241 HOME AND COMMUNITY BASED CARE FOR IN-HOME SUPPORTS (HCBC-IHS) (MAM)

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Home and Community-Based Care for In-Home Supports (HCBC-IHS) offers a variety of community-based services that a developmentally disabled child who is under age 21 may need in order to prevent institutionalization. The Division of Developmental Services (DDS) determines if the individual has a developmental disability.

Developmentally disabled children who meet the categorical requirements of any Division of Human Services financial or medical assistance program may be eligible to receive community-based services if all of the following are met:

• the individual is under age 21;

• the individual’s income and resources are within the categorically or medically needy limits;

• DDS determines that the individual is eligible for area agency services;

• the DDS area agency establishes that the individual is appropriate for community-based services;

• the individual resides at home with their family, as determined by DDS;

• DDS determines that the individual has certain individual and/or caregiver factors which impede the caregiver’s ability to care for the child;

• DDS approves the individual service agreement and individualized budget which determine the costs of the needed HCBC-IHS services;

• DDS determines that in the absence of HCBC-IHS services, the individual would require placement in an intermediate care facility for the mentally retarded (ICF-MR); and

• the individual or their representative has chosen appropriate community-based care as an alternative to institutional care.

Exception: QMB, SLMB, and SLMB135 MA-only cases are not eligible for HCBC services.

References: He-M 503, He-W 601.04(q), He-W 658.06, RSA 151-E:3, 42 CFR 435.622, Section 1929 of the SSA [42 USC 1396t]