10 Colo. Code Regs. § 2505-10-8.763

Current through Register Vol. 47, No. 18, September 25, 2024

Section 10 CCR 2505-10-8.763 - TARGETED CASE MANAGEMENT - TRANSITION COORDINATION

1. Transition Coordination means support provided to a member who is moving from a congregate setting other than an assisted living facility or being diverted from possible institutionalization and includes the following activities: comprehensive assessment for transition, community risk assessment, development of a transition plan, referral and related activities, and monitoring and follow up activities as they relate to the transition or diversion.

8.763.AEligibility

1. To be eligible for Transition Coordination, members must be adult Medicaid recipients, who reside in a congregate setting other than an assisted living facility and are willing to participate and have expressed interest in moving to a home and community-based setting or have been identified as being at risk for institutionalization by the Department. Members may also be Medicaid recipients receiving Home and Community Based Services (HCBS) provided by the State operated Regional Centers (RC) who want to move to a private Home and Community Based Services Provider. Services are expected to begin while an individual is living in a facility and continue through integration into community living, based on the community risk assessment. Excluded are children under the age of 18.

8.763.BServices

1. Transition Coordination is provided pursuant to Section 8.519.27.

8.763.CLimitations on Service

1. Transition Coordination is limited to 360 units per member per transition or diversion. A unit of service is defined as each completed 15-minute increment that meets the description of a Transition Coordination activity. When an individual has a documented need for additional units, the 360-unit cap may be exceeded to ensure the health and welfare of the member. The Transition 1 Coordinator shall submit documentation to the Department including:

a. A copy of the community risk assessment describing the member's current needs.

b. The number of additional units requested.

c. A history of Transition Coordination units provided to date and outcomes of those services

d. An explanation of the additional Transition Coordination supports to be provided by the transition coordinator using any additional approved units.

10 CCR 2505-10-8.763

47 CR 05, March 10, 2024, effective 3/30/2024

47 CR 16, August 25, 2024, effective 9/15/2024