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016.06.85-203.200. Application

AR ADC 016.06.85-203.200Arkansas Administrative CodeEffective: November 1, 2023

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 85. Life360 Homes Provider Manual
Section 203.000. Application and Approval Process
Effective: November 1, 2023
Ark. Admin. Code 016.06.85-203.200
016.06.85-203.200. Application
Currentness
Upon approval of the LOI, the hospital will submit a Life360 application within ninety (90) calendar days. The application must include a:
A. A program narrative that describes:
1. How intensive care coordination will be designed and delivered according to requirements in this manual;
2. Staff and organizational experience;
3. Subcontractor experience, if applicable; and
4. Description of community partners
B. A community network assessment (template provided) (see section 203.210 for more details);
C. A copy of the hospital's most recent Community Needs Analysis (if available);
D. At least two letters of support from potential community partner organizations;
E. Plan for community outreach, education, and client communication;
F. How services will supplement, not supplant, services already provided in the community;
G. Description of proposed referral network and signed agreements with community partner organization, pending approval of the Life360 application (See section 203.210);
H. Plan for monitoring client milestones and goals, collecting data on client outcomes, and monitoring other quality improvement measures identified by DMS;
I. Startup and first-year program budget and narrative justification; and
J. Proposed screening tool(s) and a description of the screening processes
DMS will review the hospital's application and materials upon receipt of a complete application package and will respond within a specified timeframe in writing to approve, deny, or request additional information. If additional information is needed, the applicant hospital will have thirty (30) calendar days to provide the additional information. DMS will review and approve or deny any application within a specified timeframe.
The following sections 203.210-203.230 provide criteria for each application requirement.

Credits

Adopted Nov. 1, 2023.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.85-203.200, AR ADC 016.06.85-203.200
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