Family Healthcare (FAMIS)

0955.005.05 INSTITUTIONAL CARE AND LIVING ARRANGEMENTS (MACC)

Eligible living arrangements for MACC include publicly operated community residences, private institutions, and foster homes.

  1. Publicly Operated Community ResidenceMedicaid is not available to individuals living in public institutions. This is defined as an institution that is the responsibility of a governmental unit or an institution over which a governmental unit exercises administrative control.However, an institution that otherwise meets the public institution definition is considered an eligible institution for MACC if it is a publicly operated community residence which serves no more than sixteen (16) residents and is not:
    • a residential facility located on the grounds of, or immediately adjacent to, any large institution or multiple purpose complex;
    • an educational or vocational training institution that primarily provides an approved, accredited, or recognized program to individuals residing there; or
    • a correctional or holding facility for individuals who are prisoners, have been arrested or detained pending disposition of charges or are held under court order as material witnesses or juveniles.

    publicly operated community residence is further defined as one which:

    • is designated or has been changed to serve no more than sixteen (16) residents and it is serving no more than sixteen (16); and
    • provides some services beyond food and shelter such as social services, help with personal living activities, or training in socialization and life skills. Occasional medical or remedial care may also be provided.

    If the child is in a public residence, the facility must meet the definition of a publicly operated community residence.

  2. Private Institutions or Foster HomesDMH/DYS children are in eligible living arrangements for MACC in the licensed or approved PRIVATE settings listed below which are NOT restricted to sixteen (16) or less residents:
    • family foster homes;
    • group homes;
    • residential care centers; and
    • residential schools/learning centers.

If a child is living in one of the eligible living arrangements, as designated above, (s)he may be eligible for the Medical Assistance for Children in Care (MACC) program.