Supplemental Nursing Care

0610.025.00 DETERMINATION OF FINANCIAL NEED AMOUNT

IM-#30 April 4, 2008

Determine the SNC participant’s countable income by subtracting any excluded income, overhead expenses, and the Supported Employment Income Disregard (if applicable) from their gross income.

Determine financial need by subtracting the countable income from the amount of the basic nursing facility or residential charge and round to the nearest dollar. The participant or the facility must provide theĀ MONTHLY BASE RATE.

The basic nursing facility charge means the nursing facility’s base rate for patient care, excluding any additional charges for personal expenses, clothing, etc.

The basic Residential Care Facility (RCF) or Assisted Living Facility (ALF) charge means the RCF’s or ALF’s base rate for room, food and laundry service (not personal laundry).

For DMH alternate care placements, a copy of the DMH contract showing the basic Residential Care Facility (RCF), Assisted Living Facility (ALF), or nursing facility charge must be obtained before the application can be approved. If DMH refuses to provide this copy, reject the application.

NOTE: Basic nursing facility rates may vary between facilities and within facilities. Use the specific monthly contracted rate that the participant and the facility, and/or Department of Mental Health have agreed upon.

If necessary, compute the base rate from a contracted daily charge by multiplying the daily charge by 365 days and then dividing by 12 months to arrive at the contracted rate.

When the AB eligibility criteria are used, there are two options for determining the need and grant.

OPTION 1: Determine the need and grant by subtracting the participant’s countable income (follow the income exclusions and deductions given in sections 0610.005.00 through 0610.020.00) from the basic nursing or residential care facility charge and round the deficit up to the appropriate maximum.

OR

OPTION 2: Determine the need by completing an SAB need determination on the Income Maintenance Budget (IM-30) following the policy in Section 0410.000.00. If there is need, determine the grant by taking the current Blind maximum and subtracting the SSI amount the individual receives.

Use the option which greater benefits the participant.