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

12/01/2003

The state limits the amount that can be charged to OSS recipients and Medicaid ACS clients for room and board to the amount of SSI, which is $552 plus the maximum Optional State Supplement of $78.40, which equals $630.40, minus a $54 personal needs allowance (PNA), which equals $576.40. Licensed AFCHs are required to designate at least one of their beds for an individual receiving OSS.

Family supplementation--capped at twice the amount of the SSI/OSS combined payment for room and board--is allowed. The state does not limit room and board charges for private pay residents.

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