What are the criteria for Medicaid eligibility?
A resident must be aged or disabled, have no more than $2,000 in assets (with certain exceptions), and income no more than the current "MEDS A/D" threshold. The income threshold is currently $665 per month, but will probably increase slightly in February or March of 2002. To apply for Medicaid, an individual should contact the local Department of Children and Families service center. More information about eligibility can be found on the Agency for Health Care Administration web site.

What is Optional State Supplementation?
OSS is a cash assistance program administered by the Department of Children and Families. Its purpose is to supplement a person's income to help pay for costs in a special living arrangement. It is not a Medicaid program. This Program has been re-designed to provide the state funds for the federal Medicaid match to create Assistive Care Services.

What are the eligibility criteria for OSS?
People who are at least 18 years old, have no more than $2,000 in resources, have income that is below the eligibility standard, meet certain other technical requirements, and are certified by the state as needing to live in a licensed care facility. The Department of Children and Families determines whether a person is eligible for OSS. As of January 1, 2002, the income standard for residents of assisted living facilities, adult family-care homes, and qualified residential treatment facilities will be $623.40.

Will recipients in ACS-qualified residences continue to receive OSS?
For recipients in facilities in which ACS is being implemented, about 90 percent of recipients eligible for ACS will continue to receive an OSS check. Residents with incomes below the income threshold will continue to receive a small OSS payment (up to $78.40), but residents with incomes above this level (about 10% of the current caseload) will no longer receive an OSS payment. However, the reimbursement providers receive for caring for all of these residents will increase by about 16% overall if they enroll in Medicaid.

What about recipients in other residences?
The following OSS recipients will remain eligible for the existing OSS Program, which provides reimbursement of $730 per month (as of January 2002) to the provider:

• OSS recipients who reside in non-qualifying RTFs.


• Current OSS recipients who are not Medicaid-eligible (those with incomes above $665 per month who were admitted prior to September 1, 2001).

Will recipients have money for their personal needs?
All ACS recipients are entitled to keep a minimum of $54 for personal needs whether they receive an OSS payment or not.

How will recipients find out about the changes?
All OSS recipients who experience a change as a result of OSS/ACS re-design receive notices at least 10 days in advance from DCF explaining the changes. AFCH recipients will be receiving notices in December notifying them of the changes to come in January 2002. RTF residents will also be notified of any change resulting from the RTFs enrolling in ACS.

Will recipients experience any changes in their care as a result of ACS?
The services the resident receives are expected to be the same, assuming that these are the services the resident needs and that the facility is in compliance with licensure standards.

What will happen to recipients if the facility does not participate in ACS?
If the facility is qualified to participate in ACS but does not enroll, the facility may choose to keep the resident at the reduced provider rate ($569.40 per month as of January 2002). If the facility chooses to discharge the resident, the resident must be given a written notice at least 45 days in advance of the discharge. Case managers in the Department of Children and Families are prepared to assist any such residents with relocation to a participating facility.