ELIGIBILITY

A. Eligibility for HCA shall be based on both financial need and the client's functional needs. The client shall meet eligibility for both financial and functional requirements to be approved for an HCA payment. B. To be financially eligible, the client shall: 1. Be approved for Supplemental Security Income (SSI) benefits; or, 2. Meet all eligibility criteria required for Aid to the Needy Disabled – State Only (AND-SO) program; or, 3. Have been receiving both Old Age Pension (OAP) grant payments and HCA as of December 31, 2013 and remain continuously eligible for both benefits. C. To be functionally eligible, the client shall have an HCA eligible functional assessment score. The functional assessment score is calculated by determining the client's functional capacity score and need for paid care score, as follows: 1. Functional Capacity: determined by assessing the client's ability to complete all activities of daily living (ADLs) and applying a score to his or her ability to complete the ADLs using the functional impairment scale; and, 2. Need for Paid Care: determined by identifying the unmet need for paid care and applying a score to the unmet need using the need for paid care scale, as outlined in Section 3.570.14; and, 3. Combining the functional capacity score and the need for paid care score to determine whether the client meets the minimum scores for eligibility and, if eligible, the tier of grant payments to be approved, as follows: Tier Capacity Score Need for Paid Care Score 1 21 or Higher 1 to 23 2 21 or Higher 24 to 37 3 21 or Higher 38 to 51 D. The CMA shall not approve the maximum authorized HCA amount for the tier if: 1. The authorization by the CMA shall be forwarded to the county department to determine financial eligibility. 2. The HCA provider is able to provide the authorized services for less than the maximum authorized amount; or, 3. The client is unwilling or unable to use the maximum authorized amount. E. Each client who meets the minimum functional assessment scoring requirements for the HCA program shall be functionally eligible for an HCA grant. 1. The authorization by the CMA shall be forwarded to the county department to determine financial eligibility. 2. Clients shall not be approved for HCA if financially ineligible, even if the client is functionally eligible. 3. Clients shall not be approved for HCA if functionally ineligible, even if the client is financially eligible. F. If financially and functionally eligible for HCA, the HCA grant payment shall begin on the first day of the month following the month in which the HCA is approved or the payment effective date from the State approved form completed by the CMA, whichever date is later. There shall be no retroactive HCA payments. G. If a client is assessed and does not meet the functional assessment scoring requirements, the county department and CMA shall refer the client to other agencies or services available in the community, such as Area Agencies on Aging (AAA), Aging and Disability Resources for Colorado (ADRC), Centers for Independent Living, and/or other local community resources to help with any identified needs.