Section 7.100.502. Long-term care eligibility criteria.

	(a)  To be financially eligible for Medicaid under 7 AAC 100.002(d)(4) while living in a medical institution or under 7 AAC 100.002(d)(8) while receiving home and community-based waiver services, an applicant or recipient may not  
		(1) be subject to or within a transfer-of-asset penalty period under 7 AAC 100.510(d) - (e);  
		(2) have nonexcluded resources that exceed the limits applicable under 7 AAC 100.400(a)(14), after the spousal allocation requirements of 7 AAC 100.506 are applied;  
		(3) own a home that has an equity value that exceeds $500,000; this paragraph does not apply if residing in the home is the applicant's or recipient's  
			(A) spouse;  
			(B) child under 21 years of age; or  
			(C) child who is blind, as set out in 7 AAC 40.140(a), or disabled, as set out in 7 AAC 40.170(a); or  
		(4) have total monthly income that exceeds the amount set out in AS 47.07.020(b)(6).  
	(b)  In addition to the meeting the requirements of (a) of this section, to be eligible under 7 AAC 100.002(d)(4) an individual residing in a medical institution must  
		(1) have resided in a medical institution for at least 30 consecutive days;  
		(2) require the level of care provided in  
			(A) an intermediate care facility or skilled nursing facility as determined by the department in accordance with 7 AAC 140.505; or  
			(B) an intermediate care facility for individuals with an intellectual disability or related condition as determined by the department in accordance with 7 AAC 140.600; and  
		(3) be authorized by the department for admission, transfer, or continuing placement in a long-term care facility in accordance with 7 AAC 140.500 - 7 AAC 140.595 or 7 AAC 140.600 - 7 AAC 140.640.  
	(c)  If an individual dies on or before the 30th consecutive day that the individual resides in a medical institution, the department considers the individual to have met the 30-day requirement.  
	(d)  In addition to meeting the requirements of (a) of this section, to be eligible under 7 AAC 100.002(d)(8) and receive home and community-based waiver services while living at home or in an assisted living home an individual must  
		(1) meet the requirements of one of the home and community-based waiver recipient categories identified in 7 AAC 130.205(d), as determined by the department; and  
		(2) otherwise meet the requirements of 7 AAC 130.211 - 7 AAC 130.219.  
	(e)  If an applicant under (d) of this section is a child who has already been determined to be disabled, the income and resources of the child's parent are not counted, even if the child is living at home with the child's parent.  
	(f)  An applicant or recipient who is ineligible under (a)(2) of this section, is not precluded from Medicaid eligibility under another eligibility category identified in 7 AAC 100.002.  

Authorities

47.05.010;47.07.020;47.07.040;44.62.125

Notes

Reference

7 AAC 100.002
7 AAC 100.500
7 AAC 100.504
7 AAC 100.506
7 AAC 100.510

Authority

AS 47.05.010 AS 47.07.020 AS 47.07.040 Editor's note: As of Register 207 (October 2013), and acting under AS 44.62.125(b)(6) and sec. 29, ch. 42, SLA 2013, the regulations attorney made a technical change to 7 AAC 100.502, to change "intermediate care facility for the mentally retarded" to "intermediate care facility for individuals with an intellectual disability or related condition." Chapter 42, SLA 2013 amended terminology in the Alaska Statutes to replace references to "mental retardation" and "mentally retarded" with more current terms. Section 29, ch. 42, SLA 2013 instructed that similar changes be made in the Alaska Administrative Code.

History

Eff. 7/20/2007, Register 183; am 2/1/2010, Register 193; am 7/1/2013, Register 206

References

7.100.502