JCAR890120-1011664r08 1 This version includes all HFS 1st ...

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JCAR890120-1011664r081160116111621163116411651166116711681169117011711172117311741175117611771178117911801181118211831184118511861187118811891190119111921193119411951196119711981199120012011202b) A one-month eligibility period will be used. Eligibility begins the first day of theeligibility period or the day during the month that spend-down is met.c) A one-person MANG Community Income Standard will be used (see Section120.20).d) The client shall be allowed an asset disregard in the amount for one client inaccord with Section 120.382. Assets are considered in accord with 89 Ill. Adm.Code 113.140, 113.141, 113.142 and 113.154.e) If the client has SSI income, the SSI income will be applied by DMHDD towardthe cost of room and board. However, no payment will be made by theDepartment for the cost of room and board. The client shall be responsibledirectly to DMHDD for payment of room and board costs.f) If the client's non-exempt income is greater than the MANG standard and/or nonexemptassets are over the applicable asset disregard, the client must meet thespend-down obligation determined for the eligibility period before becomingeligible to receive Medical Assistance. The spend-down obligation is the sum ofthe amount by which the client's non-exempt income exceeds the MANG standardand the amount of non-exempt assets in excess of the applicable asset disregard.g) The client may meet the spend-down by incurring Title XIX waiver (in-homecare) services. Waiver services are considered incurred in total for the month onthe first day of the month or the first day of stay for a month that the client residesin the approved residential setting if for less than an entire month. If the cost ofwaiver services equals or exceeds the spend-down amount, the spend-downobligation is met. DMHDD will provide the local office a statement of expectedmonthly charges for waiver services to ensure that the spend-down obligation ismet.h) If the client's non-exempt income is equal to or less than the MANG Standard andnon-exempt assets are not in excess of the applicable asset disregard, the client iseligible for medical assistance from the first day of the eligibility period.i) If the client's non-exempt income exceeds the MANG Standard and/or nonexemptassets are over the applicable asset disregard, eligibility for medicalassistance shall begin effective the first day that the spend-down obligation is met.The Department will pay for covered services less the client's liability (excludingTitle XIX waiver services) received from the date the spend-down obligation ismet date until the end of the eligibility period. The client shall be responsibledirectly to the provider for payment for services provided prior to the time client
JCAR890120-1011664r081203120412051206120712081209121012111212121312141215121612171218121912201221122212231224122512261227122812291230123112321233123412351236123712381239124012411242124312441245meets the spend-down obligation.j) A new application and/or a redetermination of eligibility will not be required foreligible clients who move from an institutional setting to an approved Home andCommunity based residential setting.k) A case review is required for eligible cases placed in an approved residentialsetting.l) A full redetermination of eligibility shall be made every twelve months.(Source: Repealed at 35 Ill. Reg. ______, effective ____________)Section 120.63 Department of Mental Health and Developmental Disabilities (DMHDD)Approved Home and Community Based Residential Settings (Repealed)a) In-Home Care Services1) This Section applies to individuals receiving remedial care servicesthrough the Department of Mental Health and Developmental Disabilities(DMHDD) in Home and Community Based Residential Settings approvedby DMHDD. Remedial care services are those services (except for roomand board) provided by DMHDD that are directed toward meeting theneeds of disabled clients who are not receiving services through theDepartment's In-Home Care Program (see Section 120.62). The remedialcare services are provided in the following Home and Community BasedResidential Settings:A) Community Living Facilities (CLF)B) Special Home Placements (SHP)C) Supported Living Arrangement (SLA)D) Home Individual Program (HIP)E) Community Residential Alternatives (CRA)2) A definition of the Home and Community Based Residential Settings canbe found at 59 Ill. Adm. Code 120.b) A one-month eligibility period will be used. Eligibility begins the first day of theeligibility period or the day during the month that spend-down is met.
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33813382Section 120.TABLE B Life Ex
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JCAR890120-1011664r083383338481 6.5
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