Categorically Needy – Roads to Community Living – SSI Recipients (L41)

Created on: 
Oct 07 2015

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

Who is eligible for L41 (Categorically Needy - Roads to Community Living - SSI Recipients) medical?

A person with SSI income who meets the following criteria may be eligible for L41 medical:

L41 recipients may also be eligible for and receive State Supplement Payments (SSP) or Ongoing Additional Requirements. 

How long is the L41 (Categorically Needy - Roads to Community Living - SSI Recipients) certification period?

L41 medical has no review end date.  Roads to Community Living (RCL) has continuous eligibility for 365 days from the date client is authorized.  Income or Resource changes don’t impact the client’s eligibility.

Online Processing    

How do I screen L41(Categorically Needy - Roads to Community Living - SSI Recipients) medical?

To screen an L41 Assistance Unit (AU), take the following steps:

1.    Follow the instructions in Screening an Application.

  • In the Programs section of the Programs page, click the checkbox next to HCS Waiver/DDA Waiver/Hospice.
  • In the Program Determination Criteria section, click the checkbox next to SSI Eligible.
NOTE: If ONLY the HCS Waiver/DDA Waiver/Hospice box is checked on the Programs page in screening, the AU initially starts as a L22.

How do I process a pending L41 (Categorically Needy - Roads to Community Living - SSI Recipients) Assistance Unit (AU)?

To process a pending L41 AU, follow the steps in How do I process a pending L02 AU?

NOTE: Roads to Community Living (RCL) requires an end date. The client  is categorically eligible for 365 days once RCL is approved. The RCL approval source determines the personal needs allowance (PNA) for the AU.  For more information see Apple Health eligibility manual - WAC 182-513-1235 Roads to Community Living (RCL)

How do I close an active L41 (Categorically Needy - Roads to Community Living - SSI Recipients) Assistance Unit (AU)?

An active L41 (AU) can only be closed for one of the following reason codes:

  • Failed Residency Requirement (210)
  • Death (244)
  • Living Arrangement - Cash/Medical Assistance (201)
  • Whereabouts Unknown (551)
  • RCL Error in Initial Eligibility (554)
  • AU Requested Closure (557)
  • Already Eligible for Program in Different AU (587)

Mainframe Processing

How do I screen L41(Categorically Needy - Roads to Community Living - SSI Recipients) medical?

To screen an L41 Assistance Unit (AU), take the following steps:

1.    Follow the instructions in Screening an Application.

  • In the Programs section of the Programs page, click the checkbox next to HCS Waiver/DDA Waiver/Hospice.
  • In the Program Determination Criteria section, click the checkbox next to SSI Eligible.
NOTE: If ONLY the HCS Waiver/DDA Waiver/Hospice box is checked on the Programs page in screening, the AU initially starts as a L22 (Categorically Needy Waiver or Hospice Services - SSI Related) AU.

How do I process a pending L41 (Categorically Needy - Roads to Community Living - SSI Recipients) Assistance Unit (AU)?

To process a pending L41 AU, follow the steps in How do I process a pending L02 AU?

NOTE: Roads to Community Living (RCL) requires an end date. The client  is categorically eligible for 365 days once RCL is approved. The RCL approval source determines the personal needs allowance (PNA) for the AU.  For more information see Apple Health eligibility manual - WAC 182-513-1235 Roads to Community Living (RCL)

How do I close an active L41 (Categorically Needy - Roads to Community Living - SSI Recipients)  Assistance Unit (AU)?

An active L41 AU can only be closed for one of the following reason codes:

  • 201 – Living Arrangement - Cash/Medical Assistance
  • 210 - Residency
  • 244 - Death  
  • 551 – Whereabouts Unknown
  • 554 -  RCL Error in Initial Eligibility
  • 557 – AU Request Closure
  • 587 – Already Eligible in Another AU

 

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