24.1 Alternate Care Placement

Legal Authority

The SSW may provide family members with information on unlicensed, non-registered or non-certified facilities or agencies and may suggest that the family of the adult contact such facilities or agencies.
The SSW may assist in placement by:

If no one else is available to assist when the adult is accepted for placement, the SSW may, with permission of the adult, guardian or legal representative:

Arrange transportation; and
Notify appropriate agencies (i.e. Social Security Administration, Division of Family Support or the U.S. Postal Service).

Contact with an out of state facility may be interpreted as a state agency placement as defined by federal regulations, which specify Medicaid residency conditions.
Direct contact by DCBS staff with an out of state facility, which results in placement, obligates Kentucky’s Medicaid program for care reimbursement.
If the adult, family, guardian or other legal representative desires out of state placement, the worker may:

When an adult is certified for a Medicaid placement, the adult may be placed in a Medicaid facility and the SSW:

May assist in locating placement in the appropriate level of care;
May refer the adult or family member to the Division of Family Support for the determination of Medicaid eligibility;
May tell an adult or guardian of an adult, who has a behavioral health or a developmental disability diagnosis that a pre-admission screening and record review (PASARR) evaluation will be conducted prior to admission in a Medicaid facility. The Division of Behavioral Health Developmental and Intellectual Disabilities administers the PASARR evaluation;diagnosis that a pre-admission screening and record review (PASARR) evaluation will be conducted prior to admission in a Medicaid facility. The Division of Mental Retardation administers the PASARR evaluation;
Considers every available community resource that may assist the adult to remain at home or return home during the placement process; and
May follow up within thirty (30) calendar days to determine that the adult’s care needs are being met and the adult is adjusting to the placement.

When an adult is decertified, he loses Medicaid eligibility.
If requested, the SSW assists with relocation of an adult to a non-Medicaid facility within ten (10) calendar days from the date of decertification.
If appropriate placement is not located or accepted by the adult or responsible party within the ten (10) days, Medicaid is discontinued and the resident is placed in private pay status.

As part of the assessment, the SSW:

Determines, in conjunction with the care team, the appropriate level of placement in alternate care;
Completes the assessment and submits it to the FSOS for approval;
First considers alternate care settings, which are registered, certified or licensed by Cabinet for Health and Family Services including: