Section 7 AAC 127.030 - Application for Community First Choice services; authorization; reapplication and reauthorization(a) The department will pay for and review, in any 365-day period, one initial application for Community First Choice services to determine whether there is a reasonable indication that the individual might need services at a level of care under 7 AAC 127.025(d)(b) To apply for Community First Choice services under this chapter, an individual must (1) participate in the person-centered intake process;(2) select a care coordinator to provide services under 7 AAC 128.010 and participate in pre-enrollment options counseling; and(3) with the assistance of the care coordinator, complete an application in a format provided by the department.(c) A recipient who wishes to continue to receive Community First Choice services must request that the recipient's care coordinator submit a complete application to the department not later than 90 days before the expiration of the period covered by the preceding level-of-care approval.(d) Not later than 14 business days after the date the department receives the application, the department will send to the applicant and the applicant's care coordinator notice in writing of any missing information or documentation needed to make the application complete. Unless the department receives the missing information or documentation not later than 15 business days after the date of the notice of an incomplete application, the department will deny the application.(e) The department will conduct an expedited review of an application if (1) the request is submitted in a format provided by the department with a complete application or with a request for an amendment of a support plan; and(2) the department determines, on the basis of the request and application or amendment, that the individual has no natural supports to meet the applicant's needs and the applicant qualifies because of (A) a diagnosis of terminal illness with a life expectancy of six months or less;(B) imminent or recent discharged from a general acute care hospital or nursing facility; the applicant must submit the application not later than seven days after the date of discharge;(C) an unplanned absence of the primary caregiver due to a medical or family emergency or to hospitalization;(D) the declining health of the primary caregiver that makes that caregiver unable to continue to provide care for the applicant;(E) the death of the primary caregiver 30 or fewer days before the date of the application;(F) a referral from the departmental office responsible for adult protective services or children's services; or(G) a request by a Community First Choice services agency certified under 7 AAC 127.050 for a time-limited increase in Community First Choice personal care services, not to exceed six consecutive weeks, to address an recipient's immediate need if that need is related to the recipient's functional capacity to perform the services covered under 7 AAC 127.040. (f) Not later than 30 business days after the department determines that an application is complete, and the application and supportive diagnostic documentation reasonably indicate the need for services described in 7 AAC 127.040, the department will (1) conduct an assessment or interim level-of-care review to determine if the applicant meets the level-of-care eligibility requirements in 7 AAC 127.025;(2) for an applicant who wants to receive Community First Choice personal care services, conduct an assessment of the individual; the department will use the Consumer Assessment Tool, adopted by reference in 7 AAC 160.900, to determine if the individual qualifies to receive Community First Choice personal care services; and(3) send a letter to the individual and the individual's care coordinator indicating (A) the level-of-care determination;(B) whether development of a support plan under 7 AAC 127.039 may proceed; and(C) if the individual qualifies to received Community First Choice personal care services, the level of assistance authorized for those services.(g) Notwithstanding (f) of this section, the department may extend the notification timeframe for an additional 30 business days if the department requests review by an independent qualified health care professional in accordance with AS 47.07.045(b). A request for review includes a request made as part of the process of determining whether, under AS 47.07.045(b) and 7 AAC 130.219(e)(4), a recipient's condition has materially improved.Eff. 10/1/2018, Register 227, October 2018; am 1/22/2023, Register 245, April 2023Authority:AS 47.05.010
AS 47.07.030
AS 47.07.036
AS 47.07.040