Current through Register Vol. 50, No. 9, September 20, 2024
A. The following
may result in termination of services and/or closure:
1. the participant no longer meets
eligibility criteria;
2. the
participant intentionally falsified information;
3. the participant has shown consistent
failure to cooperate with the service plan and management contractor;
4. the participant is unable to be contacted
and/or whereabouts unknown for 90 days or more and no response after an
attempted home visit and certified letter;
5. the participant made misrepresentations in
the eligibility determination process;
6. the participant made misrepresentations to
obtain goods and services;
7. any
other reason which is contradictory to policy and procedures for the SPAS
Program.
B. The
management contractor should issue a "warning" to participants who commit a
violation of policy. If the violation is not intentional, written notice of the
violation and action to correct the violation is to be given to the
participant. A copy of the warning notice to the participant is to be placed in
the participants case record. The management contractor shall make a
recommendation to the OAAS program manager to terminate a participant who
continues to violate the policy and/or procedures of the SPAS Program after a
warning has been issued. The decision to terminate will be based on the
severity of the violation(s) and/or continued violation(s) and will be made by
OAAS.
1. If the violation of policy by the
participant was intentional, the management contractor shall immediately notify
the OAAS program manager. In the case of an intentional violation of the policy
by the participant, a warning does not need to be issued prior to termination
from the program.
2. When a
participant is terminated from this program the management contractor will send
a termination letter to the participant that explains the reason(s) and right
to an appeal;
C.
Recoupment
1. In lieu of termination, the
management contractor can demand that a participant refund the SPAS Program for
all benefits received.
2. If the
management contractor rules that the participant must repay the amount in
question, the management contractor will determine the repayment schedule.
Participant can remain eligible as long as recoupment is made and a willingness
to comply with policies and procedures set forth in the SPAS Program are shown.
The management contractor shall maintain close monitoring of the participant
until such time the management contractor determines participant is complying
with the policies and procedures.
3. Recoupment is required from fraudulently
received benefits as well; however, the participant will not be eligible for
further services.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
46:2116.2.
