Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 28 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ARIZONA LONG-TERM CARE SYSTEM › Article 4 - ELIGIBILITY AND ENROLLMENT › Section R9-28-401 - Eligibility and Enrollment-related Definitions

Current through Register Vol. 30, No. 28, July 12, 2024
Definitions. For purposes of this Article, the following
				  words and phrases, in addition to definitions contained in A.R.S. §§
									36-2901
				  and
				  36-2931,
				  and 9 A.A.C. 22, Article 1, have the following meanings unless the context of
				  the Chapter explicitly requires another meaning:
"ALTCS acute care services" means services under 9 A.A.C. 22,
				  Articles 2 and 12, that are provided to a person who meets ALTCS eligibility
				  requirements in 9 A.A.C. 28, Article 4 and who:
Lives in an acute care living arrangement described in
				  R9-28-406;
				  or
Is not eligible for long-term care benefits, described in
				  R9-28-409, due
				  to a transfer under
				  R9-28-409
				  without receiving fair consideration, or
Has refused institutionalized or HCBS services.
"Community spouse" means the husband or wife of an
				  institutionalized person who has entered into a contract of marriage,
				  recognized as valid by the state of Arizona, and who does not live in a medical
				  institution.
"CSRD" means Community Spouse Resource Deduction, the amount
				  of a married couple's resources that is excluded in the eligibility
				  determination to prevent impoverishment of the community spouse as determined
				  under
				  R9-28-410.
"Fair consideration" means income, real or personal
				  property, services, or support and maintenance equal to or exceeding the fair
				  market value of the income or resources that were transferred.
"First continuous period of institutionalization" means the
				  first period beginning on or after September 30, 1989 that the applicant was
				  institutionalized for 30 consecutive days or more. To be considered
				  institutionalized, the applicant must:
Have resided in a medical institution;
Have received paid formal Home and Community Based Services
				  (HCBS);
Have received a combination of medical institutionalization
				  and HCBS, or
Intend to receive HCBS and either:
Requests a Resource Assessment and is determined in need if
				  institutional services by a Resource Assessment Medical Evaluation; or
Applies for ALTCS and is determined medically eligible by the
				  Pre-Admission Screening (PAS).
"Institutionalized" means residing in a medical institution
				  or receiving or expecting to receive HCBS that prevent the person from being
				  placed in a medical institution as determined by the PAS.
"Medically eligible" means meeting the ALTCS medical
				  eligibility criteria under Article 3 of this Chapter.
"MMMNA" means Minimum Monthly Maintenance Needs
				  Allowance.
"Redetermination" means a periodic review of all eligibility
				  factors for a recipient.
"Representative" means a person other than a spouse or a
				  parent of a dependent child, who applies for ALTCS on behalf of another
				  person.
"Share of costs" means the amount an ALTCS recipient is
				  required to pay toward the cost of long term care services.
"Spouse" means a person legally married under Arizona law, a
				  person eligible for Social Security benefits as the spouse of another person,
				  or a person living with another person of the opposite sex and the couple
				  represents themselves in the community as husband and wife.