Okla. Admin. Code § 317:35-15-6

Current through Vol. 42, No. 8, January 2, 2025

Section 317:35-15-6 - Determining financial eligibility of categorically needy individuals

Financial eligibility for State Plan Personal Care (SPPC) services for categorically needy individuals is determined as follows:

(1)Financial eligibility for Modified Adjusted Gross Income (MAGI) eligibility groups. See MAGI eligibility rules in Subchapter 6 of this Chapter to determine financial eligibility.

(2)Financial eligibility or categorically related to Aged, Blind, and Disabled. In determining income and resources for the member related to ABD, the "family" includes the individual and spouse, if any. To be categorically needy, the countable income is less than the categorically needy standard as shown on the OKDHS form 08AX001E (Appendix C-1), Schedule VI Qualified Medicare Beneficiary Plus standard. If a member and his or her spouse cease to live together for reasons other than institutionalization or receipt of a Home and Community Based Waiver, ADvantage or Developmental Disabilities services, income and resources are considered available to each other through the month in which they are separated. Mutual consideration ceases with the month after the month in which the separation occurs. Any amounts to the spouse after the mutual consideration has ended are considered.

(3)Determining financial eligibility for State Plan Personal Care. (SPPC). For individuals determined categorically needy for SPPC, the member will not pay a vendor payment for SPPC services.

Okla. Admin. Code § 317:35-15-6

Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff 7-27-95 ; Amended at 14 Ok Reg 56, eff 5-27-97 (emergency); Amended at 14 Ok Reg 1802, eff 5-27-97 ; Amended at 17 Ok Reg 2410, eff 6-26-00 ; Amended at 19 Ok Reg 136, eff 9-1-01 (emergency) ; Amended at 19 Ok Reg 2149, eff 6-27-02 ; Amended at 20 Ok Reg 1958, eff 6-26-03 ; Amended at 20 Ok Reg 2775, eff 7-1-03 (emergency); Amended at 21 Ok Reg 2234, eff 6-25-04 ; Amended at 26 Ok Reg 549, eff 2-1-09 (emergency); Amended at 26 Ok Reg 2140, eff 6-25-09 ; Amended at 30 Ok Reg 1209, eff 7-1-13

Amended by Oklahoma Register, Volume 31, Issue 24, September 2, 2014, eff. 9/12/2014

Amended by Oklahoma Register, Volume 35, Issue 24, September 4, 2018, eff. 9/14/2018

Amended by Oklahoma Register, Volume 38, Issue 22, August 2, 2021, eff. 7/1/2021

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/12/2022