225 HOME CARE FOR CHILDREN WITH SEVERE DISABILITIES (HC-CSD) SR 04-04, 05/04 (FAM-A)

Severely disabled children whose medical disability is so severe that they qualify for institutional care but who are being cared for at home by at least one parent may be eligible for TANF-related Healthy Kids-Gold medical coverage under the Home Care for Children with Severe Disabilities (HKG-HCCSD) coverage group. Application for HKG-CSD medical coverage is made on:

• Form 800, Application for Assistance; or

• Form 800HR, HEIGHTS-generated Application for Assistance, if the individual applying on behalf of the child is already open for another program of assistance and is applying for HKG-HCCSD during a reapplication.

Count only the income and resources that belong to the child. The requirements are:

• The child must be under age 19.

• The child must be living in New Hampshire with at least one parent but does not have to be deprived of parental care or support.

• For categorically needy eligibility, the child’s:

- gross monthly income must not exceed the nursing facility CAP. See the Adult Assistance Manual, Chapter 600, Table A, STANDARDS AND BUDGETS; and

- resources must not exceed the TANF categorically needy resource limit in FAM 403, RESOURCE LIMITS.

• For medically needy eligibility, the child’s:

- net income cannot exceed the Protected Income Limit (PIL) – see FAM 601, INCOME LIMITS, PAYMENT STANDARDS, AND ALLOTMENTS, Table C; and

- resources must not exceed the medically needy resource limit. See FAM 403, RESOURCE LIMITS.

• The child must meet Office of Health Planning & Medicaid (OHPM) medical disability, level of care, and eligibility criteria specified in Item 903(e) of the Medical Assistance Manual.

• The cost of care in an institution must exceed the cost of caring for the child in the home.

• The child’s parent or guardian must be willing for the child to undergo medical treatment recommended by OHPM, unless good cause exists (see ITEM 193 of the Medical Assistance Manual).