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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 October 2013 Subchapter Subject Page ending with Page M0230 VIRGINIA RESIDENCY REQUIREMENTS M0230.203 5

C. Age 21 Or Older In An Institution If the individual was placed in the institution by a state government agent, go to section M0230.203 below. 1. Capable of Stating Intent An individual in an institution who is age 21 or over and who is capable of declaring his intent to reside in Virginia, is a resident of Virginia if the individual is in an institution in Virginia with the intent to remain permanently or for an indefinite period.

2. Incapable of Stating Intent An individual in an institution who is age 21 or over and who became incapable of stating intent at or after age 21 is a Virginia resident if he or she is residing in Virginia.

M0230.203 STATE PLACEMENT IN INSTITUTION

A. Policy Any agency of the state, including an entity recognized under state law as being under contract with the state for such purposes, that arranges for an individual to be placed in an institution located in another state, is recognized as acting on behalf of the state in making the placement. The state arranging or actually making the placement is considered the individual's state of residence. When an individual is placed by state or local government in an institution in another state, the individual remains the responsibility of the placing state unless the state or local government agency in the other state assumes responsibility for the individual's care or Medicaid eligibility. When an individual is placed by a Virginia government agency in an institution in another state, the individual remains the responsibility of Virginia unless • a state or local government agency in the other state assumes responsibility for the individual's care or Medicaid eligibility, • the individual is a child who receives a IV-E foster care or adoption assistance payment, or

• the individual is a child who receives non-IV-E adoption assistance and the state in which he is placed is a reciprocal state under the interstate compact, verified by the central office Deputy Compact Administrator, Adoption Unit, Division of Family Services, Virginia Department of Social Services (DSS). B. State Placement Placement by a state government agency is any action taken by the agency, beyond providing general information to the individual and his family, to arrange admission to an institution for the individual. The following actions do not constitute state placement: • providing basic information to individuals about other states' Medicaid programs or about the availability of health care services and facilities in other states; • assisting an individual, who is capable of declaring intent and who independently decides to move out-of-state, in locating an institution in another state.