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guided by agency representatives as the components may vary depending on the type of a person’s disability, program requirements, and associated provisions under the Section 1115 Waiver and Medicaid State Plan. Accordingly, specific guidance is provided on this process. 1.8.3 Cost of Care A. In accordance with Federal requirements, under the State’s Medicaid State Plan and Section 1115 Waiver, all LTSS Medicaid beneficiaries eligible based on the SSI methodology who can afford to do so must pay a portion of income toward the cost of their care. A beneficiary’s liability for the cost of care is calculated in the post-eligibility treatment of income process in accordance with Part 50-00-8 of this Title and is based on gross monthly income – earned and unearned – less certain deductions or “allowances.” To encourage LTSS beneficiaries who have disabilities to work, there are special allowances which require the State to exclude some or all of the beneficiary’s earned income when determining the amount available to be applied toward the cost of care. In addition, under the Sherlock Plan and Ticket to Work Program, a beneficiary may opt to pay a monthly premium instead of a cost of care. B. A beneficiary’s LTSS cost of care may increase or decline when there are changes in income. The State provides timely notice of any changes in LTSS cost of care that may result at least ten (10) days before the start of the month when the change takes effect. 1.9 The Sherlock Plan A. The Sherlock Plan for Working People with Disabilities is an SSI-related eligibility pathway for working adults with disabilities age sixty-five (65) and older established pursuant 42 U.S.C. § 1396a(a)(10)(ii)(XIII) and R.I. Gen. Laws § 40- 8.7-1 et seq. B. Adults with disabilities eligible through the Sherlock pathway are entitled to the full scope of Medicaid benefits and home and community-based services and supports necessary to facilitate and/or maintain employment. This is the same scope of coverage available to all Medicaid-eligible adults with disabilities who work, without regard to eligibility pathway. Financial eligibility for the Sherlock pathway is determined in accordance with the SSI methodology as described in Subchapter 00 Part 3 of this Chapter y. Changes in employment follow the provisions in § 1.9.4. C. The Sherlock eligibility pathway is open to adults with disabilities who are working and seeking Medicaid coverage, either with or without LTSS HCBS benefits: