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 130.235 - Nursing oversight and care management services
Universal Citation: 7 AK Admin Code 130.235
Current through November 28, 2024
(a) The department may authorize nursing oversight and care management services for a recipient that is eligible under the recipient category of
(1) children with complex medical conditions;
or
(2) individuals with
intellectual and developmental disabilities if the recipient meets, except for
the age requirement in
7
AAC 130.205(d)(1)(A), the criteria
for the recipient category for children with complex medical conditions under
7
AAC 130.205(d)(1).
(b) The department will pay for nursing oversight and care management services that
(1) are approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support plan
;
(2) receive prior authorization;
(3) are provided by a registered
nurse that is
(A) qualified to practice under
AS 08.68 or
7
AAC 105.200; and
(B) employed by a home and community-based
waiver services provider ; and.
(4) are provided in compliance with the
department's Nursing Oversight and Cave Managenient Services Conditions
of Participation, adopted by reference in
7
AAC 160.900.
(c) For a home and community-based waiver services provider to qualify for payment for nursing oversight and care management services, a registered nurse must
(1) conduct a nursing assessment of the
recipient's medical care needs;
(2)
develop, for inclusion in the recipient's support plan, in a format provided by
the department,
(A) a nursing plan that
addresses the
(i) recipient's health and
safety; and
(ii) needs that require
the recipient or the recipient's paid and unpaid caregivers to perform medical
care tasks; and
(B) a
training plan that specifics the training required for the recipient and the
recipient's paid and unpaid caregivers to perform the medical care tasks
necessary to meet the recipient's needs;
(3) participate in planning the recipient's
care in accordance with
7
AAC 130.217;
(4) provide oversight by evaluating whether
(A) services are delivered in accordance with
the nursing plan and in a manner that promotes the health, safety, and welfare
of the recipient;
(B) services are
reasonable and necessary for the recipient's medical condition and the
complexity of the care required to treat that condition; and
(C) additional training is necessary for the
recipient or recipient's paid and unpaid care givers; and
(5) remain in contact with the recipient in a
manner and with a frequency appropriate to the medical condition of the
recipient and to the complexity of the care to be delivered; at a minimum, the
contact must include at least one on-site evaluation every 90 days during which
the recipient and any individual to which nursing duties were delegated shall
be in attendance.
(d) The department will not pay separately for services under this section that duplicate
(1) specialized private-duty
nursing services under
7
AAC 110.525 or
7
AAC 130.285;
(2) private-duty nursing services under
7
AAC 110.525; or
(3) intensive active treatment services under
7
AAC 130.275.
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.
