Current through Register Vol. 41, No. 3, September 23, 2024
A. Screenings
for adults living in the community. Screenings for adults who are residing in
the community but who are not inpatients shall be completed and submitted by
the CBT to ePAS. If the individual, or any of the other persons permitted to
make such requests, requests a screening, the CBT shall be required to perform
the requested screening; otherwise, CBTs shall not be required to screen
individuals who are not expected to become financially eligible for
Medicaid-funded LTSS within six months of the screening.
1. Requests for screenings shall be accepted
from either an individual, the individual's representative, an adult protective
service worker, the individual's physician, or an MCO care coordinator having
an interest in the individual. The CBT in the jurisdiction where the individual
resides shall conduct such screening. For the screening to be scheduled by the
CBT, the individual shall either agree to participate or, if refusing, shall be
under order of a court of appropriate jurisdiction to have a screening.
a. The LDSS or LHD in receipt of the request
for a screening shall contact the individual or his representative within seven
days of the request date for screening to schedule a screening with the
individual and any other persons whom the individual selects to attend the
screening.
b. When the CBT has not
scheduled a screening to occur within 21 days of the request date for
screening, and the screening is not anticipated to be complete within 30 days
of the request date for screening due to the screening entity's inability to
conduct the screening, the LDSS and LHD shall, no later than seven days after
the request date for screening, notify DARS and VDH staff designated for
technical assistance.
2.
Referrals for screenings may also be accepted by LDSS or LHD from an interested
person having knowledge of an individual who may need LTSS. When the LDSS or
LHD receives such a referral, the LDSS or LHD shall obtain sufficient
information from the referral source to initiate contact with the individual or
his representative to discuss the screening process. Within seven days of the
referral date, the LDSS or LHD shall contact the individual or his
representative to determine if the individual is interested in receiving LTSS
and would participate in the screening. If the LDSS or LHD is unable to contact
the individual or his representative, it shall document the attempt to contact
the individual or his representative using the method adopted by the CBT.
a. After contact with the individual or his
representative, or if the LDSS or LHD is unable to contact the individual or
his representative, the LDSS or LHD shall advise the referring interested
person that contact or attempt to contact has been made in response to the
referral for screening.
b.
Information about the results of the contact shall only be shared by the LDSS
or LHD with the interested person who made the referral when the LDSS or LHD
has the individual's written consent or the written consent of his legal
representative who has such authority on behalf of the individual.
B. Screenings for
children living in the community. Screenings for children who are residing in
the community but who are not inpatients shall be completed and submitted via
ePAS. If the individual or parent or guardian, or any of the other persons
permitted to make such requests, requests a screening, the DMAS designee shall
perform the requested screening; otherwise, the DMAS designee shall not be
required to screen individuals who are not expected to become financially
eligible for Medicaid-funded LTSS within six months of the screening.
1. A child who is residing in the community
and is not an inpatient shall receive a screening from a DMAS designee. The
DMAS designee may receive requests for screenings directly. Any requests for
screenings for a child received by the CBT shall be forwarded directly to the
DMAS designee. For the screening to be scheduled by the CBT, the child shall
either agree to participate or, if refusing, shall be under order of a court of
appropriate jurisdiction to have a screening.
2. The request for screening of a child
residing in the community shall be accepted from the parent, legal guardian,
the entity having legal custody of that child, an emancipated child, a
physician, an MCO care coordinator, or a child protective service worker having
an interest in the child.
3.
Referrals for screenings may also be accepted from an interested person having
knowledge of a child who may need LTSS. The process, timing, and limitations on
the sharing of the results for referrals for screenings for children shall be
the same as that set out for adults in subdivision A 2 of this
section.
C. Screenings
in hospitals for adults and children who are inpatients. Screenings in
hospitals shall be completed when an adult or child who is an inpatient may
need LTSS upon discharge or when the individual, MCO, or representative
requests a screening.
1. As a part of the
discharge planning process, the hospital team shall also complete a
face-to-face screening when:
a. The
individual's physician, in collaboration with the individual or the
individual's representative if there is one, makes a request of the hospital
team. If the individual is a child, the screening shall be completed when the
individual's physician, in collaboration with the child's parent, legal
guardian, the entity having legal custody of the child, the emancipated child,
adult protective services worker, child protective services worker, or MCO care
coordinator makes a request of the hospital team; or
b. The individual, the individual's
representative if there is one, parent, legal guardian, entity having legal
custody, emancipated child , adult protective services worker, child protective
services worker, or MCO care coordinator requests a consultation with hospital
case management.
2. When
there is a request, such individual shall receive a screening conducted by the
hospital team regardless of if he is eligible for Medicaid or is anticipated to
become eligible for Medicaid within six months after admission to a
NF.
3. The hospital team shall
exclude all institutionally-induced dependencies from the face-to-face
screening documentation.
D. Screenings shall be submitted via e-PAS
within 30 days of the screening request.
Statutory Authority: §
32.1-325
of the Code of Virginia;
42 USC §
1396 et
seq.
