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BEM 172 3 of 4 CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (SED) WAIVER BPB 2024-023 10-1-2024

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Determine if the child meets the MA eligibility factors in the following items: • BEM 220, Residence. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 257, Third Party Resource Liability. • BEM 260, MA Disability/Blindness. • BEM 270, Pursuit of Benefits. Note: The State Hospital Administration (SHA) is responsible for obtaining clinical evidence and for certifying disability on the DHS-49-A; see BCCHPS Responsibilities in this item. If a child on the SEDW turns 18 and continues to meet all the non- age related eligibility criteria, and continues to need waiver services, the child can remain on the waiver up to their 21st birthday. Note: An ex parte review (see glossary) is required before Medicaid closures when there is an actual or anticipated change, unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories; see BAM 115 and 220. INQUIRIES Inquiries from medical providers or parents concerning clinical eligi- bility under this category should be directed to the local CMHSP. FINANCIAL ELIGIBILITY FACTORS Financial eligibility is determined by the local office. Count only the child’s own income and assets. Do not deem income and assets from the child’s parents to the child. Groups The child is a fiscal and asset group of one.

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Official source

BEM 172 3 of 4 CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (SED) WAIVER BPB 2024-023 10-1-2024

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Determine if the child meets the MA eligibility factors in the following items: • BEM 220, Residence. • BEM 223, Social Security Numbers. • BEM 225, Citizenship/Alien Status. • BEM 257, Third Party Resource Liability. • BEM 260, MA Disability/Blindness. • BEM 270, Pursuit of Benefits. Note: The State Hospital Administration (SHA) is responsible for obtaining clinical evidence and for certifying disability on the DHS-49-A; see BCCHPS Responsibilities in this item. If a child on the SEDW turns 18 and continues to meet all the non- age related eligibility criteria, and continues to need waiver services, the child can remain on the waiver up to their 21st birthday. Note: An ex parte review (see glossary) is required before Medicaid closures when there is an actual or anticipated change, unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories; see BAM 115 and 220. INQUIRIES Inquiries from medical providers or parents concerning clinical eligi- bility under this category should be directed to the local CMHSP. FINANCIAL ELIGIBILITY FACTORS Financial eligibility is determined by the local office. Count only the child’s own income and assets. Do not deem income and assets from the child’s parents to the child. Groups The child is a fiscal and asset group of one.