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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 14 of 155 treatment and integrated, clinically oriented recuperative or rehabilitative services and supports are provided.

2) Short-term post-transition housing (e.g., post-hospitalization), where integrated, clinically oriented rehabilitative services and supports are provided, but ongoing monitoring of the individual's condition by clinicians is not required.

21. HRSN Intervention Duration and Frequency.

a. Housing interventions with room and board.

i. Housing interventions that are classified as episodic interventions, as described in in STC 20.a., with clinical services with room and board may be covered for a qualifying beneficiary, as medically appropriate, up to a combined 6 months per rolling year. For purposes of this demonstration, rolling year is defined as a continuous 12-month period with the start date beginning when the beneficiary begins receiving the service.

ii. For the 6-month cap, coverage will be permitted in one or more spans or episodes, as long as the total duration remains under the cap for the rolling year or demonstration period. CMS will also apply a total combined cap of 6 months of all types of HRSN housing interventions with room and board (including episodic interventions and room and board-only supports), per beneficiary, in any 12- month period.

22. Excluded HRSN Service. Excluded items services, and activities that are not covered as HRSN services include, but are not limited to:

a. Construction (bricks and mortar) except as needed for approved medically necessary home modifications;

b. Capital investments;

c. Room and board, outside of specifically enumerated care or housing transitions or beyond 6 months, except as described in STC 20;

d. Research grants or expenditures not related to monitoring and evaluation;

e. Services furnished to beneficiaries for which payment is not available under the inmate payment exclusion in the matter following the last numbered paragraph of section 1905(a) of the Act except those HRSN-related case management services provided as part of an approved reentry demonstration initiative;

f. Services provided to individuals who are not lawfully present in the United States;