Page 264

UPDATED: JANUARY 2011

690

OTHER ELIGIBILITY REQUIREMENTS STATE AND FEDERAL CHARGES

HUMAN SERVICES OVERBURDEN

Policy: The State will reimburse 100% of the local share for Medicaid expenses paid on behalf of an overburden-qualifying mentally disabled person.

References: INFs

89 INF-43

Interpretation: The local share of Medicaid expenditures for qualifying mentally disabled recipients is 100% reimbursable by the State. For Human Services Overburden funding, a person defined as mentally disabled meets one of the following criteria:

(1) resides in a Residential Treatment Facility certified by the New York State Office of Mental Health or in an Intermediate Care Facility for the Developmentally Disabled certified by the New York State Office for People with Developmental Disabilities;

(2) was discharged from a New York State Office of Mental Health Psychiatric Center or New York State Office for People with Developmental Disabilities Developmental Center from April 1, 1971 to December 31, 1982 and has 90 or more cumulative days of inpatient treatment;

(3) resides in a community-based facility as certified by the New York State Office of Mental Health or the New York State Office for People with Developmental Disabilities. This includes A/Rs who:

have received services in certified Community Residences (CR) or Individual Residential Alternatives (IRA);

are residents of schools certified by the New York State Office for People with Developmental Disabilities;

are inpatients in Terrance Cardinal Cook (Flower Hospital); or

(4) receives a minimum of 45 visits in any calendar quarter of day or continuing day treatment programs (including Subchapter A day treatment).

MRG