SR 03-17 Dated 07/03

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

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 7, 2003:

·   the MIS has increased from $1,493 to $1,515 per month; and

·   the ESD has increased from $448 to $455 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, 2003 or later, use the updated forms which replace Forms 799 and 799A released by SR 03-01/January 2003. However, rename and retain the January 2003 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 Debra Audet, DFA State Office, at 271-4558 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, 2003. 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 2003, the January 2003 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.

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted 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/DHHS/DFA/LIBRARY, effective July 1, 2003.

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

DFA/DMS:s