Increase in PNA for ICF/IID, MC/DD and SMHRF

Policy Memo

10/23/17

Summary:

State law provides for an increase in the Personal Needs Allowance (PNA) for persons who reside in:

• an Intermediate Care Facility/Individuals with Intellectual Disabilities (ICF/IID), Provider type 29;
• a Medically Complex for the Developmentally Disabled (MC/DD) facility, formerly known as Skilled Nursing Facility/Pediatrics (SNF/PDS), Provider type 29; and
• a Specialized Mental Health Rehabilitation Facility (SMHRF), Provider type 38.

Effective July 1, 2017, the PNA for persons residing in an ICF/IID, MC/DD facility and SMHRF is increased up to $60.

Budgeting the  PNA Increase

• Retroactively budget beginning July 1, 2017
• Apply to persons whose gross income minus deductions is equal to or greater than $60
• For persons whose gross income minus deductions is less than $60, the PNA is the remainder of their gross income minus deductions.

How to Identify Who Gets the PNA Increase

• For retroactive budgeting to begin the PNA increase 7/1/17, the Bureau of Long Term Care (BLTC) will provide a list of persons who are eligible for the PNA increase as of the date the list is compiled 10/01/17.
• For new admissions dated after 10/01/17, Providers have been instructed to enter the appropriate Category of Service (COS) coding under REMARKS in the 1156 section of the MEDI transaction, or
• The ICF/MR box is checked as the Level of Care designation in the 1156 section of the MEDI transaction. The ICF/MR box denotes Provider Type 29.

Reference Tool

For Provider Type 29 and 38, the BLTC has developed a list, arranged in alphabetical order by provider type, of facility names and their corresponding provider numbers for the LTC hubs to use, if needed. Caseworkers are not required to consult the list to budget the PNA for new admissions. The list is provided for use when the caseworker has a question about what is reported on the MEDI transaction; for example, when a provider marks the SNF box for level of care and enters COS 73 in Remarks. The provider type list will be sent to DHS administration for distribution to the LTC Hubs.

Provider Types and Corresponding COS codes

Note: for Provider type 29, only use COS 76 when you get an error message after attempting to enter COS 73 or 74.