SR 02-15 Dated 07/02

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

 

SIGNATURE DATE:

April 26, 2002

FROM:

OFFICE OF THE DIRECTOR Mary Anne Broshek

AT (OFFICE):

Division of Family Assistance

TO:

DFA Supervisors

 

SUBJECT:

July 2002 Spousal Impoverishment Related Maximum Income Standard and Shelter Deduction Increase; Revised Forms 799 and 799A

EFFECTIVE DATE:

July 1, 2002

 

 

SUMMARY

 

This SR releases the annual July updates to the following spousal impoverishment figures used to determine the amount of income an institutionalized individual may give to a community spouse:

 

·   the maximum income standard; and

·   the shelter deduction.

 

POLICY

 

In accordance with the spousal impoverishment provisions of Chapter 19 Section 1924(d)(2)-(4) of the Social Security Act, the maximum income standard (MIS) and excess shelter deduction (ESD) figures used to determine the amount of income an institutionalized individual may give to a community spouse must be updated annually to reflect the federal poverty income guidelines. Based upon the income guidelines published in the Federal Register dated February 14, 2002:

 

·   the MIS has increased from $1,452 to $1,493 per month; and

·   the ESD has increased from $436 to $448 per month.

 

FORMS REVISIONS

 

Form 799, Spousal Income Protection, and Form 799A, Income Computation Worksheet for Allocation of Income for Institutionalized Individuals, have been revised to include the maximum income standard and the shelter deduction increases.

 

With new spousal applications July 1, 2002 or later, use the updated forms which replace Forms 799 and 799A released by SR 02-01/January 2002. However, rename and retain the January 2002 versions of Form 799 and 799A, in case rollbacks are required.

 

The new versions of Forms 799 and 799A will be electronically transmitted to each District Office with the electronic release of this SR. Contact Erica Hallstrom, DFA State Office, at 271-4580 with any questions related to transferring the electronic versions of these forms to your PC.

POLICY MANUAL REVISIONS

 

Revised Adult Assistance Manual Topics

 

Section 627.03 Allocation to a Community Spouse

Section 627.05 Allocation to Dependents Who Reside with the Community Spouse

 

IMPLEMENTATION

 

The new figures are effective July 1, 2002. New HEIGHTS will update all reference tables and use the new amounts for any cases computed or recomputed on or after that date. When determining how much income can be allocated to the community spouse for months before July 2002, the January 2002 figures and versions of Forms 799 and 799A must be used.

 

CLIENT NOTIFICATION

 

DFA State Office will do a mass mailing to all institutionalized individuals with community spouses and to their community spouses to inform these individuals of the spousal-related increases. Copies of the letter are attached for reference.

 

TRAINING

 

No training is needed or planned due to the procedural nature of the changes.

 

POSTING INSTRUCTIONS

 

Remove and Destroy

Insert

 

Forms Manual

 

Form 799, SR 02-01/January, 2002

2 sheets

 

Form 799A, SR 02-01/January, 2002

1 sheet

 

 

Form 799, SR 02-15/July, 2002

2 sheets

 

Form 799A, SR 02-15/July, 2002

1 sheet

 

DISPOSITION

 

This SR may be deleted or destroyed once its contents have been noted, its posting instructions carried out, and the revised manual topics released by this SR have been posted to the On-Line Manual.

 

DISTRIBUTION

 

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.state.nh.us/PMIndex.htm, effective July 1, 2002.

 

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Adult Assistance Manual.