What are the Principal Issues Affecting the Financing of the Home and Community-Based Services Program for the Elderly and Disabled?
While the emphasis of the HCBSP is on providing assistance to people with functional impairments, specific eligibility criteria vary across its three current primary components. (a) Waiver Services. Medicaid waiver services are targeted to low-income individuals 65 and older and younger adults who are classified as disabled according to SSDI criteri1. The financial eligibility cut-off is 100% of SSA. To meet the state’s criteria for nursing facility level of care, an individual must need medically-related care that requires hands-on nursing and supervision or, in terms of ADL limitations, require “human assistance” with at least two of four ADLs (transferring, toileting, eating and bathing) for at least 60% of the time it takes to perform the specific ADL task. (b) SPED Services. There are no age or income requirements for SPED services and, although there is an asset limit, it is very generous — a maximum of $50,000 in countable liquid assets. SPED’s functional eligibility criteria,
