Sec. 10.22.18.06. Requests For and Approval of Supplemental Services  


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  • A. In order for the Administration to reimburse a licensee for supplemental services, the Administration shall preauthorize the service and approve the cost.

    B. To be approved for reimbursement of supplemental services, except housing, the licensee shall:

    (1) Submit a written request to the Administration justifying the request, including:

    (a) Recommendations from the individual's team,

    (b) Documentation from appropriate professionals, and

    (c) Other documentation the Administration requires; and

    (2) Justify the basis of the proposed costs and submit supporting documentation, such as:

    (a) Bids from vendors,

    (b) Advertisements for the item, and

    (c) Rates of a proposed vendor.

    C. To be approved for reimbursement of supplemental housing costs, the licensee shall submit a written request to the Administration documenting:

    (1) The individual's income and expenses;

    (2) The housing costs; and

    (3) Efforts to obtain other State or federal assistance with housing costs.

    D. In deciding whether to authorize supplemental services, the Administration shall:

    (1) Consider the documentation submitted by the provider in this regulation;

    (2) Consider the proposed cost for the service;

    (3) If appropriate, visit the individual in the setting where the continuous supplemental services are to be provided; and

    (4) Review the licensee's efforts to meet the individual's needs within existing resources.