N.H. Code Admin. R. He-M 517.03 - Eligibility

(a) Based on availability of funds, home and community-based care shall be available to any individual who:

(1) Is found to be eligible for services by an area agency pursuant to He-M 503.05, He-M 510.05 or He-M 522.03;

(2) Pursuant to He-M 517.08(a) , has also been determined by the bureau to be eligible under He-M 503.05, He-M 510.05 or He-M 522.03;

(3) Is found to be eligible for medicaid by the department pursuant to He-W 600, as applicable;

(4) Meets institutional level of care criteria as demonstrated by one of the following:

a. A developmental disability that requires at least one of the following:

1. Services on a daily basis for:

(i) Performance of basic living skills;

(ii) Intellectual, physical, or psychological development and well-being;

(iii) Medication administration and instruction in, or supervision of, self-medication by a licensed medical professional; or

(iv) Medical monitoring or nursing care by a licensed professional person;

2. Services on a less than daily basis as part of a planned transition to more independence; or

3. Services on a less than daily basis but with continued availability of services to prevent circumstances that could necessitate more intrusive and costly services; or

b. An acquired brain disorder that requires a skilled nursing facility level of care, which means requiring skilled nursing or skilled rehabilitative services on a daily basis; and

(5) Agrees to make the appropriate payment toward the cost of care as specified in He-W 654.

(b) The bureau shall deny services through the home and community-based care waiver if it determines that the provision of services will result in the loss of federal financial participation for such services.

Notes

N.H. Code Admin. R. He-M 517.03

#4315, eff 9-25-87; EXPIRED: 9-25-93

New. #6360, eff 10-23-96, EXPIRED: 10-23-04

New. #8195, INTERIM, eff 10-29-04, EXPIRED: 4-27-05

New. #8424, eff 9-1-05; ss by #9370, eff 1-24-09; ss by #10454, eff 10-31-13