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Medical Services Policy Manual, Section H

H 208 Appeal Rights Regarding Changing the CSMNA and/or CSRA H-200 Spousal Impoverishment

If an income allowance greater than the one calculated by the caseworker on the DCO-712 is granted by a hearing officer, the greater amount cannot exceed the current maximum, as shown on the DCO-712. For example, in 2013 the maximum CSMNA is $2898. A CS’s CSMNA computed on the DCO-712, based on rent and utilities, is $2600. The CS’s income is $1800 a month, and the IS is allowed to give the CS $800 per month, giving the CS a total of $2600. The CS establishes that her monthly expenses are $3000, due to exceptional circumstances. A hearing officer may allow the IS to give the remainder of the IS’s income, if any, to the CS (excluding the $40 PNA). If the IS has $298 additional income, it may be given to the CS to bring the CS’s income up to the maximum CSMNA ($1800 + $800 + $298 = $2898, the maximum allowed). No additional amount can be granted to raise the CS’s total income to $3000, because $3000 is over the maximum. REVISION OF COMMUNITY SPOUSE RESOURCE ALLOWANCE If an IS is willing to contribute all of the IS’s monthly income (less the $40 PNA) to the CS and the CS still does not have enough monthly income to raise the income to meet the needs of a CS when financial duress exists, a hearing officer may change the CS’s resource allowance to bring the CS’s income up to the maximum CSMNA. Any additional resources attributed to the CS must be income producing, otherwise the resources would not serve to increase the CS’s income. In determining an increased resource allowance, no resources can be transferred which, along with the CS’s other income (including the income from the IS) would generate total income to the CS in an amount greater than the current maximum CSMNA limit shown on the DCO-712. If a greater Community Spouse Monthly Income Allowance (CSMIA) is awarded by a hearing officer due to extreme financial duress, the county may: • Request the hearing officer to reopen and review the case when the county has reason to believe the exceptional circumstances no longer exist; • Have the hearing officer schedule future hearings to review the circumstances and determine if financial duress still exists; and • Monitor the case(s) to assure that exceptional circumstances still exist, and make adjustments when indicated. The CSRA may be changed by court order, or may be changed by the Agency in the following three instances: 1. By a hearing officer, when either the IS or CS establishes that income generated from the CSRA will be inadequate to meet the minimum monthly maintenance needs