231 HOME CARE FOR CHILDREN WITH SEVERE DISABILITIES (HC-CSD) (MAM)

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Severely disabled children whose medical disability is so severe that they qualify for institutional care but who are being cared for at home, may be eligible for *medical assistance under Home Care for Children with Severe Disabilities (HC-CSD). HC-CSD is a Medicaid eligibility category that does not use Modified Adjusted Gross Income (MAGI) in the eligibility determination process.

Application for HC-CSD medical coverage is made:

. online;

. on DFA Form 800, Application for Assistance, or DFA Form 800MA, Application for Health Coverage & Help Paying Costs; or

. via Form 800HR, HEIGHTS-generated Application for Assistance, if the individual applying on behalf of the child is already open for another program of assistance and is applying for HC-CSD during a reapplication.

Count only the income and resources that belong to the child. The requirements are:

. The child must be under age 19.

. The child must be living in New Hampshire.

. The child must qualify for institutional level of care but is being cared for at home.

. The child does not need to be deprived of parental support or care.

. For categorically needy eligibility, the child's:

- gross monthly income must not exceed the nursing facility CAP (see PART 601, Table B); and

- resources must not exceed $1000.

. For medically needy eligibility, the child's:

- net income cannot exceed the Protected Income Limit (PIL) (see PART 601, Table A); and

- resources must not exceed the medically needy resource limit (see Section 407.03, Medically Needy Medical Assistance).

. The child must meet DDU medical disability, level of care, and eligibility criteria.

. The cost of care in an institution must exceed the cost of caring for the child in the home.

. The child's parent or guardian must be willing for the child to undergo medical treatment recommended by OMBP, unless good cause exists.

References: He-W 641.04, RSA 167:3-e, RSA 167:3-f, RSA 167:3-g, 42 CFR 435.225, 42 CFR 435.845(c), 42 USC 1396a, Section 1902(a), (f), & (r) of the Social Security Act [42 USC 1396a]