(b) In addition, the following noninstitutional services are provided under specified conditions: Outpatient clinic care, laboratory services, nursing home care, physicians' services, emergency care, merication, dental care, eye care, medical appliances, examinations and remedial care for certain individuals preparing for school or other training, and rehabilitation center

care.

The program is limited to individuals eligible for a money payment, except for residence, under the State's approved plans for aged, blind, and disabled, and children under age 21 eligible under the State's approved AFDC plan, except for age and school attendance. The State agency issues identification cards to eligible individuals.

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6. What are the terms of financing the new program?

Louisiana is entitled to receive from the Federal Government approximately 76 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Louisiana during fiscal year 1967 (July 1966-June 1967) will be $27,767,000.

7. How many persons are served by the new program?

It is estimated that 155,000 persons, about 4.5 percent of the population, would receive assistance under title XIX in the first fiscal year of operation (1967).

MAINE

1. Name of State agency responsible for administering title XIX: Department of health and welfare.

2. Date program began operation: July 1, 1966.

3. What groups became eligible when the program began?

(a) All persons who receive all or part of their income from the federally aided public assistance programs: Aid to families with dependent children and aid to the aged, blind or disabled, including inpatients 65 years of age and over in institutions for mental diseases.

(b) All persons who would be eligible for federally aided public assistance, noted in group (a) above, except for any other eligibility condition or other requirement in such plan that is specifically prohibited in a program for medical assistance under title XIX.

(c) All persons in a medical facility who are not receiving a money payment but who, if they left such a facility, would be eligible for a money payment under the plan for the programs noted in (a) above.

4. What are the maintenance levels for persons eligible for coverage? The public assistance standards in the money-payment programs listed above will serve as the maintenance levels, as Maine is not going to cover nonassistance groups initially.

5. What are some of the major features of the (State) medical assistance program?

(a) Inpatient hospital services.

(b) Outpatient diagnostic hospital services.

(c) Skilled nursing home service.

(d) Other laboratory and X-ray services.

(e) Physicians' services.

(f) Home health services.

(g) Other ancillary services, e.g., drugs (limited to inpatient hospitalization administered by a physician), prosthetic devices, and ambulance service. (h) Use of medical identification card and use of declarations in establishing eligibility for medical assistance.

6. What are the terms of financing the new program?

Maine is entitled to receive from the Federal Government approximately 70 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Maine during fiscal year 1967 (July 1966-June 1967) will be $5,566,000.

7. How many persons are served by the new program?

The State estimated that about 45,000 persons, or about 3.1 percent of its population, would be served by this program during the first year.

MARYLAND

1. Name of State agency responsible for administering title XIX: Department of health.

2. Date program began operation: July 1, 1966.

3. What groups became eligible when the program began?

All residents of the State who are in need of medical care and cannot pay for all or part of such care. This includes persons receiving public assistance under the various programs for the aged, blind, disabled, and families with dependent children.

4. What are the maintenance levels for persons eligible for coverage?

The following annual income levels represent the amounts Maryland permits. individuals or families to hold for their everyday living costs. Any income in excess of these amounts must be applied to costs of medical care:

(a) For a single person: $1,800.

(b) For a family of four: $3,120.

5. What are some of the major features of the (State) medical assistance program?

(1) Inpatient: 3 days with initial extension up to 15 days; further extension as required by patient's need for continued care at the general hospital level.

(2) Nursing home care: 6 months; with further extensions requiring certification of medical need.

(3) Physicians' services in office, home, or nursing home, or approved OPD: Without limit as to number of visits.

(4) Blood: The first 3 pints, when not available from other sources. (5) Outpatient hospital services.

(6) Other laboratory and X-ray.

(7) Prescribed drugs and medical supplies.

(8) Dental services: Within budget limitations.

(9) Home health care: Where available; with plans to establish agencies in all counties and Baltimore City. Meanwhile, supplement with public health nursing services.

(10) Physical therapy and related services.

(11) Services to aged in TB and mental institutions.

(12) Clinic services, MCH, CC, family planning, community services for mentally ill and mentally retarded.

(13) Ambulance service.

6. What are the terms of financing the new progrm?

Maryland is entitled to receive from the Federal Government approximately 50 percent of the costs of operating its medical assistance program.

It is esti

mated that the Federal share of the cost of operating the program in Maryland during fiscal year 1967 (July 1966-June 1967) will be $16,857,000.

7. How many persons are served by the new program?

The State estimated that 350,000 persons, or 9.7 percent of its population, would be entitled to benefits under this program. Of this number, some 260,000 individuals were expected to receive medical care services in the first year. 8. Financial eligibility to determine persons who are medically needy: Amount protected for maintenance needs:

(a) Income scale beginning with annual net income of $1,800 for one person and $2,280 for two persons plus $480 for each additional person. A person receiving continuing care in certain specified medical institutions may retain $10 of monthly income for personal needs and, if likely to return to his home in future, an amount necessary to maintain the home.

(b) Assets.-Real property: May have home, unless it represents a substantial investment. Other assets up to $2,500 for families of one or two persons, plus $420 for each additional person.

MASSACHUSETTS

1. Name of State agency responsible for administering title XIX:

(a) State department of public welfare for the part of the plan relating to individuals other than the blind.

(b) State commission for the blind for the part of the plan relating to the blind.

2. Date program began operation: September 1, 1966.

3. What groups became eligible when the program began?

(a) All persons who receive all or part of their incomes from the federally aided public assistance programs: Old-age assistance, aid to the blind, aid to families with dependent children, and aid to the permanently and totally disabled.

(b) All persons who, except for having enough income for their daily needs (under State assistance standards), could qualify for public assistance under the Federal eligibility requirements.

(c) All children (under 21) who could not qualify for public assistance, but whose income and resources are insufficient to pay for all or part of the cost of the medical care they need. (This includes families in which the parents are working but do not earn enough to pay for medical expenses.) 4. What are the maintenance levels for persons eligible for coverage?

The amount of income they have will be taken into consideration in determining what people are eligible. In general, however, income at or below the following amounts is considered to be sufficient only for maintenance, and not available for medical care:

(a) For a single person: $2,160.

(b) For a family of four : $4,176.

5. What are some of the major features of the (State) medical assistance program?

(1) Inpatient hospital services;

(2) Outpatient hospital services;

(3) Other laboratory and X-ray services;

(4) Skilled nursing home services;

(5) Physicians' services, whether furnished in the office, the patient's home, a hospital, or a skilled nursing home or elsewhere;

(6) Medical care, or any other type of remedial care recognized under State law, furnished by licensed practitioners within the scope of their practice as defined by State law;

(7) Home health care services;

(8) Private duty nursing services;

(9) Clinic services;

(10) Dental services;

(11) Physical therapy and related services;

(12) Prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select;

(13) Other diagnostic, screening, preventive, and rehabilitative services; (14) Inpatient hospital services and skilled nursing home services for individuals 65 years of ago or over in an institution for tuberculosis or mental diseases;

(15) The first 3 pints of whole blood, when it is not available to the patient from other sources; and

(16) Any other medical care recognized under State law including transportation, ambulance, oxygen, and podiatry.

6. What are the terms of financing the new program?

Massachusetts is entitled to receive from the Federal Government approximately 50 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Massachusetts during fiscal year 1967 (July 1966-June 1967) will be $69,967,000. 7. How many persons are served by the new program?

The State agency estimated that a total of 380,000 cases (2,600 recipients of aid to the blind) would be eligible for benefits under the new program. 8. Relationship to medical insurance programs of title XVIII of the Social Security Act. (Same for both agencies.)

(a) Hospital insurance benefits. For persons over 65 who are categorically needy or medically needy, State will meet Federal requirements regarding payment of deductibles and coinsurance.

(b) Supplemental medioal insurance benefits.-State has entered into a "buy in" agreement for payment of SMI premiums of aged public assistance recipients who are not beneficiaries under OASDI or Railroad Retirement; recipient-beneficiaries under those programs will receive an additional $3 in their monthly assistance grant. Proportion of the deductibles and coinsurance which will be paid by the State agency will be determined on a basis reasonably related to the recipient's income or his income and resources. Financial eligibility to determine persons who are medically needy: Amount protected for maintenance needs in plans of both agencies:

(a) Income scale beginning with annual net income up to $2,160 for one person and $672 for each additional person. In the case of a person re

ceiving care in a licensed nursing home or chronic hospital, or in an approved public medical institution, the first $23.60 a month may be retained for personal needs, and in addition, if married, up to $225 per month of combined total monthly income for the maintenance of a spouse remaining in the home.

(b) Assets. Real property: May own real property used as a home or from which applicant is absent because of mental or physical incapacity; if applicant has ownership interest in any other real property, including vacant land, from which no income is derived, eligibility is conditional upon applicant's agreeing to take immediate and continuing action to dispose of the property. Personal property: Up to $2,000 for one person, $3,000 for two persons, plus $100 for each additional dependent member of the family. Personal property defined as ownership of cash on hand, bank deposits, securities, cash surrender value of insurance, or similar assets readily convertible into cash.

MICHIGAN

1. Name of State agency responsible for administering title XIX: State department of social services.

2. Date program began operation: October 1, 1966.

3. What groups became eligible when the program began?

(a) All persons who receive money payments under federally aided public assistance programs: Old-age assistance, aid to the blind, aid to families with dependent children, and aid to the permanently and totally disabled, and residents who would be eligible for one of the programs except for meeting durational residence requirements and those who would be eligible except for any other eligibility condition or requirement in such plan that is prohibited under title XIX.

(b) All residents who, except for having enough income for their daily needs (under State assistance standards), could qualify for public assistance under the State's eligibility requirements.

(c) Persons 65 and over who are patients in institutions for tuberculosis and for mental diseases.

(d) All categorically needy children under 21, who would be, except for age and school attendance, dependent children under the approved title IV plan, and the relatives with whom they are living, and similar groups who are medically needy.

4. What are the maintenance levels for persons eligible for coverage? The following annual income levels represent the amounts Michigan permits individuals or families to hold for their living costs. Any income in excess of these amounts must be applied to costs of medical care.

(a) For a single person: $1,900.

(b) For a family of four : $3,540.

5. What are some of the major features of the medical assistance program? (a) The scope of care and services provided for in the Michigan plan is very broad and will be the same for the categorically needy and the medically need. Institutional and noninstitutional care is given.

(b) The major features are:

Inpatient and outpatient hospital services including the physicians' services; other laboratory and X-ray services;

Skilled nursing home care;

Inpatient hospital and skilled nursing home services for persons 65 or over in institutions for tuberculosis and mental diseases; and ambulance service to obtain medical care.

6. What are the terms of financing the new program?

Michigan is entitled to receive from the Federal Government approximately 50 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Michigan during fiscal year 1967 (July 1966-June 1966) will be $21,070,000.

7. How many persons are served by the new program?

It is estimated that 4 percent of the population of the State, or 330,000 persons, would be served by this new program during the first year.

8. Financial eligibility to determine persons who are medically needy:

Amount protected for maintenance needs:

(a) Income scale beginning with annual net income of $1,900 for one person, $2,700 for a family of two, plus $420 for each legal dependent.

This income scale applies to persons considered to be in a family-living situation. For an individual in a skilled nursing home or hospital more than 1 month who is not maintaining a family home for himself, spouse, or a blind, disabled, or minor child, the protected income level is $20 a month, or $240 a year; if maintaining a home for his own return for which he has continuing expenses for care, maintenance, and upkeep, the protected income level is $35 a month or $420 a year. A child who has been released to an adoption agency, or made a permanent or temporary court ward, and who is living outside his own home, may retain $20 a month in excess of the charges for room, board, and care.

(b) Assets. Real property: May have homestead. Other property: May have up to $1,500 for one person, $2,000 for two persons, plus $200 for each additional person. Clothing, household effects, $1,000 cast surrender value of life insurance, and the fair market value of tangible personal property used in earning income are excluded from consideration.

MINNESOTA

1. Name of State agency responsible for administering title XIX: Department of welfare.

2. Date program began operation: January 1, 1966.

3. What groups became eligible when the program began?

(a) All persons who receive all or part of their incomes from the federally aided public assistance programs: Old-age assistance, aid to the blind, aid to families with dependent children, aid to the permanently and totally disabled, and persons who would be eligible for the programs except for meeting durational residence requirements.

(b) All persons who, except for having enough income for their daily needs (under State assistance standards), could qualify for public assistance under the Federal eligibility requirements.

(c) All children (under 21) who could not qualify for public assistance, but whose families cannot afford to pay for all or part of the cost of the medical care they need. (This includes families in which the parents are working but do not earn enough to pay for medical expenses.)

4. What are the maintenance levels for persons eligible for coverage? The amount of income they have will be taken into consideration in determining what people are eligible. In general, however, income at or below the following amounts are considered to be sufficient only for maintenance, and not available for medical care:

(a) For a single person: $1,600.

(b) For a family of four : $3,000.

5. What are some of the major features of the (State) medical assistance program?

Services go beyond the basic five: Inpatient hospital care, outpatient hospital care, physicians' services, nursing home services for adults, and lab and X-ray services. Minnesota provides "whatever the doctor orders."

6. What are the terms of financing the new program?

Minnesota is entitled to receive from the Federal Government approximately 60 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Minnesota during fiscal year 1967 (July 1966-June 1967) will be $41,689,000. Actual cost to the Federal Government during fiscal year 1966, in which the program was in operation for 6 months (January 1966-June 1966), was $20,556,664.

7. How many persons are served by the new program?

The State estimated that 72,600 persons would be served by this program during the first year.

8. Financial eligibility to determine persons who are medically needy: Amount protected for maintenance needs:

(a) Income scale beginning with $1,600 for a single person and $2,200 for two persons, plus $400 for each additional legal dependent. For persons in long-term institutional care, the sole amount protected is $5 per month for bed-ridden patients, $9 per month for partially ambulatory patients, and $11 per month for ambulatory patients.

(b) Assets. Real property: Equity in real property not to exceed $15,000. Personal property: Liquid assets up to $750 for single person and $1,000 for 2 persons, plus $150 for each legal dependent.