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West Virginia Income Maintenance Manual Chapter 23
West Virginia Income Maintenance Manual Page 49 Chapter 23 Specific Medicaid Requirements
• Income is not deemed. • The MNIL for one person is always used. • The spenddown amount is determined on a monthly basis. When the monthly Medicaid rate for the facility in which the client resides equals or exceeds his monthly spenddown amount, the spenddown is assumed to be met and Medicaid eligibility is established. The Medicaid daily rate for the facility is multiplied by 30 to determine the average monthly rate. The daily rates for all Medicaid are found only on the DFA intranet page. The rates are updated semi-annually. 23.11.5.C Individuals Receiving Home and Community-Based Services under Title XIX Waivers Income Assets 300% SSI Payment Level $2,000 Individual The DOHS has elected to provide Medicaid to individuals who would be eligible for Medicaid if institutionalized and who would require institutionalization was it not for the availability of home and community-based services. To qualify, an individual must be aged/disabled, intellectually/ developmentally disabled, or have a traumatic brain injury. The waiver programs are: • ADW (Aged and Disabled Waiver) (Code: MALH, MALW – pending waiver slot) • I/DD (Intellectual/Developmental disability) Waiver (Code: MALM) • TBI (Traumatic Brain Injury) Waiver (Code: MALH w/reason code 709) • CSED (Children with Serious Emotional Disorder) Waiver (Code: MALM w/reason code 730) Details about the AD (aged/disabled) Waiver, I/DD (intellectual/developmental disability) Waiver, CSED (Children with Serious Emotional Disorder) Waiver, and TBI (traumatic brain injury) Waiver are found in Chapter 24. The determination of which income to count is the same as SSI-Related Medicaid, see Chapter 4. No income is deemed to the client. The client's monthly gross non-excluded income is compared to 300% of the maximum SSI payment for a single individual. The determination of countable assets is the same as for SSI-Related Medicaid, see Chapter 5. The SSI-Related Medicaid asset limit for one person is used.