The Implications to Medicaid Long Tenn Care Eligibility for Employed and/or Previously Employed Clients
Colorado Department of Health Care Policy and Financing
1570 Grant St., Denver, CO 80203-1818
NUMBER: HCPF 12-006
DIVISION OR OFFICE: Medical and CHP+ Program Administration Office
SUBJECT AREA: Nursing Facility Level of Care Functional Assessment
SUBJECT: The Implications to Medicaid Long Tenn Care Eligibility for Employed and/or Previously Employed Clients APP~7V
TYPE: 1 -Information
APPROVED BY: Indeciferable Initials
HCPF Agency Letters can be accessed online at:
The purpose of this letter is to provide policy clarification regarding paid and volunteer work for adults who are applying or being re-determined for long-term care services. This clarification is directed to Single Entry Point agencies (SEPs), Community Centered Boards (CCBs), private case management agencies and financial eligibility partners.
Clients and advocates have expressed concern that past or present work activity may adversely affect an individual's functional eligibility for Medicaid Long Tenn Care (LTC) services. While work earnings may impact an individual's financial eligibility for services, paid and volunteer work alone should not affect an individual's functional eligibility for Medicaid LTC.
The Uniform Long Tenn Care 100.2 (ULTC 1 00.2) assessment tool is used in part to determine functional eligibility for Medicaid LTC services. Many individuals are able to work and unable to complete activities of daily living (ADLs), as listed in the ULTC 1 00.2, without assistance.
The Department understands that people who are engaged in activity and have valued community roles have better health outcomes and encourages Medicaid LTC clients to be actively engaged in their communities. This may involve paid work for some and education or
volunteer work for others. Some individuals may choose not to be actively engaged in their communities but all should know that, absent a functional change in condition, either choice will not affect their assessed score and their ability to access Medicaid LTC benefits.
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W. Sean Bryan @ email@example.com