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A. Though the application of the SSI methodology sometimes varies across coverage groups, there are several key common elements, as follows: 1. Financial Determination – The basis for determining financial eligibility using the SSI methodology is a multi-step process for evaluating income and resources, including the formation of the FRU and Medicaid eligibility groups and the application of exclusions, deductions and disregards, all of which may be applied differently depending on eligibility pathway. 2. Characteristic Requirements – Due to the historical tie to the SSI program, some IHCC Community Medicaid group members must have certain characteristics related to age, blindness or disability, or clinical status to qualify for Medicaid health coverage. General characteristic requirements that drive eligibility for Community Medicaid are in Part 05-1 of this Chapter. 3. LTSS Need and Level of Care – LTSS is a Medicaid State Plan benefit for both IHCC and MACC group beneficiaries who have the need for a level of care typically provided by a health care institution. Federal law defines “institution” narrowly in terms of three (3) specific types of health facilities – nursing facilities (NF), intermediate care facilities for persons with intellectual/developmental disabilities (ICF-ID), and hospitals. To qualify for Medicaid-funded LTSS, individuals must meet the functional/clinical criteria related to level of need for care in one (1) of these health institutions as described in Part 50-00-5 of this Title. 4. General and Group Specific Eligibility Requirements – All persons seeking Medicaid benefits must also meet the general eligibility requirements related to residency, citizenship, third (3rd) party coverage and cooperation. The general eligibility requirements for IHCC Community Medicaid are specified in Part 05-1 of this Chapter as well as in the sections related to specific coverage group requirements. Documentation related to both financial and functional/clinical eligibility factors is specified in these same sections. 5. Clinical Reviews – Clinical reviews may consist of a determination of disability, an assessment of functional need and/or health status, or an evaluation whether an applicant or beneficiary requires the level of care provided in a health institution. The criteria and processes for making these determinations may vary considerably in accordance with the type of Medicaid health coverage a person is seeking and the scope of Medicaid coverage available. a. The provisions governing clinical reviews for the determination of disability for non-LTSS, Community Medicaid are located in Part 05-1 of this Chapter. For Medicaid LTSS, the provisions governing functional/clinical eligibility are set forth in Part 50-00-5 of this Title;