- (1) Financial eligibility is limited to those individuals receiving SSI, SSI related protected groups deemed to be eligible for SSI/Medicaid (widow/widower, Disabled Adult Child, Continuous (Pickle) Medicaid) and special home and community-based optional categorically needy group whose income is not greater than 300 percent of the SSI federal benefit rate.
- (2) Medical eligibility is determined based on current admission criteria for nursing facility level of care as described in Rule No. 560-X-10-.10. In addition, waiver services are limited to those individuals with complex skilled medical conditions who have a medical history of being ventilator-dependent or who have a tracheostomy.
- (3) No waiver services will be provided to recipients in a hospital or nursing facility.
- (4) The Alabama Medicaid Agency may also deny home and community-based services if it is determined that an individual's health and safety is at risk in the community; if the individual does not cooperate with a provider in the provision of services; or if an individual fail to meet the goals and objectives of being on the waiver program.
- (5) The Alabama Medicaid Agency is restricted by the waiver to serving the estimated annual unduplicated number of beneficiaries approved by the Centers for Medicare and Medicaid Services.
- (6) The eligibility age criteria is 21 years and above.
Author: Ginger Wettingfield, Director LTC Healthcare Reform Division
Statutory Authority: 42 C.F.R. Section 441, Subpart G and the Home and Community-Based Technology Assisted Waiver for Adults.
History: New Rule: File May 12, 2003; effective June 16, 2003. Amended: Filed August 11, 2008; effective September 15, 2008. Amended: Filed June 11, 2014; effective July 16, 2014. Amended: Filed June 11, 2018; effective July 26, 2018.