Common use of HCBS Services Clause in Contracts

HCBS Services. Services provided to ALTCS enrollees receiving HCBS are enumerated in Table 4. Table 4 – ALTCS HCBS Service Title XIX EPD DD Acute Hospital Admission X X Adult Day Health Services X N/A Attendant Care X X Community Transition Services* X X DME / Medical Supplies X X Emergency Alert X X Habilitation X X Home Delivered Meals X n/a Home Health Agency Services X X Home Modifications X X Home Maker Services X X Hospice Services (HCBS & Institutional) X X ICF / MR n/a X Medical Care Acute Services X X Nursing Facility Services X X Personal Care X X Respite Care (in home) X X Respite Care (Institutional) X X Therapies X X Transportation X X 3) HCBS Expenditures- Expenditures for individual members are limited to an amount that does not exceed the cost of providing care to the eligible individual in an institutional setting. Exceptions are permitted including when the need for additional services is due to a change in condition that is not expected to last more than 6 months.

HCBS Services. Services provided to ALTCS enrollees receiving HCBS are enumerated in Table 4. Table 4 – ALTCS HCBS Service Title XIX EPD DD Acute Hospital Admission X X Adult Day Health Services X N/A Attendant Care X X Community Transition Services* X X DME / Medical Supplies X X Emergency Alert X X Habilitation X X Home Delivered Meals X n/a Home Health Agency Services X X Home Modifications X X Home Maker Services X X Hospice Services (HCBS & Institutional) X X ICF / MR n/a X Medical Care Acute Services X X Nursing Facility Services X X Personal Care X X Respite Care (in home) X X Respite Care (Institutional) X X Therapies X X Transportation X X *As Defined in State Medicaid Director Letter #02-008 (see Attachment C) 3) HCBS Expenditures- Expenditures for individual members are limited to an amount that does not exceed the cost of providing care to the eligible individual in an institutional setting. Exceptions are permitted including when the need for additional services is due to a change in condition that is not expected to last more than 6 months.

HCBS Services. Services provided to ALTCS enrollees receiving HCBS are enumerated in Table 4. Table 4 – ALTCS HCBS Service Title XIX EPD DD Acute Hospital Admission X X Adult Day Health Services X N/A Attendant Care X X Community Transition Services* X X DME / Medical Supplies X X Emergency Alert X X Service Title XIX Habilitation X X Home Delivered Meals X n/a Home Health Agency Services X X Home Modifications X X Home Maker Services X X Hospice Services (HCBS & Institutional) X X ICF / MR n/a X Medical Care Acute Services X X Nursing Facility Services X X Personal Care X X Respite Care (in home) X X Respite Care (Institutional) X X Therapies X X Transportation X X 3) HCBS Expenditures- Expenditures for individual members are limited to an amount that does not exceed the cost of providing care to the eligible individual in an institutional setting. Exceptions are permitted including when the need for additional services is due to a change in condition that is not expected to last more than 6 months.