All Medicaid Programs |
Obsolete Policy |
An applicant for a home and community based waiver must meet the level of care requirements for the applicable waiver.
Need for Level of Care
The waiver agency will evaluate waiver applicants for the level of care requirements. The waiver case manager completes the form 927 to verify that the client meets the level of care provided in a nursing home.
The agencies that will determine the need for the level of care are:
Division of Services for People with Disabilities (DSPD),
Division of Family Health and Preparedness (DFHP),
Area Agency on Aging (AAA),
Bureau of Authorization and Community Based Services (BACBS).
General Rules for the Form 927
The 927 must be signed and completed by the waiver agency worker. The form has two required dates which are:
The date the client meets the level of care requirements.
The expiration date that applies only for a new 927 associated with an application, which will be 60 days from the level of care date.
For a new application, the 927 is valid for an eligibility decision when it meets the following requirements.
The eligibility decision is made within 60 days of, but not before the date the client meets the level of care, and
The benefit effective date must start before the end of the 60 day period. The benefit effective date will go back to the first day of the month subject to the exceptions defined in 711.
For reviews of ongoing eligibility, the form 927 remains effective until the waiver agency tells us the client no longer meets the criteria.