Ala. Admin. Code r. 560-X-54-.02
Current through Register Vol. 43, No. 1, October 31, 2024
Section 560-X-54-.02 - Eligibility(1) Financial eligibility is limited to those individuals receiving SSI, SSI related protected groups deemed to be eligible for SSI/Medicaid (widow/widower, Disabled Adult Child, Continuous (Pickle) Medicaid) and special home and community-based optional categorically needy group whose income is not greater than 300 percent of the SSI federal benefit rate.(2) Medical eligibility is determined based on current admission criteria for nursing facility level of care as described in Rule No. 560-X-10-.10. In addition, waiver services are limited to those individuals with complex skilled medical conditions who have a medical history of being ventilator-dependent or who have a tracheostomy.(3) No waiver services will be provided to recipients in a hospital or nursing facility.(4) The Alabama Medicaid Agency may also deny home and community-based services if it is determined that an individual's health and safety is at risk in the community; if the individual does not cooperate with a provider in the provision of services; or if an individual fail to meet the goals and objectives of being on the waiver program.(5) The Alabama Medicaid Agency is restricted by the waiver to serving the estimated annual unduplicated number of beneficiaries approved by the Centers for Medicare and Medicaid Services.(6) The eligibility age criteria is 21 years and above.Ala. Admin. Code r. 560-X-54-.02
New Rule: File May 12, 2003; effective June 16, 2003. Amended: Filed August 11, 2008; effective September 15, 2008.Amended by Alabama Administrative Monthly Volume XXXII, Issue No. 09, June 30, 2014, eff. 7/16/2014.Amended by Alabama Administrative Monthly Volume XXXVI, Issue No. 09, June 29, 2018, eff. 7/26/2018.Author: Ginger Wettingfield, Director LTC Healthcare Reform Division
Statutory Authority:42 C.F.R. Section 441, Subpart G and the Home and Community-Based Technology Assisted Waiver for Adults.