Page 304
MRG
UPDATED: JANUARY 2012
730
OTHER ELIGIBILITY REQUIREMENTS WAIVERS
LONG TERM HOME HEALTH CARE PROGRAM (LTHHCP)
Policy: An individual participating in the LTHHCP waiver (including AHCP participants) must fulfill requirements in three categories:
1. Be medically eligible for placement in a residential health care facility or hospital for an extended period of time;
2. Have total expenditures for health and medical services described in a comprehensive plan of care that do not exceed, on an annual basis, 75% of the monthly cost of care in a RHCF or 100% of the monthly cost when determined as special needs or 50% of the monthly cost when residing in an Adult Care Facility; and
3. Be determined eligible for Medicaid.
An important feature of the LTHHCP is the use of a comprehensive and coordinated assessment process to formulate a summary of the required services and a plan of care. Two distinct assessment processes are required for each individual prior to the development of a summary of services requirements for the individual; these are a medical assessment and a home assessment.
Individuals participating in the LTHHCP are assessed prior to enrollment in the program and must be reassessed for continued participation in the program every 180 days through the use of a joint assessment process between the local department of social services and a certified LTHHCP provider.
References: ADMs 11 OLTC/ADM-1
09 OLTC/ADM-01
02 ADM-04
85 ADM-27
83 ADM-74
78 ADM-70
GISs 11 LTC005
11 LTC008
11 LTC009
10 LTC001
09 OLTC003
09 OLTC002
08 OLTC-008
06 MA-011
05 MA-37
01 MA-035