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TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE 63 3. notify the recipient's representative and facility. 20670 Annual Redetermination A redetermination of eligibility will be completed every 12 months, as outlined in 14100.6 Annual Renewal of Eligibility. A financial redetermination includes: 1. a signed renewal form; 2. verification of current income, 3. verification of current resources, unless the resource test can be waived. See Section 20670.1 Resource Test Waived at Annual Renewal. A redetermination of eligibility is not needed for those patients receiving an SSI payment of $30.00. It is Social Security Administration’s (SSA’s) responsibility to redetermine these cases for continued eligibility. However, it is the responsibility of the financial case worker to monitor and address alerts from the State Data Exchange (SDX) to verify their continued receipt of SSI eligibility. 20670.1 Resource Test Waived at Annual Renewal The resource test will be waived for certain Long Term Care individuals subject to a resource test at annual renewal. The resource test will be waived whether the individual is in the community, assisted living, or in a nursing home. Exception: The resource test is not waived for individuals who are determined eligible for conditional Medicaid coverage and are within a conditional Medicaid period. See Section 20360 Conditional Medicaid While Disposing of Resources. There is no change to lookback requirements, or the transfer of asset rules. If the case worker receives asset information after a renewal has been completed, the receipt of new information will be treated as a change in circumstances and may affect the individual’s eligibility. 20680 Inappropriate Placement If a recipient's condition changes and he requires a nursing facility level of care that the facility is not certified to provide or the recipient no longer needs nursing facility care, the vendor payment must be terminated. From the time it is determined that the recipient is inappropriately placed he or she will be given a 30 day planning period to secure alternate placement. The Long Term Care Coordinator will determine the planning period and notify the recipient's facility in writing. She will contact the case worker who will notify the recipient's responsible party, first of the need to transfer the recipient and second, that failure to make the transfer will result in case closing. If the level of care reverts back to a level appropriate to the current facility before the 30 days expire, payments will not be terminated. 20690 Disposition of Deceased Nursing Facility Residents Effects Nursing Facility Administrators must turn over the clothing, valuables and unexpended patient funds of a deceased recipient to the administrator of the estate. If a recipient dies leaving no will and having no heirs, his property reverts to the State. The Secretary of Delaware's Department of Finance has the responsibility of handling the transfer of the property to the State. 20700 Home and Community Based Services Federal Regulation - 42 CFR 435.217 1115 Social Security Act (42 U.S.C. 1315) Effective April 1, 2012, all Home and Community Based Waiver programs, except for the Division of Developmental Disabilities Services Waiver, are incorporated into Diamond State Health Plan Plus, a managed care program. See section DSSM 14900 for additional information regarding this program. 15 DE Reg. 1718 (06/01/12) 20700.1 Division of Developmental Disabilities Services Lifespan Waiver 1. Only clients of the Division of Developmental Disabilities Services (DDDS) are eligible for the Lifespan Waiver. 2. Individuals must be medically eligible. Initial and ongoing medical eligibility is determined by DDDS staff. 3. Individuals must be financially and technically eligible. If the client is not already Medicaid eligible as an SSI recipient, DDDS submits an application (individuals in residential placements) or referral packet (individuals residing in the family home) to the appropriate DMMA Operations