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 130.255 - Residential supported-living services
Universal Citation: 7 AK Admin Code 130.255
Current through November 28, 2024
(a) The department will pay for residential supported-living services that
(1) are provided to a recipient in one of the
following recipient categories:
(A) older
adults or adults with physical disabilities;
(B) adults with physical and developmental
disabilities;
(2) are
provided in accordance with the department's Residential
Supported-Living Services Conditions of Participation, adopted by
reference in
7
AAC 160.900;
(3) are approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support
plan;
(4) receive prior
authorization; and
(5) are provided
in an assisted living home licensed under AS 47.32.
(b) The department will consider services to be residential supported-living services if the services
(1) are provided in a residential setting
staffed 24 hours a day by on-site personnel capable of
(A) meeting both scheduled and unpredictable
resident needs; and
(B) providing
supervision, safety, and security;
(2) assist a recipient in the assisted living
home with
(A) activities of daily living
described in
7
AAC 125.030(b); and
(B) supportive services, including social and
recreational activities; and
(3) are designed for a recipient that
(A) can no longer live alone, but whose need
for institutional level of care can be met though the support provided in the
24-hour residential supported-living setting; and
(B) without the services, would require
placement in a nursing facility for lack of alternate placements.
(c) If a recipient is eligible for residential supported-living services, the department will not make separate payment for
(1) chore services
under 7 AAC 127.087;
(2) meal services under
7
AAC 130.295, unless the meals are provided in a
congregate setting other than an assisted living home licensed under AS
47.32;
(3) respite care services
payable under
7
AAC 130.280;
(4) the recipient's room and board;
(5) the cost of facility maintenance, upkeep,
or improvement; or
(6) activities
or supervision for which a source other than Medicaid makes payment.
(d) A provider of residential supported-living services under this section may not compel a recipient to be absent from the assisted living home for the convenience of the provider.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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