IM-89 06/12/00 INC VENDOR MIN MAINT & SHELTER STANDARDS ADJ
|INCREASES IN VENDOR MINIMUM MAINTENANCE STANDARDS AND SHELTER STANDARDS ADJUSTMENTS IN VENDOR CASES|
|During the weekend of June 17, 2000, the
Division of Data Processing and the Division of Family Services will adjust
Vendor cases with allotments based on changes effective July 1, 2000.
Vendor Adjustments to Allotments and Surpluses
Effective for allotments for July 2000
and later for community spouses, minor children and eligible dependents,
the Minimum Maintenance Standard and the Shelter Standard are revised in
accordance with the new poverty guidelines. In computing these allotments,
use the following amounts:
Use the current standards for allotment and surplus computations completed prior to the mass adjustment. After the adjustment, compute allotments and surpluses for July 2000 and later using the new standards.
For mass-adjusted cases, State Office will compute the new allotment amounts and the resulting surplus amounts. State Office will do the complete adjustment: send adjustment notices to claimants, list the cases for the counties, and send the updated surplus amounts to the nursing facilities. Turnaround IM-5 forms will not be generated for this adjustment.
County office staff must complete adjustments on cases listed on report "Cases Needing Review for Adjustment".
State Office and county office responsibilities in handling this allotment adjustment:
If the case contains a community spouse, minor or eligible dependent and has an "N" or a "Y" in Field 13X (Main. Std.), State Office will compute a proposed new allotment amount using the revised standards. We will then add the difference between the current and new allotment amounts to Field 33 (Expense) and compute the new surplus/deficit amount in Field 35 (Deficit/Surplus).
State Office will include the case on a listing for each county, "Cases Adjusted," with reason "Surp. Dec." We will also print and mail a separate listing for each nursing facility.
These cases will be included on the "Cases Adjusted" listing with reason "No Chg." We will print and mail a separate listing for each nursing facility.
This listing includes cases in which the surplus decreases or does not change. It will be sorted by county and load. It is for information only and does not require action by the caseworker.
None of the cases on this listing will have been adjusted by State Office. In all these situations, compute the new allotments and surpluses based on the standards contained in this memorandum. Notify the claimant and the facility or institution via the IM-62.
The reason "Review 13X" will appear on the listing.
The reason "OASDI > Income" will appear on the listing. Correct Field 13J or 13V as appropriate. Manually adjust the case.
The reason "Max Allot > Exp" will appear on the listing. If the institutionalized spouse intends to make the maximum allotment available to the community spouse, but has insufficient income, add the full amount of the maximum allotment to the other allowable deductions and show the total in Field 33.
The reason "Surp. Inc." will appear on the listing. If this occurs, recompute the allotment and surplus based on the new standards contained in this memorandum.
Adjustment notices on computer actions will be computer-generated. There will be no computer-generated adverse action notices. Letters to nursing facilities will also be computer generated explaining the changes in the surplus amounts. The following are samples of the claimant notice and the notice to the nursing facility.NOTICE TO CLAIMANT:
Dear (case name) (case ID) (date)
Beginning July 1, 2000, the amount of the allotment that may be given to your spouse and eligible dependents increases.
Because of this increase, the allotment you make to your spouse and eligible dependents will be $XXX.XX beginning July 1, 2000. Since all your available income is considered in determining your benefits (13 CSR 40-2.200), the amount you must pay the nursing home or institution will be $XXX.XX beginning July 1, 2000.
We determined the amount you must pay to the nursing home or institution by assuming that the entire allotment will be given to your spouse and eligible dependents. If you do not wish to give the full amount of the allotment stated above to your spouse or eligible dependents, contact your caseworker and an adjustment will be made.
If your income increases, you may give your spouse and eligible dependents up to $XXX.XX monthly.
If you believe this decision is not correct, you have the right to request a hearing within 90 days of the date of this letter.
If you wish to have a hearing, you may advise us by phone, in person or in writing. We will schedule a hearing for you and notify you of the time of the hearing. At the hearing, you may present your case or be represented by someone else including an attorney. You may bring and/or question witnesses.
NOTICE TO NURSING FACILITY OR INSTITUTION
To the Administrator:
Enclosed is a list of patients for whom you receive Nursing Facility (NF), Mentally Retarded (IMR) or Mental Hospital (MHC) payments from the Division of Family Services. Beginning July 1, 2000, the amount of the allotment the patient may make to his/her spouse and eligible dependents is increased. The increase in the allotment amount will change the amount of surplus paid to your facility or institution.
The attached listing shows the name and
Medicaid number of each patient who is making an allotment and the old
and new surplus amounts. The surplus amount shown is effective July
1, 2000, unless you receive a notice (IM-62) mailed from the county office
after June 19, 2000, which indicates a different surplus amount.