Haw. Code R. § 11-88.1-10

Current through September, 2024
Section 11-88.1-10 - Decrease or termination of services
(a) Division and waiver services may be decreased or terminated when the:
(1) Participant and the division or its agent mutually agree to terminate or reduce services;
(2) Provider of service contract is terminated and no other options are available through contractual agreement;
(3) Friends or relatives of the participant express willingness and are able to care for the participant without charge in lieu of division services;
(4) Current services or level of services are not necessary based on an assessment by the division;
(5) Participant, or the participant's legal guardian, or the participant's family member, or other representative with the best interest of the participant, elects to not approve or sign the proposed individualized service plan and the current individualized service plan has expired; or
(6) Allocated resources to pay for services have reached or exceeded its limit after DOH and DHS have acted with good faith in their best efforts to secure sufficient state and federal funding, respectively.
(b) The division will provide a written notice of the action to decrease or terminate services to the participant. Such notice shall be provided at least ten (10) working days prior to the effective date of decrease or termination of services and shall also describe the appeal process.
(c) The effective date of decrease or termination of services shall be determined by the division's policy for termination. This effective date may change accordingly based on the following exceptions:
(1) The date of the participant's death;
(2) The day before the date the participant becomes the responsibility of department of human services managed care health plan as a long-term care enrollee;
(3) In cases of possible fraud, the date five (5) working days after the mailing date of the notification of possible fraud.

Haw. Code R. § 11-88.1-10

[Eff 10/26/2014] (Auth: HRS §§ 321-9, 333F-18, 333F-19) (Imp: HRS §§ 333F-2, 333F-18; 42 CFR §§431.211, 431.213, 431.214 )