SR 05-25 Dated 08/05

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

 

DFA SIGNATURE DATE:

August 2, 2005

FROM:

OFFICE OF THE DIRECTOR, DFA Terry R Smith

AT (OFFICE):

Division of Family Assistance

TO:

DFA Supervisors

District Office Managers of Operations

 

SUBJECT:

Elimination of the Requirement that a Child Live With a Parent to Receive Home Care for Children with Severe Disabilities (HKG-HCCSD); Revised Forms Requirement for HKG-HCCSD and Children with Severe Disabilities (CSD)

EFFECTIVE DATE:

August 8, 2005

 

 

SUMMARY

 

This SR eliminates the requirement that a child live with a parent to receive Home Care for Children with Severe Disabilities (HKG-HCCSD). This change brings policy into alignment with Section 1902(e)(3) of the Social Security Act and the recent adoption of RSA 167:3-f.

 

In addition, this SR releases a policy clarification related to the forms required by the Office of Medicaid Business and Policy (OMBP) when determining medical eligibility for HKG-HCCSD and Children with Severe Disabilities (CSD) medical assistance.

 

FORMER POLICY

NEW POLICY

A severely disabled child had to be living with at least one parent to be eligible for TANF-related Healthy Kids-Gold medical coverage under the Home Care for Children with Severe Disabilities (HKG-HCCSD) category of assistance.

Living with a parent is no longer an eligibility requirement for HKG-HCCSD.

 

POLICY

 

Effective August 8, 2005, living with a parent is no longer an eligibility requirement for Home Care for Children with Severe Disabilities (HKG-HCCSD) medical assistance.

 

Additionally, the Office of Medicaid Business and Policy (OMBP) has clarified the departmental forms required in the medical determination process for HKG-HCCSD and Children with Severe Disabilities (CSD) medical assistance.

 

The following lists the only forms that are required in the medical eligibility process for HKG-HCCSD and CSD:

 

§   a separate Form 900, Authorization for Release of Protected Health Information, for each provider listed on the Form 968;

§   Form 940, Cover Memo for Medical Eligibility Information;

§   Form 968, Children with Severe Disabilities Family Information Report; and

§   a copy of the child’s Individual Education Plan (IEP) or "504" plan, if available.

 

The following forms are no longer required by OMBP to make a medical eligibility determination for HKG-HCCSD and CSD:

 

§   Form 11, Authorization to Release Information;

§   Form 966a/966b, Children with Severe Disabilities Report of Mental Status;

§   Form 967, Children with Severe Disabilities Report of Medical Findings;

§   Form 969, Children with Severe Disabilities Report of Medical Care; and

§   Form 970, Children with Severe Disabilities Authorization to Release Information.

 

FAM 223.03 and FAM 225.03, Required Verification, will be updated accordingly. OMBP will release any planned obsoletion of the above forms under separate cover.

 

NEW HEIGHTS CHANGES

 

New HEIGHTS has been reprogrammed to eliminate the requirement that HKG-HCCSD applicants must live with a parent, effective August 8, 2005.

 

POLICY MANUAL REVISIONS

 

Revised Family Assistance Manual Topics

 

Section 223.03   Required Verification

PART 225   HOME CARE FOR CHILDREN WITH SEVERE DISABILITIES (HC-CSD)

Section 225.03   Required Verification

 

IMPLEMENTATION

 

Policy released in this SR is effective August 8, 2005.

 

CLIENT NOTIFICATION

 

No special client notification is planned or needed.

 

TRAINING

 

No special training is planned or needed.

 

DISPOSITION

 

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

 

DISTRIBUTION

 

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.nh.gov/DHHS/DFA/LIBRARY, effective September 1, 2005.

 

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Family Assistance Manual.

 

DFA/JBV:s