32.03.04.23

.23 Participant Eligibility for Subsidy.

A. An individual in a facility whose provider has a subsidy services agreement for a Standard Congregate Housing Services Plan is eligible to receive a subsidy if:

(1) The individual has been determined to be eligible to be a participant and receives services in the facility;

(2) The individualís net monthly income is insufficient to pay the full monthly fee approved by the Department in the subsidy services agreement with the provider;

(3) The individual's net annual income is less than 60 percent of the State median income as most recently published by the Maryland Department of Human Services;

(4) None of the exclusions under §G of this regulation applies; and

(5) The individual's assets do not exceed $27,375.

B. A couple in a facility whose provider has a subsidy services agreement for a Standard Congregate Housing Services Plan shall be eligible to receive a subsidy if:

(1) Both members of the couple have been determined to be eligible to be participants and receive services in the facility;

(2) The coupleís net monthly income is insufficient to pay the full monthly fee for a couple approved by the Department in the subsidy services agreement with the provider;

(3) The combined net annual income of the members of the couple is less than 60 percent of the State median income for a couple as most recently published by the Maryland Department of Human Services;

(4) None of the exclusions under §G of this regulation applies; and

(5) The couple's combined assets do not exceed $35,587.

C. An individual in a facility whose provider has a subsidy services agreement for an Individualized Congregate Housing Services Plan shall be eligible for a subsidy if:

(1) The individual has been determined to be eligible to be a participant and receive services in the facility;

(2) The individual's net annual income is less than 60 percent of the State median income as most recently published by the Maryland Department of Human Services;

(3) None of the exclusions under §G of this regulation applies; and

(4) The individual's assets do not exceed $27,375.

D. Real property that was the primary residence of a participant immediately before admission to the Program may not be counted towards the asset limit for 1 year after the date of admission to the Program. If after 1 year from admission the participant retains any ownership interest in the real property that was the primary residence of the participant immediately before admission, the value of the participant's ownership interest shall be counted against the asset limit.

E. An individual applying for a subsidy shall submit, along with the subsidy application, written documentation of all income and assets.

F. If an individual is placed on a waiting list under Regulation .21D(2) of this chapter, the provider may process an advisory subsidy application and subsidy calculation form in order to estimate for the individual the probable amount of subsidy, if any, the individual could receive if enrolled in the program.

G. An individual is not eligible to receive a subsidy if the individual is enrolled in:

(1) A Medicaid waiver program under 26 U.S.C. §1915(c) in Title XIX of the federal Social Security Act;

(2) The Program of All-Inclusive Care for the Elderly, commonly known as PACE; or

(3) A Medicaid capitated program that includes long-term care services.