| (a) To be eligible for a CFC service, an individual
must:
(1) be eligible for medical assistance under the state
plan;
(2) as determined annually, be in an eligibility group
under the state plan that includes an institutional level of care;
and
(3) receive a determination, at least annually, that
in the absence of the home and community-based personal assistance
services and supports, the individual would otherwise require the
level of care furnished in a hospital, a nursing facility, an intermediate
care facility for individuals with an intellectual disability or related
condition, an institution providing psychiatric services for individuals
under age 21, or an institution for mental disease for individuals
age 65 or over, if the cost could be reimbursed under the state plan.
(b) Individuals who qualify for medical assistance
under the special home and community-based waiver eligibility group
defined at section 1902(a)(10)(A)(ii)(VI) of the Social Security Act
must meet all section 1915(c) waiver requirements and receive at least
one home and community-based service per month.
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