Programs |
Manual Section |
ALTCS |
An active ALTCS customer lived in an assisted living home in January 2021. The assisted living home is licensed and registered with AHCCCS. The customer is not married and has no other health insurance. The share of cost calculation is as follows:
Total countable income |
$2200.00 |
Personal Needs Allowance |
-$2349.00 |
Total Share of Cost |
=$0.00 |
On February 23, 2021, the customer moved to a skilled nursing facility. The skilled nursing facility is licensed and registered with AHCCCS. The customer notified AHCCCS of the move on the same day. The new SOC calculation is as follows:
Total countable income |
$2200.00 |
Personal Needs Allowance |
-$119.10 |
Total Share of Cost |
=$2080.90 |
Since the new SOC amount is higher, the customer must be notified of the change 10 days before it is effective. The effective date of the new SOC will be April 1, 2021.
An active ALTCS customer lives in a skilled nursing facility in February 2021. The nursing facility is licensed and registered with AHCCCS. The customer is not married and has no other health insurance. The share of cost calculation is as follows:
Total countable income |
$1823.00 |
Personal Needs Allowance |
-$119.10 |
Total Share of Cost |
=$1703.90 |
On March 10, 2021, the customer moved to an assisted living home. The assisted living home is licensed and registered with AHCCCS. The customer notified AHCCCS of the move the same day. The new SOC calculation is as follows:
Total countable income |
$1823.00 |
Personal Needs Allowance |
-$2349.00 |
Total Share of Cost |
=$0.00 |
Since the new SOC is lower and for the benefit of the customer, the effective date is March 1, 2021.
An active ALTCS customer lives in a skilled nursing facility in January 2021. The nursing facility is licensed and registered with AHCCCS. The customer is not married and has no other health insurance. The share of cost calculation is as follows:
Total countable income |
$2053.00 |
Personal Needs Allowance |
-$119.10 |
Total Share of Cost |
=$1933.90 |
On April 25, 2021, the customer moved to an assisted living facility. The assisted living facility is licensed but is NOT registered with AHCCCS. The customer notified AHCCCS of the move the same day.
Because the assisted living facility is licensed but not registered with AHCCCS, the net income test is used when the customer is in the unregistered facility for the full month. The customer is over income using the net test income limit of 100% of the Federal Benefit Rate for May 2021. The change is an adverse action in which the customer must be notified at least 10 days before it is effective. As a result, the customer will be discontinued for ALTCS effective June 1, 2021.
The customer’s personal needs allowance (PNA) will be increased in April 2021 because the customer is HCBS for part of the month. The increase in the PNA reduces the customer’s share of cost (SOC). A reduction in SOC is not an adverse action and is effective April 1, 2021.