Common use of In Lieu of Services Clause in Contracts

In Lieu of Services. 5.9.1 The PASSE may provide in lieu of services to an enrolled member in an Institution for Mental Diseases for fifteen (15) days per month in accordance with 42 CFR § 438.6(e) when the PASSE determines that the in lieu of services will reduce cost and avoid institutional placement or enhance the enrolled member’s ability to move from an institutional or residential setting to a HCBS setting. DHS will periodically review any stays in an IMD. 5.9.2 The benefit to the PASSE is that the service will reduce expenditures for institutional care. For example, if providing a mobile phone or paying for a WIFI connection allows the PASSE to avoid residential or ICF placement by monitoring a member’s health and vitals remotely, the cost of the mobile phone service or WIFI service would be an in lieu of cost. 5.9.3 The PASSE may cover in lieu of services for members if the following conditions are met: a. The member is not required by the PASSE to use the alternative service or setting; and b. The approved in lieu of services are offered to members at the option of the PASSE, and only if the member agrees to the in lieu of service.