PART 371 PUBLIC INSTITUTIONAL CARE
371.2 Documentation of eligibility
371.3 Determination of initial eligibility
371.4 Determination of continuing eligibility
371.5 Authorization of assistance and care
371.6 Public lodging house or shelter care
Section 371.1 Definitions. Public home care.
Public home care means domiciliary, sheltered or custodial care in a city or county home for a person 16 years of age or over for whom care in his own home or some other suitable family home is not appropriate.
371.2 Documentation of eligibility.
(a) General. Initial and continuing eligibility for public home care shall be established, and documented in the form of a case record for each person applying for and receiving such care as a public charge. A resident shall be considered a public charge unless he is paying for the cost of his care at a rate which is at least equal to the rate approved by the department and in effect during the period of care.
(b) Applicability of department regulations. Insofar as they are appropriate, the provisions of department regulations shall apply to the provision of care in a public home.
371.3 Determination of initial eligibility.
In general, the scope of the social investigation shall conform to the policies set forth in sections 351.1 through 351.4, 351.20 through 351.24, 354.1, 354.2 and 354.4 of this Title, but these processes shall be modified to the extent indicated by the nature of institutional care and the needs of persons requiring such care.
(a) Appropriate form of care.
(1) Primary emphasis shall be placed upon the form of care which will best meet the needs of the individual concerned. This shall include consideration of his previous living arrangements; his current physical and mental condition; his ability to live outside the protected environment of an institutional setting; the availability and suitability of care in a private home for the aged or a private home for adults for which an applicant may be eligible because of membership in a fraternal organization or other association or in a government home or institution for which an applicant may be eligible because of veteran status; his personal wishes and those of his family.
(2) Residents of public homes, which are supported by county and State funds, are ineligible for supplemental security income payments.
(3) Residents of public homes who have medical problems should be considered for possible placement in skilled nursing or intermediate care facilities.
(b) Financial need.
(1) A person for whom care in his own home is not appropriate shall be eligible as public charge for public home care when his own resources and available support from relatives are insufficient to provide appropriate care elsewhere.
(2) When care in a public home is determined to be the most suitable form of care, the application shall be accepted. Any available income shall be applied as a refund against current operation and maintenance costs of the institution.
(3) Resources shall be explored and utilized and recoveries reported in accordance with department regulations. An agency may modify these policies when:
(i) the individual may reasonably be presumed to require only short-term care (not in excess of 90 days) and the established local policy provides for modification of liquidation, adjustment and/or assignment requirements in such cases;
(ii) the individual has a dependent spouse who is aged or has short life expectancy and with whom he has lived prior to his admission; in such cases, a $250 burial reserve may be permitted for the spouse, in addition to a reserve for the applicant himself.
371.4 Determination of continuing eligibility.
The determination of continuing eligibility shall be based upon contact with the resident and with appropriate collateral sources, and upon periodic evaluation and supervisory review and approval of all variable factors.
(a) Personal contact shall be not less frequent than once in six months.
(b) All variable factors of need and eligibility shall be reconsidered and evaluated at least once in 12 months. This shall include:
(1) the form of care provided and whether it continues to be the most suitable to the individual's needs; and
(2) possible changes in such factors as employability, availability of employment, eligibility for work-related or other benefits, changes in the amount of such payments, and ability of relatives to support.
371.5 Authorization of assistance and care.
(a) An authorization of assistance shall be issued by the income maintenance division to authorize public home care and to specify the effective date. For cases already in the public home, the effective date is the date of admission. The State-prescribed authorization form will be used for this purpose.
(b) Determination of continuing eligibility every 12 months or any change in eligibility shall be similarly confirmed by issuance of an authorization.
(c) All such authorizations shall be maintained in a file in the social services district.
371.6 Public lodging house or shelter care.
The local plan of administration shall specify the policies and procedures governing the provision of lodging house or shelter care. All requirements for the approval of such plans shall be applicable.
Return to DSS Regs Table of Contents | NLS Home Page| Search DSS Regs