The CAO will apply the modifications outlined in this Chapter when determining eligibility for Long -Term Care (LTC) for an individual residing in a State-operated or private Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/ID)
Intermediate care for individuals with intellectual disabilities is provided by a State-operated or private facility licensed as an ICF/ID by the Department of Public Welfare (DPW). The care and services provided by these facilities are specifically designed to meet the needs of individuals with intellectual disabilities. See 486, Appendix A, for a list of State ICF/ID.
Intermediate care is also available for individuals diagnosed with "other related conditions" (ORCs). These are conditions are severe physical disabilities such as cerebral palsy, muscular dystrophy, epilepsy, or similar conditions that are diagnosed before age 22 and which result in three or more functional limitations of daily living. Currently, the number of ICF/ORCs in Pennsylvania is limited. The Department will provide information about eligibility for residents of these facilities to CAOs on an as needed basis. 55 Pa. Code § 4310 55 Pa. Code § 6600
Resources are excluded when determining MA eligibility for SSI-related, AFDC-related and GA-related children under 21 years of age and SSI-related, AFDC-related and GA-related families with children under 21 years of age and SSI-related, AFDC-related and GA-related families with children under 21 years of age.
Spousal Impoverishment rules apply if the individual meets the conditions in the Long Term Care Handbook, Section 440.9. 55 Pa. Code § 178.121
Updated August 27, 2013 Issued May 1, 2012