*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: November 1, 2012 |
|
13.25.05 - Excluded Time |
Archived: June 1, 2016 (Previous Versions) |
The policies in this section apply to MA.
County Moves and Excluded Time.
Excluded time is time a person spends in certain facilities or receiving certain services that does not count when determining or redetermining county of financial responsibility.
Excluded time affects the determination of the county of financial responsibility when MA applicants or enrollees:
l Apply for MA while living in an excluded time facility or receiving excluded time services.
l Move to an excluded time facility in another county.
l Receive excluded time services in another county.
Excluded time facilities include:
l Hospitals.
Note: People who are hospitalized for less than 30 days are not considered to ”reside” in the hospital. A brief hospitalization does not interrupt the two-month transfer period for enrollees who move to other counties.
Example:
Bill receives MA from County A. He moves to an apartment in County B on June 1. He is hospitalized in County C from July 2-10 and then returns to his apartment in County B.
Action:
County B becomes financially responsible on September 1. Bill’s hospitalization was not a move to an excluded time facility and does not interrupt the two-month transfer period.
l Long-Term Care Facilities (LTCF).
l Shelters (other than emergency shelters).
l Foster homes.
l Board and lodging facilities.
l Regional treatment centers (RTC).
l Placement in a facility based on an emergency hold.
l Placements in day training and habilitation (DT&H) programs (including a rehabilitation facility or work or employment program).
l Assisted living services.
l Placements with an indeterminate commitment, including independent living.
Receipt of the following is not considered excluded time:
l Adoption assistance.
The county initially responsible for an adoption assistance child’s MA is the county in which the original Findings and Order Terminating Parental Rights was signed.
If the child moves to non-excluded time in another county, financial responsibility transfers to the new county after the child has lived in the new county for two calendar months.
l Relative custody assistance.
Excluded time services include:
l Participation in a rehabilitation facility which meets the definition of a long-term sheltered workshop.
l Receipt of services from a Semi-Independent Living Service (SILS) Program.
l Day training and habilitation programs.
Some of these services can include:
l providing training and support in money management.
l household management.
l chores.
l shopping.
l hygiene.
l supported work.
l sheltered workshops.
A person may receive excluded time services while living at home or in a group living situation.
Example:
Paul lives in County A and receives services from a day training and habilitation program in County A..He moves to an apartment in County B, and continues to receive services from the day training and habilitation program in County A.
Action:
County A is still financially responsible for Paul's MA. If Paul stops receiving services from a day training and habilitation program and stays in County B, County B will become financially responsible two full calendar months after Paul's services end.
The county of financial responsibility for an applicant who resides in an excluded time facility or receives excluded time services is the county in which the applicant lived immediately before entering the facility or receiving the services.
Example:
Linda files an MA application as the authorized representative for her mother, Rita. Rita entered a nursing home in County B directly from her home in County A.
Action:
County A is financially responsible for Rita's MA.
County Moves and Excluded Time
Do not transfer financial responsibility to the new county when active MA enrollees move to another county and
l Enter excluded time facilities immediately.
l Begin receiving excluded time services immediately.
l Enter excluded time facility or begin receiving excluded time services during the two-month transfer period.
If the enrollee leaves excluded time, transfer financial responsibility on the first of the month following two full calendar months of non-excluded time.
Example:
Roland receives MA from County A. He enters a nursing home in County B on March 3. The nursing home discharges him May 15 and he moves into an apartment in County B.
Action:
County A remains financially responsible for two full calendar months (June and July) until August.
Example:
Justin receives MA from County A. He moves to County B on May 1. He enters an excluded time facility in County B on June 2. He leaves the excluded time facility and returns to an apartment in County B on July 7.
Action:
County A remains financially responsible for August and September. County B becomes financially responsible on October 1.
Example:
Marsha receives MA from County A. She moves to County B on April 1 to receive excluded time services arranged by County A. The services begin on May 1.
Action:
County A remains financially responsible as long as Marsha continues to receive the services.
For MA, a person who moves directly from another state to a Minnesota excluded time facility is the financial responsibility of the county where the facility is located unless the person meets an exception in Institutional Residence.