For both PCHs and Dom Care Homes, the County Assistance Office (CAO) must decide whether the individual meets the following conditions:
The individual must be living in or requesting placement in a licensed PCH or certified Dom Care Facility.
The individual must be age 18 or older.
The individual must (a) be getting SSI benefits or (b) have personal income less than the combined federal SSI payment and Personal Care Supplement, meet all other SSI eligibility requirements, and agree to apply for SSI. The Social Security Administration (SSA) decides on eligibility for SSI. (See Section 391.4, Approving the Supplement.)
The individual must be functionally disabled; that is, he or she needs help in carrying out basic activities of daily living and the type of help needed is more than just room and board.
The county Area Agency on Aging (AAA) decides whether an individual is functionally disabled. The Functional Eligibility Determination (FED), formerly called the Level of Care Determination (LCD), uses the same forms and actions used for deciding whether someone needs Long Term Care. (See Section 391.3, Application for the Supplement.)
The PCH must provide a copy of its license. The Dom Care Home must provide a copy of its certificate of compliance. These documents show that the home has followed all rules for providing care.
Updated December 31, 2019, Replacing April 1, 2019