; or
             (C) an older Alaskan or adult with a physical disability, no longer has a functional limitation or cognitive impairment that would result in the need for nursing home placement, and is able to demonstrate the ability to function in a home setting without the need for waiver services.
   (c) If a child who is financially dependent on a military service member is eligible for home and community-based services while physically present in the state, the department shall provide for home and community-based services when the child returns to the state as though the child had remained in the state if the military service member provides proof acceptable to the department that
        (1) the member has maintained residency in the state for the period of eligibility; proof under this paragraph must include official military personnel records;
        (2) the member and the dependent child are physically present in the state and intend to reside permanently in the state while receiving the home and community-based services;
        (3) the member returned to the state within 18 months after separating from military service; and
        (4) the member's dependent child is not eligible for coverage of home and community-based services under another health insurance plan.
   (d) In (c) of this section, "military" means the armed forces of the United States, the United States Coast Guard, or the Alaska National Guard.

Authorities

47.05.270

Notes

Recent Bills that will modify this

SB 10 ADULT FOSTER CARE FOR DISABLED; MEDICAID
SB 53 ADVANCED PRACTICE REGISTERED NURSES

Implemented As

7 AAC 130.200
7 AAC 130.205
7 AAC 130.207
7 AAC 130.209
7 AAC 130.211
7 AAC 130.213
7 AAC 130.215
7 AAC 130.217
7 AAC 130.219
7 AAC 140.545
7 AAC 145.533
7 AAC 145.535
7 AAC 145.537

References

7 AAC 100.990
7 AAC 130.207
7 AAC 130.213
7 AAC 130.219
7 AAC 160.990
AS 47.05.270 Medical assistance reform program.

History

(Sec. 8 ch 96 SLA 2006; am Sec. 17 ch 42 SLA 2013; am Sec. 10 ch 102 SLA 2014; am Sec. 49 ch 33 SLA 2016)