IM-45 06/13/08 INCREASES IN VENDOR MINIMUM MAINTENANCE STANDARDS AND SHELTER STANDARDS ADJUSTMENT IN VENDOR CASES

TO:	ALL COUNTY OFFICES
FROM:	JANEL R. LUCK, DIRECTOR
SUBJECT:	INCREASES IN VENDOR MINIMUM MAINTENANCE STANDARDS AND SHELTER STANDARDS ADJUSTMENT IN VENDOR CASES VENDOR MANUAL REVISION #18: APPENDIX B

DISCUSSION:

On June 14, 2008, the Information Technology Services Division and the Family Support Division will adjust Vendor cases with allotments based on changes effective July 1, 2008.

Allotments for community spouses, minor children, and eligible dependents and the Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Standard are revised for actions effective the month of July 2008 and later. The revised guidelines effective July 2008 are:

Minimum Maintenance Standard:	$1750.00
Shelter Standard:	$ 525.00

Use the current standards for allotment and surplus determinations completed prior to the mass adjustment. After the adjustment, determine allotments and surpluses for July 2008 and later using the new standards. The Vendor Manual Appendix B has been revised.

EXAMPLE: Ms. Landon is a resident in a nursing facility. She applies for vendor benefits on 7/3/08. Mr. Landon, her spouse, still lives in their home in the community. Ms. Landon has income of $2000.00 per month. Mr. Landon has income of $1200.00 per month. His house payment, including taxes and insurance is $950.00 per month. He provides verification that he pays utility expenses for heat. Ms. Landon will make available to Mr. Landon as much of her income as the Family Support Division will allow.

Total Shelter Expense:	$1202.00 ($950.00 + $252.00 utility standard)
Minus Shelter Standard:	$ 525.00
Excess Shelter Expense:	$ 677.00

Minimum Maintenance Standard:	$1750.00
Plus Excess Shelter Expense:	$ 677.00
Total Maintenance Standard:	$2427.00 (< Maximum of $2610.00)
Minus Mr. Landon's Income:	$1200.00
Allotment Amount:	$1227.00

For mass-adjusted cases, State Office will determine the new allotment amounts, the resulting surplus amounts, adjust the case, and send the appropriate adjustment notices to participants and nursing facilities. Turnaround IM-5 forms will not be generated for this adjustment.

State Office and county office responsibilities in handling this allotment adjustment

Calculating new surplus amounts for cases with community spouses, minors, or eligible dependents:

If the case contains a community spouse, minor or eligible dependent and has “N” or “Y” in Field 13Q (Main. Std.), State Office will determine a proposed new allotment amount using the revised standards. The difference between the current and new allotment amounts will be added to Field 33 (Expense) and the new surplus/deficit amount will be determined and added to Field 35 (Deficit/Surplus).
State Office actions as a result of the new surplus amounts:
1. If the new surplus amount is a decrease in surplus, the case will be adjusted during the mass adjustment and a notice will be sent to the participant. State Office will include the case on a listing for each county, “Cases Adjusted,” with reason “Surp. Dec” and will mail a separate listing for each nursing facility.
2. If either the current or the new amounts for Field 35 is 0.00 or a deficit, the case will adjust and a notice will be sent to the participant.
  
  These cases will be included on the “Cases Adjusted” listing with reason “No Chg.” and a separate listing will be mailed for each nursing facility.
3. If the new surplus amount represents an increase, the case will not be adjusted. We do not anticipate increases in surplus amounts due to this adjustment. Any such cases will be noted on the listing, “Cases Needing Review for Adjustment,” with reason “Surp. Inc.”
County actions needed on listings:
1. “Cases Adjusted.”
  
  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 Eligibility Specialist.
  
  If the new surplus amount was determined using $2610.00 as the Total Maintenance Standard, the “Cases Adjusted” listing will note that a “Y” has been entered in Field 13Q with the message “Max Std = $2610.00” .
  
  If the case was incorrectly coded “Y” (maximum allotment) in Field 13Q as determined by the amounts entered in fields 13O, 13P, 13R and 22, the case will be adjusted. Field 13Q will be changed to “N”. The message will read “Max Std < 2610.00.”
2. “Cases Needing Review For Adjustment.”
  
  None of the cases on this listing will adjust during the mass adjustment. For these cases, determine the new allotment and surplus based on the new standards in this memorandum. Notify the participant and the facility or institution via the IM-62.
  1. Cases that have an “H” or “L” in Field 13Q (Main. Std.). The reason “Review 13Q” will display on the listing.
    
    Review Field 13Q for these cases:
    - Use “H” only if a hearing decision set the allotment amount.
    - Use “L” only if the institutionalized spouse chooses to make an allotment of less than the maximum allowable.
    Change Field 13Q to “N” or “Y” for cases which do not meet either of these criteria. This will allow these cases to be mass adjusted at the next adjustment.
  2. Cases in which the OASDI amount in Field 14M is greater than the amount in Field 13O (income of community spouse field).
    
    The message “OASDI > Income” will display on the listing. Correct Field 14M or 13O as appropriate. Manually adjust the case.
  3. Cases in which the amount entered in Field 33 (Expense) is less than the current maximum allotment amount.
    
    The reason “Max Allot > Exp” will display 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.
  4. Cases in which there is an increase in the surplus. The reason “Surp. Inc.” will display on the listing. If this occurs, re-determine the allotment and surplus based on the new standards contained in this memorandum.
Notices

No adverse actions will be generated for this adjustment. State office will send notices to participants and nursing facilities explaining the changes in surplus amounts.

NOTE: No paper reports or notices will be produced for counties. These documents will be on MOBIUS.

NECESSARY ACTION:

Review this memorandum with appropriate staff.
Take necessary action for cases on the Mobius reports as soon as possible.
After June 14, 2008, use $1750.00 as the Minimum Maintenance Standard and $525.00 as the Shelter Standard.

ATTACHMENTS:

Vendor Notice