Virginia Administrative Code › Title 22 - SOCIAL SERVICES › Agency 30 - DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES › Chapter 130 - ADULT SERVICES STANDARDS › Section 22VAC30-130-40 - Eligibility determination

Current through Register Vol. 40, No. 24, July 15, 2024
A. To
				request home-based services, the adult or the adult's responsible person shall
				submit a service application (Application for Adult Services Form) to the local
				department. The service application shall be on a form provided by the
				department. The local department shall document receipt of the application in
				the department-designated case management system. A service application shall
				not be required to request a screening for long-term care services and
				supports, for an assisted living facility assessment, or for review of an
				annual guardian report.
B.
				Determinations for functional eligibility and financial eligibility are
				separate processes but shall be pursued simultaneously. Functional and
				financial eligibility shall be determined as promptly as possible. The local
				department shall notify the adult of its eligibility determination decision no
				later than 45 days from the date the application is received by the local
				department.
C. The local department
				shall determine the adult's functional eligibility for home-based services.
				Home-based services shall not be available to adults who reside in an
				institutional setting including a nursing facility, assisted living facility,
				or hospital. The local department shall assess the adult using the UAI, the
				department-designated form, including evaluating the adult's degree of
				independence or need for assistance with performing ADLs and IADLs.
D. The local department shall determine the
				adult's financial eligibility for home-based services.
1. If the local department chooses to offer
				home-based services under universal access, the adult is financially eligible
				for home-based services without consideration of the adult's income.
2. If the local department chooses to offer
				home-based services under income maintenance, the local department shall verify
				and document the adult's source of income in the department-designated case
				management system, and document whether the adult is eligible for an Auxiliary
				Grant, Temporary Assistance for Needy Families, or Supplemental Security
				Income. Adults who receive an Auxiliary Grant, Temporary Assistance for Needy
				Families, or Supplemental Security Income meet the financial eligibility
				requirement for home-based services offered under the income maintenance
				category.
3. If the local
				department chooses to offer home-based services under eligibility based on
				income, each local board shall select a threshold percentage of the median
				income to evaluate financial eligibility for adults. The department shall
				provide a scale of the median income for a family of four in Virginia as
				updated periodically in the Federal Register by the U.S. Department of Health
				and Human Services annually to local departments to use to determine financial
				eligibility. The adult's income, not resources, shall be counted when
				determining the adult's financial eligibility. The local department shall
				verify and document the adult's income in the department-designated case
				management system. Income from the following resources shall be disregarded
				when determining financial eligibility for home-based services in eligibility
				based on income category:
a. Home produce
				utilized by the adult for his own consumption;
b. The value of food benefits under the
				Supplemental Nutrition Assistance Program;
c. The value of supplemental food assistance
				received under the Child Nutrition Act of 1966 (42 USC
				§§
												1771 through
				1789).
				This includes all school meals programs; the Women, Infants and Children
				program; and the Child Care Food program;
d. The value of foods donated under the U.S.
				Department of Agriculture Commodity Distribution Program, including those foods
				furnished through the school meal programs;
e. Benefits received under Nutrition Program
				for the Elderly, Title VII of the Older Americans Act of 1965, as amended
				(42 USC §§
												3001 et seq.);
f. Grants or loans to any undergraduate
				students for educational purposes made or insured under any program
				administered by the U.S. Secretary of Education;
g. A scholarship or grant obtained and used
				under conditions that preclude its use for current living costs;
h. Training allowance provided by the
				department for persons participating in rehabilitative services
				programs;
i. Payments to VISTA
				volunteers;
j. The Veterans
				Administration educational amount for the caretaker 18 years of age or older
				when used specifically for educational purposes. Any additional money included
				in the benefit amount for dependents is to be counted as income;
k. Income tax refunds including earned income
				tax credit advance payments and refunds;
l. Payments made under the Energy Assistance
				Program;
m. All federal, state, and
				local government rent and housing subsidies and utility payments;
n. Funds distributed to or held in trust for
				members of any Indian tribe under Public Laws 92-254, 93-134, 94-540, 97-458,
				98-64, 98-123, or 98-124. Additionally, interest and investment income accrued
				on such funds while held in trust, and purchases made with such interest and
				investment income;
o. All bona fide
				loans. The loan may be for any purpose and may be from a private individual as
				well as from a commercial institution. The amount disregarded is limited to the
				principal of the loan;
p. Monetary
				gifts for special occasions such as the adult's birthday, holidays, or
				graduations;
q. Withdrawals of bank
				deposits;
r. Payments to vendors
				for services provided to the adult; and
s. Lump sum insurance payments.