6700, Transitioning to a Community Medicaid Program Other than the HCS Program

Body

Revision 25-1; Effective Nov. 12, 2025

For a person transitioning from an NF to a community Medicaid program that is not HCS, an assigned ECC coordinator must:

  • facilitate trial visits to providers in the community for the person and LAR, as requested by the person or LAR;
  • convene and facilitate SPT meetings as necessary to conduct transition planning and to develop, revise and implement the person’s Form 1053, Transition Plan, regardless of the program chosen by the person;
  • assist with service planning by:
    • making all available assessments available to the entity responsible for service planning; and
    • addressing the person’s:
      • strengths and preferences; and
      • medical, nursing, clinical, nutritional management and support needs;
  • conduct a pre-move site review in person using Form 1042, Pre-Move Site Review, to determine if essential supports identified in the transition plan are in place and any areas of concern are addressed before the person enrolls in the identified program; and
  • complete the following activities before the person transitions if, during the pre-move site review, any one of the essential supports is not in place or if issues are raised about the suitability of the site:
    • convenes the SPT to resolve the issues; and
    • conducts another pre-move site review following resolution.

6710, Transition Day

Revision 25-1; Effective Nov. 12, 2025

The MCO SC and RS are expected to be present at the new address on transition day to make sure all services are in place and to assist in setting up the household, as needed. The ECC coordinator is also encouraged to be present.

Note: If the transition plan includes essential supports that are due to be delivered or transferred with the person on transition day, the ECC coordinator must verify the supports are in place.