11-293. Long-term care; counties; duties; requirements for payment; home health care

785 words·~4 min read·/az/title-11/11-293

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

A. From and after October 1, 1989, each county shall provide nursing care institution services, supervisory care services or adult foster care services for indigent persons qualified for hospitalization and medical care pursuant to this article who were receiving services pursuant to this section on September 30, 1989 or who had requested to be screened pursuant to subsection F of this section, and who are not determined eligible for long-term care pursuant to title 36, chapter 29, article 2.

If a person was determined ineligible under title 36, chapter 29, article 2 because that person did not meet the resource requirements pursuant to section 36-2934, a county may bill and collect from that person the actual cost of services provided pursuant to this section until such time as the person's remaining resources equal the maximum resource limit allowable under title 36, chapter 29, article 2. Notwithstanding any law to the contrary, a county shall not reduce the eligibility standards, benefit levels and categories of services in effect on March 1, 1988 for persons eligible pursuant to this section.

B. The standards adopted by a board of supervisors shall provide that a portion of the indigent person's income allowed pursuant to this section shall be retained by the person for the person's personal use. This portion shall not be less than fifteen per cent of the maximum benefit available under title XVI of the federal social security act, as amended. As provided by state and federal law, counties may file a claim against a person's estate to recover paid assistance. For the purposes of this article, the counties may impose liens according to state and federal law on the property of these persons.

C. The medical, nursing and social needs of the indigent person eligible pursuant to subsection A of this section shall be evaluated annually in order to provide placement of the indigent person in the least restrictive health care environment possible.

D. A nursing care institution, supervisory care home or adult foster care provider is not eligible for payment of the costs of providing health care services to an indigent person pursuant to this section unless the person has been determined to be eligible for placement pursuant to this section.

E. A person shall not be placed in a supervisory care home or with an adult foster care home provider pursuant to this article unless home health care services and outpatient medical services, as necessary, are provided as a condition of the placement.

F. A county shall screen members as defined in section 36-2901 or persons eligible pursuant to this article within eight days, excluding Saturdays and holidays, if there is a written request for such screening before October 1, 1989, including a request by a contractor as defined in section 36-2901. The screening shall determine whether placement is appropriate in a nursing care institution or adult foster care home. The county shall also determine eligibility for such members or persons within this eight day period, excluding Saturdays and holidays.

If the county determines that placement is appropriate, it shall place the person at the appropriate level of care within ten days, excluding Saturdays and holidays, after the written request for screening. The member's provider who contracts with the administration pursuant to section 36-2904, subsection A is responsible for the member's care until the county screens and places the member.

G. If the county does not complete the eligibility determination, screening and placement of a member or person determined appropriate for placement in the specified time period, the county shall reimburse the Arizona health care cost containment system for the medical expenses incurred or paid for which the Arizona health care cost containment system would not have been responsible except for the county's failure to determine eligibility, screen and place the person within the specified time period.

H. If a dispute arises between the Arizona health care cost containment system, including contractors as defined in section 36-2901, and the county regarding the appropriateness of placement in long-term care for persons eligible pursuant to subsection A of this section, the dispute shall be submitted to a multidisciplinary review board designated by the board of supervisors. The review board shall consist of one physician, one nurse and one social worker, and two appropriate representatives from the Arizona health care cost containment system administration.

If the review board determines that the long-term care was appropriate when requested the county shall reimburse the Arizona health care cost containment system for the medical expenses incurred or paid for which the Arizona health care cost containment system would not have been responsible except for the county's failure to determine eligibility, screen and place the person within the specified time period.