Page 297

MRG

UPDATED: JANUARY 2012

723

OTHER ELIGIBILITY REQUIREMENTS WAIVERS

NURSING HOME TRANSITION AND DIVERSION WAIVER

Due to the many roles the LDSS has in the NHTD waiver, it is important for all staff in the LDSS to be aware of the NHTD program. The Regional Resource Development Specialist (RRDS) and Service Coordinator must collaborate with LDSS staff to have an understanding of the applicant’s history, if any, of participation in Medicaid State Plan community- based services or adult protective services. This collaboration furthers the RRDS and Service Coordinator’s understanding of the strengths and needs of the applicant, as well as the availability of informal and formal supports. This knowledge and understanding will enhance the development of the waiver Service Plan and support the applicant’s health and welfare if s/he is approved for the NHTD waiver.

The LDSS and/or State DOH retain responsibility for all prior authorizations/approvals of Medicaid State Plan services such as the Personal Care Services Program (PCSP), the Consumer Directed Personal Assistance Program (CDPAP), Personal Emergency Response Services (PERS) or private duty nursing (PDN). It is anticipated the RRDS/Service Coordinator will be in contact with LDSS home care staff when applicants require referrals for assessment and authorization of these services. LDSS home care staff may be asked to participate in team meetings, convened by waiver Service Coordinators, related to development or reassessment of the participant’s waiver Service Plan.

In addition, the LDSS is responsible for determining financial eligibility for NHTD A/Rs.

References: SSL Sect. 366 (6-a)

ADMs 11 ADM-06

08 OLTC-1

GISs

11 LTC007

11 LTC004

08 OLTC-03

Interpretation: Individuals interested in participating in the NHTD waiver will be applying for Medicaid coverage for Community-Based Long-Term Care. The RRDS will send a Letter of Introduction to the LDSS for such individuals and will also give a copy of the letter to the individual to bring with him/her when he/she meets with the LDSS to file the application. The LDSS will determine financial eligibility and return the letter, along with the appropriate form(s) and notices, to the applicant and RRDS.