DMAS Important Updates

LRI – Frequently Asked Questions (FAQ’s)

On March 1st, all current legally responsible individuals may continue to provide services and be reimbursed for up to 40 hours per work week. If there is a paid LRI, respite care will no longer be available.

A legally responsible individual is any person who has a duty under state law to care for another person and includes parents of children under age 18 (including biological, foster, stepparents, and legal guardians) and spouses.

“Objective, written documentation” (OWD) means documentation that demonstrates there are no persons available to provide support to the individual other than the unpaid family/caregiver who lives in the home with the individual. At least one criteria must be met.

  • Unable to hire staff 
    • Copies of dated advertisements
    • Copies of interview notes
    • Documentation indicating high turnover of staff
  • Special behavioral needs documented in the record
    • Behavioral supports are in place/current plan is effective
    • A referral for behavioral support has been made.
  • Special medical needs documented in the record that do not require skilled care
  • Language is a factor in service delivery (documented in the record)

Copies need to be uploaded to our Secure Documentation Dropbox  prior to every request for authorization.

For LRI Attendants 

  • Respite will not be available when there is a paid LRI.
  • LRI payments will be limited to 40 hours per week.  LRIs are permitted to find other caregivers for the additional hours approved in the plan of care.

No, only one LRI attendant is permitted to be employed at a time for that child.

Yes, Consumer Directed and Agency Directed are both under the new guardrails and have the same standards.

Yes. A live-in attendant is the attendant of last resort, meaning that the EOR should continue to advertise the position and submit documentation of attempts to their service facilitator to be used for every authorization request.

The ad must be placed within the last 6 weeks and show documentation of that date. The CD EOR Manual is a wonderful tool for job descriptions and hiring attendants.

Yes, they can still be approved for more hours if that is the need of the individual. The LRI attendant is limited to working 40 hours total per week.

No. If there is an unpaid primary caregiver who regularly supports the individual and is in need of respite, respite will still be available. Only if there is an LRI attendant on the payroll will the respite be ended. If another attendant is found and the LRI attendant is disassociated from the individual as being a paid attendant and the unpaid primary caregiver meets the qualification for respite, your provider can request a respite service line.

No, the approved hours are based on the waiver individuals need, not how many hours are available for the attendant to use.

If you have guardianship over a loved one who is 18 or over, please view this video.

No. DMAS received federal approval to extend some of the current program rules. At this time, the Extraordinary Form will not be required.

Yes, due to the CMS-approved extension, there are no limits on who can serve as the EOR.

Can I still be paid to provide care after 3/1? Yes, LRIs can continue to work and be paid for up to 40 hours.

Not at this time. LRIs may continue to provide care up to 40 hours of care a week based on the current plan of care.

Yes, agencies may continue to pay LRIs for up to 40 hours per week for personal care. Respite care is not available when there is a paid LRI.

LRIs may be reimbursed for up to 40 hours a week regardless of the number of members they serve.

Mom in thought of what to do with the upcoming LRI and EOR changes from DMAS.

Do you still have questions?

Contact out Family Resource Team at 1(800)417-0908

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