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(a) An individual who applies for assistance under 7 AAC 47.300 - 7 AAC 47.525 must also submit an application to each agency, organization, or program that provides financial assistance for which the individual may be eligible, including Social Security, SSI, Medicaid, Adult Public Assistance (APA), the home and community-based waiver services program under 7 AAC 43.1000 - 7 AAC 43.1110, and the programs listed in 7 AAC 47.380(a) and (b). Each application must be submitted within 30 days after filing an application for assistance under 7 AAC 47.300 - 7 AAC 47.525. The department, or a responsible person acting on the individual's behalf, may assist the individual in submitting each application. The individual's failure to apply for each program will result in denial of assistance under 7 AAC 47.300 - 7 AAC 47.525, unless the department determines that the individual is ineligible for a specified program.
(b) The department may also require an individual to apply for other benefits for which the department believes the individual is eligible. These benefits include veteran's and disability insurance benefits, worker's compensation, unemployment compensation, retirement system benefits, awards, and annuities. The individual's failure to apply for the benefits, after being given 30 days' written notice of the request, may result in denial of assistance under 7 AAC 47.300 - 7 AAC 47.525. The department will provide to the assisted living home a copy of the written notice if the individual is a resident when notice is given. An assisted living home that receives a notice under this subsection may choose to immediately issue a notice under 7 AAC 47.490, advising that the individual may be subject to involuntary discharge from the home if the individual fails to apply for benefits as requested by the department under this subsection.
(c) A resident of an assisted living home, placed in the home under 7 AAC 47.400, who is later determined eligible for other assistance applied for as required by (a) and (b) of this section, or whose total monthly countable income exceeds the minimum daily reimbursement rate set under 7 AAC 47.470, shall
(1) inform the department of any payments or benefits for which the resident has been determined eligible; and
(2) forward to the department
(A) any retroactive payments received, up to the amount the department has provided for that resident under 7 AAC 47.300 - 7 AAC 47.525, if the additional assistance received is intended to cover any portion of the same care that the assistance under 7 AAC 47.300 - 7 AAC 47.525 covered for that resident; and
(B) an amount that reimburses the department for assistance paid under this chapter for any period that the resident's total monthly countable income exceeded the minimum daily reimbursement rate set under 7 AAC 47.470.
(d) If an assisted living home receives a payment, including a retroactive payment, from another agency, organization, or program, or from a family member, relative, or other person, for providing care to a resident receiving assistance under 7 AAC 47.300 - 7 AAC 47.525, the administrator shall reimburse the department, up to the amount the department has provided for that resident under 7 AAC 47.300 - 7 AAC 47.525, if the additional assistance received is intended to cover any portion of the same care that the assistance under 7 AAC 47.300 - 7 AAC 47.525 covered for that resident.
(e) The department may require an assignment of rights to bill for and receive reimbursement for assistance provided under 7 AAC 47.300 - 7 AAC 47.525 from
(1) a resident receiving assistance under 7 AAC 47.300 - 7 AAC 47.525; or
(2) an assisted living home that is entitled to receive a retroactive payment from another agency, organization, or program for providing care to a resident receiving assistance under 7 AAC 47.300 - 7 AAC 47.525 for financial assistance received that is intended to cover any portion of the same care that the assistance under 7 AAC 47.300 - 7 AAC 47.525 covered for that resident.
History: Eff. 11/23/80, Register 76; am 6/18/82, Register 82; am 1/14/2000, Register 153; am 6/28/2002, Register 162
Authority: AS 47.05.010
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Last modified 7/05/2006