§ 42-66.4-4. Provision of long-term home healthcare program.
(a) When a long-term home healthcare program as defined under this chapter is available,
the office of healthy aging shall notify the eligible person, in writing, of the provisions
of this chapter.
(b) If a person eligible to receive services under the provisions of this title who requires
care, treatment, maintenance, nursing, or other services in a nursing home desires
to remain and is deemed by the person's physician able to remain in the person's own
home or the home of a responsible relative or other responsible adult if the necessary
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§ 42-66.4-4. Provision of long-term home healthcare program.
(a) When a long-term home healthcare program as defined under this chapter is available,
the office of healthy aging shall notify the eligible person, in writing, of the provisions
of this chapter.
(b) If a person eligible to receive services under the provisions of this title who requires
care, treatment, maintenance, nursing, or other services in a nursing home desires
to remain and is deemed by the person's physician able to remain in the person's own
home or the home of a responsible relative or other responsible adult if the necessary
services are provided, that person or that person's representative shall inform the
office of healthy aging. If a long-term home healthcare program as defined under this
chapter is provided, the office of healthy aging shall authorize an assessment under
the provisions of this chapter. If the results of the assessment indicate that the
person can receive the appropriate level of care at home, the case manager shall prepare
for that person a plan for the provision of services comparable to those that would
be rendered in a nursing home. In developing this plan, the office of healthy aging
shall consult with those persons performing the assessment. The services shall be
provided by certified home health agencies, home health aide/homemaker agencies, and
adult daycare centers.
(c) At the time of the initial assessment, and at the time of each subsequent assessment,
the case manager shall establish a monthly budget in accordance with which the case
manager shall authorize payment for the services provided under the plan. Total monthly
expenditures made under this title for each person shall not exceed a maximum of one
hundred percent (100%) or any lesser percentage as may be determined by the director,
of the average of the monthly rates payable under this title for skilled nursing/intermediate
care facility services as provided for in the department of human services principles
of reimbursement for skilled nursing/intermediate care facility services eligible
requests of the medical assistance program. If an assessment of the person's needs
demonstrates that the person requires services, the payment for which would exceed
the monthly maximum, but it can be reasonably anticipated that total expenditures
for required services for that person will not exceed the maximum calculated over
a one-year period, the office of healthy aging may authorize payment for those services.