016.06.09 Ark. Code R. 034

Current through Register Vol. 49, No. 10, October, 2024

Rule 016.06.09-034 - DDS Alternative Community Services (ACS) Waiver Update Transmittal # 105

Section IIDDS Alternative Community Services (ACS) Waiver

219.000 Adaptive Equipment (Environmental Accessibility Adaptations)

Adaptive equipment service provides for the purchase, leasing and, as necessary, repair of adaptive, therapeutic and augmentative equipment required to enable individuals to increase, maintain or improve their functional capacity to perform daily life tasks that would not be possible otherwise.

Adaptive equipment needs for supportive employment for a person are also included. This service may include specialized medical equipment such as devices, controls or appliances that will enable the person to perceive, to control or to communicate with the environment in which they live.

Equipment may only be covered if not available to the individual from any other source. Professional consultation must be accessed to ensure that the equipment will meet the needs of the individual. All items must meet applicable standards of manufacture, design and installation.

Computer equipment may be approved when it allows the participant control of his or her environment, assists in gaining independence or when it can be demonstrated that it is necessary to protect the health and safety of the person. Computers will not be purchased to improve socialization or educational skills.

Printers may be approved for non-verbal persons.

Computer desks or other furniture items will not be covered.

Communication boards are allowable devices. Computers may be approved for communication when there is substantial documentation that a computer will meet the needs of the person more appropriately than a communication board.

Software will be approved only when required to operate the accessories included for environmental control or to provide text-to-speech capability.

Permanent modifications to make a participant/legally responsible party's vehicle accessible may be approved under certain conditions. See Section 219.100 for more information.

Personal emergency response systems (PERS) may be approved when they can be demonstrated as necessary to protect the health and safety of the participant. PERS are electronic devices that enable individuals to secure help in an emergency. The individual may also wear a portable "help" button to allow for mobility. The system is connected to the individual's telephone and programmed to signal a response center once a "help" button is activated. The response center must be staffed by trained professionals.

PERS services are limited to individuals who live alone or who are alone for significant parts of the day and have no regular caregiver for extended periods of time and who would otherwise require extensive routine supervision.

219.100 Vehicle Modifications

Payment for permanent modifications of a vehicle is based on the cost of parts and labor, which must be quoted and paid separately from the purchase price of the vehicle to which the modifications are or will be made.

A. Transfer of any part of the purchase price of a vehicle, including preparation and delivery, to the price of a modification is a fraudulent activity. All suspected fraudulent activity will be reported to the Program Integrity Section of the Division of Medical Services for investigation.

B. Reimbursement for a permanent modification cannot be used or considered as down payment for a vehicle.

C. Lifts that require vehicle modification and the modifications are, for purposes of approval and reimbursement, one project and cannot be separated by plan of care years in order to obtain up to the maximum of $7500 for each component.

Permanent vehicle modifications may be replaced if the vehicle is stolen, damaged beyond repair as long as the damage is not through negligence of the vehicle owner, or used for more than its reasonable useful lifetime.

A. A vehicle has reached its reasonable useful lifetime when repairs are required to make the vehicle useable, and the cost of the repairs exceeds the fair market value of the vehicle in repaired condition.

B. Cost of repair shall be determined by repair estimates from three qualified repairers.

C. Vehicle value shall be determined by reference to sales listing for similar vehicles within a 200 mile radius of the beneficiary's home, and to listings in Dallas, Texas, Kansas City, Missouri, Saint Louis, Missouri and Memphis, Tennessee.

D. If the participant/legally responsible party sells or trades a permanently modified vehicle before the vehicle reaches its reasonable useful lifetime, the modification will not be replaced on any replacement vehicle. Instead, the participant may be eligible for partial payment based on the estimated remaining residual value of the vehicle at the time of sale.

1. Estimated residual value shall be determined by comparing the purchase price of the modified vehicle when acquired by the participant/legally responsible party when the vehicle value at the time of sale determined as stated above.

Example:

Apermanently modified vehicle purchased for $30,000 is sold with a value of $20,000 (66% residual value). If parts and labor for the modification of the replacement vehicle are $10,000, the amount paid is $3,333 (33%).

219.200 Benefit Limits for Adaptive Equipment

The annual expenditure for adaptive equipment is $7500.00 per person. If the person is also receiving environmental modification services, the COMBINED annual expenditure cannot exceed $7500.00.

016.06.09 Ark. Code R. 034

10/16/2009