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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 50 Chapter 23 Specific Medicaid Requirements

23.11.5.D Children with Disabilities Community Service Program (CDCSP) Income Assets 300% SSI Payment Level $2,000 Individual The DOHS has chosen the option of providing Medicaid to disabled children, up to the age of 18, who require an institutional level of care but can receive necessary medical services while residing in their family (natural or adoptive) homes or communities. The medical services must not be more expensive for the State than placement in a medical institution, such as a nursing facility, ICF/IID facility, and acute care hospital or approved Medicaid psychiatric facility for children under the age of 21. This coverage group allows children to remain with their families by providing medical services in the home or community that are at least as cost-effective as care in a medical institution. It also eliminates the SSI requirement that the income and assets of parents and/or legal guardians be deemed to the children. A child is eligible for Medicaid as a CDCSP client when all the following conditions are met: • The child has not attained the age of 18. • The child’s own gross income does not exceed 300% SSI payment level. • The child has been determined to require a level of care provided in a medical institution, nursing facility, ICF/IID, hospital, or psychiatric facility. • The child is expected to receive the necessary services at home or in the community. • The estimated cost of services is no greater than the estimated cost of institutionalization. • The child would be eligible for an SSI payment if in a medical institution. • The child has been denied SSI eligibility because the income and assets of his parent(s) were deemed to him, and as a result, the SSI income or asset eligibility test was not met. Details for CDCSP are found in Chapter 24.