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3455.14.00 INSTITUTIONAL AND HCBS WAIVER ELIGIBILITY BUDGETING UNDER THE SPECIAL

INCOME LEVEL (MED 1)

The Special Income Level (SIL) test is a specific financial eligibility determination that applies only to the Aged, Blind, and Disabled categories for individuals who either reside in an institution or are eligible to receive home and community-based services under a waiver (including those invited off the waiver waitlist). The Special Income Level (SIL) standard is 300% of the maximum benefit payable under the SSI program. The SIL increases annually when SSI increases in January. Refer to Chapter 3000 for the SIL amount. There is no couple SIL for a married applicant/recipient. Only the income of the applicant/recipient is included in the SIL test. Income of parents and spouses is not included. Countable income in the SIL test is as follows: • Gross earnings (no exemptions, and no employment disregard) • Net rental income (Section 34.20.05, 3420.05.05, 3415.10) • Net self-employment income (Section 3410.15) • All gross unearned income except SSI and German Reparations13 Payments. The amount of any income placed into a Miller trust as defined in IHCPPM 3320.10.00 and/or IHCPPM 2615.75.15, is exempt in the SIL test. The amount of income placed into the trust could be the entire amount or a portion. Income placed into the Miller trust counts in the post- eligibility calculation. If countable income is equal to or less than the SIL, the person passes the SIL test. This applies to people who pass the SIL Test and reside in a Medicaid certified long-term care (LTC) facility or hospital Effective 6/1/2014, any applicant or recipient whose countable income is over the applicable standard for the SIL test must establish an approved Miller Trust and must be place income into the trust to allow the person to pass the SIL test. Otherwise, the person would be considered categorically ineligible for Medicaid on and after 6/1/2014. A person who is serving a transfer property penalty may be considered categorically eligible for Medicaid by passing the SIL. A person who is or would be serving a transfer property penalty cannot be considered categorically eligible without passing the SIL. When a person serving a transfer penalty passes the SIL, there will not be a post-eligibility budget. Medicaid will not pay for the long-term services and supports (including nursing home level of care or HCBS waiver services) provided to the member during a transfer penalty. 3455.15.00 POST-ELIGIBILITY BUDGETING (MED 1)