Eligibility Policy Manual

Transmittal #7

Subject: Changes in Determination of County of Fiscal Responsibility

Implementation Date: December 3, 2004

Previously both the Arizona Administrative Code and the ALTCS manual addressed how to determine the County of Fiscal Responsibility (COFR) when a customer moved from another state within the last thirty days. Rule and policy contained a similar provision for situations where a person resided in a facility 30 days prior to moving to another county.

However, these policies were confusing and did not address variations; for example, what to do if the person moved from another state more than 30 days ago, or if the person lived in a facility less than 30 days before moving into a different county.

The Central Office, Program Support Administration and the Division of Health Care Management worked together to simplify the initial determination of the COFR into 3 simple rules. The County of Fiscal responsibility is:

• The county in which the customer currently resides in their own home, as defined;
• The county in which a customer resides when the customer moved from another state directly into a medical institution or alternative HCBS setting; or
• If the customer is in a nursing facility, alternative HCBS setting or is preparing to leave a public institution such as prison or the Arizona State Hospital, the County of Fiscal responsibility is the County where the customer last resided in their own home, as defined, prior to entering the medical facility, alternative HCBS setting or public institution.

Once the COFR is determined, it does not change unless a person moves to a new home, as defined, in another county or there is a an agreement to a change between two program contractors.

If you have any questions, please call Dan McKeever at 602-417-4455.