R9-28-406. ALTCS Living Arrangements

A. Long-term care living arrangements. A person may be eligible for ALTCS services, under Article 2, while living in one of the following settings: 1. Institutional settings: a. A Nursing Facility (NF) defined in 42 U.S.C. 1396r(a), b. An Institution for Mental Diseases (IMD) for a person who is either under age 21 or age 65 or older, c. An Intermediate Care Facility for the Mentally Retarded (ICF-MR) for a person with developmental disabilities, d. A hospice (free-standing, hospital, or nursing facility subcontracted beds) defined in A.R.S. § 36-401; or 2. Home and community-based services (HCBS) settings: a. A person’s home defined in R9-28-101(B), or b. Alternative HCBS settings defined in R9-28-101(B). B. ALTCS acute care living arrangements. 1. A person applying for and otherwise entitled to receive ALTCS coverage shall receive only ALTCS acute care coverage if residing in one of the following living arrangements, settings, or locations: a. A noncertified medical facility, or b. A medical facility that is registered with AHCCCS but does not have a contract with an ALTCS program contractor, or c. At home or in an alternative HCBS setting when the person refuses HCBS services, or d. A licensed or certified HCBS facility that is not registered with AHCCCS. 2. Eligibility income limits. a. For a person residing in a setting described in subsection (1)(a) or (1)(b), the gross income limit is 300 percent of the Federal Benefit Rate (FBR). b. For a person residing in a setting described in subsection (1)(c) or (1)(d), the net income limit is 100 percent of the FBR. C. Inmate of a public institution. An inmate of a public institution is not eligible for the ALTCS program if federal financial participation (FFP) is not available as described under R9-22-310.