Chapter

Policy

Policy Number

1. Introduction

Index

 

2. Medicaid Funding

Medicaid Eligibility

2.00

3. Available Home and Community Based Services

Home and Community Based Service (HCBS) Introduction

3.00

Waiting List Notice for Independent Living Waiver Services
Form / Instructions

3.55 Appendix 2

4. Home and Community Based Assessment, Care Planning and Authorization Process

HCBS Service Processes Introduction

4.00

Participant Choice Statement Form and Instructions (Agency, CDS, and ADC)
Form / Instructions

4.00 Appendix 2a

Participant Choice Statement Form and Instructions (RCF/ALF)
Form / Instructions

4.00 Appendix 2b

In-Home Services Worksheet
Form / Instructions

4.00 Appendix 3

Consumer-Directed Services Worksheet
Form / Instructions

4.00 Appendix 4

Physician Notification
Form / Instructions

4.00 Appendix 5

SLUMS
Form / Instructions

4.00 Appendix 8

Self Direction Assessment Questions
Form / Instructions

4.00 Appendix 10

Participant Contact Letter
Form / Instructions

4.00 Appendix 11

Healthcare Professional Inquiry
Form / Instructions

4.00 Appendix 13

HCBS Assessment Attestation
Form / Instructions

4.00 Appendix 14

Healthcare Information Request
Form / Instructions

4.00 Appendix 15

5. Adverse Action

Adverse Action

5.00

Adverse Action
Form / Instructions

5.00 Appendix 3

Application for a State Hearing
Form / Instructions

5.00 Appendix 4

Reversal of Adverse Action
Form / Instructions

5.00 Appendix 5

Notice of Closure
Form / Instructions

5.00 Appendix 6

6. Appeals and Hearing Process

Appeal and Hearing Process

6.00

CMS Letter

6.00 Appendix 6

Cover Letter

6.00 Appendix 7

Agency Witness List
Form / Instructions

6.00 Appendix 8

7. Show-Me Home Program

Show-Me Home

7.00

Show-Me Home Approval Notice Plan
Form / Instructions

7.00 Appendix 6

Show-Me Home Ombudsman Referral
Form / Instructions

7.00 Appendix 7

8. Miscellaneous and Forms

Abuse, Neglect and Exploitation

8.00

9. Confidentiality and HIPAA

Confidentiality Requirements

9.00

Acknowledgement
Form / Instructions

9.00 Appendix 5

Authorization
Form / Instructions

9.00 Appendix 6

10. HCBS Web Tool Guide

Web Tool - Introduction

10.00

HCBS Memos

Policy Clarification Questions