reglab/statecodes huggingface dataset:
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.155 - Determination of General Relief Medical financial eligibility

Current through May 31, 2024
(a) Financial
				  eligibility for General Relief Medical assistance exists only if the
				  household's monthly net income, as determined under this section, does not
				  exceed the need standard in
				  7 AAC 47.150(b). The applicant must
				  provide verification of the household's income, including, for example, tax and
				  wage statements.
(b) Except as
				  provided in (c) of this section and in
				  7 AAC 47.170(b), persons who are
				  included in the household and who will therefore have their financial needs,
				  income, and resources considered in determining financial eligibility, include
				  the applicant and all persons related to the applicant by blood, marriage, or
				  adoption who, at the time of application, have continuously resided with the
				  applicant for a period of 30 days or more and who do not maintain a separate
				  residence from the applicant.
(c)
				  Persons who are receiving a cash assistance grant from Aid to Families with
				  Dependent Children, Adult Public Assistance, or Supplemental Security Income
				  will not have their financial needs, income, or resources considered in
				  determining the General Relief Medical assistance applicant's financial
				  eligibility.
(d) Monthly net income
				  is determined by
(1) counting all income
				  earned or unearned, from any source, except Alaska Permanent Fund Dividends
				  received during the calendar month in which application is made; (to determine
				  monthly income, income received weekly is multiplied by 4.3, that received
				  every two weeks by 2.15, that received twice monthly by 2, and that received
				  monthly by 1);
(2) subtracting all
				  payroll deductions required by the employer, including federal and state income
				  tax, FICA, unemployment insurance, union dues, insurance premiums, and
				  retirement, from gross earned income, and subtracting from earned or unearned
				  income voluntary health insurance premiums which are paid for persons included
				  in the household as described in (b) of this section; and
(3) not counting income received in the month
				  before the month in which application is made, but considering that income a
				  resource as described in
				  7 AAC 47.160.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.160 - Resources

Current through May 31, 2024
(a) General Relief or General Relief Medical
				  assistance may not be granted if the applicant, despite an excess of need over
				  income, has a prior resource, as described in (b) of this section available to
				  meet the specific need, or personal resources in excess of $500 as described in
				  (c) of this section.
(b) Prior
				  resources include
(1) coverage by Social
				  Security, workers' compensation, or medical and hospital insurance;
(2) eligibility for assistance from
				  categorical programs, such as Adult Public Assistance;
(3) qualification to receive other medical
				  assistance or coverage, including assistance or coverage through the Veteran's
				  Administration, Civilian Health and Medical Program of the Uniformed Services
				  (CHAMPUS), United States Seaman's Act Program, Program for Children with
				  Disabilities, division of vocational rehabilitation, division of mental health
				  and developmental disabilities, Medicaid, Medicare, or free health
				  clinics;
(4) qualification to
				  receive assistance from the Bureau of Indian Affairs general relief
				  program;
(5) availability of cash,
				  medical, or subsistence items and assistance from the Salvation Army, Red
				  Cross, Lion's International, or other charitable organizations;
(6) payment for medical bills or medical
				  insurance coverage available through a liable party, including payment for
				  medical claims resulting from an accident; and
(7) payment for medical bills or medical
				  insurance coverage available through an absent parent.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.170 - Age at which applicant may be eligible

Current through May 31, 2024
(a) Applicants 18
				  years of age or older may be found eligible for General Relief and General
				  Relief Medical assistance.
(b) An
				  applicant under 18 years of age may apply on his or her own behalf if the
				  applicant is living apart from parents or guardian and is managing his or her
				  own personal financial affairs. A female applicant under 18 years of age living
				  at home with her parents or guardian may apply without regard to her parents'
				  or guardian's income if she is seeking a therapeutic abortion.
Authority:
AS
						09.65.100
AS 47.05.010
AS 47.25.120
AS 47.25.130
AS
						47.25.170
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.180 - Provision of medical benefits

Current through May 31, 2024
The division shall provide a written certification of
					 eligibility for General Relief Medical benefits upon a form or card specified
					 by it. This certification signifies that the person or persons named on it have
					 been found eligible for medical assistance for the period of time stated. This
					 certification neither guarantees to the recipient that certain medical services
					 and supplies will be furnished nor guarantees to the provider that he will
					 receive unrestricted payment for any and all services and supplies he
					 provides.
Emergency amendments of
						7 AAC 43.005(c),
						7 AAC 47.030,
						7 AAC 47.050,
						7 AAC 47.060,
						7 AAC 47.070,
						7 AAC 47.110,
						7 AAC 47.180,
						7 AAC 47.200,
						7 AAC 47.210,
						7 AAC 47.220 and
						7 AAC 47.900, filed on 4/15/82 (effective 5/17/82), were
						repealed on 5/25/82 and are therefore not being printed. The text of these
						provisions appears as it did before the emergency
						amendments.
Authority:
AS
						47.05.010
AS
						47.25.170
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.200 - General Relief Medical coverage

Current through May 31, 2024
(a) The General
				  Relief Medical program provides payment on behalf of needy persons who are
				  eligible under the provisions of this chapter for any of the following
				  services:
(1) major medical care as defined in
				  7 AAC 47.290;
(2) skilled nursing home care;
(3) intermediate nursing home care;
(4) physician services if
(A) related to major medical care provided in
				  a hospital on an inpatient basis;
(B) provided in a hospital emergency room the
				  same day on which the recipient is admitted for major medical care;
(C) provided to a recipient residing in a
				  nursing home;
(D) provided in
				  either an outpatient or an inpatient setting to a recipient with a diagnosis
				  described in
				  7 AAC 47.271(b);
(E) provided in determining eligibility for a
				  therapeutic abortion; or
(F)
				  provided for a therapeutic abortion;
(5) outpatient laboratory and x-ray services
				  provided in conjunction with a therapeutic abortion or nursing home
				  care;
(6) medical transportation
				  related to major medical care, nursing home care, or a therapeutic
				  abortion;
(7) outpatient surgical
				  center services provided in conjunction with therapeutic abortion or nursing
				  home care;
(8) prescribed drugs and
				  medical supplies for a recipient with a specific diagnosis as described in
				  7 AAC 47.271(b);
(9) repealed 7/1/87.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.210 - Exclusions from General Relief Medical program

Current through May 31, 2024
(a) Notwithstanding
				  any other provisions contained in this chapter or 7 AAC 105 - 7 AAC 160, a
				  payment may not be made under the General Relief Medical program for any
				  expense
(1) that is for major medical care
				  not determined necessary by the professional review organization on contract
				  with the division of medical assistance;
(2) that is for nursing home care not
				  approved by the division of medical assistance;
(3) for items and services not properly
				  prescribed or determined necessary by a health care practitioner;
(4) for more than 12 outpatient physician
				  visits by a recipient in a calendar year;
(5) for outpatient physician visits that are
				  not for a recipient with a diagnosis as described in
				  7 AAC 47.271(b);
(6) if persons are in the care and custody of
				  penal facilities, including juveniles in detention facilities;
(7) for an elective procedure, including an
				  elective abortion;
(8) if the
				  expense is for the first $50 of each day of hospital stay up to a maximum of
				  $200 per hospital admission for major medical care;
(9) if the expense is for a prescription drug
				  or prescribed medical supply for a recipient who does not have a diagnosis
				  specified in
				  7 AAC 47.271(b);
(10) repealed 7/1/87;
(11) for room, board or ancillary services
				  provided in a hospital beyond the length of hospitalization stay authorized in
				  7 AAC 47.245;
(12) for a service provided on or after
				  August 1, 1998.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.220 - Responsibility of recipient

Current through May 31, 2024
(a) It is the
				  responsibility of the recipient to
(1) guard
				  his certification of eligibility with reasonable care to prevent it being used
				  by unauthorized persons;
(2)
				  present it to the provider at the time service is rendered;
(3) provide the identification supporting the
				  proper use of the certification which the provider may require; and
(4) refrain from using the certification
				  after eligibility has expired.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.230 - Responsibilities of provider

Current through May 31, 2024
Providers under the General Relief Medical program are
					 bound by the provisions of this chapter and the provisions of 7 AAC 105 - 7 AAC
					 160. If the provisions of this chapter conflict with the provision of 7 AAC 105
					 - 7 AAC 160, the provisions of this chapter will take precedence over the
					 provisions of 7 AAC 105 - 7 AAC 160 when the service is being provided under
					 the General Relief Medical program.
Authority:
AS
						47.05.010
AS
						47.25.170
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.240 - Reimbursement of provider

Current through May 31, 2024
(a) Providers shall
				  submit all claims for payment on invoices prescribed by the department and in
				  accordance with the requirements under
				  7 AAC 105.220 for Medicaid providers.
(b) Claims for payment must be filed promptly
				  following care. The department will not make payment for services provided more
				  than six months before presentation of the claim.
(c) Except as provided in (d) of this
				  section, payment will be made in the amount determined under the provisions of
				  7 AAC 105 - 7 AAC 160. For those services not covered by Medicaid, the
				  department will furnish providers with information for those services covered
				  exclusively under the General Relief Medical program.
(d) The department will reimburse a health
				  facility for services covered under this chapter at 28.7 percent of the
				  facility's Medicaid rate set by the department under
				  7 AAC 150.210. The department will deduct the amount
				  owed by the recipient under
				  7 AAC 47.220 from the amount of payment made to the
				  health facility.
(e) Payment
				  provided by the department represents full and total reimbursement for those
				  covered services authorized under General Relief Medical assistance. By
				  accepting reimbursement from the department, the provider of medical care or
				  medically related services agrees not to charge the recipient for any
				  difference between the amount billed and the amount received in payment from
				  the department, except charges for which the recipient is responsible under
				  7 AAC 47.220(b). If the hospital was
				  aware at the time of admission that the patient was a General Relief Medical
				  assistance applicant or recipient, admission of the patient serves as agreement
				  to accept reimbursement from the department as full payment for hospital
				  services. A recipient is responsible for payment of all services not
				  reimbursable under General Relief Medical assistance and for the payments
				  specified in
				  7 AAC 47.220(b).
Authority:
AS
						47.05.010
AS 47.25.170
AS
						47.25.195
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.245 - Length of hospitalization

Current through May 31, 2024
(a) The maximum
				  number of days of hospitalization payable by the division for an individual
				  recipient is limited to the 50th percentile of the length of hospitalization
				  stay for that particular primary medical or surgical diagnosis involved
				  identified in the
Length of Stay by Diagnosis and Operation, Western
				  Region, 1994,
which is adopted by reference.
(b) Notwithstanding (a) of this section the
				  division of medical assistance will not pay for more than a total of eight days
				  for a recipient for all hospitalizations in any 12 consecutive month
				  period.
(c) In this section
(1) "hospitalization" includes room, board,
				  and charges for ancillary services;
(2) "ancillary services" include pharmacy,
				  medical and surgical supplies, laboratory, radiology, respiratory services,
				  physical therapy, and operating room services.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.260 - Third-party liability

Current through May 31, 2024
If an applicant is granted General Relief Medical
					 assistance for treatment of an injury negligently or intentionally caused by
					 another person, institution, corporation, or public or private agency, details
					 of the incident from which the injury arose must be noted on the application to
					 facilitate possible recovery. Unless the tort feasor is judgment-proof, the
					 applicant will be required to assign his cause of action to the state, or repay
					 the value of the assistance he has received if he refuses to make such an
					 assignment.
Authority:
AS
						47.05.010
AS
						47.25.150
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.271 - Prescribed drugs and medical supplies

Current through May 31, 2024
(a) The division of
				  medical assistance may not pay for a brand-name prescription drug if an
				  FDA-approved generic drug of equal therapeutic effectiveness is available,
				  unless the prescriber prohibits substitution.
(b) The division of medical assistance may
				  only pay for prescription drugs and medical supplies prescribed to treat a
				  person who
(1) repealed 7/1/87;
(2) has a terminal illness;
(3) has cancer and requires chemotherapy;
				  or
(4) has a specific chronic
				  condition that would normally in its untreated course result in the death or
				  disability of the recipient, but which is amenable to outpatient medication;
				  the chronic conditions for which drugs will be reimbursed are limited to the
				  following diagnoses:
(A) diabetes and
				  diabetes insipidus;
(B) seizure
				  disorders;
(C) chronic mental
				  illness;
(D)
				  hypertension.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.280 - General Relief Medical waivers for persons requiring long-term care services

Current through May 31, 2024
(a) A person who requires a level of medical
				  or rehabilitative care that could appropriately be provided in a skilled
				  nursing facility or an intermediate care facility may apply to the department
				  for waiver of any or all of the following standards of and requirements for
				  eligibility for General Relief Medical assistance:
(1) the need standards of
				  7 AAC 47.150;
(2) the resource requirements of
				  7 AAC 47.160; and
(3) the service limitations of
				  7 AAC 47.200.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 1 - General Relief and General Relief Medical › 7 AAC 47.290 - Definitions

Current through May 31, 2024
In
					 7 AAC 47.010 -
					 7 AAC 47.290
(1) "prescribed drug" means a simple or
				  compound substance, or mixtures of substances, prescribed for the cure,
				  mitigation, or prevention of disease, or for health maintenance that is
				  prescribed by a physician or other licensed practitioner of the healing arts
				  within the scope of practice as defined and limited by federal and state law,
				  and is dispensed by a licensed pharmacist on a valid prescription that is
				  recorded and maintained in the pharmacist's records;
(2) "disabled" or "disability" means being
				  unable to or the inability to engage in substantial gainful activity by reason
				  of a medically determinable physical or mental impairment that can be expected
				  to result in death or that has lasted or can be expected to last for a
				  continuous period of not less than 12 months;
(3) "elective procedure" means a procedure
				  that is subject to the choice or decision of the patient or physician regarding
				  medical services that are advantageous to the patient but not necessary to
				  prevent the death or disability of the patient, and includes an elective
				  abortion;
(4) "major medical care"
				  means non-elective inpatient hospital services that cannot be performed on an
				  outpatient basis and that are certified as necessary by the professional review
				  organization contracted by the division of medical assistance; "major medical
				  care" does not include inpatient psychiatric hospital services;
(5) repealed 2/19/93;
(6) "recipient" means an individual who is
				  financially eligible for General Relief Medical assistance and who may receive
				  a covered medical service if determined to be eligible to receive the
				  service;
(7) "elective abortion"
				  means a procedure, other than a therapeutic abortion, to terminate a
				  pregnancy;
(8) "therapeutic
				  abortion" means the termination of a pregnancy;
(A) certified by a physician as medically
				  necessary to prevent the death or disability of the woman, or to ameliorate a
				  condition harmful to the woman's physical or psychological health; or
(B) that resulted from actions that would
				  constitute a crime of sexual assault under
				  AS
				  11.41.410-11.41.425, a crime of sexual abuse
				  of a minor under
				  AS
				  11.41.434-11.41.440, or the crime of incest
				  under AS
				  11.41.450.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.300 - Applicability

Current through May 31, 2024
(a) The department has determined that a need
				  exists among the state's adult population for the availability of nonmedical
				  residential care. The purpose of the program described in
				  7 AAC 47.300 -
				  7 AAC 47.525 is to provide financial assistance to
				  eligible adults, including vulnerable adults, who require the protective
				  oversight of an assisted living home. The program objective is to enable those
				  adults to
(1) obtain the level of care that
				  an individual could receive in the individual's own home from interested
				  friends or relatives; and
(2) live
				  in the least restrictive setting possible.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.310 - Assisted living care

Current through May 31, 2024
Assisted living care is a range of care described in AS
					 47.33 and 7 AAC 75 that includes more than housing and food service, but does
					 not include continuous nursing or medical care. Assisted living care
					 encompasses 24-hour supportive and protective services in the activities of
					 daily living and in the instrumental activities of daily living for an
					 individual who is 18 years of age or older, as those services are described in
					 that individual's residential services contract executed under
					 AS
					 47.33.210 and assisted living plan prepared
					 under AS
					 47.33.220 and
					 47.33.230. Assisted living care is
					 provided in a residential environment and encourages independent living to the
					 greatest extent possible for each resident.
Authority:
AS
						47.05.010
AS 47.24.011
AS 47.24.017
AS 47.25.120
AS 47.33.210
AS 47.33.220
AS 47.33.230
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.320 - Assisted living home

Current through May 31, 2024
In this chapter, an assisted living home is a home licensed
					 by the department under AS 47.33 and 7 AAC 75, and with which the department
					 has entered into an assisted living home agreement for services under
					 7 AAC 47.440.
Authority:
AS
						47.05.010
AS 47.25.170
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.330 - Eligible individuals

Current through May 31, 2024
Assistance under
					 7 AAC 47.300 -
					 7 AAC 47.525 is available for an individual
(1) who is a resident of the state;
(2) who is 18 years of age or
				  older;
(3) who has been assessed
				  for eligibility by a case manager or other person approved by the
				  department;
(4) who has
(A) a disability that is attributable to a
				  severe and persistent mental illness, or to mental retardation or another
				  condition closely related to mental retardation, that
(i) significantly impairs intellectual
				  functioning and adaptive behavior; and
(ii) includes a significant deficit in the
				  daily living skills that are necessary to function without supervision or
				  support;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.340 - Income

Current through May 31, 2024
(a) Subject to allowable exclusions, to be
				  eligible for assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525, the total monthly countable income, if
				  any, of an individual described in
				  7 AAC 47.330 may not exceed the minimum daily rate set
				  under 7 AAC 47.470.
(b) Unless otherwise specified in
				  7 AAC 47.340 -
				  7 AAC 47.367, income not received in cash is valued at
				  the current fair market value of that which is received.
(c) Income is determined on a monthly basis
				  except that earnings from self-employment are computed on a yearly basis and
				  then divided by 12 to determine monthly income. Unless otherwise specified, any
				  property, money, or service described in the definition of "income" set out in
				  7 AAC 47.367 is considered income in the month of
				  receipt but is considered a resource in any calendar month after the month of
				  receipt.
(d) For the purpose of
				  determining eligibility of an individual who does not receive monthly SSI
				  payments, income is that received or expected to be received in the month for
				  which assistance is to be provided.
(e) For an individual who also receives
				  monthly SSI payments, income is equal to the applicable SSI payment standard
				  for the month for which assistance is provided, less the value of any support
				  and maintenance furnished the applicant in kind in the relevant
				  month.
Authority:
AS
						47.05.010
AS 47.25.120
AS
						47.25.130
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.350 - Resources

Current through May 31, 2024
(a) Subject to allowable exclusions, to be
				  eligible for assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525, the total resources, if any, of an
				  individual described in
				  7 AAC 47.330 may not exceed
(1) $2,000 for the individual; or
(2) $3,000 for an individual living with a
				  spouse, regardless of whether or not the spouse is eligible for assistance
				  under 7 AAC 47.300 -
				  7 AAC 47.525.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.357 - Disposal of excess resources

Current through May 31, 2024
(a) If the
				  nonexcludable resources of an otherwise eligible applicant exceed the resource
				  limits of 7 AAC 47.350, assistance will be
				  provided if the applicant enters into an agreement with the
(1) Social Security Administration under
				  20 C.F.R.
				  416.1240 -  20 C.F.R. 416.1244  to dispose of
				  the excess resources and to repay SSI benefits; and
(2) department to repay assistance provided
				  during the duration of the SSI agreement, in the amount of the proceeds of the
				  disposal less the amount repaid to SSI or the assistance provided, whichever is
				  smaller.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.360 - Spousal income and resources

Current through May 31, 2024
(a) Subject to
				  allowable exclusions, the income and resources of a spouse who is living with
				  an individual seeking assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525 are considered available to the individual
				  for purposes of computing the amount of the individual's income under
				  7 AAC 47.365. The department will apply the standards to
				  prevent spousal impoverishment established under the Medicaid requirements of
				  42 U.S.C.
				  1396r-5 (Title XIX of the Social Security
				  Act, as amended) or a regulation adopted under that statute.
(b) If the individual lives with a spouse and
				  the income of that spouse is considered available to the individual under (a)
				  of this section, certain types of income of the spouse, excluded under the APA
				  program in 7 AAC 40, are also excluded under this chapter in determining the
				  total monthly income, including
(1) the amount
				  of any financial assistance furnished by a state, political subdivision of a
				  state, or the United States on the basis of need, and the amount of any income
				  taken into account in determining eligibility for and amount of that
				  assistance;
(2) a grant,
				  scholarship, or fellowship to the extent used to pay tuition or fees to an
				  educational institution;
(3)
				  payments received for the foster care of a child who is ineligible for SSI or
				  assistance under 7 AAC 40;
(4) the
				  value of food stamps, United States Department of Agriculture donated foods,
				  and home produce and subsistence foodstuffs obtained for personal
				  consumption;
(5) income tax refunds
				  and any taxes on real property or food refunded by a public agency;
(6) any income used to comply with a court
				  order of child support and support payments made under Title IV-D of the Social
				  Security Act  (42 U.S.C.
				  654);
(7) the value of any support and maintenance
				  furnished to a spouse, parent, spouse of a parent, or children who reside with
				  the individual seeking assistance and are ineligible for SSI or assistance
				  under 7 AAC 40;
(8) payments made
				  under AS 47.45 (Alaska Longevity Bonus);
(9) income needed to fulfill a plan for
				  achieving self-support that has been approved by the Social Security
				  Administration or by the division of vocational rehabilitation;
(10) income that is not listed in this
				  subsection, but is excluded under
				  7 AAC 47.345(a) (1) - (30).
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.365 - Income computation

Current through May 31, 2024
The following computations are made to determine total
					 monthly income:
(1) the monthly income
				  available to the individual seeking financial assistance is identified by
				  source, type, and amount;
(2) from
				  the amounts identified under (1) of this section are subtracted any amounts
				  excluded under
				  7 AAC 47.345 or
				  7 AAC 47.360;
(3) the resulting amounts derived under (2)
				  of this section are added and rounded to the nearest dollar; this amount, which
				  cannot be less than zero, is the total monthly income.
Authority:
AS
						47.05.010
AS 47.25.120
AS
						47.25.130
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.367 - Definitions for terms used in 7 AAC 47.340 - 7 AAC 47.365

Current through May 31, 2024
For purposes of
					 7 AAC 47.340 -
					 7 AAC 47.365, unless the context otherwise
					 requires,
(1) "earned income" means
				  wages or other compensation paid by an employer in exchange for service
				  rendered; in the case of a self-employed person, "earned income" means gross
				  earnings less the cost of doing business;
(2) "income" means property, money, or
				  service received by the individual, together with a spouse, if any, under
				  7 AAC 47.360, that can be used, directly or indirectly,
				  to meet the individual's need for food, clothing, and shelter;
(3) "living with" means residing as a family
				  unit in a single residence, except that
(A)
				  spouses, both of whom are otherwise eligible for assistance, who have separated
				  without either having taken another spouse are reputably presumed to be living
				  together unless they have been separated for six months;
(B) spouses, only one of whom is otherwise
				  eligible for assistance, who have separated are rebuttably presumed to no
				  longer live together on the first day of the calendar month following the month
				  of separation; and
(C) spouses who
				  have separated because one spouse enters long-term medical or nursing care are
				  considered to no longer live together on the first day of the calendar month
				  following the month of separation;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.380 - Alternative financial assistance

Current through May 31, 2024
(a) An individual
				  who is eligible for one or more of the following programs is not eligible for
				  assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525 until available benefits under each program
				  have been exhausted:
(1) a 24-hour care or
				  treatment program for alcoholism or drug abuse financed by the department under
				  AS 47.37; and
(2) an inpatient
				  mental health program for the mentally ill financed by the department under AS
				  47.30.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.390 - General relief assistance application

Current through May 31, 2024
(a) A person
				  described in
				  7 AAC 47.330 may apply for assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525 on a form provided by the department. The
				  department, or a responsible person acting on an applicant's behalf, may assist
				  the applicant in completing the application.
(b) An applicant must be available for an
				  interview at the department and must furnish evidence that shows eligibility
				  for the assistance. The department may dispense with the personal interview
				  requirement if distance, weather conditions, road access, available
				  transportation, or the applicant's physical or mental condition would make the
				  requirement unduly harsh, and if other reliable evidence is available to
				  establish eligibility.
(c) Subject
				  to (d) of this section, if the department determines that the applicant meets
				  the eligibility criteria established in
				  7 AAC 47.330 -
				  7 AAC 47.380, the applicant must submit to a medical
				  examination by a licensed physician chosen by the applicant from those
				  physicians enrolled with the department under 7 AAC 105 - 7 AAC 160, or by a
				  physician assistant or a nurse practitioner chosen by the applicant. The
				  physician, physician assistant, or nurse practitioner shall furnish the
				  department a written report on a form provided by the department. The
				  department may pay the costs of the examination and necessary transportation to
				  and from the place of examination if the applicant requires immediate
				  protection and if funding is available.
(d) The department may dispense with the
				  medical examination requirement in (c) of this section if a current medical
				  report is available.
Authority:
AS
						47.05.010
AS 47.24.011
AS 47.24.017
AS 47.25.120
AS 47.25.150
AS
						47.25.160
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.400 - Eligibility determination and placement

Current through May 31, 2024
(a) Except for an
				  emergency placement under
				  7 AAC 47.510, within 30 days after the department
				  receives an identifiable application for assistance under this chapter, the
				  department will forward a written eligibility decision to the applicant. The
				  time period may be extended by agreement of the applicant and the department
				  when a decision cannot be rendered because of a factor that is beyond the
				  control of the applicant or the department.
(b) After consulting with an eligible
				  individual, available family members, a court-appointed representative, or a
				  representative appointed by the individual, the department will assist in
				  selecting an appropriate assisted living home that has available space and that
				  accepts placements under this chapter. An individual who has applied for
				  residential supported living services under
				  7 AAC 43.1000 -
				  7 AAC 43.1110, may not be placed in an assisted living
				  home under 7 AAC 47.300 -
				  7 AAC 47.525 until residential supportive living
				  services have been authorized under
				  7 AAC 43.1000 -
				  7 AAC 43.1110, unless care cannot be provided in the
				  individual's home, or in a nursing facility, acute care hospital, or other
				  appropriate facility. The division of vocational rehabilitation, in the
				  Department of Labor and Workforce Development, will be consulted on the
				  placement of a vocational rehabilitation client.
(c) The department will at least semiannually
				  review the individual's placement to determine whether the individual continues
				  to need assisted living care and whether the particular assisted living home
				  continues to meet the individual's needs.
Authority:
AS
						47.05.010
AS 47.24.011
AS 47.24.017
AS 47.25.120
AS 47.25.160
AS 47.25.170
AS 47.25.200
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.410 - Availability of hearing

Current through May 31, 2024
(a) An individual
				  is entitled to a prompt hearing before a department representative, upon oral
				  or written request directed to the department, if
(1) the individual's application is not acted
				  upon within 30 days after receipt by the department;
(2) the individual's application is modified
				  or denied; or
(3) the individual's
				  assistance is reduced or discontinued.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.420 - Report of change

Current through May 31, 2024
An individual receiving financial assistance under
					 7 AAC 47.300 -
					 7 AAC 47.525 must report to the department any change in
					 circumstances that could affect eligibility or the amount of assistance under
					 this chapter. A report of change must be made within 10 working days after the
					 event occurs, and may be made by a responsible person acting on behalf of the
					 individual.
Authority:
AS
						47.05.010
AS 47.24.011
AS 47.24.017
AS 47.25.200
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.430 - Review of eligibility

Current through May 31, 2024
(a) Upon receiving information indicating a
				  change in an individual's situation that could affect eligibility or the amount
				  of assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525, the department will investigate and, if
				  necessary, adjust, suspend, or terminate the assistance.
(b) An individual who receives assistance
				  under 7 AAC 47.300 -
				  7 AAC 47.525, or a responsible person acting on the
				  individual's behalf, must annually complete a review application. As a result
				  of this review procedure, the department may continue, adjust, suspend, or
				  terminate the assistance.
(c) Upon
				  taking action under either (a) or (b) of this section, the department will
				  provide notice as required by
				  7 AAC 49.060.
Authority:
AS
						47.05.010
AS 47.25.120
AS 47.25.200
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.440 - Assisted living home agreement for services

Current through May 31, 2024
(a) Application for
				  an assisted living home agreement for services must be made by an assisted
				  living home on a form supplied by the department. The department will annually
				  send an application form to each assisted living home licensed by the
				  department under AS 47.33 and 7 AAC 75. The home must submit the application to
				  the department within 30 days after receiving the form to be considered
				  eligible for an agreement.
(b) An
				  assisted living home agreement for services between the department and an
				  assisted living home will
(1) include the
				  appropriate minimum daily reimbursement rate under
				  7 AAC 47.470; and
(2) incorporate by reference each resident's
				  residential service contract executed under
				  AS
				  47.33.210 and assisted living plan prepared
				  under AS
				  47.33.220 and
				  47.33.230, that describe the
				  services the home must provide to the individual in accordance with AS 47.24,
				  AS 47.33, 7 AAC 47.475, and 7 AAC
				  75.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.450 - Payment by individual

Current through May 31, 2024
(a) The total monthly countable income
				  considered available to an individual under
				  7 AAC 47.365, plus APA benefits and the Alaska longevity
				  bonus payment, if applicable, and any other financial assistance for which the
				  individual may be eligible and which is not excluded under
				  7 AAC 47.345, will be applied first toward the
				  personal-needs allowance required by (b) of this section, and then toward the
				  cost of the individual's assisted living care.
(b) An individual may retain the following
				  amount of the total monthly countable income as a personal-needs allowance,
				  which may be used for clothing, unreimbursable medical expenses, and personal
				  incidentals:
(1) $100 for an individual who
				  is eligible for Medicaid or chronic and acute medical assistance coverage;
				  and
(2) $150 for an individual who
				  is not eligible for Medicaid or chronic and acute medical assistance
				  coverage.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.460 - Payment by department

Current through May 31, 2024
(a) For an individual who is placed in an
				  assisted living home under
				  7 AAC 47.400, the department will pay the appropriate
				  minimum daily reimbursement rate established by
				  7 AAC 47.470, multiplied by the number of days of actual
				  residence, minus the individual's share of the cost of care as calculated under
				  7 AAC 47.450.
(b) Except for a placement under
				  7 AAC 47.510, payment will begin only after an
				  eligibility determination has been made under
				  7 AAC 47.400. The department will make payment directly
				  to the home on a monthly basis for services provided under
				  7 AAC 47.475. Payment will cover the day of admission,
				  but not the day of departure.
(c)
				  The department's payment will not increase to compensate for the withholding of
				  an individual's social security, SSI, or APA benefit when the withholding is
				  due to an overpayment caused by fraud or failure to report a change, unless
				  protection of the individual outweighs the issue of that fraud or failure to
				  report.
(d) If an individual placed
				  in an assisted living home under
				  7 AAC 47.400 has no income, the department may pay a
				  personal-needs allowance of $100 monthly to the home for that individual. The
				  home shall give the personal-needs allowance to the individual, unless the home
				  has obtained written authorization under
				  7 AAC 75.310 to manage the individual's personal-needs
				  allowance, or management of the allowance is included in the individual's
				  residential services contract executed under
				  AS
				  47.33.210 and assisted living plan prepared
				  under AS
				  47.33.220 and
				  47.33.230.
Authority:
AS
						47.05.010
AS 47.25.120
AS 47.25.130
AS 47.25.170
AS 47.25.195
AS 47.33.920
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.465 - General relief assistance subject to appropriation

Current through May 31, 2024
(a) When
				  legislative appropriations are not adequate to meet the projected service needs
				  for general relief assistance in a given fiscal year, the department will limit
				  the number of individuals who will receive assistance to avoid having to
				  suspend the program before the end of the fiscal year. To limit the number of
				  participants, the department will establish a wait list for individuals who
				  would be eligible to receive general relief assistance under
				  7 AAC 47.300 -
				  7 AAC 47.525 if adequate legislative appropriations were
				  available.
(b) To select
				  individuals from the wait list under (a) of this section, the department will
				  use the following order of preference, based on the date of the letter
				  approving a complete application:
(1)
				  individuals who the department has determined are vulnerable and in need of
				  protective placement under
				  AS
				  47.24.017(d);
(2) individuals who will be discharged
				  directly from an institution for mental disease, a facility operated by the
				  Department of Corrections, a hospital, or a long-term care facility;
(3) all other individuals.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.470 - Minimum daily reimbursement rates

Current through May 31, 2024
(a) The minimum
				  daily reimbursement rate set in this section is for each individual placed in
				  an assisted living home under
				  7 AAC 47.400 and is to assist in payment for
(1) housing and food service; and
(2) the basic services described in
				  7 AAC 47.475.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 3 - Public Assistance and Medical Assistance › Chapter 47 - General Relief › Article 2 - General Relief Assisted Living Home Care › 7 AAC 47.471 - Augmented rates; general

Current through May 31, 2024
(a) Except for a
				  resident who also receives financial assistance under
				  7 AAC 47.472, or from another agency, organization, or
				  program for the cost of services provided in an assisted living home, the
				  department may augment the minimum daily reimbursement rate set in
				  7 AAC 47.470 if a resident requires assistance with four
				  or more activities of daily living, or if a resident requires a level of care,
				  monitoring, and protective service that is significantly higher than that
				  required for other residents of the home, including other residents with an
				  impairment described in this subsection, to protect the resident from abuse,
				  neglect, or exploitation because of
(1)
				  severe alcohol or drug dependency acting out behavior, including use of alcohol
				  or drugs in or out of the home;
(2)
				  severe mental health, mental impairment, or emotional disturbance issues
				  resulting in disruptive acting out behaviors, including aggressive, violent,
				  offensive, or assaultive behavior;
(3) a major health impairment; or
(4) other variables or factors that make the
				  resident extremely difficult to place and protect in an assisted living
				  home.