Revision 06-0; Effective May 22, 2006
Question | Answer |
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1. Can the individual receiving Transition Assistance Services (TAS) services request a specific brand or type of appliance, furniture or other TAS item, even if a similar item can be purchased at a lesser amount? | Yes, as long as the individual's needs are met within the cost limit. |
2. Can the TAS item be placed in someone else's home? For example, the individual is moving in with a daughter and they are requesting bedroom furniture. | TAS can be used in this situation only when furnishings are not available and are necessary for the individual to be able to transition from the nursing facility. |
3. Can TAS replace existing furniture that the individual/individual's representative deems no longer usable? | TAS can be used only to provide the necessary basic items for the individual to live in the community. If an existing item is truly not usable and the lack of a usable basic/essential item creates a barrier that keeps the individual from returning to the community, then the individual has a need for the item. However, TAS cannot be used for upgrading to a better quality item just because the individual would like new items. |
4. What happens to the TAS items if the individual chooses to return to the nursing facility? | If the individual has left the nursing facility and has possession of the TAS items, the items belong to the individual. The individual is responsible for making any decision regarding the disposition of the TAS items upon returning to the nursing facility |
5. Can security deposits or utility deposits be in someone's name other than the individual? | No. The deposits must be in the individual's name. |
6. Will TAS pay for the deposit on a cell phone if that is the individual's only telephone service? | Most cell phones do not require a deposit. Since a telephone is considered a basic need, TAS can purchase a telephone, but may not pay for any minutes or services. |
7. Can TAS be used to pay for arrears on previous utilities that must be paid before the new service is turned on? | Yes, only if it is in the individual's name and the individual will not be able to get utilities unless the previous balance is paid. |
8. Will TAS pay for pet deposits? | No, TAS will not pay pet deposits, unless the individual has a service animal. If the individual has a service animal, pet deposits can be considered essential to the individual. |
9. Can TAS be used to pay for repairs (not home modifications) on the individual's dwelling? | No. TAS cannot be used to pay for repairs. |
10. Can TAS be used to set up a septic system in rural areas? | No. |
11. It appears that the first day of authorization for TAS is the initial eligibility date from the Individual Service Plan/Individual Plan of Care form. The individual should still be in the nursing facility awaiting the completion of TAS and the start of service. Will the provider agency be able to bill for TAS items purchased during this period if nursing facility coverage is still open? | Yes. The system has been designed for this overlap. |
12. Does the case manager amend the TAS authorization form only if there is a new item requested, or must the case manager amend the TAS authorization form if there is a change in the price of a specific item? | The case manager amends the TAS authorization form, Individual Service Plan (ISP), for any valid change requests. If more funds are needed to purchase an item on the estimated cost list, the case manager also makes that change on the TAS authorization form. |
13. Is there a window of time in which the individual can request additional items on TAS? Implementation material states TAS is "one-time," but then allows for individuals to request additional items. How long after the initial authorization can the individual request additional items under TAS? | To assist the individual in making a successful transition to the community, the individual may request additional items or seek resolution of a problem until the completion date specified on the TAS authorization form. This date is two days prior to the planned discharge date. The case manager must make every effort to ensure that all basic/essential items are authorized while the individual is still in the nursing facility. |
14. If the individual requests items under TAS, can the case manager authorize a flat $2,500? | No. |
15. Should the TAS authorization form include the individual's date of birth and Social Security number, since utility companies for deposits usually require this information? | The case manager must provide any necessary information to the TAS agency. The TAS authorization form requires the individual's date of birth and Social Security number. |
16. Should a copy of the intake be sent with the TAS authorization? | To protect the privacy of the individual, a copy of the intake should not be provided to the TAS agency. If any additional information is needed, it should be attached on Form 2067, Case Information. |
17. Can the TAS agency exceed the amount for a particular item, as long as the amount for the total category is not exceeded? For example, a water deposit is noted for $100 and an electricity deposit is noted for $200. It turns out the electric company will only require a $100 deposit, but the water company raised its deposit to $150. The total for deposits is still under the $300 authorized. | Yes. The TAS agency can exceed the amount for a particular item as long as there are adequate funds authorized. The amounts listed in the guide are estimated, since utility deposits vary widely across the state. The case manager does not need to make a change on the authorization as long as there is adequate money authorized to cover the need. |
18. If the TAS agency finds it needs additional funds in a specific category, but fewer in others, should the case manager change the TAS authorization form? | No. The case manager does not change the TAS authorization form as long as the total authorized amount is adequate to cover the costs. However, if the TAS agency identifies a new item required by the individual, then a TAS authorization form is completed, processed as a change and sent to the agency with the additional items and amounts authorized. |
19. Does the agency request a change in the authorization if the amount of one of the items is not enough or if the amount of the categories is not enough? | The TAS agency may request a TAS authorization form change if the actual cost exceeds the authorized amount or if a new item/service not previously requested needs to be included. |
20. Long Term Care (LTC) Information Letter No. 04-33 states, "The TAS provider is authorized to purchase only the specific items or services found on the form, within the dollar amount authorized for each item or service." The memo also states the TAS provider may submit separate claims for each item or service. What does each item or service mean? | The memo quoted is LTC Information Letter No. 04-33, which was sent to providers from the Provider section. While the TAS agency is usually going to submit only one claim for all services, it can submit a second billing (or third, etc.) for additional items or changes added on a revised TAS authorization form. Examples of items and services include utility/security deposits, moving expenses and essential furnishings necessary to establish a household. |
21. If a TAS individual is moving into an apartment and the apartment requires the first and/or last month's rent as part of the security deposit, can TAS pay this amount? | According to the Centers for Medicare and Medicaid Services (CMS), security deposits may be paid as long as:
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22. The TAS agency purchases an item or service that has prior approval by the case manager, but the nursing facility resident changes his mind and doesn't leave the facility or dies before being discharged. What does the TAS agency do with the purchased item? |
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23. If a TAS individual has no resources for purchasing food at the time of move-in, can TAS pay for food? | No, TAS funds cannot be used for food. The case manager may refer the individual to emergency Supplemental Nutrition Assistance Program (SNAP) or local food pantry resources. Some funding is available through the Transition to Living in the Community (TLC) program. TLC funds are primarily designated for non-waiver individuals, but if a waiver individual has no other resources, TLC may be able to pay for food. |
24. If an individual is moving from the nursing facility into an apartment, but plans to have a roommate, can TAS pay for (a) the security deposit and (b) furniture and other items the individual will need? |
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