Page 309

Medical Services Policy Manual, Section H

H 400 Post Eligibility

6. Spousal support payments for the community spouse and Family Member Allowance (MS H-410 #4-6) 7. Applicable income trust fees (MS H-111 #3) 8. Earnings up to the monthly SSI/SPA amount if employment is prescribed as therapeutic by the attending physician The ALF recipient’s income, minus room and board, personal allowance, and certain other expenses, will be contributed to their cost of care each month. H-413 Contribution to the Costof Care for PACE MS Manual 08/29/22 Post-eligibility treatment of income provisions will apply to PACE participants upon entry into a nursing facility using the procedures for Long-Term Services and Supports (LTSS) nursing facility Health Care. Refer to MS H-410. For PACE participants in the community, there is no cost of care unless the individual has income over the income limit and has established an income trust. For income trust guidelines, refer to MS H-110. The eligibility worker will calculate a patient liability amount for those PACE participants in nursing homes and those who are eligible through establishing an Income Trust. The patient liability amount will be calculated in the electronic record. The PACE provider will collect and retain the patient liability. For individuals in nursing facilities, a personal needs allowance (PNA) equal to the current nursing facility PNA, any applicable community spouse allowances, family allowances, court-ordered child support, court-ordered spousal support, and excess medical expenses will be deducted from the PACE participant’s monthly income. Refer to MS H-410. For individuals in the community who are eligible through establishing an income trust, income in excess of the current LTSS Health Care limit will also be paid to the PACE provider. A personal needs allowance equal to the current LTSS/PACE limit of three (3) times the current SSI standard payment amount (SPA), plus any applicable spousal or family support or excess medical expenses will be deducted before making payment to the PACE provider.