Assistive Care Services and Assisted Living for the Elderly Waiver

Assistive Care Services and Assisted Living for the Elderly Wavier Services
Coverage and Limitations Handbook
Leave of Absence and Discharge, continued
Move to a Non-
ACS Provider or to
Unlicensed Setting
Changes in residence for a recipient who receives Optional State
Supplementation (OSS) payments must be coordinated with DCF. If it
appears that a nursing facility or other placement is necessary, the facility must
coordinate with the DCF case manager. If the resident participates in the
ALE Waiver, the local Department of Elder Affairs (DOEA) Comprehensive
Assessment and Review for Long Term Care Services (CARES) unit must
also be included in coordinating the plan to seek an appropriate placement.
The discharging facility may not bill ACS for the day of discharge.
Termination of Services
Introduction
In most cases, ACS recipients must be given a written 10-day advance notice
of termination including their right to request a fair hearing.
Reasons for
Termination
Termination of ACS for any of the following reasons triggers the requirement
for a 10-day written notice:
• Loss of Medicaid eligibility;
• The recipient’s condition no longer meets functional criteria;
• The recipient voluntarily moves out of the facility to a non-ACS setting;
• The recipient elects to stop assistive care services; or
• Transfer to a non-participating ALF, RTF, or AFCH.
Right to a Fair
Hearing
An ACS consumer has the right to appeal any action taken by the facility,
AHCA, DOEA, or DCF that adversely affects the recipient’s receipt of
services.
Note: See Part I, Chapter 3, Appendix B of this handbook for fair hearing
process information.
July 2001 2-15