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APPENDIX K: Emergency Preparedness and Response and COVID-19 Addendum Background: This standalone appendix may be utilized by the state during emergency situations to request amendments to its approved
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01
Obtain the necessary forms from the HCBS provider or case manager.
02
Fill out personal information such as name, address, date of birth, and social security number.
03
Provide information on income, assets, and any other financial resources.
04
Include details on medical conditions, medications, and any special needs that require accommodation.
05
Review the completed form for accuracy and sign where required.
06
Submit the form to the HCBS provider or case manager for processing.

Who needs hcbs room and board?

01
Individuals who require assistance with daily living activities due to physical or mental disabilities.
02
Individuals who are eligible for Medicaid-funded services and are enrolled in a HCBS program.
03
Individuals who are unable to live independently and require support with room and board expenses.
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HCBS room and board refers to Home and Community-Based Services that provide support for individuals with disabilities to live in a community setting rather than an institutional one. It includes the cost of housing and meals.
Individuals or their caregivers who receive HCBS services are required to report room and board expenses.
You can fill out the HCBS room and board form provided by your service provider or case manager. Make sure to include all expenses related to housing and meals.
The purpose of HCBS room and board reporting is to ensure that individuals with disabilities are receiving appropriate support and services in a community setting.
You must report all expenses related to housing and meals, including rent, utilities, groceries, and dining out.
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