*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: September 1, 2011 |
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Archived: June 1, 2016 (Previous Versions) |
Minnesota Health Care Program (MHCP) clients live in a variety of community and facility (or institutional) living arrangements. It is important to code a client’s living arrangement correctly in the MMIS system. A client’s living arrangement may affect health care program eligibility, what services are covered, or what funding source pays for covered services. This chapter discusses living arrangements and the proper codes to use to identify them in MMIS.
Community Living Arrangements.
People who do not have a facility living arrangement have a community living arrangement. Do not change the community living arrangement default code of ”80” on the MMIS RLVA screen for the following settings. The following are some examples of community living arrangements:
l Private Residence (home, apartment or home of another person).
l Campground.
l Car.
l Chemical dependency halfway house. This is a chemical dependency halfway house that offers only halfway house services and no other level of chemical dependency treatment.
l Child foster care - Rules 1, 4, and 8.
l Detox-only facilities. Chemical detoxification is the only service offered by these facilities.
l Halfway house, correctional. Privately operated facility of any size or a stand-alone publicly owned and operated community correctional halfway house.
Note: There are currently no publicly owned and operated correctional halfway houses in Minnesota. See Correctional Facilities for more information.
l Homeless.
l Homeless shelter.
l Hotel or motel.
l Medical hospital when the stay is 30 days or less.
l Community-based behavioral health hospital (CBHH) when the stay is less than 30 days.
l Maternity shelter.
l Non-Medicaid medical or nursing facility.
Note: Facility costs are not paid for enrollees who reside in this type of a facility. Do not use a LTC income calculation for people residing in this type of facility.
l Veteran’s Administration (VA) Facility.
People who live in the following settings are considered to have a facility living arrangement. The code used on the RLVA panel in MMIS is based on the facility type. People in facility settings may be subject to special eligibility rules related to the living arrangement. See each section for the specific living arrangement information.
l Institutions for Mental Diseases (IMDs).
l Long-Term Care Facilities (LTCFs).
Exception: People who meet all other eligibility requirements for Refugee Medical Assistance (RMA) are eligible for RMA regardless of their living arrangement.