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e. Reside in the Alliance Behavioral Health (Alliance) catchment area of Cumberland, Durham, Johnston, Harnett, Mecklenburg, Orange and Wake counties.

f. Meet all financial and non-financial eligibility requirements

g. When under the age of 65, have been determined to be disabled by disability determination Services (DDS) or the Social Security Administration (SSA).

2. TBI Nursing Facility (BN)

TBI/BH provides home and community-based services to individuals who:

a. Are age 18 and older

b. Are aged, blind, disabled or both (MAABD, SAABD)

c. Are in need of specialized nursing facility level of care to support people with a diagnosed brain injury who have significant cognitive, behavioral, and rehabilitative needs (BN)

d. Live in either a private living arrangement (PLA) or in living arrangements of 6 beds or less

e. Reside in the Alliance Behavioral Health (Alliance) catchment area of Cumberland, Durham, Johnston, Harnett, Mecklenburg, Orange and Wake counties.

f. Meet all financial and non-financial eligibility requirements.

II. REQUESTING TBI WAIVER SERVICES

To receive TBI services an applicant/beneficiary (a/b) must meet the Medicaid eligibility requirements in one of the following programs: • MAABD (Medicaid for the Aged, Blind and Disabled) • SAAD (State/County Special Assistance for Aged or Disabled Adults) A. When the a/b has requested TBI services and the:

1. Individual is currently not a Medicaid beneficiary

a. A Medicaid application must be submitted.

b. Evaluate for Medicaid eligibility in appropriate Medicaid programs.