Any activity that cannot be clearly tied to the administration of PASRR cannot be claimed at the enhanced 75% match. Examples include, but are not limited to:
- Any clinical services, including all Specialized Services. Recall that PASRR is an administrative activity and not a service.
- Some aspects of determining NF LOC. For more information, please refer to our FAQ Can a state receive 75% FFP for its NF level of care determination?
- Case management for evaluated individuals, such as monitoring and/or coordinating services for individuals over time.
- Evaluation activities for individuals to whom PASRR (Level II) does not apply. For example, there could be a case in which an individual is admitted into a NF but does not have ID, MI, or a related condition as defined by PASRR. This individual does however have a traumatic brain injury (TBI) and associated disability-specific needs. Any evaluation activities designed to meet these needs cannot be claimed at the enhanced match rate. This is not to say that concurrent operation is not efficient, but costs must be allocated properly. (Note that sometimes it is in the PASRR evaluation itself that it is discovered that the disability actually was a TBI occurring after the developmental period, and is therefore not a related condition. In a situation like this, it is appropriate to claim the Level II evaluation that “ruled out” a PASRR condition at the enhanced rate.)
- Diversion planning for an individual who is denied admission to a nursing facility (e.g., working to identify an appropriate HCBS waiver or state-only program).