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for children with complex medical conditions under 7 AAC 130.205(d)(1). (b) The department will pay for nursing oversight and care management services that

(1) are approved under 7 AAC 130.217 and 7 AAC 130.218 as part of the recipient’s support plan;

(2) receive prior authorization;

(3) are provided by a registered nurse that is

(A) qualified to practice under AS 08.68 or 7 AAC 105.200; and

(B) employed by a home and community-based waiver services provider; and

(4) are provided in compliance with the department’s Nursing Oversight and Care Management Services Conditions of Participation, adopted by reference in 7 AAC 160.900. (c) For a home and community-based waiver services provider to qualify for payment for nursing oversight and care management services, a registered nurse must

(1) conduct a nursing assessment of the recipient’s medical care needs;

(2) develop, for inclusion in the recipient’s support plan, in a format provided by the department,

(A) a nursing plan that addresses the

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Page 2643

Official source

for children with complex medical conditions under 7 AAC 130.205(d)(1). (b) The department will pay for nursing oversight and care management services that

(1) are approved under 7 AAC 130.217 and 7 AAC 130.218 as part of the recipient’s support plan;

(2) receive prior authorization;

(3) are provided by a registered nurse that is

(A) qualified to practice under AS 08.68 or 7 AAC 105.200; and

(B) employed by a home and community-based waiver services provider; and

(4) are provided in compliance with the department’s Nursing Oversight and Care Management Services Conditions of Participation, adopted by reference in 7 AAC 160.900. (c) For a home and community-based waiver services provider to qualify for payment for nursing oversight and care management services, a registered nurse must

(1) conduct a nursing assessment of the recipient’s medical care needs;

(2) develop, for inclusion in the recipient’s support plan, in a format provided by the department,

(A) a nursing plan that addresses the

(i)recipient’s health and safety; and#

(i) recipient’s health and safety; and

(ii)needs that require the recipient or the recipient’s…#

(ii) needs that require the recipient or the recipient’s paid and unpaid caregivers to perform medical care tasks; and

(B) a training plan that specifies the training required for the recipient and the recipient’s paid and unpaid caregivers to perform the medical care tasks necessary to meet the recipient’s needs;

(3) participate in planning the recipient’s care in accordance with 7 AAC 130.217;

(4) provide oversight by evaluating whether

(A) services are delivered in accordance with the nursing plan and in a manner that promotes the health, safety, and welfare of the recipient;

(B) services are reasonable and necessary for the recipient’s medical condition and the complexity of the care required to treat that condition; and

(C) additional training is necessary for the recipient or recipient’s paid and unpaid caregivers; and

(5) remain in contact with the recipient in a manner and with a frequency appropriate to the medical condition of the recipient and to the complexity of the care to be delivered; at a