Current through Register Vol. 24-18, September 15, 2024
(1) This section
describes how to calculate the monthly maintenance needs allowance (MMNA) in
post-eligibility treatment of income for long-term care (LTC) programs for a
community spouse or dependent of the institutionalized individual.
(2) The community spouse MMNA standards are
found at
www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources,
unless a greater amount is calculated under subsection (5) of this section. The
MMNA standards may change each January and July based on the consumer price
index.
(3) The community spouse
MMNA is allowed only to the extent that the institutionalized spouse's income
is made available to the community spouse, and is calculated as follows:
(a) The minimum MMNA as calculated in
subsection (4)(a) of this section plus excess shelter expenses as calculated in
subsection (4)(b) of this section;
(i) The
total under (a) of this subsection cannot be less than the minimum MMNA;
and
(ii) If the total under
subsection (4)(a) of this section exceeds the maximum MMNA, the maximum MMNA is
the result under subsection (4)(a) of this section; and
(b) The total under subsection (4)(a) of this
section is reduced by the community spouse's gross income. The result is the
MMNA.
(4) The minimum
MMNA and excess shelter expense values are calculated as follows:
(a) The minimum MMNA is 150 percent of the
two-person federal poverty level (FPL); and
(b) If excess shelter expenses are less than
zero, the result is zero. Excess shelter expenses are calculated as follows:
(i) Add:
(A)
Mortgage or rent, which includes space rent for mobile homes;
(B) Real property taxes;
(C) Homeowner's insurance;
(D) Required maintenance fees for a
condominium, cooperative, or homeowner's association that are recorded in a
covenant; and
(E) The food
assistance standard utility allowance (SUA) under WAC
388-450-0195 minus the cost of
any utilities that are included in (b)(i)(D) of this subsection.
(ii) Subtract the standard shelter
allocation from the total in (b)(i) of this subsection. The standard shelter
allocation is 30 percent of 150 percent of the two-person FPL. The result is
the value of excess shelter expenses.
(5) The amount allocated to the community
spouse may be greater than the amount determined in subsection (3) of this
section, but only if:
(a) A court order has
been entered against the institutionalized spouse approving a higher MMNA for
the support of the community spouse; or
(b) A final order has been entered after an
administrative hearing has been held under chapter 182-526 WAC ruling the
institutionalized spouse or the community spouse established the community
spouse needs income, above the level otherwise provided by the MMNA, due to
exceptional circumstances causing significant financial duress.
(6) If a final order establishes
that the conditions identified in subsection (5)(b) of this section have been
met, then an amount of allocated resources under subsection (3) of this section
will be substituted by an amount adequate to provide such an MMNA.
(7) The agency or its designee determines the
dependent allowance for dependents of the institutionalized individual or the
institutionalized individual's spouse. The amount the agency allows depends on
whether the dependent resides with the community spouse.
(a) For each dependent who resides with the
community spouse:
(i) Subtract the
dependent's income from 150 percent of the two-person FPL;
(ii) Divide the amount determined in (a)(i)
of this subsection by three;
(iii)
The result is the dependent allowance for that dependent.
(b) For each dependent who does not reside
with the community spouse:
(i) The agency
determines the effective MNIL standard based on the number of dependent family
members in the home;
(ii) Subtracts
each dependent's separate income;
(iii) The result is the dependent allowance
for the dependents.
(c)
Child support received from a noncustodial parent is the child's
income.
