Worker responsibilities - HCB services

Revised March 25, 2011

Worker responsibilities

1. Follow procedures in Eligibility Requirements to establish financial eligibility. 
   • Determine if there are resource transfers.
   • Determine resource eligibility
   • Determine any excluded income for LTC
   • Compare gross income to the medicaid SIL (300% of the FBR).
   • Refer to the long-term care standards chart for current standards.
   • Refer to the long-term care personal needs allowance chart for PNA amounts
2. If the client becomes ineligible for the HCB services (COPES, New Freedom, PACE, WMIP), the ending date is the last day of the month in which the plan of care ends or by the end of the following month when 10-day notice is needed to give advance notice.
3. A 30 day break in HCB services (when there is no admission into a medical institution), will result in the closure of  the service and a redetermination of medicaid eligibility under a non institutional program.
4. An admission into a nursing home that is over 30 days would be a program change to the L02 institutional program.  NFLOC is not needed when an individual goes from a HCS Waiver program into a nursing home since they are already considered institutionalized.