Nursing Facility Waiver Services for those Members who qualify for such services The state provides an enriched array of services to clients who would otherwise qualify for nursing facility care through a Home and Community Based Medicaid Waiver. In traditional Medicaid, this is known as the Community Based Alternatives (CBA) waiver. The STAR+PLUS HMO must also provide the services that are available to clients through the CBA waiver in traditional Medicaid to those clients that meet the functional and financial eligibility for the 1915 (c) Nursing Facility Waiver Services. o Personal Attendant Services (including the three service delivery options: Self-Directed; Agency Model, Self-Directed; and Agency Model) o In-Home or Out-of-Home Respite Services o Nursing Services (in home) o Emergency Response Services (Emergency call button) o Home Delivered Meals o Minor Home Modifications o Adaptive Aids and Medical Equipment o Medical Supplies o Physical Therapy, Occupational Therapy, Speech Therapy o Adult Xxxxxx Care o Assisted Living o Transition Assistance Services (These services are limited to a maximum of $2,500.00. If the HMO determines that no other resources are available to pay for the basic services/items needed to assist a Member, who is leaving a nursing facility, with setting up a household, the HMO may authorize up to $2,500.00 for Transition Assistance Services (TAS). The $2,500.00 TAS benefit is part of the expense ceiling when determining the Total Annual Individual Service Plan (ISP) Cost.) Subject: Attachment B-2.2 - CHIP Perinatal Covered Services DOCUMENT HISTORY LOG STATUS1 DOCUMENT REVISION2 EFFECTIVE DATE DESCRIPTION3 Baseline n/a Initial version of Attachment B-2, Covered Services Revision 1.1 June 30, 2006 Revised Attachment B-2, Covered Services, by adding Attachment B-2.1, STAR+PLUS Covered Services. Revision 1.2 September 1, 2006 Revised Attachment B-2, Covered Services, by updating provisions applicable to MCOs participating in the STAR and CHIP Programs. Revision 1.3 September 1, 2006 Revised Attachment B-2, Covered Services, by adding Attachment B-2.2, CHIP Perinatal Covered Services. This is the initial version of Attachment B-2.2, which lists the CHIP Perinatal Covered Services, exclusions and DME/Supplies. Revision 1.4 September 1, 2006 Contract Amendment did not revise Attachment B-2.2- CHIP Perinatal Covered Services. Revision 1.5 January 1, 2007 Contract Amendment did not revise Attachment B-2.2- CHIP Perinatal Covered Services. Revision 1.6 February 1, 2007 ...
