The LTSS application process: who makes the eligibility determinations?

PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. The PBS also determines maximum client responsibility.

Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CARE assessment.

For HCS clients, both functional and financial eligibility are determined concurrently. Functional eligibility for DDA is determined prior to the submission of a financial application. LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place.