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G. If approved for TBI waiver services

1. The LME/MCO sends a Memorandum of Approval to the local agency along with a copy of the Individual Budget which contains the approved Medicaid waiver services for this person.

2. Select the appropriate TBI indicator code (BH/BN) in NC FAST. For keying instructions refer to NC FAST job aid: Community Alternatives Program (CAP), Traumatic Brain Injury and Innovations. III. BUDGETING

A. Follow the basic Income rules

IN ADDITION TO THE BASIC INCOME RULES, THE FOLLOWING APPLIES TO TBI WAIVER

1. There is no spouse-for-spouse or parent-for-child financial responsibility (income limit of 1). 2. Only the income of the a/b is used in determining financial eligibility, beginning the month of TBI Waiver approval.

3. The one-third reduction does not apply, even if applied by SSI.

4. Income is compared to 300% of the current poverty limits.

B. Follow the basic Resource Rules

IN ADDITION TO THE BASIC RESOURCE RULES, THE FOLLOWING APPLIES TO TBI WAIVER

1. Evaluate all assets of a married a/b living with their spouse (jointly or individually owned) when one spouse receives TBI Waiver services. 2. Compare available resource amount to the resource limit of 1. 3. Evaluate spousal resource protection (if applicable) For keying instructions refer to NC FAST job aid: Community Spouse Resource Protection C. Follow the basic Transfer of Assets Rules

Transfer of Assets sanctions apply. D. Follow the basic Deductible Rules