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Aged, Blind and Disabled Manual Policy Manual Number: 130.005 Section: CHOICES Chapter: TennCare CHOICES in Long-Term Services and Supports August 01, 2024 Division of TennCare 3 individual requires specialized services and is appropriate for NF placement. See TennCare Rule 1200-13-01-.02. 3. General Eligibility Criteria In order to be enrolled in CHOICES, an individual must be determined eligible to receive CHOICES by the LTSS Unit and be approved for Institutional Medicaid by the Member Services Unit or be eligible for Medicaid as an SSI cash recipient. It is only once both determinations are made that the individual is enrolled in the programs. An applicant must meet the following conditions to receive CHOICES: a. The individual has been determined to need and likely to receive LTCF services for a continuous period of at least 30 days going forward as evidenced by an approved CHOICES Group 1 PAE and actual admission to a NF; b. The individual has been admitted to a NF or an Intermediate Care Facility for Individuals with Intellectual Disabilities ICF/IID, and the period of continuous confinement in the institution, combined with the period of time for which a PAE is approved, exceeds 30 days; c. The individual is receiving HCBS and has been determined to need HCBS for a continuous period of at least 30 days going forward, as evidenced by an approved CHOICES Group 2 PAE; or d. The individual is age 65 or older, or an adult age 21 or older with physical disabilities, who has entered a NF and does not meet the NF LOC criteria, but in the absence of HCBS is determined to be at risk for NF care. These individuals will have an approved CHOICES Group 3 PAE and will begin receiving CHOICES benefits once they are in the home or community-based setting, and there is an open slot available; and e. The individual meets the non-financial and financial eligibility requirements of one of the following TennCare Medicaid categories: i. SSI Cash Recipient; or ii. Institutional Medicaid. f. The individual is not in a penalty period for an uncompensated transfer of assets, and the value of the individual’s home does not exceed the home equity limit. Note: Certain individuals who have met 30 days continuous confinement may be approved for Institutional Medicaid, but they are not enrolled in CHOICES until a PAE is submitted and approved. See Section 6 in this chapter, the Institutional Medicaid policy, and section 4 in the Institutional Status policy for groups of individuals covered. 4. CHOICES Application Process a. Overview of Application Process The application and enrollment process for CHOICES requires collaboration between TennCare, the local AAAD, LTCFs and the TennCare MCOs.