ADvantage program members may receive services in a contracted ADvantage Assisted Living Center; an ADvantage Assisted Living Center is the only housing-with-nursing-supervised personal care services option in which a person may appropriately receive ADvantage Services.

Only individuals who are categorically related to ABD may be served through ADvantage Waiver Assisted Living services. If categorical relationship to disability has not already been established, the Level of Care Evaluation Unit (LOCEU) will render a decision on categorical relationship to the disabled using the same definition used by the Social Security Administration.

INCOME

Countable income must be equal to or less than the Categorically Needy Standard found on Appendix C-1, Schedule VIII. B.1. If income is between the Categorically Needy Standard and the Maximum monthly countable income for a Medicaid Income Pension Trust, also found on Schedule VIII B.1, a Medicaid Income Pension Trust (MIPT) must be established and funded prior to applicant/client being determined financially eligible.

Refer to article LTC: Medicaid Income Pension Trust – Establish

If payment of income is made to the individual and another person(s), the income is considered in proportion to the individual’s interest. Otherwise, we look at the income of the applicant only in determining income eligibility.

RESOURCES  

The resource standard for an individual is shown on Appendix C-1, Schedule VIII.D. If the individual applying has a spouse, it is necessary to determine the amount of resources for both spouses for the month of the individual’s application for ADvantage Waiver Assisted Living services.

The monthly maintenance standard for individuals residing in an ADvantage Assisted Living Facility, which is the amount of money the client may retain for his/her own needs, and is found on OKDHS Appendix C-1, Schedule VIII B.2

Please follow the steps below prior to starting the application process on a possible Assisted Living Application: Please email the ADvantageAL@okdhs.org with any questions.

**APPLICATIONS AND REVIEWS IN 00c, 55 01, 02, 03, 04 DO NOT TOUCH OR MOVE**

**VIEW EKL SCREEN IN IMS FOR ASSISTED LIVING VENDOR LINE**

**VIEW PREVIOUS CASE NOTES IN FACS**

1. If you receive an Assisted Living application through Harmony:

• If application is in 00c, 55 01, 02, 03, 04 DO NOT TOUCH OR MOVE
• Review the entire application to determine if an Assisted Living Facility is listed. Be sure to check the notes at the bottom to identify the type of assistance being requested. If there is no Assisted Living Facility listed on the Harmony application, contact the applicant to verify they are not currently in a facility.
• If the applicant is requesting ADvantage in the home, the application will remain in the county to be completed and ADvantage certified.
• If the applicant is requesting Assisted Living and is residing in an Assisted Living, email ADvantageAL@okdhs.org to see if this is a true Assisted Living application and needs to be assigned/reassigned to the appropriate AL worker.
• If the applicant is requesting Assisted Living but is residing in their home, the application will remain in the county to be completed and ADvantage certified.

***Once the Assisted Living Referral has been completed in Harmony by the Case Manager and member moves into the ADvantage Certified AL, the case will then be transferred to the MSU Assisted Living Unit***

2. If Applicant moves into AL during financial application process:

• If applicant moves into the AL during the financial process the application will remain in the county to make a financial determination.
• Do NOT put the AUSW line in “F” status once financial eligibility has been determined
• Send email to ADvantageAL@okdhs.org before certification.
• AL Unit will request certification and add additional required documents in Harmony.

***If the applicant is requesting Assisted Living and is residing in an Assisted Living, email ADvantageAL@okdhs.org to see if this is a true Assisted Living application and needs to be assigned/reassigned to the appropriate AL worker.***

 How to Determine an Assisted Living Annual Review

 **Annual Reviews will remain with the Assisted Living Unit**

1. Check the EKL lines.

• If there is an open ADvantage line and an open AL Provider line, please email ADvantageAL@okdhs.org for verification if the case should remain in the county or be assigned to the prior AL worker.

2. Check to see whom the case was assigned to prior to receiving it.

• If assigned to any of the following workers: 00c55001, 00c5502, 00c5503, 00c5504, or 00c5505, please send an email to ADvantageAL@okdhs.org for verification if the case should remain in the county or reassigned to the prior AL worker. Do NOT touch or make any changes to the case.

Do NOT change the Living Arrangement box under the Household tab.

Members/Applicants living in an Assisted Living cannot receive SNAP benefits.

If you have additional questions or need more clarification, please reach out to us through the ADvantageAL mailbox at ADvantageAL@okdhs.org