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1. Medicaid LTSS in Health Care Institutions – Persons who meet the applicable eligibility requirements may access LTSS in the following State- licensed health care institutions/facilities a. Nursing Facilities (NF). A person is eligible to access Medicaid LTSS in a NF when it is determined, based on a comprehensive assessment, that he or she has the highest need for a NF level of care. b. Intermediate Care Facility for persons with Intellectual/Developmental Disabilities (ICF/ID). To qualify, a person must meet the applicable statutory standards set forth in R.I. Gen. Laws § 40.1-22-6 pertaining to developmental disabilities and: (1) Have the level of need for LTSS typically provided in an ICF- ID; or (2) Would require an ICF/ID level of care if were not for LTSS provided in a home or community based setting. As the State's Section 1115 waiver provides the authority for the home and community-based LTSS provided to members of this population with developmental disabilities, the BHDDH is required to provide services in the least restrictive setting appropriate to a person's level of care needs. c. Long-term Hospital (LTH) – A person must meet the needs-based criteria for long-term services in a hospital setting established by BHDDH and/or the EOHHS. Medicaid LTSS may also be available to children in State custody or with special health care needs receiving services in residential treatment facilities and hospitals if they meet the applicable level of care requirements. 2. Medicaid Home and Community-based (HCBS) LTSS – The State’s Section 1115 demonstration waiver authorizes Medicaid LTSS when provided in a home and offers an array of community-based settings as an alternative to care in one (1) of the three (3) principal covered health care institutions (NF, ICF/ID, or LTH). Access to these services enables beneficiaries to optimize their health and retain their independence while delaying or diverting the need for care in a more restrictive health care institutional setting. a. Scope of HCBS Coverage. Medicaid HCBS includes both core and specialized services and supports authorized under the State Plan or Section 1115 demonstration that address each individual beneficiary's unique long-term functional and clinical needs. The array of HCBS may vary depending on the beneficiary’s needs and the institutional level of care required.