E How to Establish the FCPI

Program	Manual Section
ALTCS	MA707

Procedures

The processes for establishing the FCPI vary depending on whether it is based on:

Medical institutionalization
Receipt of formal HCBS
Intent to receive HCBS

1) FCPI Based on Medical Institutionalization

When a stay in a medical facility or a combination of medical facilities may have been the customer’s first continuous period of institutionalization, take the following steps:

Step	Action
1	Is the customer resource eligible using the minimum CSRD? If YES, STOP. An FCPI date is not needed. Add a case note that the customer is resource eligible without the CSRA. If NO, continue to step 2.
2	Did the customer receive paid HCBS that began at least one month prior to the entering a medical facility? If YES, STOP. Use the procedures below in Section 2) FCPI Based on Receipt of Paid Formal HCBS. If NO, continue to step 3.
3	Go to the FCPI battery in HEAplus and use the “Add Service” button to add each stay in a medical facility.
4	Review the file for case notes or records verifying any of the periods in a medical facility and update the FCPI Service Summary Screen as needed.
5	For any stay in a facility that is not verified, contact the records department at the agency or facility to get the dates the customer entered and left, and update the FCPI Service Summary Screen as needed. Add a case comment for each facility stay that includes the following: The name of the person you spoke with; and The name of the facility or agency.
6	Did the customer stay for 30 or more continuous days in a medical facility or a combination of medical facilities? If YES, continue to step 7. If NO, skip to step 8.
7	Click on the “Establish FCPI” button. HEAplus will determine the FCPI date based on the information entered.
8	Did the customer receive paid HCBS after receiving services at the medical facilities? If YES, STOP. Use the procedures below in Section 2) FCPI Based on Receipt of Paid Formal HCBS. If NO, STOP. Use the procedures below in Section 3) How to Establish an FCPI Based on Intent to Receive HCBS.

2) FCPI Based on Receipt of Paid Formal HCBS

When information provided indicates that the customer’s first continuous period of institutionalization may include receiving paid formal HCBS , take the following steps:

Step	Action
1	Is the customer resource eligible using the minimum CSRD? If YES, STOP. An FCPI date is not needed. Add a case note that the customer is resource eligible without the CSRA. If NO, continue to step 2.
2	Go to the FCPI battery in HEAplus and add the paid HCBS and medical facility stays for the earliest period of 30 continuous days.
3	Click on the FCPI Referral link and select YES on the Alert Pop-up to change the FCPI column to “referred”. The referral will be added to the PAS Assessor’s task list.
4	When the FCPI column on the worker task list reflects “complete” the PAS Assessor has finished the FCPI determination. Click the “Establish FCPI Date” button to lock in the FCPI date the PAS assessor entered.

3) How to Establish an FCPI Based on Intent to Receive HCBS

When an FCPI cannot be established based on prior periods of receiving services, but the customer intends to receive long-term care services, take the following steps:

Step	Action
1	Review applications in HEAplus for prior eligible PAS determinations. Did the customer already have an eligible PAS? If YES, STOP. The FCPI is the month the CSRA, private request PAS or ALTCS application was submitted that led to the prior eligible PAS. NOTE If it has been more than 180 days an Benefits and Eligibility Manager will need to enter the date of the eligible PAS. If NO, continue to step 2.
2	Is the current case a CSRA Only or an application for ALTCS? If it is a CSRA Only, request a Private Request PAS (PRP). If it is an ALTCS application and the PAS has not already been referred, make a PAS referral. Do not click on Establish FCPI Date or FCPI Referral.
3	Is the customer PAS eligible? If YES, STOP. The FCPI is the month the customer applied or requested the CSRA. If NO, continue to Step 4.
4	Since the customer is not medically eligible, there is no FCPI. If an application was filed, deny the application for “not medically eligible”. If a resource assessment was requested, process the CSRA with the decision reason “unable to establish FCPI”.