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D. Individuals requesting Innovations services must have LME-MCO assessment to determine the need for services appropriate to the Innovations program

E. Upon completion of LME-MCO assessment; the DSS will receive:

A Level of Care Determination form(LOC) indicating approval or denial of services

F. When Medicaid eligibility can be established regardless of Innovations eligibility:

1. Do not wait for LME-MCO approval

2. Authorize, if appropriate, as for any other application/change in circumstances

G. When Medicaid eligibility cannot be established without Innovations eligibility:

1. Verify the status of the Plan of Care with the LME-MCO case manager, and

2. Deny the application if the LME-MCO decision is not received by the 45/90th day

H. If approved, the LME-MCO sends a Memorandum Approval Notice to the local agency Eligibility Worker along with a copy of the Individual Budget which contains the approved Medicaid waiver services for this person.

IV. BUDGETING

When the Level of Care (LOC) is approved; apply Innovations budgeting the first month that Innovations is effective.

A. Follow basic Income rules

1. In addition to the basic income rules the following apply to Innovations

a. There is no spouse-for-spouse or parent-for-child financial responsibility (income unit of one (1))

b. Only the income of the applicant/beneficiary is used in determining financial eligibility, beginning the month of Innovations approval

c. The One-Third reduction does not apply, even if applied by SSI

B. Follow basic Resources rules

1. In addition to the basic resource rules the following apply to Innovations