SUBJECT:
ALLOCATION OF INCOME BEFORE ASSETS TO MEET THE NEEDS OF A COMMUNITY SPOUSE
MANUAL REFERENCE 1030.035.00
DISCUSSION:
Senate Bill (SB) 539 requires the allotment of an institutionalized spouse's (IS) income to the community spouse (CS) prior to the raising of the CS's share of the couple's assets in an administrative hearing. If the IS can provide enough monthly income to raise the CS's income to the Minimum Monthly Maintenance Allowance (MMMA), the CS's share of the assets will not be raised. SB 539 added this requirement as subsection 12 of RSMo. Section 208.010.
This change applies to administrative hearings on Medical Assistance (MA) vendor nursing facility applications made on or after August 28, 2005.
There is no change in the way Family Support Division (FSD) caseworkers determine the community spousal share of assets in the Division of Assets or process MA vendor applications. If the applicant is ineligible for assistance based on available resources, the application will be rejected. The applicant or the community spouse may request a fair hearing within 90 days of the date of the rejection notice.
If a hearing is requested, the Hearing Officer (HO) will first look at the income of the IS and CS before determining if the CS needs a higher share of the couple's assets. If the income of the CS is less than the current MMMA ($1604.00), the HO will determine the maximum amount of the IS's income that could be allocated to the CS. If that amount is enough to raise the CS's income to the MMMA, no additional assets will be set aside for the CS. If the income of the IS is not sufficient to raise the CS's income to the MMMA, all or a portion of, the couple's assets may be awarded to the CS.
NECESSARY ACTION:
- Share this memorandum with appropriate staff as soon as possible.