Special Assistance SA-3120 EIS Instructions for SA

VI. FACILITY INQUIRY/UPDATE SCREEN

Always complete a facility inquiry in EIS when approving an SA application or making a change to an SA case, by accessing the Facility Inquiry/Update screen. See EIS-1063 II. Determining the Facility Code, for instructions. This is necessary to determine the correct three-digit facility code for the a/r based on the facility in which he/she currently resides.

Note: Licensure rules do not apply to private living arrangements. There is no 3-digit facility code for SA/IH recipients in private living.

A. Case applications and changes to ongoing cases cannot be processed unless the facility associated with the three-digit facility code has a “Y” in both the SA eligible, and the civil rights agreement fields in the EIS Facility/Inquiry Update Screen.

B. EIS edit to prevent authorization in unlicensed facilities and facilities that are not SA approved.

There is an edit in EIS which will not allow entries or changes to cases with invalid facility codes. If an incorrect facility code is entered, an error message DOM FACILITY MUST BE SA ELIGIBILE & HAVE CIVIL RIGHTS AGREEMENT will be displayed. Invalid facility codes for this edit will consist of those codes where the SA eligible indicator or the civil rights indicator is not a “Y”. The correct facility code must be entered before a change will be allowed. See EIS-1063 III. Facility Code Validation.

C. If you cannot find an accurate code for the facility:

1. Check to verify that the facility is a licensed facility by using the licensed facilities list on the Division of Health Service Regulation website. (http://www.ncdhhs.gov/dhsr/reports.htm)

2. If the facility is a mental health facility, make certain the facility is licensed as a 27G. 5600 A, 27G. 5600 C, or (for children and adolescents) 27G.2101 facility, the only mental health facilities that are SA eligible. ICF/MR facilities are not eligible.

D. There are several cases of identified residents of 5600 F facilities that have been receiving SA.

1. These SA residents may continue to receive SA as long as they remain in the same 5600 F facility in which they resided on September 15, 2008, and they meet all other eligibility requirements.

2. These residents are identified in EIS with an exempt code which will allow counties to make cases changes, except for the three digit facility codes. The case data page in EIS will display EXEMPT DOM FACILITY CASE across the bottom of the screen. If the facility code is changed, the case will lose its exempt status.

Note: Because the SA eligible indicator and/or the civil rights agreement indicator are “N” (no), counties will not be able to view the EIS facility inquiry page for 5600 F facilities.

3. A monthly report identifying exempt SA 5600 F cases is found in NCXPTR, titled DHREJ EXEMPT SA CASES. If there are no cases listed for a county, the county has no residents receiving SA in 5600 F facilities. This report is not mailed to counties.

E. SA eligible or civil rights status change.

1. The status of a facility may change from SA eligible to non-SA eligible due to change, expiration, or revocation of the facility’s license.

2. NCXPRTR cumulative daily report DHREJ SA ELIG DAILY IND CHANGE lists changes in SA eligible or civil rights status by facility code, type, SA and civil rights indicator change, date of change and site county. Counties should review this report frequently.

3. SA recipients living in an SA eligible facility which changes to SA facility ineligible to accept SA must be issued a timely notice of termination via the DSS 8110. Assure that continuing eligibility for Medicaid is evaluated.