Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 130 - Medicaid Coverage; Home and Community-Based Waiver Services
Article 2 - Home and Community-Based Waiver Services; Nursing Facility and ICF/MR Level of Care
7 AAC 130.231 - Services during temporary absence
Universal Citation: 7 AK Admin Code 130.231
Current through November 28, 2024
(a) The department will pay for home and community-based waiver services rendered to a recipient during a recipient's temporary absence from the recipient's community when the recipient travels to another location within the state or to an out-of-state destination, if the services
(1) are provided
by a home and community-based waiver services provider that is certified under
7
AAC 130.220;
(2) are limited to the following:
(A) day habilitation services under
7
AAC 130.260;
(B) supported-living habilitation services
under 7 AAC
130.265(e);
(C) in-home support habilitation services
under 7 AAC
130.265(i);
(D) hourly respite care services under
7
AAC 130.280;
(E) adult day services under
7
AAC 130.250;
(F)
employment services under
7
AAC 130.270;
(3) are approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support plan;
and
(4) receive prior
authorization.
(b) A request for services for a recipient under this section must show that
(1) the services are necessary to maintain
the recipient's current level of functioning or to prevent placing the
recipient at risk of institutionalization;
(2) the services provided during the
recipient's temporary absence are the same as those provided when the recipient
is in the recipient's community, and are at the level approved in the
recipient's support plan;
(3) the
absence is justified as
(A) a medical
necessity documented by a physician licensed under AS 08.64;
(B) an educational opportunity of limited
duration that is not available in the recipient's community or in the state,
and that will enhance the recipient's capacity to attain the goals outlined in
the recipient's support plan; or
(C) a vacation;
(4) the absence will be for a period of at
least 24 hours; the total period for which the recipient may receive services
under this section may not exceed 30 days during the period that a support plan
is in effect;
(5) the recipient
meets the requirements of
7
AAC 100.064 if travel is to be out-of-state;
and
(6) the home and
community-based waiver services provider will
(A) maintain an employer relationship with
any employee traveling with and providing services to a recipient during a
temporary absence; and
(B)
supervise that employee during the provision of those services.
(c) Notwithstanding (b)(4) of this section, the department may approve a temporary absence of more than 30 days during the period that a support plan is in effect, if
(1) a physician licensed under AS 08.64
justifies a longer temporary absence as a medical necessity under (b)(3)(A) of
this section; or
(2) the department
determines in advance that the benefits to the recipient of an educational
opportunity under (b)(3)(B) of this section justify a longer temporary
absence.
(d) The department will not pay for
(1)
transportation, room and board, or any other expenses for any individual
providing services under this section; or
(2) services provided in a location other
than this or another state.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
