Utah Admin. Code R414-307-13 - Community Transitions Waiver

(1) The Community Transitions Waiver is limited to individuals with intellectual disabilities and other developmental disabilities as defined in 42 CFR 483.102(b)(3), who are moving from intermediate care facilities into home and community-based settings. In addition, individuals from other waiver programs who need professional nursing services due to chronic conditions that state plan services cannot support, may be eligible for this waiver.

(2) To qualify, an individual shall demonstrate substantial functional limitations in three or more areas of major life activity as described in Section R414-502-8.

(3) An individual's resources must be equal to or less than $2,000. Nevertheless, the treatment of spousal impoverishment resources for married and institutionalized individuals in Section R414-305-6 apply to this rule.

(4) Countable income is determined using the income rules of Section R414-304-7 for Aged, Blind, or Disabled Institutional Medicaid. The eligibility agency counts an individual's income except for income excluded under other federal laws to determine eligibility for federally funded, needs-based medical assistance. Eligibility is determined counting only the gross income of an individual.

(5) The eligibility agency counts a spouse's income only if an individual receives a cash contribution from the spouse.

(6)

(a) An individual whose income does not exceed 300% of the federal benefit rate may be required to pay a cost-of-care contribution.

(b) The eligibility agency counts an individual's income except for income excluded under other federal laws to determine eligibility for federally funded, needs-based medical assistance.

(c) The eligibility agency deducts the maximum allowance available, which is a personal needs allowance equal to 300% of the federal benefit rate payable under 42 U.S.C. 1382(b)(1) for an individual with no income. No other income deductions are allowed.

(7) An individual whose income exceeds three times the federal benefit rate payable under 42 U.S.C. 1382(b)(1) may pay a spenddown to become eligible. To determine the spenddown amount, the income rules and medically needy income standard for non-institutionalized aged, blind, or disabled individuals in Rule R414-304 apply except that income is not considered from the individual's spouse.

(8) Section R414-305-9 concerning transfers of assets applies to individuals seeking eligibility or receiving benefits under this HCBS waiver.

Notes

Utah Admin. Code R414-307-13

Adopted by Utah State Bulletin Number 2015-20, effective 10/1/2015 Repealed by Utah State Bulletin Number 2020-22, effective 11/10/2020 Amended by Utah State Bulletin Number 2020-23, effective 11/24/2020 Amended by Utah State Bulletin Number 2024-03, effective 1/22/2024