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Chapter: 1400 Technical Requirements Program: MSSI, SFP 50 It is the HCBS case manager’s responsibility to request a level of care (LOC) for HCBS applicants. In no situation should ACCESS staff submit requests for LOC to CARES, CMAT, DS or other entities that make LOC determinations for HCBS applicants. 1440.1306 Appropriate Placement for the HCDA Program (SFP) The individual must meet the following requirements as certified by CF-ES Form 1020 from the Adult Services counselor:

1. have a physician's statement that the resident is in danger of immediate nursing home placement and that care provided by the HCDA provider is appropriate for the well-being of the individual; and 2. have a priority need for home care services based on the scoring of the comprehensive applicant/recipient assessment. (This assessment is completed by Adult Services.)

The eligibility specialist should refer to the OSS/HCDA Desk Guide Pamphlet 140-3 (July 1, 1993) for more specific information regarding procedures for HCDA. 1440.1307 Appropriate Placement for the OSS Program (SFP) The Adult Services counselor or Mental Health case manager is responsible for evaluating the individual's needs for OSS placement in a facility most compatible with those needs. Individuals must be in an approved home or licensed facility which will provide room and board with personal care for a set charge called “provider rate”. Placements are made in one of the following types of living arrangements:

1. Adult Family Care Homes, 2. Assisted Living Facility (ALF), 3. Home for Special Services, or 4. Mental Health Residential Treatment Facility (MHRTF).

See 1440.1308 and 1440.1309 for more information on OSS placement. 1440.1308 Appropriate Placement for OSS/Absence Provision (SFP) If an individual leaves the OSS facility for a period of 30 consecutive days, the individual is no longer eligible for OSS. Therefore, action must be taken to terminate assistance and intercept the warrant for the following month.

If the individual leaves the facility with no intent to return, cancel the case immediately. A written notice is required but 10 days advance notice may be waived in this situation. (See Chapter 3400 regarding notice requirements.)

Note: If the facility becomes unlicensed and the individual will not be moving to a licensed facility, take immediate action to cancel the case providing 10 days advance notice. 1440.1309 Verification of Appropriate Placement for OSS (SFP) Appropriate placement for OSS is determined by the need for alternate care and placement in a setting which will provide that care. Form CF-ES 1006 (Alternate Care Certification for Optional State Supplementation) is required as evidence of appropriate placement and must be in the applicant/recipient's case record. The form verifies that the Adult Services counselor or Mental Heath case manager certify that the applicant/recipient needs alternate care and the applicant/recipient and provider agree that care will be provided for the specified amount.

The CF-ES 1006 (Alternate Care Certification for OSS) must be updated any time there is a change. The eligibility specialist must request the CF-ES 1006 from the Adult Services counselor, Mental Health case manager, Developmental Services counselor, or their contract providers in the following circumstances: