Section R414-307-11 - Home and Community-Based Services Waiver for Individuals with Physical Disabilities(1) To qualify for the waiver for individuals with physical disabilities, the individual must meet non-financial criteria for Aged, Blind, or Disabled Medicaid.(2) A member's resources must be equal to or less than $2000. The treatment of spousal impoverishment resources for married and institutionalized individuals in Section R414-305-6 apply to this rule.(3) Countable income is determined using income rules of Aged, Blind, or Disabled Institutional Medicaid. The eligibility agency counts income unless the income is excluded under other federal laws that exclude certain income from being counted to determine eligibility for federally funded, needs-based medical assistance. Eligibility is determined counting only the gross income of the member.(4) The eligibility agency counts a spouse's income only if the member receives a cash contribution from a spouse.(5)(a) An individual whose income does not exceed 300% of the federal benefit rate may be required to pay a cost-of-care contribution.(b) The eligibility agency counts the member's income except income that is excluded under other federal laws from being counted to determine eligibility for federally-funded, needs-based medical assistance.(c) The eligibility agency deducts the maximum allowance available, which is a personal needs allowance equal to 300% of the federal benefit rate payable under Section 1611(b)(1) of the Social Security Act for an individual with no income. No other deductions from income are allowed.(6) An individual whose income exceeds three times the federal benefit rate payable under Section 1611(b)(1) of the Social Security Act may pay a spenddown to become eligible. To determine the spenddown amount, the income rules and medically needy income standard for non-institutionalized aged, blind, or disabled individuals in Rule R414-304 apply except that income is not deemed from the member's spouse.(7) Section R414-305-9 concerning transfers of assets applies to individuals seeking eligibility or receiving benefits under this home and community-based services waiver.Utah Admin. Code R414-307-11
Amended by Utah State Bulletin Number 2015-22, effective 11/1/2015Amended by Utah State Bulletin Number 2024-03, effective 1/22/2024