Program administration - HCS and DDA LTC Specialty Unit

Home and Community Services (HCS) determines eligibility for hospice when clients are receiving services authorized by HCS.

HCS services include Medicaid Personal Care (MPC), Community First Choice (CFC), or HCS Home and Community Based (HCB) Waiver services authorized by the HCS social service specialist.

HCS determines eligibility for hospice when one spouse is receiving services from HCS and the other spouse is in need of hospice.

HCS does not retain nursing facility cases once a nursing facility client has made an election of hospice. Upon receipt of the notice of election in a nursing facility (NF), the HCS office makes a program change to the hospice program and transfers the case to the Developmental Disabilities Administration (DDA) LTC Specialty Unit. (CSO 017).

Example

Client is admitted to a nursing facility. Client elects hospice in the facility. Once a client has elected hospice, the nursing home service with HCS ends. The case changes from a L02 nursing home to a L32 hospice case by the HCS financial worker. The case is then transferred to the Hospice LTC Specialty Unit to be maintained by the hospice financial worker. The client is still residing in the nursing facility, but the funding is through the hospice program.

The hospice program is currently specialized within the DDA LTC Specialty Unit. The unit determines eligibility for the hospice program for clients who elect hospice services either at home, an alternative living facility, hospice care center, or nursing facility. If a client who is currently active on Medicaid in an NF, the HCS office that maintains the case will update the hospice election and transfer the case to CSO 017 for ongoing maintenance.

The unit does not determine eligibility for clients who are currently receiving HCS HCB waiver services, CFC, or MPC. If a client who is currently receiving MPC or CFC services authorized by HCS, the HCS office that maintains the case will update the hospice election and transfer the case to CSO 017 for ongoing maintenance. If a client who is currently receiving HCS waiver services in home, the HCS office that maintains the case will update the hospice election and continue maintaining the case.