Revision 06-0; Effective May 22, 2006

January 6, 2006

Mr. Smith, a current Medicaid nursing facility resident, contacts the Department of Aging and Disability Services (DADS) intake staff to request services in the community.

January 15, 2006

The CBA case manager meets with Mr. Smith and his sister to discuss the CBA service array and living arrangement options, and to obtain his choice of provider agencies. During the interview, Mr. Smith indicates that he plans to live in a house owned by his sister, Mary. Mary informs the case manager that she married and moved from her house last month and the home has all utility services in place. She also indicates the house already has living room/bedroom furniture, a clothes dryer, a fully equipped kitchen (with the exception of pots and pans), window blinds, a closet full of linens, etc. Mr. Smith indicates that he needs a dinette set, microwave oven, pots and pans, and washing machine. The case manager documents the identified items on the TAS assessment form.

January 16, 2006

The case manager authorizes a CBA Home and Community Support Services (HCSS) agency to perform a pre-enrollment assessment to identify Mr. Smith's total needs for CBA services and to develop an individual service plan (ISP).

February 12, 2006

The case manager determines that Mr. Smith meets all eligibility criteria for the CBA program and that no other resources are available to pay for his basic furnishings. The case manager finalizes the ISP, establishes an ISP effective date, and confirms the nursing facility discharge date and Mr. Smith's new home address. The case manager will send the TAS authorization and assessment forms to the TAS provider agency selected by Mr. Smith. The items authorized, with corresponding maximum costs per item, will be a small oak dinette ($200), a small microwave oven ($100), pots and pans ($50) and a washing machine ($400). The authorization will also include Mr. Smith's nursing facility discharge date of February 20, 1006, his address, and delivery date of February 20.

February 14, 2006

A TAS provider agency employee contacts the case manager to find out if Mr. Smith requested specific types of pots and pans.

February 14, 2006

The case manager contacts Mr. Smith to find out what specific pots and pans are needed. Mr. Smith informs the case manager that he needs stainless steel and prefers two medium pans and a small, medium and large pot. The case manager documents Mr. Smith's preferences on the assessment form and sends the revised form to the TAS provider agency.

February 16, 2006

The TAS provider agency employee goes to the local retail store to purchase the authorized items and arranges for delivery and installation on February 20, 2006. The TAS provider agency must ensure the sales receipt includes the purchase date, the item purchased and the total cost (including sales tax and delivery/installation charge, if any).

February 20, 2006

The TAS agency contacts Mr. Smith or his sister to confirm that the authorized items were delivered. The TAS agency documents the delivery and submits a claim for reimbursement.