Illinois Administrative Code
Title 59 - MENTAL HEALTH
Part 120 - MEDICAID HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAM FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES
Subpart D - OPERATIONAL PROCEDURES
Section 120.140 - Eligibility criteria
Current through Register Vol. 48, No. 12, March 22, 2024
a) The individual shall be age 18 or older at the time services are initiated.
b) The individual shall be a resident of Illinois.
c) Prior to Medicaid waiver enrollment, the PASARR agent shall assess the individual using the same level of care criteria as used for placement into a State-operated developmental center or community ICF/MR. Program services are an alternative to ICF/MR placement. The criteria for this determination are contained in DPA's rule at 89 Ill. Adm. Code 140.642. Individuals demonstrating the ability to function independently shall not be eligible for program services.
d) The individual shall meet all financial and non-financial Medicaid eligibility criteria as specified in the approved State Medicaid Plan.
e) The individual shall not need a nursing facility level of care.
f) The individual shall not be receiving services in a nursing facility, skilled nursing facility (SNF), intermediate care facility (ICF), intermediate care facility for developmental disabilities (ICF/DD), including ICF/DD for 16 beds or fewer, State-operated facility, skilled nursing facility for pediatrics (SNF/PED), or hospital at the time program services are delivered.
