7 AAC 43.1044. Residential supported living services

(a) The department will reimburse for residential supported living services that

(1) are provided to a recipient in one of the following recipient categories:

(A) adults with physical disabilities; however, the department will reimburse only if a recipient in that recipient category does not experience a developmental disability;

(B) older adults;

(2) are approved under 7 AAC 43.1030 as part of the recipient's plan of care;

(3) receive prior authorization; and

(4) are provided in an assisted living home licensed under AS 47.33.

(b) The department will consider services to be residential supported living services if they

(1) assist, in a residential setting, a recipient with the activities of daily living; and

(2) are designed for a recipient who can no longer live alone and who does not need 24-hour care provided by a nursing facility, but who would be placed in a nursing facility for lack of alternate placements.

(1) for residential supported living services that are provided the same day as the recipient receives

(A) personal care assistant services reimbursable under 7 AAC 43.750 - 7 AAC 43.795;

(B) chore services reimbursable under 7 AAC 43.1042;

(C) meals services reimbursable under 7 AAC 43.1053, unless the meals are provided in a congregate setting other than an assisted living home licensed under AS 47.33; or

(D) respite care services reimbursable under 7 AAC 43.1049; or

(2) under this section for

(A) payment of the recipient's room and board;

(B) the cost of facility maintenance, upkeep, or improvement, except for actual costs for modifications or adaptations to a facility required to assure the health and safety of residents or to meet the life safety requirements of 13 AAC 50, 13 AAC 55, or an applicable municipal code; or

(3) for residential supported living services that are subject to the restrictions in 7 AAC 43.1080.

History: Eff. 5/15/2004, Register 170

Authority: AS 47.05.010

AS 47.07.030

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