Ariz. Admin. Code § R9-28-406 - ALTCS Living Arrangements

A. Long-term care living arrangements. A person may be eligible for ALTCS services, under Article 2, while living in one of the following settings:

1. Institutional settings:

a. A Nursing Facility (NF) defined in 42 U.S.C. 1396 r(a),

b. An Institution for Mental Diseases (IMD) for a person who is either under age 21 or age 65 or older ,

c. An Intermediate Care Facility for the Mentally Retarded (ICF-MR) for a person with developmental disabilities,

d. A hospice (free-standing, hospital, or nursing facility subcontracted beds) defined in A.R.S. § 36-401; or

2. Home and community-based services (HCBS) settings:

a. A person's home defined in R9-28-101(B), or

b. Alternative HCBS settings defined in R9-28-101(B) .

B. ALTCS acute care living arrangements. A person applying for or receiving ALTCS coverage shall be eligible for only ALTCS acute care coverage in the following living arrangements, settings, or locations:

1. The gross income limit is 300 percent of the FBR for a person meeting the requirements of the 236 coverage group under R9-28-402(B) and who resides in one of the following settings:

a. A noncertified medical facility, or

b. A medical facility that is registered with AHCCCS but does not have a contract with an ALTCS program contractor, or

c. A location outside of Arizona if the person is temporarily absent from Arizona.

2. The net income limit is 100 percent of the FBR for a person who does not meet the requirements of the 217 or 236 coverage groups specified in R9-28-402(B) and who resides in one of the following settings:

a. At home or in an alternative HCBS setting if a person refuses HCBS service; or

b. A room in an assisted living center, or a licensed assisted living home or center which is not registered with AHCCCS.

B. ALTCS acute care living arrangements.

1. A person applying for and otherwise entitled to receive ALTCS coverage shall receive only ALTCS acute care coverage if residing in one of the following living arrangements, settings, or locations:

a. A noncertified medical facility, or

b. A medical facility that is registered with AHCCCS but does not have a contract with an ALTCS program contractor, or

c. At home or in an alternative HCBS setting when the person refuses HCBS services, or

d. A licensed or certified HCBS facility that is not registered with AHCCCS.

2. Eligibility income limits.

a. For a person residing in a setting described in subsection (1)(a) or (1)(b), the gross income limit is 300 percent of the Federal Benefit Rate (FBR).

b. For a person residing in a setting described in subsection (1)(c) or (1)(d), the net income limit is 100 percent of the FBR.

C. Inmate of a public institution. An inmate of a public institution is not eligible for the ALTCS program if federal financial participation (FFP) is not available as described under R9-22-310.

Notes

Ariz. Admin. Code § R9-28-406

Adopted effective October 1, 1988, filed September 1, 1988 (Supp. 88-3). Section repealed, new Section adopted by final rulemaking at 5 A.A.R. 369, effective January 6, 1999 (Supp. 99-1). Amended by exempt rulemaking at 7 A.A.R. 4691, effective October 1, 2001 (Supp. 01-3). Amended by final rulemaking at 20 A.A.R. 234, effective January 7, 2014 (Supp. 14-1).