Content by Keyword: Waivers

In the 1980s, Texas implemented a demonstration waiver program called the Frail Elderly Program, which provided only attendant services. Texas was the only state that participated in the demonstration and in the early 1990s when the program ended, federal law permitted Texas to retain the program as a personal care option under 1929(b) regulations

A client's degree of functional impairment is measured on a 60-point functional needs assessment to determine if the impairment is severe enough to qualify for services. Applicants for primary home care services must meet functional needs criteria as follows: Must score 24 or above on the Client Needs Assessment Questionnaire. Must have

Family payments made for support and maintenance may be counted when determining Medicaid eligibility, in accordance with SSI policy.

There are no spousal income and asset protections for community spouses of persons receiving personal care services.

To be eligible for the Primary Home Care program an applicant must be eligible for SSI or have income no higher than the SSI level, or meet 1929(b) income and resource limits.

In 1979, Texas added personal care to its Medicaid State Plan. The personal care program is called the Primary Home Care Program, and it serves the aged and disabled. The program provides non-technical, medically related personal care services prescribed by a physician as part of a client's plan of care. Primary Home Care is available to eligible

To be eligible for waiver services, a person must meet the nursing home level-of-care criteria and several CBA waiver specific criteria. They must:

Family payments for an individual's food, clothing, and shelter are considered support and maintenance for waiver clients and a value is assigned. Because support and maintenance are not considered for clients in institutional settings, and institutional and waiver financial eligibility rules are the same, support and maintenance is not considered

The state's maximum monthly maintenance needs allowance for the spouse of a waiver client is the monthly SSI limit for an individual. The spouse's income is deducted from the SSI limit and the wavier recipient's income is diverted to make up the difference.

The state does not require persons in Group B who are receiving waiver services in their own home to share the cost of services. For people in Group B who are living in residential care settings, the cost sharing amount is equal to the client's remaining income after all allowable expenses have been deducted. These deductions include: the c

Two groups are financially eligible for waiver services: Group A  includes individuals who are eligible because they are receiving SSI. Group B  includes persons with incomes up to the special income standard of 300 percent of SSI, which is $1656. Asset limits for both groups are $2,000 for an individual and $3,000 for a

As part of its Olmsted initiative, the State has tried to increase the ability of individuals in nursing facilities who could transition into the community to do so through the CBA waiver program. Because there are too few slots in the waiver program relative to demand, the State is using a money follows the person initiative to fund home and comm

The Community Based Alternatives (CBA) waiver program provides home and community services to persons age 21 and older who qualify for nursing facility care. The goal of the CBA waiver program is to provide individuals with meaningful choices regarding long term care services. Waiver funds are used to allow individuals to avoid premature nursing f

Applicants for Medicaid coverage of nursing home care must meet one of the following criteria: Must require licensed nursing care (RN or LVN); Must meet two or more of the criteria for nursing home risk, as specified in the Resident Assessment Instrument-Home Care Assessment for Nursing Home Risk as revised in April 1996 and summarized

Family members may pay a nursing home facility the difference in cost between a semi-private and private room.

The institutionalized individual's eligibility is determined using the individual income limit before the protected spousal needs allowance is determined. Community spouses may keep any income in their own name, and the state allows the institutionalized spouse's income to supplement the community spouse's income up to the federal maximum

Two groups are financially eligible for nursing home services: Group A  includes individuals who are eligible because they are receiving SSI. Group B  includes persons with incomes up to the special income standard of 300 percent of SSI, which is $1,656. Asset limits for both groups are $2,000 for an individual and $3,00

The state has a process for determining where new nursing home beds will be allowed based on the nursing home occupancy rate in a given county. The statewide occupancy rate is approximately 72 to 74 percent. 1  The state also has a process for determining the proportion of nursing home beds allocated for Medicaid. 1. Gibson , M. J. and Greg