225 HOME CARE FOR CHILDREN WITH SEVERE DISABILITIES (HC-CSD) SR 05-25, 08/05 (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*, 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-HCCSD 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*.

§   The child must qualify for institutional level of care but is being cared for at home.

§   The child does not need to be deprived of parental support or care.

§   For categorically needy eligibility, the child’s:

-   gross monthly income must not exceed the nursing facility CAP. See the Adult Assistance Manual, Chapter 601, Table A: Income Limits; and

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

§   For medically needy eligibility, the child’s:

-   net income cannot exceed the Protected Income Limit (PIL) – see FAM PART 601, INCOME LIMITS, PAYMENT STANDARDS, AND ALLOTMENTS, Table C, TANF Medical Assistance Net Income Limits and Percentages of Poverty Level; and

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

§   The child must meet *Office of Medicaid Business & Policy (OMBP) 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 OMBP, unless good cause exists (see ITEM 193 of the Medical Assistance Manual).