Home & Community Based Services For Children
Nursing Facility Level of Care Criteria:1. The child is dependent on medical equipment on a daily basis; or
2. Skilled nursing care or comprehensive rehabilitative interventions are necessary, including:
- Medications are necessary throughout the day
- There is a high probability for complications or adverse reactions
- Specialized professional training and monitoring are needed to assist parents
- The child’s condition substantially interferes with the ability to engage in everyday activities and perform age appropriate activities of daily living at home and in the community
- The daily routine is altered by the need to complete these specialized treatments or the need for assistance with self care activities.
- The child’s condition is expected to last at least one year
- Hands on nursing or rehabilitative care must be provided daily
- The child requires direct hands on assistance to perform treatments.
Hospital Level of Care Criteria:1. The child has a severe, chronic health condition that is expected to last for at least one year.
2. The child requires a skilled nursing level of care daily including:
- Hands on medical interventions
- Rehabilitative care
- Direct medical monitoring
- Intense medical regimen
- Substantial amount of time to complete
- Training to perform treatment safely
- The ability to recognize changes that require prompt interventions
- The ability to modify treatment plans during the day.
- Children needing an organ transplant
- Children on a ventilator
- Children in the hospital over 30 days and cannot discharge without services.
- Children receiving Hospice
Application ProcessApply for Long Term Care Medicaid:
- In person at your County Human Services office
- Apply online
* An SSI denial letter will be requested from the parent by your case manager and is only needed at the time the child enters the program.
* The final decision on eligibility is determined by the Department of Health Care Policy & Financing (HCPF)