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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsJanuary 2018

Authenticated PDF Version

16 DE Admin. Code 20700 & 20720
The Department published its notice of proposed regulation changes pursuant to 29 Delaware Code Section 10115 in the October 2017 Delaware Register of Regulations, requiring written materials and suggestions from the public concerning the proposed regulations to be produced by October 31, 2017 at which time the Department would receive information, factual evidence and public comment to the said proposed changes to the regulations.
In accordance with the federal public notice requirements established at Section 1902(a)(13)(A) of the Social Security Act and 42 CFR 447.205 and the state public notice requirements of Title 29, Chapter 101 of the Delaware Code, Delaware Health and Social Services (DHSS)/Division of Medicaid and Medical Assistance (DMMA) gives public notice and provides an open comment period for thirty (30) days to allow all stakeholders an opportunity to provide input on the proposed regulation. Comments were to have been received by 4:30 p.m. on October 31, 2017.
First, §20720.1 describes financial deductions from countable income. Countable income cannot exceed 250% of the Federal Benefit Rate (FBR). See Waiver, pp. 8-9 and 47-48. Deductions for a "maintenance needs allowance" are different for residential versus non-residential DDDS Waiver participants. See Waiver, p. 49. The daily living needs deductions in the Waiver are generally reflected in the proposed revisions to §20720.1. However, the following sentence has been omitted: "All earned income in the form of wages shall be allowed to be protected." See attached p. 49 from Waiver. DMMA may wish to include the sentence in §20720.1.
Second, §20720.1 authorizes the following deduction for residential Waiver participants:
Third, §20720.1 describes the daily living needs deduction for non-residential participants as follows:
Agency Response: DMMA agrees with the suggestions provided and has revised the proposed language in §20720.1.
Initial and ongoing medical eligibility is determined by DDDS staff. The DDDS Intake Coordinator makes a preliminary determination for each applicant for initial eligibility. Once an individual accepts a residential setting, the DDDS Social Service Benefits Administrator sends all waiver requests to the Division of Medicaid & Medical Assistance Medical Review Team (MRT) for review. Based on the information provided on the comprehensive Medical Report (MAP-25), Social Evaluation Form, Cost Projection Data Sheet and the Level of Care (LOC) form, the MRT will either concur with the initial decision to approve or deny the applicant for an ICF/MR level of care.
3. Individuals must be financially and technically eligible.
If the client is not already Medicaid eligible as an SSI recipient, DDDS submits an application (individuals in residential placements) or referral packet (individuals residing in the family home) to the appropriate Long Term Care DMMA Operations Unit for the financial and technical eligibility determination. The financial and technical Eeligibility determination is made by using financial criteria applied to those institutionalized and receiving Long Term Care (LTC) Medicaid.
Individuals receiving Medicaid under the Division of Developmentally Disabled Developmental Disabilities Services (DDDS) Lifespan Waiver who receive Residential Habilitation services are allowed a deduction equal to the current Adult Foster Care (AFC) rate. The AFC rate is based on the current SSI income level plus [$140.00 the Optional State Supplement amount].
Individuals receiving Medicaid under the DDDS Lifespan Waiver who [reside in the family home or in the Long Term Care Community Services (LTCCS) program do not receive a residential habilitation service] are allowed an amount equal to their total income including income that is placed in a Miller Trust. [All earned income in the form of wages shall be allowed to be protected.]
Last Updated: December 31 1969 19:00:00.
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