Chapter 256S — Generally

256S.01 Generally This section authorizes the Commissioner of Human Services to apply for federal waivers that help pay for home and … 256S.02 Definitions This section defines the key terms used throughout the Elderly Waiver chapter. It explains what words like … 256S.03 Administration by Tribes This section allows the commissioner to work with tribal governments to manage the Elderly Waiver program for tribal … 256S.04 Limits of Elderly Waiver Cases This section limits the number of Elderly Waiver participants each county or lead agency can serve. The number is set … 256S.05 Eligibility This section sets out who is eligible for the Elderly Waiver program. To qualify, a person must meet Medical Assistance … 256S.06 Assessments and Reassessments This section requires lead agencies to assess each participant's needs when they first enter the program and to reassess … 256S.07 Case Management Administration This section explains how case management works for Elderly Waiver participants. Counties and tribes provide case … 256S.08 Case Management Provider Qualifications and Standards This section sets the qualifications and standards that case management providers must meet to serve Elderly Waiver … 256S.09 Case Management Activities This section lists the activities that case managers must perform for Elderly Waiver participants. These include helping … 256S.10 Support Plans This section requires each Elderly Waiver participant to have a written support plan. The plan describes the services … 256S.11 Approval Required for Certain State Plan Home Care Services This section requires approval from the lead agency before certain home care services can be funded through Medical … 256S.12 Adult Day Services This section covers adult day services available under the Elderly Waiver. It sets limits on how many units of adult day … 256S.13 Individual Community Living Supports This section covers individual community living supports, which help Elderly Waiver participants live independently in … 256S.14 Termination of Elderly Waiver Services This section explains when and how Elderly Waiver services can be ended. The case manager must give the participant at … 256S.15 Establishment of Elderly Waiver Service Rates and Service Rate Limits This section explains how service rates and rate limits are set for Elderly Waiver services statewide. The commissioner … 256S.16 Authorization of Elderly Waiver Services and Service Rates This section requires lead agencies to use the service rates and rate limits published by the commissioner when … 256S.17 Costs Excluded From Elderly Waiver Service Rates This section says that room and board costs cannot be included in Elderly Waiver service rates for foster care and … 256S.18 Monthly Case Mix Budget Caps; Generally This section establishes monthly budget caps for Elderly Waiver services based on case mix classifications. The caps … 256S.19 Monthly Case Mix Budget Caps; Nursing Facility Residents This section sets special monthly budget caps for people leaving nursing facilities to receive Elderly Waiver services … 256S.191 Elderly Waiver Budget and Rate Exceptions; High-need Participants This section allows budget and rate exceptions for Elderly Waiver participants who have especially high care needs. … 256S.20 Customized Living Services; Policy This section sets policy and provider requirements for customized living services under the Elderly Waiver. Customized … 256S.201 Customized Living Services; Rates This section establishes the rates for customized living services under the Elderly Waiver. It sets the authorized rate … 256S.202 Customized Living Services; Rate Limits This section sets rate limits for customized living services, capping how much can be paid per month. The limits vary … 256S.203 Customized Living Services; Managed Care Rates This section addresses how customized living service rates work within managed care plans. The commissioner must adjust … 256S.204 Alternative Rate System for 24-hour Customized Living Services This section creates an alternative rate system for 24-hour customized living services. It allows higher payments for … 256S.205 Customized Living Services; Disproportionate Share Rate Adjustments This section provides disproportionate share rate adjustments for customized living providers that serve a high … 256S.21 Rate Setting; Application; Evaluation This section explains when and how the rate-setting methodologies in this chapter apply. It covers which services use … 256S.2101 Rate Setting; Phase-in This section phases in the new rate-setting system for customized living services under the disability waiver. It … 256S.211 Rate Setting; Updating Rates; Spending Requirements This section covers how base wages are established and updated for rate-setting purposes, and sets spending requirements … 256S.212 Rate Setting; Base Wage Index This section establishes the base wage index used to calculate payment rates for Elderly Waiver services. It uses … 256S.213 Rate Setting; Factors This section defines the factors used to calculate Elderly Waiver service rates, including payroll taxes, benefits, … 256S.214 Rate Setting; Adjusted Base Wage This section explains how the adjusted base wage is calculated for rate-setting purposes. The adjusted wage accounts for … 256S.215 Rate Setting; Component Rates This section sets out how component rates are calculated for specific Elderly Waiver services like medication setups, …