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Title 8: Medicaid Page 9 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Attribution of Resources Revised September 13, 2024 Calculating the Amount to Attribute to the…

3. Mr. M enters a facility in January 2016. Mrs. M remains at home. The Ms file an application for medical assistance for Mr. M in August 2016. An attribution of resources is completed. Mrs. M is attributed $24,000. The Ms have $6,000 in resources. The application is approved. The review form is sent out in January 2017 and not returned. The case is canceled effective February 1, 2017. Another application is filed in March 2017. The Ms now have $42,000 in resources. The worker subtracts the current year’s community spouse resource allowance. The remaining resources exceed the resource limit. The worker issues an NOD denying the application in March 2017. Mr. M files an appeal regarding the NOD. A hearing is granted. The final appeal decision attributes additional resources to Mrs. M. The couple’s income is low enough that the average of the annuities, $99,424, is used to set aside additional resources for Mrs. M. The new community spouse resource allowance exceeds the current resources owned by Mr. and Mrs. M. The March 2017 decision to deny the application based on excess resources is reversed. Verify the couple’s available gross monthly income. Do not count income that is earned by resources used in the attribution process. When determining gross monthly income, include any income the community spouse or institutionalized spouse may be entitled to but is not receiving. When the community spouse works only part of the year and received income only during the time worked, annualize the income as directed in 8-E, Determining Income from Self-Employment. For couples where one spouse entered an institution before February 8, 2006, county only the community spouse’s income. For couples where one spouse entered an institution on or after February 8, 2006, consider the institutionalized spouse’s income that can be made available to the community spouse according to the facility client participation calculation. See 8-I, Deductions from Client Participation. Allow a $50 personal needs allowance deduction from the gross countable income of the institutionalized spouse for facility, HCBS waiver, or PACE applicants.