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									Recent Policy Developments at DHMH:
 Long-Term Care

 AAHAM , January 20, 2012
    Lorie Mayorga
    Deputy Director
    Eligibility Policy

  Michelle Woodson
Healthcare Policy Analyst
     Eligibility Policy
Streamlined Guidelines for the Long Term Care
Application and Redetermination

   Partners in application development were:
      DHMH
      DHR
      Long Term Care Providers
      Client Advocates
      Focus Groups
New LTC Application and Redetermination Forms

     Application - yellow     Redet - green
New LTC Application and Redetermination Forms

  Forms are available as fillable or non-fillable PDFs on the
   DHMH website:
Action Transmittal #12-02
Procedural Changes

  New streamlined process to evaluate 60-month
    The Deficit Reduction Act (DRA) of 2005 lengthened the
     36-month look-back period for initial long term care (LTC)
     applications to 60-months prior to the month of the initial
     application. This resulted in an increased workload for case
     managers when determining an applicant’s initial eligibility. The
     extra work on the applications adversely affected the timely
     processing of the LTC applications.
Documents DHMH Requires at Application

  A federal tax return will be needed for:
    The current tax year; and
    The preceding four years
    In lieu of a tax form for a given year,
     an IRS Record of Account is acceptable
  Bank and financial statements for:
    The month of application
    The month prior to application; and
    For the last five years of the anniversary
     month of application
Documents DHMH Requires at Application
  Bank and Financial statements for the last
   five years of the anniversary month
   of application:
       Application date - Mar 2011:
       Feb 2011 (prior to appl month)
       Mar 2011 (month of appl)
       Mar 2010
       Mar 2009
       Mar 2008
       Mar 2007
       Mar 2006
Bank & Financial Verifications
        Checking Accounts
        Savings Accounts
        Credit Union Accounts
        Trust Funds
        IRA & Keogh Accounts
        Stocks
        Bonds
        Money Market Funds
        Electronic verification sources accessed
         by caseworkers
Action Transmittal #11-26

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