Member Information Session FAQs

Topic oriented questions and answers which will provide information on how things may have changed for members during the COVID-19 outbreak.

Within this page are a series of topic oriented questions and answers from the May 5, 2020 IDD/TBI and May 7, 2020 MHSU Member Information Sessions.

Select a member topic below to display the frequently asked questions specific to that topic.

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Will I lose services if I am unable to attend services or receive services at home due to being at increased risk for COVID-19?

(Answered May 5, 2020) No, the utilization requirements for services are currently waived. As long as Appendix K is in place, a member is not at risk of losing their waiver slot.

Any direction for job coaching on worksites that is not allowed due to social distancing?

(Answered May 5, 2020) Job coaching can be provided at any specified off-site location

Can Appendix K be retroactively applied to respite hours that have already been billed?

(Answered May 5, 2020) CLS hours can be increased by contacting the provider to have an appendix K form issues. Respite hours are expected to run out and you can ask for more if you do run out. Already billed hours cannot be changed but can be reviewed to see if they were billed accurately.

Will the ability to request additional respite hours continue throughout the year?

(Answered May 5, 2020) Yes, requesting additional respite hours will be considered throughout the end of the plan year.

What are the most recent Appendix K changes?

The following changes are effective April 30, 2020:

  • Home Delivered Meals – Home Delivered Meals can be added as an additional service. Home Delivered Meals consists of two Home Delivered Meals per day.
  • Waive requirement for the Letter of Medical Necessity or Prescription from the Physicians, Nurse Practitioner or Physician’s Assistant for ongoing supplies or replacement equipment for which member has an already established authorization. This applies to Assistive Technology, Equipment and Supplies.
  • Allow primary Alternative Family Living (AFL) Providers to provide Supported Employment, Day Supports or Community Networking to the participant living in the AFL during times that Supported Employment, Day Supports or Community Networking would be regularly provided.
  • Allow legally responsible persons of minor waiver beneficiaries who reside in the home and out of the home to provide, Day Supports, Supported Employment, Community Living and Supports, and Community Networking when other providers are not available.
  • Allow for additional services to be provided by relatives who live in the home of the adult waiver beneficiary (current waiver only allows for Community Living and Supports) to include Community Networking, Day Supports and Supported Employment for 90 days. There may be more than one 90-day period.
What is the process for switching providers?

(Answered May 7, 2020) Contact 1-888-235-4673 for assistance with finding providers that offer the services that you currently receive. You can also ask your Care Coordinator (if you have one) for recommendations for a new provider. Please check that the new provider offers the services you want to receive.

If my child has Medicaid in one county but we have moved to another county, how do we get services?

(Answered May 7, 2020) Contact the LME/MCO from your original county to have a referral to the new LME/MCO. Please call the access to care line for help finding a provider that meets your needs, please relay all needs to the access to care line.

If I live in assisted living, how can I get an apartment?

(Answered May 7, 2020) Go to the website https://www.socialserve.com/pre_screening/ncdrst/DiversionScreeningTool.html and enter the data requested to be evaluated for independent living. If you are already in contact with TCLI, reach out to your in-reach specialist to let them know that you are interested.

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