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8. The payment review period begins with the first full SAIH month and

can be authorized for 12 months from that date, just as in SA facility

cases.

9. Do not allow the Medicaid to be terminated at any point.

VII. REDETERMINATIONS

In order to complete the SAIH recertification process, it is essential that the SA IMC and the Adult Services Case Manager establish and maintain open lines of communication to keep each other informed about the status of SAIH beneficiaries. Failure by the IMC to give the Adult Services Case Manager sufficient notice of the SAIH eligibility redetermination due date (via the DSS- 0031 SAIH Program Interagency Referral Form) could jeopardize successful completion of the recertification process.

A. Requirement for Annual Eligibility Redetermination

The payment review period for SAIH eligibility begins with the month of

application and ends on the last day of the twelfth month. Eligibility for the

SAIH Program must be redetermined annually. When the IMC is notified

of the upcoming eligibility redetermination, the IMC must immediately

notify the appropriate adult services case manager of the redetermination

due date(s) for individual SAIH beneficiaries via DSS-0031.

B. Requirement for Annual Reassessment

A case management reassessment must be completed annually by the Adult Services Case Manager. When the Adult Services Case Manager completes the reassessment, they must provide that information via DSS- 0031 to the IMC. The IMC will file that DSS-0031 Referral in the client record and document in case notes in NC FAST the date the confirmation of annual reassessment was received.

VIII. CHANGES IN SITUATION

A. The IMC and the adult services case manager must notify

each other of any changes in the beneficiary’s situation

that might affect eligibility for SAIH or the amount of the

SAIH payment. SA-5200 VI-VIII.