Rule 23-208-3.2 - EligibilityA. To be eligible for the Assisted Living Waiver Program a waiver participant must: 1. Be twenty-one (21) years of age or older, 2. Require nursing facility level of care as determined by a standardized comprehensive preadmission screening, and 3. Be in the Supplemental Security Income (SSI) Category of Eligibility (COE) or an aged, blind or disabled individual who meets all factors of institutional eligibility. If income exceeds the current institutional limit, the individual must pay the Division of Medicaid the portion of their income that is due under the terms of an Income Trust in order to qualify. B. To be eligible for care in a Traumatic Brain Injury Residential facility a participant must: 1. Meet all the requirements in Miss. Admin. Code Part 208, Rule 3.2.A., 2. Have a diagnosis of an acquired traumatic brain injury defined by the Division of Medicaid as a non-degenerative structural brain damage excluding a brain injury that is congenital or due to injuries induced by birth trauma, 3. Have completed acute rehabilitation treatment, 4. Be in a crisis/high stress environment with behavioral needs which place the participant at high risk for institutionalization, 5. Have documentation as to why the services could not be provided inside the State of Mississippi, and 6. Have an Executive Director's Letter of Approval for Out-of-State Placement. C. Persons enrolled in the Assisted Living Waiver who elect to receive hospice care may not receive waiver services which are duplicative of any services rendered through hospice. Persons may receive non-duplicative waiver services in coordination with hospice services.23 Miss. Code. R. 208-3.2
42 USC § 1396n; 42 CFR §§ 435.217, 440.180441.301; Miss. Code Ann. §§ 43-13-115, 43-13-117, 43-13-121.Added Miss. Admin. Code, Part 208, Rule 3.2.B. to correspond with the AL Waiver renewal (eff. 10/01/2013) eff. 05/01/2014.