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

C-252 ALF Applications from Nursing Facilities or ARChoices Waiver Recipients MS Manual 07/01/20 Medicaid certified nursing facility residents who are classified Intermediate Level of Care and ARChoices Waiver recipients who wish to apply for ALF will be referred to the DHS RN for coordination of a new medical assessment. Once functional need is established, the DHS RN will develop a person-centered Service Plan. If a non-Medicaid eligible nursing facility resident wishes to apply for ALF Waiver, the DHS-0777, Application for Assistance, must be completed and submitted. The caseworker will notify the DHS RN, who will initiate the assessment process.

C-254 ALF Eligibility Determination MS Manual 07/01/20 Eligibility determination for ALF 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 MS E-400-530 will be followed. SSI exclusions are not allowed from gross income in determining eligibility. In determining an ALF applicant’s countable gross income when both spouses apply, each individual will be budgeted separately and his/her income compared in his/her budget to the current LTSS limit. Refer to Appendix S. An individual with income over the current LTSS income limit may establish Medicaid/Waiver eligibility by establishing an Income Trust. Refer to MS H- 110- 116. When there is a married couple and only one member of the couple applies, the rules for spousal impoverishment regarding income will be applied. Refer to MS H-200. 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 at application. • When there is a married couple and only one member of the couple applies, the rules for spousal impoverishment (MS H-200) regarding resources will be applied. For information regarding contribution to the cost of care, refer to MS H-412. C 252 ALF Applications from Nursing Facilities or ARChoices Waiver Recipients