Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 26 - Division of Aging, Adult and Behavioral Health Services
Rule 016.26.21-001 - DAABHS COVID-19 Response Manual

The following rules are duly adopted and promulgated by the Division of Aging, Adult, and Behavioral Health Services (DAABHS) Arkansas Department of Human Services (DHS) under the authority of Arkansas Code Annotated §§ 20-76-201, 20-77-107, 25-10-129, and 25-10-126.

Families First Coronavirus Response Act (Public Law 116-127 - March 18, 2020)

Coronavirus Aid, Relief, and Economic Security (CARES) Act (Public Law No. 116-136 - March 27, 2020)

In response to the COVID-19 pandemic, DHS identified programs and services that required additional flexibility or changes to adapt to ensuring the health and safety of our clients. This manual details them so that DHS may render uninterrupted assistance and services to our clients.

Appeal requests for the COVID-19 response policies must adhere to the policy set forth in the Medicaid Provider Manual Section 160.000 Administrative Reconsideration and Appeals which can be accessed at https://medicaid.mmis.arkansas.gov/Provider/Docs/all.aspx.

Each section of this manual is severable from all others. If any section of this manual is held to be invalid, illegal, or unenforceable, such determination shall not affect the validity of other sections in this manual and all such other sections shall remain in full force and effect. In such an event, all other sections shall be construed and enforced as if this section had not been included therein.

The Person-Centered Service Plan (PCSP) serves to document the level of service need and is the official plan of care for those beneficiaries who have been found medically eligible for services.

Agency nurses should be able to extend PCSPs and authorizations based on review of current medical/functional needs. DAABHS nurses will complete an evaluation of the beneficiary's current needs and will extend the dates for qualifying beneficiaries, ensuring continued eligibility for services. PCSPs are living documents and are to be updated as goals and needs are met. During the extension period, the PCSP will continue to be updated to the level of current service needs based on continued phone contact with beneficiary.

The following rule provisions are suspended until December 31, 2021.

ARChoices: 212.312 which requires that a PCSP expiration date be 365 days from the date of the DHS RN's signature of the AAS-9503, the ARChoices PCSP.

Living Choices: 211.150 The Independent Assessment Contractor RN performs an assessment periodically (at least annually), and the Division of County Operations re-determines level of care annually. The results of the level of care determination and the re-evaluation are documented on form DHS-704.

212.200 Each Living Choices beneficiary will be evaluated at least annually by a DHS RN. The DHS RN evaluates the resident to determine whether a nursing home intermediate level of care is still appropriate and whether the plan of care should continue unchanged or be revised.

PACE: 212.200 involving involuntary dismissal of a Program of All-Inclusive Care for the Elderly (PACE) patient.

215.200 (B) and (C) require semi-annual and annual evaluations by providers.

These services will be available until December 31, 2021.

Families First Corona Virus Response Act requires states to maintain an individual eligibility for amount, duration, and scope of benefits during the public health emergency ArChoices, Living Choices and PACE clients who do not receive an evaluation within 365 days of their existing eligibility date would be transitioned to traditional Medicaid or lose access to care under these programs.

This rule is suspended to allow members who do not receive a timely evaluation to remain eligible for ARChoices, Living Choices and PACE.

ARChoices 212.312 which requires functional eligibility be determined prior to the expiration of financial and functional eligibility

Living Choices 211.150 which requires that an evaluation is completed annually by DHS RN to help inform the determination of functional eligibility

PACE 212.200 which refers to involuntary dismissal of a PACE patient.

These services will be available until December 31, 2021.

The rate reduction scheduled to occur January 1, 2021 will be suspended resulting in additional cost to the Medicaid program of $4.36 dollars per client day.

DMS is suspending the Acute Crisis Unit benefit limits of 96 hours per encounter, one encounter per month, and 6 encounters per state fiscal year. The rule to be suspended is in Section 253.003 of the Outpatient Behavioral Health Services Provider Manual.

The allowable code for this rule suspension:

* Acute Crisis Unit

* H0018 U4

* Benefit Limits 96 hours or less per encounter, 1 encounter per month, 6 encounters per SFY

These services will be available until December 31, 2021.