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F-200.1 Division of Welfare and Supportive Services HOME AND COMMUNITY BASED SERVICES Medical Assistance Manual Eligible Groups 24 Jan 25 MTL 02/24

1. Administration – Division of Health Care Financing and Policy District Offices (DHCFP).

2. Aid Code – HD

e. Persons with Intellectual Disabilities

Waiver for Persons with Intellectual Disabilities and Related Conditions.

1. Administration – Aging and Disability Services Division (ADSD).

2. Aid Code – HR

F-200.2 Identification of Applicants/Recipients Who May Be Eligible

Individuals eligible for this category of assistance will be identified in the following ways:

a. Individuals referred to the administering division will be pre-screened for nursing home level of care. The screening is completed by the administering division staff.

b. Medicaid applications or inquiries which do not appear eligible in any other category but have indicated a need for home based services, will be referred by the case manager to the appropriate division for pre-screening.

Note: The case manager should submit a referral if they see a need even if it is not indicated on the application.

F-205 DEFINITIONS

Institutionalized Spouse - a married person residing in a medical facility at least 30 consecutive days (including Home and Community Based Services Waiver - HCBW customers) with a spouse in an independent living situation.

Community Spouse - a married person who is not in a medical facility or receiving HCBW services whose spouse has been residing in a medical facility or receiving HCBW services at least 30 consecutive days.

Medical Facility - a facility for skilled nursing or intermediate care, or a hospital.

Spousal Share – an amount equal to one-half of the total resources (separately and jointly held) at the time of the customer’s institutionalization/application for HCBW services.