HAR §17-1714.1-20. Residency requirements

(a) An individual shall be considered to be a resident of the State when: (1) Residing or expressing intent to reside in the State, even if the individual does not have a fixed address; (2) Has entered the State with a job commitment or seeking employment (whether or not currently employed); or (3) Is in receipt of State Supplementary Payment (SSP). (b) For an individual under age twenty-one who is capable of indicating intent and who is not eligible for Medicaid based on receipt of assistance under Title IV-E of the Social Security Act and not receiving a State Supplementary Payment who is: (1) Emancipated from their parent(s) or who is married, the state of residence shall be in accordance with subsection (a); UNOFFICIAL 1714.1-9 (2) Not described in paragraph (b)(1), the state of residence is: (A) The state where the individual resides, even if the individual does not have a fixed address; or (B) The state of residency of the parent or caretaker with whom the individual resides. (c) For an institutionalized individual who is neither married nor emancipated, and who: (1) Became incapable of indicating intent to reside before age twenty-one, except as provided in subsection (a)(3), the state of residence is that of the individual’s: (A) Parent(s) or guardian, if one has been appointed; or (B) Parent applying for medical assistance on the individual’s behalf if the parents reside in separate states and there is no appointed legal guardian. (2) Became incapable of indicating intent to reside after age twenty-one, the state of residence is the state in which the individual is physically present, except where another state makes the placement. (d) For purposes of subsection (b), an individual is considered incapable of indicating intent to reside when: (1) The individual’s I.Q. is forty-nine or less, or has a mental age of seven years or less, based on tests acceptable to the intellectual disability agency of the State; (2) The individual is judged legally incompetent; or (3) The individual is found incapable of indicating intent based on medical documentation obtained from a physician, psychologist, or other individual licensed by the State in the field of intellectual disability. (e) When a placement is initiated by a state due to the lack of appropriate facilities to provide UNOFFICIAL 1714.1-10 services to its residents, the state making the placement is the individual’s state of residence. (f) A resident who is eligible for medical assistance and who is temporarily absent from the State with the intent to return when the purpose of the absence has been accomplished, does not interrupt a resident’s State residency unless another state has determined that the individual is a resident there for purposes of Medicaid. Within ninety days of the day of departure, the department shall re-evaluate the individual’s intent to return to the State based on the submission of the following: (1) The intended date of the out-of-state visit and the intended date of return back to the State; and (2) The intended date of return, if an extension from the original date previously submitted was changed. (g) Medical assistance shall be provided to a resident temporarily absent from the State who: (1) Meets all conditions of eligibility for medical assistance as specified in the department rules; and (2) Requires medical services outside the State under circumstances where services were emergent or when it would be impractical to return to the State for the necessary services. (h) The department may have a written agreement with another state setting forth rules and procedures to resolve disputes involving the place of residency. (i) Where two or more states disagree on an individual’s state of residence, the state where the individual is physically located shall be the state of residence. (j) The department shall accept a self- attestation by the individual or attestation by an adult who is in the household, authorized representative, or someone acting responsibly on behalf of a minor or incapacitated individual for information to verify State residency. UNOFFICIAL 1714.1-11 (k) Evidence of immigration status may not be used to determine that an individual is not a State resident. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §§435.403, 435.945, 435.956) (Imp: HRS §346- 14; 42 C.F.R. §§435.403, 435.945, 435.956) §17-1714.1-21 Eligibility requirements for a resident of a public institution. (a) An individual shall not be eligible for medical assistance when the individual is: (1) An inmate in a public institution; or (2) Under age sixty-five who is a resident or patient in an institution for mental disease or tuberculosis, unless the individual is under age twenty-two and is in receipt of inpatient psychiatric services. (b) An individual described in paragraph (a) shall be eligible for medical assistance during that part of the month in which the individual has been paroled from a public institution, or is on conditional release or convalescent leave from an institution for mental diseases or tuberculosis. (c) An individual on conditional release or convalescent leave from an institution for mental diseases is not considered to be a patient in that institution, unless the individual is under age twenty-two and in receipt of inpatient psychiatric services, until the individual is unconditionally released or, if earlier, reaches age twenty-two years. (d) An individual shall not be considered an inmate of a public institution when the individual is in a public educational or vocational training institution for purposes of securing education or vocational training; or is in a public institution for a temporary period pending other arrangements appropriate to the individual’s needs. (e) An inmate of a public institution may be eligible, provided all other requirements are met, for inpatient services that are provided in a medical institution that is not located on the grounds of the public institution. [Eff 09/30/13] (Auth: HRS UNOFFICIAL 1714.1-12 §§346-14, 346-29; 42 C.F.R. §§435.403, 435.1009, 435.1010) (Imp: HRS §346-29; 42 C.F.R. §§435.403, 435.1009, 435.1010) §