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Services Conditions of Participation, adopted by reference in 7 AAC 160.900;

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

(4) receive prior authorization; and

(5) are provided in an assisted living home licensed under AS 47.32. (b) The department will consider services to be residential supported-living services if the services

(1) are provided in a residential setting staffed 24 hours a day by on-site personnel capable of

(A) meeting both scheduled and unpredictable resident needs; and

(B) providing supervision, safety, and security;

(2) assist a recipient in the assisted living home with

(A) activities of daily living described in 7 AAC 125.030(b); and

(B) supportive services, including social and recreational activities; and

(3) are designed for a recipient that

(A) can no longer live alone, but whose need for institutional level of care can be met though the support provided in the 24-hour residential supported-living setting; and

(B) without the services, would require placement in a nursing facility for lack of alternate placements. (c) If a recipient is eligible for residential supported-living services, the department will not make separate payment for

(1) chore services under 7 AAC 127.087;

(2) meal services under 7 AAC 130.295, unless the meals are provided in a congregate setting other than an assisted living home licensed under AS 47.32;

(3) respite care services payable under 7 AAC 130.280;

(4) the recipient’s room and board;

(5) the cost of facility maintenance, upkeep, or improvement; or

(6) activities or supervision for which a source other than Medicaid makes payment. (d) A provider of residential supported-living services under this section may not compel a recipient to be absent from the assisted living home for the convenience of the provider. (Eff. 2/1/2010, Register 193; am 7/1/2013, Register 206; am 11/5/2017, Register 224; am