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FBS can begin up to 30 days prior to discharge from an RTF. Note: Item 3-E must be completed.Waiver Administration and Operation. Failure to perform the services with sufficient labor, equipment, or material to complete the specified work in accordance with the Agreement terms;. 3). A properly completed Outpatient Service Authorization Request Form (MA-97). 24 hour availability of services for diagnosis, continuous monitoring and assessment of the person's response to treatment,. The NC Innovations 1915(c) waiver program services definition and limitations. Residential Treatment Facility Application for Services under O.C.G.A § 20-2-133. I. School District and RTF Information. APPENDIX C: MEDICAID 1915(B)(3) WAIVER SERVICES .