Ala. Admin. Code r. 660-2-4-.16

Current through Register Vol. 43, No. 1, October 31, 2024

Section 660-2-4-.16 - Eligibility Factors Other Than Need

A person meeting general eligibility criteria (1) must be certified as needing independent homelife care, formerly personal care in a private home, or foster home licensed or approved by the Department (only for persons who were receiving payment for such care as of September 30, 1986) or (2) must be certified as needing (on or after October 1, 1986) specialized independent homelife care in a private home, or foster home licensed or approved by the Department; and must be receiving benefits under the Elderly/Disabled Medicaid Waiver Program; and must meet the definition of skilled nursing facility criteria outlined in 660-2-4-.28. The determination of whether an applicant/recipient meets such definition will be made by the Alabama Medicaid Agency after review of the applicant/recipient's medical and social records. Recommendation for care must be made by a legally licensed physician of the person's choice. The applicant/recipient and the provider (as defined in 660-2-4-.29) of care must also sign statements indicating care will be provided and paid for.

Author:

Effective June 28, 1983. Amendment effective January 9, 1985. Succedent amendment effective July 9, 1985. Succedent permanent amendment effective September 9, 1986. Succedent permanent amendment effective December 9, 1986. Succedent permanent amendment effective January 9, 1987. Succedent permanent amendment effective January 15, 1992.

Statutory Authority: Social Security Act Titles XVI and XIX; 20 C.F.R. 416 ; 42 C.F.R. 435 ; Title XIX State Plan; Code of Ala. 1975, Title 38.