Categorically Needy LTC in a Medical Facility - SSI Recipient (L01)

Created on: 
Oct 13 2015

 See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

Who is eligible for L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) medical?

A person who receives federal cash benefits under the Supplemental Security Income (SSI) program who also meets the eligibility and institutional criteria in the following may be eligible for L01 medical:

How long is the L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) certification period?

L01 medical has no review end date and is certified for as long as the client is eligible for both Supplemental Security Income (SSI) and institutional Long-Term Care (LTC) services.

Online Processing

How do I screen L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) medical?

To screen an L01 Assistance Unit (AU), take the follow the steps:

  1. Follow the instructions in Screening an Application.
  • On the Programs page:
    • Click the Long Term Care checkbox in the Programs section.
    • Click the SSI Eligible checkbox in the Determination Criteria section.

How do I process a pending L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) Assistance Unit (AU)?

To process a pending L01 AU, follow the steps in How do I process a pending L02 AU? 

How does ACES issue cash to an active L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) Assistance Unit (AU)?

When Social Security Administration (SSA) determines a Supplemental Security Income (SSI) only recipient’s stay in a medical facility is to exceed three months, the SSI cash payment is reduced to $30 a month. When this occurs, ACES issues a cash supplement to bring the client’s income up to the Personal Needs Allowance (PNA) standards. For more information, see Apple Health eligibility manual - Long-Term Care - Personal Needs Allowance (PNA) Chart.

When a cash benefit is issued from an L01 AU, the program type is set to SSI MIL Client/Aged with Cash Payment (M),  Blind with Cash Payment (N) or Disabled with Cash Payment (O) and the benefit amount displays in the PNA/CPI field in the Income/Expenses section on the Eligibility Details page.

Mainframe Processing

How do I screen L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) medical?

To screen an L01 Assistance Unit (AU), take the follow the steps:

  1. Follow the instructions in Screening an Application.
  • On the Programs page:
    • Click the Long Term Care checkbox in the Programs section.
    • Click the SSI Eligible checkbox in the Determination Criteria section.

How do I process a pending L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) Assistance Unit (AU)?

To process a pending L01 AU, follow the steps in How do I process a pending L02 AU? 

How does ACES issue cash to an active L01 (Categorically Needy LTC in a Medical Facility - SSI Recipient) Assistance Unit (AU)?

When Social Security Administration (SSA) determines a Supplemental Security Income (SSI) only recipient’s stay in a medical facility is to exceed three months, the SSI cash payment is reduced to $30 a month. When this occurs, ACES issues a cash supplement to bring the client’s income up to the Personal Needs Allowance (PNA) standards. For more information, see Apple Health eligibility manual - Long-Term Care - Personal Needs Allowance (PNA) Chart.

When a cash benefit is issued from an L01 AU, the program type is set to [M] - SSI MIL Client/Aged with Cash Payment, [N] - Blind with Cash Payment or [O] - Disabled with Cash Payment and the benefit amount displays in the CPI field on MAFI screen.

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.