Conn. Agencies Regs. § 17b-4(a)-2 - Conditions and standards of eligibility

(a) Eligible families:

(1) In order to be eligible for any services, families must reside in Connecticut and meet the income guidelines in subsection (d) of this section.

(2) Eligible families may receive social work and case management services in appropriate circumstances including, but not limited to, homelessness, child rearing problems, pending eviction and family violence.

(3) Eligible families may receive paid community based services when the supervising relative is temporarily incapacitated or unable to manage the household and children are in need of temporary foster care, homemaker services or the supervising relative is in need of a teaching homemaker. Additionally, paid services may also be provided if the supervising relative is a person with a disability.

(b) Eligible adults

(1) In order to be eligible for any services, the adult must reside in Connecticut, be between the ages of 18 and 64, be a person with a disability as defined in Section 17b-4(a) -1 and meet the income guidelines as defined in subsection (d) of this section.

(2) Eligible adults may receive social work and case management services in appropriate circumstances including, but not limited to, homelessness, pending eviction, and inappropriate institutionalization.

(3) Eligible adults with disabilities may receive paid community based services if such services, as part of the overall case plan, are provided in order to maintain the individual in the community.

(c) Medical need for Community-Based Services will be determined by the Department as follows:

(1) The adult applicant for paid services shall document the medical basis of his or her need, and the Department will review all documentation submitted to determine its sufficiency. Medical data may include a statement from a medical doctor, therapist or other appropriate health care professional stating that services are necessary to allow the applicant to remain in the community. The incapacitated supervising relative of a family shall also document medical need when applying for paid services.

(2) The Department social worker shall assess the case to determine the impact of the disability on the individual and/or the family, and how this directly affects their ability to meet needs.

(3) A Department social worker shall determine whether services provided or paid for by the Department can adequately meet the need.

(4) The Department may authorize Community-Based Services for families and adults when the social worker's assessment indicates that a need for services exists due to an individual's disability, appropriate medical data confirms this assessment, and fiscal information verifies that there is financial eligibility.

No service plan shall be established unless the client has a need which can specifically be met by a Community-Based Service as defined in Section 17b-4(a) -1.

If an applicant is eligible for or receiving comparable services from another agency, such applicant shall be considered ineligible for the same Community-Based Services through the Department.

(d) Income

(1) In determining an applicant's eligibility, or a recipient's continuing eligibility, the following income of the applicant/recipient and any legally liable relative shall be counted:

(A) All gross monthly earned income, based on the most recent 13 weeks, minus:

(i) Non-personal work expenses such as: union dues (if mandatory), tools, materials, uniforms or other special protective clothing necessary for the job if they are not furnished or paid for by the employer.

(ii) Personal work expenses such as: withholding tax based upon the maximum number of dependents to which the applicant is entitled, FICA, group life insurance, health insurance, and a mandatory retirement plan.

(B) The gross monthly amount of all other income, including any cash assistance from federal, state, or municipal assistance programs not otherwise excluded as income by federal or state law, and including the gross amount of social security benefits, minus any Medicare deductions.

(2) A person shall be eligible for services when earned and other income of his or family as determined in accordance with this subsection and based on family size, does not exceed Title XIX Medical Assistance levels for Region A as established annually by the Department of Social Services (DSS).

(e) Spend Down:

(1) Applicants and recipients who have excess income shall be eligible if the excess income is less than the authorized payment for Community Based Services, and the excess income is applied to the cost of Community Based Services.

(2) Excess income which is already being applied to medical expenses for the purpose of qualifying the applicant/recipient for Title XIX medical assistance shall not be considered available for community based services.

(f) Assets

(1) Total assets of applicants and recipients and any legally liable relatives shall be considered in determining eligibility with the exception of real property used as the primary residence, any medical or remedial appliance or device, prepaid funerals or a vehicle essential for transportation.

(2) Assets shall not have been disposed of or transferred for less than reasonable consideration or fair value, or for the purposes of qualifying for services, within a period of 30 months prior to the date of application.

(3) Total assets of applicants and recipients and any legally liable relatives minus the exclusions set forth in subdivision (1) of this subsection shall not exceed the asset limits established by the Department of Health and Human Services through the Social Security Administration for the Supplemental Security Income Program.

(g) Grandfathered Cases:

(1) Recipients of Community-Based Services at the time that the legislation transferred new intake to the State Department on Aging in 1990 were grandfathered as are those clients who turned 60 between July 1, 1990 and June 30, 1991 and will continue to receive services provided that their need for Community-Based Services continues to exist, and all the eligibility requirements other than age are met.

(2) Community-Based Services for Families and Adult recipients who were receiving service payments in excess of $650.00 per month prior to July 1, 1984, and who continue to satisfy the eligibility standards, shall not be subject to subsection (d) of Section 17b-4(a) -4, whicn establishes a maximum payment of $650.00 per month.

Notes

Conn. Agencies Regs. § 17b-4(a)-2

Effective November 30, 1995