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MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID
Division of Welfare and Supportive Services F-210 Medical Assistance Manual HOME AND COMMUNITY BASED SERVICES 24 Jan 25 MTL 02/24 ELIGIBILITY REQUIREMENTS 3. Require a level of care provided in a nursing facility (determined by DHCFP District Office staff);
4. Be approved, eligible for and receiving home based services (determined by DHCFP); and
5. Meet all financial and non-financial eligibility criteria of an institutional case except for residing in an institution.
e. MR Waiver - Persons with Intellectual Disabilities
1. Be diagnosed as having an intellectual disability or related condition, or evaluated and certified to need placement in an intermediate care facility for individual with intellectual disabilities (ICF/IID) within 30 to 60 days if waiver services were not available (determination made by ADSD);
2. Be living at home, in a foster home, group care home or a supported living arrangement (SLA) which is overseen by ADSD; and
3. Meet all financial and non-financial eligibility criteria of an institutional case except for residing in an institution.
F-215 ELIGIBILITY DETERMINATION PROCESS
Two separate eligibility determinations must be made on these cases:
a. Administering division - will have the individual complete an application packet and send with Form NMO-3010 to DWSS when the applicant/recipient is pending approval for waiver admission to their program.
The administering division is responsible for completing an assessment to determine if the recipient meets the need for an appropriate level of care.
b. DWSS - is responsible for determining if the applicant meets all financial and non-financial Medicaid eligibility criteria.
c. DHCFP Central Office - The DHCFP waiver team will review the application/packet with the NMO-3010 and complete a post approval waiver admission, notifying the administering division by sending Form NMO-3010.