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205.528 Hospital-to-Home Transition Program.
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(2)
(3)
(4)
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(8)
The Department for Medicaid Services shall submit a waiver or waiver amendment
for approval to the Centers for Medicare and Medicaid Services in order to establish
the Hospital-to-Home Transition Program to provide coverage for services provided
by an approved Medicaid waiver provider to elderly and physically disabled persons
over the age of eighteen (18) years. The program shall provide coverage for up to
sixty (60) days for services not otherwise provided as part of the Medicaid essential
benefits coverage in order to assist waiver applicants while transitioning from an
institutional setting to their home or to a community setting.
The Hospital-to-Home Transition Program shall provide nonmedical support
services to applicants, including but not limited to:
(a) Adult day-care services;
(b) Attendant services;
(c) Home-delivered meal services; and
(d) Transportation services.
The daily cost of services covered by the Hospital-to-Home Transition Program
shall be less than the average daily Medicaid payment for a stay at a nursing facility.
An applicant shall be eligible for the Hospital-to-Home Transition Program if the
applicant:
(a) Is determined to be functionally eligible for services in his or her home or
community setting; and
(b) Has a pending application for Medicaid waiver services, provided that he or
she complies with all other medical assistance application requirements.
The cabinet shall develop a screening tool to determine whether an applicant meets
the eligibility criteria under subsection (4) of this section for the Hospital-to-Home
Transition Program. The screening tool shall include but not be limited to the
following:
(a) Procedures for determining whether an applicant is functionally able to live at
home or in a community setting;
(b) Procedures for determining financial eligibility;
(c) Procedures to address patient treatment preferences; and
(d) Procedures to address patient goals of care and family caregiver concerns.
An applicant for the program shall:
(a) Sign a written agreement attesting to the accuracy of the financial and other
information that the applicant provides; and
(b) Complete a Medicaid application on the date the applicant is screened for
functional eligibility or not later than ten (10) days from the screening.
The cabinet shall make the Medicaid level of care final determination of eligibility
for Medicaid and Medicaid waiver services by sixty (60) days following an eligible
applicant's discharge from an institutional setting to a home or community setting.
The cabinet shall request funding to support the waiver program. Not later than July
(9)
1, 2016, subject to appropriations provided by the General Assembly and approval
of the waiver or waiver amendment from the Centers for Medicare and Medicaid
Services, the cabinet shall initiate the Hospital-to-Home Transition Program as
described in this section.
The Department for Medicaid Services shall promulgate administrative regulations
to implement this section.
Effective: June 24, 2015
History: Created 2015 Ky. Acts ch. 98, sec. 1, effective June 24, 2015.
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