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MEDICAL SERVICES POLICY MANUAL,SECTION C C-200 Alternative Application Processes

To qualify for the ARChoices waiver, the individual aged 21-64 must be determined to have a physical disability through the Social Security Administration (SSA), the DHS Medical Review Team (MRT), or Railroad Retirement Board (RR). The individual may have a mentaldisability, but if so, it must be in addition to a physical disability to qualify for ARChoices. Individuals requiring services in ARChoices must be classified as requiring an Intermediate Level of Care. Individuals classified as Skilled Level of Care are not eligible for the ARChoices Program. Refer to MS F-155. C-243 Residents of Residential Care Facilities Applying for ARChoices Waiver MS Manual 07/01/20 If an individual living in a residential care facility (RCF) applies for Waiver services and has no plans to move out of the RCF, he/she does not meet the required Level of Care to receive Waiver services and the application will be denied. When the applicant gives a date that he or she plans to move out of the RCF and the relocation date is within the next 45 days, the application will be taken. At the end of the 45 day period, if the applicant has not relocated, the application for Waiver services will be denied if the relocation does not occur within the next 10 days.

C-244 ARChoices Waiver Eligibility Determination MS Manual 07/01/20 Eligibility determinations for ARChoices Waiver cases will be conducted in the same manner as for Long Term Services and Supports (LTSS) nursing facility cases. The SSI related income and resource criteria located in section MS Section E will be followed. SSI exclusions are not allowed from gross income in determining eligibility. When determining an applicant’s countable gross income when both spouses apply, each individual will be budgeted separately and his/her income will be compared to the current LTC limit. Only the income of the applicant will be considered for eligibility. In determining resource eligibility, the current LTSS resource limits will apply. • A single applicant’s resources will be compared to the one-person limit. • When there is a married couple and both apply, their combined resources will be compared to the couple’s resource limit. • If only one individual of a couple applies for ARChoices, the rules for spousal resources C 243 Residents of Residential Care Facilities Applying for ARChoices Waiver