21.04 Placement by a state in an out-of-state institution26

Any state agency, 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 a placement. For purposes of this subsection, “institution” includes foster care homes licensed under 45 CFR § 1355.20 that provide food, shelter and supportive services to one or more people unrelated to the proprietor. The state arranging or actually making the placement is considered as the individual’s state of residence. Any action beyond providing information to the individual and the individual’s family would constitute arranging or making a state placement. However, the following actions do not constitute state placement: (1) Providing basic information to individuals about another state’s Medicaid program and information about the availability of health care services and facilities in another state. (2) Assisting an individual in locating an institution in another state, provided the individual is capable of indicating intent and independently decides to move. When a competent individual leaves the facility in which the individual is placed by a state, that individual’s state of residence for Medicaid purposes is the state where the individual is physically located. Where a placement is initiated by a state because the state lacks a sufficient number of appropriate facilities to provide services to its residents, the state making the placement is the individual’s state of residence. 21.05 An individual receiving Aid to the Aged, Blind, and Disabled (AABD)27 (01/01/2024, GCR 23- 26 42 CFR § 435.403(e). 27 Effective January l, l974, the major portion of Vermont’s federal-state program of AABD became the federal program of Nonfinancial eligibility requirements Part 3 – Page 16 (Sec.21.00, Sub.21.06) 084) In general. For an individual of any age who is receiving a state supplemental payment (in Vermont, known as AABD), the state of residence is the state paying the state supplemental payment. Exception. A transient worker may claim Vermont as their state of residence and be granted Medicaid if they meet all other eligibility criteria. These individuals may be granted Vermont Medicaid even though they continue to receive a state supplement payment from another state.