The proposed amendments to the rules clarify residency policy to provide Medicaid for citizen children born to noncitizen parents. Technical and non-substantive changes in the rule are included.

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency Program

RULE NO: RULE TITLE
65A-1.705: Family-Related Medicaid General Eligibility Criteria
65A-1.711: SSI-Related Medicaid Non-Financial Eligibility Criteria
PURPOSE AND EFFECT: The proposed amendments to the rules clarify residency policy to provide Medicaid for citizen children born to noncitizen parents. Technical and non-substantive changes in the rule are included.
SUMMARY: The proposed amendments clarify residency requirements for Medicaid.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 409.818, 409.919 FS.
LAW IMPLEMENTED: 409.818, 409.902, 409.903, 409.904, 409.906, 409.919 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: June 9, 2008, 1:30 p.m.
PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, FL 32399
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Pat Whitford, Economic Self-Sufficiency Services, Telephone [phone]

THE FULL TEXT OF THE PROPOSED RULE IS:

65A-1.705 Family-Related Medicaid General Eligibility Criteria.

(1) Technical eligibility criteria of living in the home of a specified relative, age, residence, citizenship and deprivation apply to coverage groups as follows.

(2) through (4) No change.

(5) The individual must be a resident of Florida as provided by s. 1902(b) of the Social Security Act (2007), incorporated by reference.  Individuals who are in the United States with certain temporary visas may be considered residents of the state if they indicate their intent to remain in Florida and can verify residency.  The temporary visa must be in one of the following classifications:  treaty traders and investors and their families; foreign students; international organization representatives and individuals and their families and servants; temporary workers including agricultural contract workers; or members of foreign press, radio, film or other information media and their families.

(6) The individual must be a citizen of the United States or a qualified alien as defined in 8 USC s. 1641(b) (2000 Ed., Sup. IV), incorporated by reference.

(7) (a) through (j) No change.

(k) The needs, income and assets of individuals who receive only SSI-related Medicaid under Sections 1619(a) and (b) of the Social Security Act (2007), incorporated by reference, are excluded when determining the eligibility of the assistance group if the SSI recipient otherwise would be included in the filing unit. These recipients of SSI-related Medicaid only are SSI individuals who have become employed and whose income exceeds the SSI income standard.

(l) through (m) No change.

(8) through (9) No change.

Specific Authority 409.818 409.918, 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.818, 409.919 FS. History–New 10-8-97, Amended 9-28-98, 4-5-99, 11-23-99, 2-15-01, 9-24-01, 4-1-03,__________.

 

65A-1.711 SSI-Related Medicaid Non-Financial Eligibility Criteria.

To qualify for Medicaid an individual must meet the general and categorical requirements in 42 C.F.R. Part 435, subparts E and F (2007) (incorporated by reference), with the exception that individuals who are neither aged nor disabled may qualify for breast and cervical cancer treatment, and the following program specific requirements as appropriate.; Individuals who are in the United States with certain temporary visas may be considered residents of the state if they indicate their intent to remain in Florida and can verify residency. The temporary visa must be in one of the following classifications:  treaty traders and investors and their families; foreign students; international organization representatives and individuals and their families and servants; temporary workers including agricultural contract workers; or members of foreign press, radio, film or other information media and their families.

(1) For MEDS-AD Demonstration Waiver, the individual must be age 65 or older, or disabled as defined in 20 C.F.R. §416.905 (2007) (incorporated by reference).

(2) For ICP benefits, an individual must be:

(a) No change.

(b) Determined to be in medical need of institutional care services according to Rules 59G-4.180 and 59G-4.290, F.A.C., for nursing facility, hospital swing bed placements and placements in a hospital-based skilled nursing facility bed according to Chapter 65B-38, F.A.C., for ICF/DD facilities or according to Rule 59G-4.300 59G-4.165, F.A.C., for state mental hospitals.

(c) If the individual is in a hospital swing bed or in a hospital-based skilled nursing facility bed, meet the requirements for length of stay prescribed in Rule subsection 59G-4.200 59G-4.200(13), F.A.C.

(3) No change.

(4) To be eligible for a Home and Community Based Services Waiver program, an individual must meet the requirements of Rule 59G-13.080 59G-8.200, F.A.C. An individual cannot receive waiver coverage and institutional care program coverage at the same time. An individual residing in a nursing home may apply for the waiver, but the individual’s approval must be subject to their discharge and move into a community living arrangement. AHCA, in coordination with the program responsible for the daily operations of the waiver, requests the number of individuals to be served by the waiver as part of each waiver submission. The Centers for Medicare and Medicaid Services approve the request based on information provided by the state. Additionally, an individual must meet the criteria for one of the following waivers:

(a) No change.

(b) Be determined disabled in accordance with SSI disability criteria set forth in 42 C.F.R. §§ 435.540 (2007) and 435.541 (2007) (both incorporated by reference) and meet the requirements of subsection 65A-1.701(24), F.A.C., to participate in the Project AIDS Care waiver; or

(c) Be age 65 or older, or be 18 years of age through 64 years of age and disabled in accordance with SSI disability criteria set forth in 42 C.F.R. §§ 435.540 (2007) and 435.541 (2007) (both incorporated by reference), and meet the requirements of subsection 65A-1.701(1), F.A.C., to participate in the ADA/Home and Community Based Services waiver program; or

(d) Be disabled in accordance with SSI disability criteria set forth in 42 C.F.R. §§ 435.540 (2007) and 435.541 (2007) (both incorporated by reference) and meet the requirements of subsection 65A-1.701(10), F.A.C., to participate in the Developmental Services waiver program; or

(e) No change.

(f) Be age 18 through 64 and disabled in accordance with SSI disability criteria set forth in 42 CFR §§ 435.540 (2007) and 435.541 (2007) (both incorporated by reference) with a medical condition of traumatic brain injury or spinal cord injury in accordance with the Centers for Medicare and Medicaid Services approved Medicaid waiver.

(5) No change.

(6) To be eligible for WD the individual must be entitled to enroll for Medicare Part A in accordance with Title XVIII, Section 1818A of the Social Security Act (42 U.S.C. § 1395i-2a, 2000 Ed., Sup. IV, incorporated by reference).

(7) In addition, optional coverage is provided in accordance with Secs. 1920B and 1902(aa) of the Social Security Act (2007), incorporated by reference, as it pertains to breast and cervical cancer treatment. This coverage is provided only for the duration of the individual’s treatment. Applicants are referred by the Department of Health. A face to face interview is not required as a result of this referral. The application form for this coverage is CF-ES 2099, Medicaid Application for Breast and Cervical Cancer Treatment, July 2002 (incorporated by reference). Additional rights and responsibilities are explained to applicants on form CF-ES 2064, Your Rights and Responsibilities (incorporated by reference in Rule 65A-1.204, F.A.C.); this form is provided to each applicant. A form requesting verification of the length of treatment, CF-ES 2701, Request for Length of Treatment Information, Dec. 2001 (incorporated by reference), along with a return envelope are given to the applicant to obtain the required verification from the provider. Alternatively, this information may be obtained by the department through telephone contact with the provider, when known.

(8) No change.

Specific Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 4-1-03, 8-10-06 (1), 8-10-06 (8), (9),___________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Nathan Lewis
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Jennifer Lange
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: January 16, 2008
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: January 25, 2008