20.01 In general

21 26 CFR § 1.36B-2(a)(4); 45 CFR § 155.305(a)(2). 22 26 CFR § 1.36B-2(a)(4); See, §§ 1312(f)(1)(B) and 1312(f)(3) of the ACA (42 USC §§ 18032(f)(1)(B) and (f)(3)) and 26 CFR § 1.36B-3(b)(2). Nonfinancial eligibility requirements Part 3 – Page 13 (Sec.20.00, Sub.20.02) Individuals or couples meet the living-arrangement requirement for Medicaid eligibility purposes if they live in: Their own home; The household of another; or The following public institutions: (1) The Vermont Psychiatric Care Hospital (VPCH) or successor entity or entities, if the individual is: (i) Under the age of 21 (if a Medicaid enrollee is a patient of VPCH upon reaching their 21st birthday, eligibility may be continued to the date of discharge or their 22nd birthday, whichever comes first, as long as they continue to meet all other eligibility requirements); or (ii) Age 65 or older. (2) An intermediate care facility for people with developmental disabilities (ICF-DD). (3) A facility supported in whole or in part by public funds whose primary purpose is to provide medical care other than the treatment of mental disease, including nursing and convalescent care, inpatient care in a hospital, drug and alcohol treatment, etc. A private facility, if: (1) The primary purpose of the facility is to provide medical care other than the treatment of mental diseases, including nursing and convalescent care, inpatient care in a hospital, drug and alcohol treatment, etc.; and (2) The facility meets the following criteria: (i) There is no agreement or contract obliging the institution to provide total support to the individual; (ii) There has been no transfer of property to the institution by the individual or on their behalf, unless maintenance by the institution has been of sufficient duration to fully exhaust the individual’s equity in the property transferred at a rate equal to the monthly charges to other residents in the institution; and (iii) There is no restriction on the individual’s freedom to leave the institution. (3) An individual under the age of 21 or age 65 or older meets the living arrangement requirement if they live at the Brattleboro Retreat. In addition, an individual who is a patient at the facility upon reaching their 21st birthday, has eligibility continued to the date of discharge or their 22nd birthday, whichever comes first, as long as they continue to meet all other eligibility requirements.