CurrentCareSourcePolicy AR PASSE-AD-1422

Community and Employment Support Waiver Services: Unable to Provide for Member's Identified Needs

Governs procedures and responsibilities when an Arkansas PASSE CES provider is unable to assure a member's health, safety, welfare, or otherwise cannot provide identified services; applies to CareSource PASSE members and contracted CES providers in Arkansas.

Policy Summary

PayerCareSource

PolicyCommunity and Employment Support Waiver Services: Unable to Provide for Member's Identified Needs

Policy CodePolicy AR PASSE-AD-1422

Change TypeNew Policy

Effective Date02/01/2026

Next Review Date

Key ActionIf unable to assure health, safety, or welfare, provider must notify CareSource within 2 business days and submit a formal letter to DHS.

SourceLink

POLICY UPDATE CHANGES

New Policy.

02/01/2026Policy effective date

Arkansasjurisdiction governed

2 business daystimeframe for provider to notify CareSource and submit formal letter to DHS

30 daysnotice (non-immediate)

60 daysnotice (residential supports)

When a CES Provider Cannot Provide Services

CES provider inability and transition criteria

Conditions and procedures when a CES provider cannot provide services:

All services delivered under the CES waiver must be documented in the member's Person-Centered Service Plan (PCSP). If a member selects an approved CES provider within the member's geographic location, the CES provider is required to provide the identified services unless the provider cannot assure the member's health, safety, or welfare.

If provider becomes unable to assure health, safety, or welfare

Provider must notify CareSource within 2 business days and submit a formal letter to the Arkansas DHS.
Provider must submit Incident Reports to CareSource and to DHS for any event meeting the criteria for a reportable event (e.g., member experiencing harm while receiving services).

Policy Summary

PayerCareSource

PolicyCommunity and Employment Support Waiver Services: Unable to Provide for Member's Identified Needs

Policy CodePolicy AR PASSE-AD-1422

Change TypeNew Policy

Effective Date02/01/2026

Next Review Date

Key ActionIf unable to assure health, safety, or welfare, provider must notify CareSource within 2 business days and submit a formal letter to DHS.

SourceLink

On This Page

Non-immediate inability to provide services (not due to immediate health/safety)

Provider must give at least 30 days' notice to CareSource.
If the provider is providing residential supports to maintain living, 60 days' notice to CareSource is required.
The inability to serve the member must be based on the provider's limitation and not on prohibited discrimination; CareSource prohibits refusal to treat based on protected characteristics. CareSource will not discriminate against providers acting within protections of provider conscience laws per HHS guidance.

Transition and discharge responsibilities

After contacting CareSource, provider will send written notice to the member, family member, or authorized representative that includes the reason for transitioning care, the effective date, and a statement regarding the member's appeal rights with a copy of DDS Policy #1076; provider will CC carecoordination@caresourcepasse.com and place a copy in the member's service record.
Provider will conduct a transfer or discharge planning conference with the member, family, care coordinator, legal representative, and advocate as applicable to support a smooth transition.
Provider will complete a written discharge summary that includes, at minimum, the member's health, developmental, behavioral, and social issues and nutritional status to be provided to the newly selected provider.
If the member files a timely appeal, the member may remain with the provider and not be transferred until a decision is rendered on the appeal.

Timeframes and References

Referenced statutory and policy sourcesmixed

Amendment to the Community and Employment (CES) 1915(c) Waiver	the CES Provider Manual and the CES Certification Standards, 016.05.17 ARK. CODE R. § 004 (2017).
Arkansas Department of Human Services, Division of Developmental Disability Services. Appeals. Policy No. 1076	Accessed August 25, 2025. www.humanservices.arkansas.gov
Community and Employment Support (CES) Waiver Provider List	Arkansas Dept of Human Services; 2025. Accessed August 25, 2025. www.humanservices.arkansas.gov

Referenced statutory and policy sources (raw citations)mixed

016.05.17 ARK. CODE R. § 004 (2017)

CES Certification Standards referenced in the CES Provider Manual and amendment to the CES 1915(c) waiver.

Notice timeframe (non-emergent)

Notice timeframe (non-emergent)Provider must give at least 30 days' notice to CareSource when inability to meet member needs is not due to immediate health or safety.

ApplicabilityApplies to CES providers unable to adequately meet a member’s needs for reasons other than immediate health/safety.

Basis for inabilityInability to serve must be based on the provider's limitation.

Notice timeframe (residential supports)

Notice timeframe (residential supports)60 days' notice to CareSource is required when the provider is providing residential supports to maintain living.

ScopeSpecific to residential support services under the CES waiver where living is maintained by the provider.

Relation to non-emergent noticeThis is a longer notice requirement than the 30-day notice for non-residential, non-immediate cases.

Immediate safety notification

Immediate safety notification timeframeProvider must notify CareSource within 2 business days and submit a formal letter to DHS if unable to assure the health, safety, or welfare of a member.

Additional reportingProviders must submit Incident Reports to CareSource and DHS for any event that meets criteria for a reportable event (e.g., member harm while receiving services).

Content when staffing-relatedIf inability is due to staffing, notification must include efforts to employ and retain qualified personnel and the outcome.

Provider Notification, Reporting, and Transition Responsibilities

Documentation Required

Notify CareSource within 2 business days and submit formal DHS notice when unable to assure member safety

If a CES provider becomes unable to assure a member’s health, safety, or welfare, the provider must notify CareSource within 2 business days and submit a formal letter to DHS. Providers must submit Incident Reports to CareSource and to DHS for any reportable event. If inability is due to staffing, the notification must describe efforts to employ and retain qualified personnel and the outcome. If due to inadequate housing, the provider should propose alternative housing arrangements within the member’s resources; if the member is unable or unwilling to accept a proposed alternative, the provider must document the refusal and immediately notify CareSource.

Notify CareSource within 2 business days when unable to assure health, safety, or welfare.
Submit a formal letter to DHS documenting the provider’s inability.
Submit Incident Reports to CareSource and DHS for any reportable event.
If staffing-related, include recruitment/retention efforts and outcomes in the notification.
If housing-related, propose alternative housing within member resources and document refusal if member declines; immediately notify CareSource.

Prior Authorization

Provide written notice, conduct discharge planning, and supply discharge summary when discontinuing services

When discontinuing services, the provider must send a written notice to the member, family, or authorized representative after contacting CareSource; the notice must state the reason for transition, the effective date, and include a statement about appeal rights with a copy of DDS Policy #1076. The provider must CC carecoordination@caresourcepasse.com, place a copy in the member’s service record, conduct a transfer/discharge planning conference with relevant parties, and provide a written discharge summary addressing health, developmental, behavioral, social issues and nutritional status. If the member files a timely appeal, the member may remain with the provider until the appeal decision is rendered.

Send written notice to member/family/authorized representative including reason, effective date, and appeal rights with DDS Policy #1076.
CC notice to carecoordination@caresourcepasse.com and place a copy in the member’s service record.
Conduct a transfer/discharge planning conference with member, family, care coordinator, legal representative, and advocate as applicable.
Provide a written discharge summary that includes health, developmental, behavioral, social issues, and nutritional status.
If a timely appeal is filed, the member may remain with the provider until the appeal is decided.

Key Terms

CES waiver — Community and Employment Supports (CES) waiver definition

CES waiver (definition)Community and Employment Supports (CES) waiver allows members to receive supportive living services in the home and/or community as an alternative to institutionalization.

Provider roleCES providers may specify maximum number of members served, services provided, and service levels offered based on staff availability.

Member choicePASSE members have freedom of choice to choose a provider; a selected provider cannot refuse services unless unable to assure the member's health, safety, or welfare.

Provider inability — definition of provider inability to assure health, safety, or welfare

Provider inability (definition)A CES provider's inability to assure the health, safety, or welfare of a member — triggering required notifications and actions.

Immediate actions requiredWhen unable to assure health/safety/welfare, provider must notify CareSource within 2 business days and submit a formal letter to DHS; submit Incident Reports as required.

Non-immediate actionsFor non-immediate inability, provider must provide at least 30 days' notice to CareSource; 60 days for residential supports.

Cause-specific requirementsIf due to staffing, include recruitment/retention efforts and outcomes; if due to inadequate housing, propose alternative housing and document refusal if member declines.