922 KAR 5:160 - Accounting provisions for adult guardianship
RELATES TO: KRS 210.290(3), (4), (5), 387.500-387.990, 42 C.F.R. 483.10, 42 U.S.C. 1320b-20
NECESSITY, FUNCTION, AND CONFORMITY: KRS 387.600(1) authorizes the Cabinet for Health and Family Services to be appointed as limited guardian, guardian, limited conservator, or conservator to conduct an active guardianship or conservatorship program. KRS 387.760 authorizes reasonable compensation for services rendered and for reasonable and necessary expenses incurred in the exercise of guardianship or conservatorship duties and powers from the financial resources of the ward. KRS 194A.050(1) requires the secretary of the cabinet to promulgate administrative regulations necessary under applicable state laws to protect, develop, and maintain the health, personal dignity, integrity, and sufficiency of the individual citizens of the commonwealth. This administrative regulation establishes accounting provisions for adult guardianship.
Section 1.
Definitions.
(1) "Best interest" means a
course of action that maximizes what is best for a ward and that includes
consideration of the least intrusive, most normalizing, and least restrictive
course of action possible given the needs of a ward.
(2) "Budget" means a financial spending plan
that estimates revenues and expenditures of an individual for a stated period
of time by examining and analyzing available financial information.
(3) "Division" means the Division of
Operations and Support.
(4)
"Emergency" means unexpected expenses such as:
(a) Medical needs not paid by Medicare or
Medicaid;
(b) Home repair;
or
(c) Transportation for a medical
appointment.
(5)
"Fiduciary Management Branch" means a central office branch under the Division
of Operations and Support.
(6)
"Field Services Branch" means a central office branch under the Division of
Guardianship.
(7) "Order of
appointment" means a type of guardianship appointment pursuant to
KRS 387.590(6).
(8) "Ordinary and necessary expenses" means
those expenses that are requested by a field services worker to maintain a
ward's quality of life such as clothing, snacks, and non-medical
transportation.
(9) "Personal
needs" means an individual's need to purchase varied goods such as:
(a) Clothing;
(b) Personal care items; or
(c) Social support items such as:
1. A telephone;
2. Stationery;
3. Books;
4. Snacks; or
5. Occasional outings.
(10) "Personal spending accounts"
means money maintained by the facility for the client's personal use in
accordance with 42 C.F.R.
483.10.
(11) "Provider" means a facility or entity
providing services for a ward such as:
(a)
Self;
(b) Caretaker;
(c) Family;
(d) Group home placement;
(e) Hospital; or
(f) Psychiatric hospital.
(12) "Ward" is defined by
KRS 387.510(15).
(13) "Work allowance" means a portion of a
ward's wage check sent to the ward to use for personal
spending.
Section 2.
Budget.
(1) The Field Services Branch shall
complete a budget upon receipt of the ward's funds or when the ward moves to a
facility without an established rate.
(2) The Fiduciary Management Branch shall
revise the budget once the guardianship compensation has been determined,
pursuant to KRS 387.760.
(3) The budget shall include:
(a) The ward's monthly income and
expenses;
(b) Other expenses of the
ward, including any applicable guardianship compensation that are on a monthly
basis, to calculate a monthly amount;
(c) The ward's net amount; and
(d) Submission of the completed budget to the
Fiduciary Management Branch for review and processing.
Section 3. Bed Holds.
(1) The facility, provider agency, or the
Division of Guardianship shall notify the Fiduciary Management Branch, within
twenty-four (24) hours, or if on a weekend or holiday by noon on the next
business day, that a ward is leaving or has left the facility or
placement.
(2) The Fiduciary
Management Branch may:
(a) Give verbal
authorization for the bed to be reserved, including the number of days;
and
(b) Authorize bed hold days in
excess of the period covered by Medicaid, or other funding source, only if the
availability of the ward's funds has been verified.
(3) If authorizing a bed hold, the Fiduciary
Management Branch shall:
(a) Verify the verbal
authorization of a bed hold; and
(b) Provide written notification of the
number of days approved to the facility within twenty-four (24) hours of
determination.
(4) If a
ward is in a public assistance eligible placement and moves to a temporary stay
at a hospital, or a state or privately run psychiatric hospital, the ward may
be entitled to retain the public assistance for ninety (90) days in accordance
with 42 U.S.C.
1382(e)(1)(G) and
20 C.F.R.
416.212. Eligible placements include a:
(a) Licensed personal care home;
(b) Licensed family care home;
(c) Caretaker; or
(d) A private residence in accordance with
Section 4(2)(d) of
921 KAR 2:015 supported by the
community integration supplementation.
(5) In order to continue public assistance,
the following requirements shall be met:
(a)
A bed hold has been approved;
(b) A
physician has certified in writing within ten (10) calendar days of admission
that the recipient is unlikely to be confined for longer than ninety (90) full,
consecutive days; and
(c) The
Fiduciary Management Branch provides the Department for Community Based
Services with the following:
1. Notification
of the temporary admission; and
2.
The physician statement as specified in paragraph (b) of this
subsection.
(6)
If the bed hold is not approved or a physician statement is not received within
ten (10) calendar days, the ward shall lose eligibility for public assistance
and all public assistance shall be returned by the Fiduciary Management Branch
to the Kentucky State Treasury from the date of admission.
(7)
(a) The
Field Services Branch may only authorize a bed hold for a ward residing in
other levels of care by verifying and documenting the availability of the
ward's funds with the Fiduciary Management Branch.
(b) If funds are verified by the Fiduciary
Management Branch, the Field Services Branch shall verify the verbal
authorization of a bed hold as specified in subsection (3) of this
section.
Section
4. Work Allowances. The Field Services Branch shall complete a
budget for a ward based on individual needs, taking into account Social
Security Administration work incentive rules,
42 U.S.C.
1320b-20.
Section 5. Quarterly Reports and Personal
Spending Accounts.
(1)
(a) Providers shall submit a quarterly report
to the cabinet, which includes documentation of a ward's personal needs income
and expenses.
(b) The maximum
allowable balance to be held in a personal spending account shall be $100 on
the last day of a calendar month.
(2) The division shall review the ward's
account for a discrepancy and to ensure:
(a)
The accounting report includes all personal needs income received on behalf of
the ward;
(b) Receipts are attached
to the accounting report including special requests that may have been
initiated by the provider such as:
1.
Clothing;
2. Furniture;
and
3. Electronics;
(c) All personal needs
expenditures incurred for that ward are ordinary and necessary; and
(d) The balance does not exceed
$100.
(3) If no
discrepancies are found, the Fiduciary Management Branch shall ensure the
balance is in compliance and that appropriate backup receipts are attached to
the accounting report.
(4) If a
discrepancy is found, the Fiduciary Management Branch shall contact the
provider to resolve the issue.
(5)
Upon completion, the Field Services Branch shall provide the review to the
Fiduciary Management Branch for final review and processing.
(6) The Fiduciary Management Branch with
input from the Field Services Branch, may:
(a)
Request a refund;
(b) Modify the
amount;
(c) Suspend the
disbursement of funds; or
(d)
Resume the disbursement of personal needs funds for the ward.
Section 6. Negotiable
Checks.
(1) The Field Services Branch shall
promptly forward all checks and money orders received on behalf of a ward to
the Fiduciary Management Branch.
(2) Any cash received on behalf of a ward
shall be converted to a money order or cashier's check as allowable by the
banking institution, and forwarded to the Fiduciary Management Branch as
specified in subsection (1) of this section.
(3) Each field services office shall have and
maintain a tracking system for cash and checks received on behalf of a
ward.
Section 7. Personal
Checking Accounts of a Ward.
(1) Establishment
of a checking account for a ward shall be at the direction of the
court.
(2) The Field Services
Branch shall ensure that the facility where the ward resides is aware that:
(a) An individual savings or checking account
shall not be established for the ward unless the account is listed in the
provider's name for the benefit of the ward; and
(b) The ward shall not legally write or
endorse checks from this account unless directed by the court.
Section 8. Checks Sent
to a Ward as Payee.
(1) The Field Services
Branch shall ensure that a ward of the cabinet does not receive or endorse
checks made payable directly to the ward unless:
(a) The court has directed that the ward may
receive and endorse checks; or
(b)
The order of appointment is for a limited type of appointment that does not
specify that the ward cannot execute instruments or enter into a contractual
relationship.
(2) Unless
the ward can endorse a check through an AOC-775, Order of Appointment of
Guardianship that is issued by the Administrative Office of the Courts and
available at www.courts.ky.gov, the
division shall ensure that no payment requests with the ward as payee is
made.
Section 9. Requests
for Payments and Supporting Documentation. A ward's expenses shall be paid
through a payment request system that has been developed by the Fiduciary
Management Branch to meet accounting internal control best practice and
reporting required by the courts.
Section
10. Medical Payments and Medical Spend Downs, Pharmacy and Health
Insurance Premium Payments.
(1) The Fiduciary
Management Branch shall review for payment a ward's expenses such as medical,
medical spend down, pharmacy and health insurance premium payments.
(2) The Fiduciary Management Branch shall
arrange payments when the ward has financial means to pay medical expenses not
reimbursable or covered by insurance, such as:
(a) Glasses;
(b) Diabetic shoes; or
(c) Dental services.
Section 11. Provider Payments. The
Fiduciary Management Branch shall:
(1) Review
a provider statement received; and
(2) Ensure that the provider statement does
not include inappropriate expenses such as medical, medical co-payments,
pharmacy charges, or personal needs.
Section 12. General Expenses.
(1)
(a)
Extra personal needs shall be personal needs that exceed the budgeted or
regulatory personal needs such as for personal care in accordance with
921 KAR 2:015.
(b) The Field Services Branch may request the
extra personal needs specified in paragraph (a) of this subsection at any
time.
(c) The Field Services Branch
shall follow the procedures for requests for payment and supporting
documentation in accordance with Section 9 of this administrative
regulation.
(2) The
Fiduciary Management Branch shall review and approve any payment
request.
(3) The Fiduciary
Management Branch shall approve or disapprove a payment request based on if:
(a) Funding is available; and
(b) The request indicates that the expense is
supported through documentation, if required, including:
1. Utility bills; or
2. House hold items.
Section 13. Burial
Policies and Related Issues.
(1) If funds are
available beyond providing for the ward's needs, a preneed burial may be
arranged for the ward.
(2) Prior to
purchasing a burial policy or making any other funeral arrangements, the Field
Services Branch shall:
(a) Request a burial
policy by contacting the Benefits Management Branch;
(b) Take into consideration a ward's desires
and cultural and religious views, if known; and
(c) Review a ward's records to:
1. Assess what burial policies or
arrangements have previously been acquired; and
2. Ensure the same funeral home is listed on
all policies.
(3) The Field Services Branch may discuss
with the ward, relative, or other individual with knowledge of the ward's
wishes concerning burial arrangements.
(4) If the Field Services Branch is unable to
obtain information regarding a burial preference from the ward, relative, or
other individual with knowledge of the ward's wishes, the Field Services Branch
shall:
(a) Examine the ward's record for
information pertaining to burial;
(b) Decide the location for the burial and
the funeral director who will handle the arrangements; and
(c) Submit burial request information to the
Benefits Management Branch for determining purchase of a burial
policy.
Notes
STATUTORY AUTHORITY: KRS 387.600(1), 387.760, 194A.050(1)
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