State Institutional Alternatives (SIA) Facility Processes

This business process is to be used in reference to the State Institutional Alternatives documented process when a consumer enters an SIA IMD/Non-IMD facility for the following scenarios but has not yet discharged per KEESM 8112.4(4).

SIA= State Institutional Alternatives

IMD= Institution for Mental Disease

Active HCBS/IDD waiver recipient turns 21 prior to entering an SIA – IMD facility for a temporary stay

1. Navigate to the HCBS LTC record.

2. Add an end date in the HCBS record for the date of admission into the facility.

3. Navigate to Run EDBC screen.

   1. Select the month of admission.

   2. Select Yes for Timely Notice Exception.

   3. Select LTC Late Change for the Reason.

   4. Click Run EDBC.

   5. Ensure the HCBS LOC has ended for the date of admission.

   6. Click Accept.

4. Click Save and Continue.

5. Navigate to the LTC data detail page.

   1. Create an Institutional Care record for the IMD facility Temp Stay.

      1. Note: State Hospital – Mental Health should be the current level of care selected.

      2. Note: Begin date should be the day after admission to the facility.

   2. Click Save and Continue.

6. Update the RMT to Medical effective the month of admission for the IMD facility Temp Stay.

7. Navigate to Run EDBC screen.

   1. Select the month after the month of admission.

   2. Ensure the coverage is discontinued.  Staff should see a role reason of Get LTC/SSI.

   3. Click Accept.

   4. Click Save and Continue.

8. Delete the system-generated NOA and create a manual notice using the provided snippets/KEESM references.

Active (MDN)/MSP/SSI/MAGI recipient (age 22-64) enters an SIA – IMD facility/Active Medically Needy (MDN) recipient turns 21 before entering the IMD Facility

1. Navigate to the LTC data detail page.

   1. Create an Institutional Care record for the IMD facility Temp Stay.

      1. Note: State Hospital – Mental Health should be the current level of care selected.

   2. Click Save and Continue.

2. Do NOT change the RMT to LTC.

3. Navigate to Run EDBC screen.

   1. Select the Month of admission and Run EDBC.

   2. Ensure the coverage is discontinued   Staff should see a role reason of Gets LTC/SSI.

   3. Click Accept.

   4. Click Save and Continue.

4. Delete the system generated NOA and create a manual notice using the provided snippets/KEESM references.

5. Staff will need to shorten the Spenddown Base Period following the process for shortening a base period in the KEES User Manual.

Consumer discharges from IMD facility after the 21st birthday and readmits to IMD facility prior to 22nd birthday

1. Navigate to the LTC data detail page.

   1. Create an Institutional Care record for the IMD facility Stay.

      1. Note: State Hospital – Mental Health should be the current level of care selected.

   2. Click Save and Continue.

2. Change the RMT from LTC to Medical.

3. Navigate to Run EDBC screen.

   1. Select the month of admission and Run EDBC.

   2. Ensure the coverage is discontinued.  

      1. Staff should see a role reason of Gets LTC/SSI.

   3. Click Accept.

   4. Click Save and Continue.

4. Delete the system generated NOA and create a manual notice using the provided snippets/KEESM references.