(Revised 2/1/17 ML #3489)
Prior authorization by a case manager is required for all personal care tasks provided to an individual who meets the qualifying criteria for personal care services. The case manager must complete Personal Care Services Plan SFN 662 (PCSP) authorizing the services and hours that may be provided per month. Services and hours may be authorized for a period not to exceed 6 months.
The case manager must submit SFN 662 and supporting SFN 663(s) to either Aging Services or the Developmental Disabilities Division within three (3) working days of the date of completion of an assessment. Payment for personal care services may not be made without a prior authorization. With the exception of the authorization of Personal Care Services to be provided in a basic care facility, Personal Care Services may not be authorized prior to the date of the assessment. Authorization of Personal Care Services in a basic care facility may be authorized or up to 10 working days prior to the date of the assessment.
In addition, prior authorization from a State HCBS or DD Program Administrator is required to authorize units for meal prep, laundry, shopping, and housekeeping when performed by a live in provider or for a client who lives with other capable persons. Authorizations must be renewed annually.