G. Short-Term Hardship Exceptions

States have the option under section 1902(xx)(3)(B) of the Act to include in their State plans a “short-term hardship” exception to the community engagement requirement for applicable individuals. States electing this option must, under procedures established by the State, in accordance with standards specified by the Secretary, deem applicable individuals to have demonstrated community engagement during a month in which they meet the criteria for one of the circumstances described in the statute's definition of a “short-term hardship event.” A “short-term hardship event” exists under section 1902(xx)(3)(B) of the Act when the criteria for any of the following circumstances are met for all or part of a month:

As described in section 1902(xx)(3)(B)(ii)(I) of the Act, an applicable individual receives inpatient hospital services, nursing facility services, services in an intermediate care facility for individuals with intellectual disabilities (ICF/IID), inpatient psychiatric hospital services, or such other services of similar acuity (including outpatient care relating to the preceding institutional services) as the Secretary determines appropriate;

An applicable individual resides in a county (or equivalent unit of local government) in which, as described in section 1902(xx)(3)(B)(ii)(II)(aa) of the Act, there exists an emergency or disaster declared by the President under the National Emergencies Act (NEA) or the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act); or, as described in section ( printed page 33380) 1902(xx)(3)(B)(ii)(II)(bb) of the Act, the unemployment rate is at or above the lesser of 8 percent or 1.5 times the national unemployment rate; or

As described in section 1902(xx)(3)(B)(ii)(III) of the Act, an applicable individual, or the dependent of the applicable individual, must travel outside of their community for an extended period of time to receive medical services necessary to treat a serious or complex medical condition (as described in section 1902(xx)(9)(A)(ii)(V)(ee) of the Act) that are not available within their community of residence.

For the circumstance described in section 1902(xx)(3)(B)(ii)(II)(bb) of the Act (relating to an area with a particular unemployment rate percentage), the State must make a request to the Secretary, in such form, at such time, and containing such information as the Secretary may require, for the short-term hardship to be available. Under section 1902(xx)(3)(B)(i) of the Act, the applicable individual must request of the State a short-term hardship exception for the circumstances described in section 1902(xx)(3)(B)(ii)(I) or (III) of the Act (relating, respectively, to the receipt of certain institutional services or services of similar acuity or where the individual or individual's dependent must travel outside their community for necessary medical treatment for an extended period of time).

We are implementing this State option at new § 435.555.