Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Endnotes


  1. Gibson, M. J. and Gregory, S. R., Across the States 2002: Profiles of Long-Term Care, AARP, 2002.

  2. When SSI recipients enter a nursing home, SSI provides only $30 for personal needs. For these individuals, the state provides a supplement of $30 per month.

  3. The provisions of Rider 28 were originally contained in Rider 37 in the 76th legislative session. The number was changed during the 78th legislative session.

  4. Although the AFDC program no longer exists, allowable maintenance costs are still tied to the basic monthly grant when it did exist.

  5. "Support and maintenance are not counted as income if eligibility is being tested for a waiver program; for example, Community Living Assistance and Support Services (CLASS), the Community Based Alternatives (CBA), Home and Community-Based Services (HCS), and Medically Dependent Children's Program (MDCP). The 1929(b) program is not a waiver program." Texas Administrative Code, Title 40, Part I, Chapter 15, Subchapter E, Rule 15.455.

  6. The TILE classification system was developed by the Department of Human Services to group nursing home residents on the basis of their clinical conditions and functional abilities.

  7. The respondent who provided this figure stated that it is a conservative estimate based on incomplete data, and that a larger number is probably being served in these settings.

  8. Type C facilities are Adult Foster Care Homes with four or more beds. In 1999, when personal care facilities were renamed assisted living facilities, the state required AFC homes with four or more beds to be licensed as an assisted living facility. Type D facilities are operated by the Department of Mental Health and Mental Retardation for persons with serious mental illness and developmental disabilities. Type E facility residents are the same as Type A except that they do not require assistance with ADLs, but only with medication administration.

  9. Use of advertising terms such as "medication reminders or assistance," "meal and activity reminders," "escort service," or "short-term memory loss, confusion, or forgetfulness" will not trigger a requirement for certification as an Alzheimer's facility. (Source: Texas Administrative Code, Title 40, Chapter 92)

  10. Texas Administrative Code, Title 40, Social Services and Assistance, Chapter 92, Licensing Standards for Assisted Living Facilities, Subchapter A, Rule 92.2,a.

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