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3. If the hardship exemption request is denied, the beneficiary will be required to pay the premium.

4. Beneficiaries have the right to appeal an adverse hardship decision. Additional information regarding appeals can be found in Part 10-05-2 of this Title. 1.9.4 Loss of Employment or Eligibility A. A Sherlock beneficiary who loses employment may retain eligibility for up to four (4) months by continuing to pay the applicable cost share, whether a premium or LTSS cost of care payment. If the person is still unemployed at the end of the four (4) month period, Sherlock eligibility is terminated. Prior to taking this action, the State evaluates the Sherlock beneficiary for all other forms of Medicaid eligibility as well as for coverage for a commercial plan through HSRI, the State’s health insurance marketplace. 1.9.5 Available Services A. Services include the full scope of categorical Medicaid benefits, including home and community-based services if eligible for LTSS, including personal care services provided through an agency or through a self-directed program and services needed to facilitate and/or maintain employment, as described in Chapter 50 of this Title. Services are coordinated through the appropriate unit in EOHHS, DHS or BHDDH or a contractual designee of the agency. B. Services to maintain and support employment are determined when developing a service plan, or through an assessment of need utilizing a state approved assessment instrument or an EOHHS approved prior authorization plan. Authorized personal care services may be provided in the home, workplace or other necessary setting (such as a physician office). 1.10 The Ticket to Work Program A. The Ticket to Work Program is an SSI-related eligibility pathway for working adults with disabilities established pursuant to 42 U.S.C. § 1396a(a)(10)(A)(ii)(XV) and R.I. Gen. Laws § 40-8.7-1 et seq. B. Adults with disabilities eligible through the Ticket to Work Program 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 Ticket to Work pathway is determined in accordance with the SSI methodology as described in Subchapter 00 Part 3 of this Chapter.