Non-Citizen LTC - Family (K03)

Created on: 
Oct 15 2018

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

Who is eligible for Non-Citizen LTC - Family (K03) Medical?

A non-citizen adult who has met institutional status described in the Apple Health eligibility manual - WAC 182-513-1320 Determining institutional status for long-term care (LTC) services and who do not meet aged, blind or disabled criteria may be eligible for K03 medical if they also meet the following requirements:

  • Residing in a medical institution for a period of 30 days or longer; or
  • Residing in a psychiatric institution for 30 days or longer; or
  • Residing in a psychiatric institution for 90 days or longer.

K03 medical coverage is for adults who do not meet aged, blind or disabled criteria and who are one of the following:

  • The parent of, or relative caring for, an eligible dependent child;
  • A dependent child age 18 or older
  • A pregnant woman;

For more information, see the following Apple Health eligibility manual references:

NOTE: Federally qualified Supplemental Security Income (SSI) related clients aged 18 and older, who meet the following should be opened on an L-track medical program: 
  • Reside in an Institution for Medically Diseased (IMD) or Psychiatric Residential Treatment Facility (PRFT)
  • Applied for LTC prior to their 21st birthday
  • Meet all financial and non-financial eligibility rules

How long is the Non-Citizen LTC - Family (K03) Medical certification period?

The K03 certification period is only valid for the period of time the person is receiving services. For more information, see Apple Health WAC 182-507-0115 Alien emergency medical program (AEM).

Online Processing

How do I screen a Non-Citizen LTC - Family (K03) Assistance Unit (AU)?

To screen in a K03 AU, take the following steps:

  1. Follow the instructions in Screening an Application - How do I screen an application for a client?
  • On the Programs page, click the Long Term Care checkbox.
  • On the Finalize page, click the Specify Program button and update the following fields:
    • Program field - Select Medical Assistance (MA) from the drop down menu.
    • Medical Coverage Group field - Select Non-Citizen Long Term Care (K03) from the drop down menu. 
    • Program Type field Select Regular (R) from the drop down menu.
    • Click Next the next button.

How do I process a pending Non-Citizen LTC - Family (K03) Assistance Unit (AU)?

To process a pending K03 AU, take the following steps:

  1. From the Case Action page, click the Start Interview link in the Pending Application section.
  2. Click Begin Intake on the Pending Applications page to initiate the interview. For more information on completing the intake, see Interview - How do I initiate and complete an intake interview?
  3. On the Contact Information page, add an Authorized Representative/Payees if appropriate. See Add/Edit/Delete Authorized Representative (AREP) - How do I add an authorized representative (AREP) during screening?
  4. On the AU Details page, update the Financial Responsibility field as follows:
  • Applicant (PN) for the applicant.
  • Non-Member (NM) for any other household member(s).

      5. On the Client Details page, update the following fields:

  • Marital Status field - Select the appropriate marital status from the drop down menu.
  • Living Arrangement field - Select the appropriate living arrangement from the drop down menu.

      6. On the Institutional Care page - click from the Action bar to Add a Facility and update the following fields:

  • Type field - Select the type of facility from the drop down menu.
NOTE: The facility type must be from the same subset as the living arrangement coded on the Client Details page.
  • ID field - Enter the [Provider Identification number] if the provider is a Nursing Facility - Medicaid (MD), Nursing Facility - Medicare (ME) or  Hospice Care Center (HC).
  • Entry Date field - Enter the [MM/DD/YYYY] the client enters the institution or medical facility. 
  • Level of Care field - Select the client's level of care from the drop down menu.
  • Payment Auth Date field - Enter the [MM/DD/YYYY] you want payment to the facility to begin. An entry in this field is optional. However, if the field is blank, LTC Services cannot begin. This field is not used for hospital settings.
  • Private Rate field - Enter the [facility's private daily rate].
  • State Rate field - Enter the [state daily rate]

      7. On the Institution Care page, click from the Action bar to Add a Long Term Care Expense/Deduction and update the following fields:

  • Type field - Select the type of Expense/Deduction from the drop down menu.
  • Amount field - Enter the [amount of the Expense/Deduction].

      8. On the Institution Care Page, click from the Action bar to Add an Family Member Allowance and update the following fields: 

  • Type field - Use the drop down menu to select one of the following:
    • Dependent child living with Community Spouse (C) - an applicant/recipient's natural or adopted child who is living in the household with the Community Spouse (CS).
    • Dependent not living with Community Spouse (O) - any dependent (child or otherwise) not living with a CS.
    • Other Dependent living with Community Spouse (D) - dependents other than the applicant/recipient's natural or adopted child.
  • Amount field: Enter the gross income amount of the dependent. If the dependent does not have any income, leave the Amount field blank.

      9. On the Unearned Income page, update the following fields if the applicant child receives monies from a parent:

  • Source field - Select Other Countable (OC) from the drop down menu.
  • Method field - Select the appropriate method from the drop down menu.
  • Amount field - Enter the [income contributed to a child from their parents].

      10. After committing the interview data, follow the instructions in the Process Application Month - How do I complete Process Application Months? for all pending months.

      11. Once the pending months have been processed, follow the instructions in the Finalize Application - How do I complete Finalize Application?

Mainframe Processing

How do I process a pending Non-Citizen LTC - Family (K03) Assistance Unit (AU)?

This function does not currently exist in ACES Mainframe, see Online Processing - How do I process a pending Non-Citizen LTC - Family (K03) Assistance Unit (AU)?

 

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