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Medical Services – Appendix W, ARChoices in Homecare and Living Choices Assisted Living Facility (ALF) Waiver Application Tracking and Release Procedures 10/17/18 Appendix W Page 3 of 6 4. Based on the information on the application, the LTSS eligibility worker will screen the waiver application for possible eligibility in another Medicaid category. If it appears the applicant may be eligible in another Medicaid category, the application will be referred to the appropriate DCO County Office for an eligibility determination through the normal process for possible Medicaid coverage outside of the HCBS category. 5. Financial and MRT, if applicable, eligibility for the HCBS waiver will continue to be determined. (Refer to MS B-312 for ALF or MS B-313 for ARChoices.) If found eligible based on the non-functional need criteria for the category, the LTSS eligibility worker will update the Application List by entering the date of financial eligibility determination in the “DCO Eligibility Date” field. 6. If the applicant is found not eligible based on non-functional need criteria for the category, then the application will be denied in ANSWER. The LTSS eligibility worker will send a DHS-3330 to the DHS RN advising of the denial and update the Application List by entering the date of financial eligibility determination in the “Ineligible Date” field. This action will remove the applicant from the Application List. DHS RN /DAABH Central Office Responsibilities 1. Upon receipt of the DHS-3330 referral, the DHS RN will complete the functional eligibility assessment. 2. If the applicant is determined functionally eligible, the DHS RN will receive an email notification from DAABH Central Office which states: “704 Completed by OLTC – Wait for further instructions to process.” 3. The DAABH Central Office will update the Application List by entering the date of the functional eligibility determination in the appropriate field based on the date the DHS-0704 was signed. 4. DAABH Central Office will monitor the Application List for eligibility and move the appropriate applicants to the Tracking and Release List. 5. DAABH Central Office will send an email to the DHS RN to obtain the eligibility date and Medicaid number. 6. Upon receipt of the email request from Central Office, the DHS RN will send a DHS-3330 and the DHS- 0704, if available, to the LTSS eligibility worker requesting the eligibility date and Medicaid number.