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INCOME PERSONS IN MEDICAL FACILITIES

CHRONIC CARE BUDGETING METHODOLOGY FOR INSTITUTIONALIZED SPOUSES

Policy: Chronic care budgeting procedures are used for institutionalized spouses in permanent absence status. References: SSL-Sect. 366

366-ee

Dept. Reg. 360-4.9

360-4.10

ADMs 10 OHIP/ADM-01

95 ADM-19

92 ADM-32

89 ADM-47

GISs

09 MA/027

01 MA/021 Interpretation: An institutionalized spouse as defined in the Glossary is in permanent absence status as of the month of institutionalization or the month s/he begins receiving home and community-based waivered services. Chronic care budgeting begins the first day of the first month following the establishment of permanent absence.

NOTE: Spousal rules and definitions apply to an institutionalized S/CC or ADC-related individual who has a community spouse and is seeking Medicaid coverage. For such individuals, there will be no coverage for nursing home care until the individual has been certified disabled. An institutionalized spouse's eligibility for Medicaid and the amount of his/her income applied to the cost of his/her medical care are determined by making the appropriate deductions from his/her available monthly income. The local district may not require that the following income of the A/R be applied toward the cost of care:

BLOOD PLASMA SETTLEMENTS - Payments received as a result of a federal class action settlement with four manufacturers of blood plasma products on behalf of hemophilia patients who are infected with human immunodeficiency virus (HIV).

CASH ASSISTANCE INCOME - SSI benefits paid under Section

(MRG)