SR 15-21 Dated 07/15

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 institutionalized individuals may give to their community spouses:

·      the maximum income standard (MIS); and

·      the excess shelter deduction (ESD).

DFA Forms 799, Spousal Income Protection, and DFA Form 799A, Income Computation Worksheet for Allocation of Income for Institutionalized Individuals, and the associated New Heights-generated Form AE0017, have been updated accordingly.

POLICY

In accordance with the spousal impoverishment provisions of 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. The MIS reflects the poverty income guidelines for a family of two published in the Federal Register (Volume 80, Number 14) dated January 22, 2015, multiplied by 150%, divided by 12 months, and rounded up to the next higher dollar. The ESD represents 30% of the new unrounded MIS, which is then rounded up to the next higher dollar:

·      the MIS has increased from $1,967 to $1,992 per month; and

·      the ESD has increased from $591 to $598 per month.

NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

Effective July 1, 2015, New HEIGHTS will modify the allocation of income functions for community spouses of institutionalized individuals and dependents who live with community spouses of institutionalized individuals so that the maximum income standard and excess shelter deduction reflect the 2015 amounts.

DESCRIPTION OF REVISIONS MADE TO FORMS

Electronic DFA Forms 799, Spousal Income Protection, and DFA Form 799A, Income Computation Worksheet for Allocation of Income for Institutionalized Individuals, and the associated New Heights-generated Form AE0017, have been revised to include the maximum income standard and the excess shelter deduction increases as released in this SR. Additionally, DFA Forms 799 and 799A and New Heights-generated Form AE0017 were updated to include an increase to the Personal Needs Allowance (PNA) from $65 to $70 as released in DFA SR 15-05, dated July 2015. Copies of DFA Forms 799 and 799A are attached to this SR for reference.

With new spousal applications July 1, 2015 or later, use the updated forms which replace DFA Forms 799 and 799A released by SR 15-01/January 2015. However, prior to detaching the new versions, rename and retain the January 2015 electronic versions of DFA Forms 799 and 799A, in case rollbacks are required.

The new versions of DFA Forms 799 and 799A will be electronically transmitted to each District Office with the electronic release of this SR. Contact Linda White, DFA State Office, at 271-9474 with any questions related to transferring the electronic versions of these forms to your PC. The forms are also available electronically, for Department staff only, on the Lotus Notes Family Services Database.

Since there are no changes associated with the use of these forms, their instructions did not require revisions and will not be re-released with this SR.

POLICY MANUAL REVISIONS

Revised Medical 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, 2015. 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 2015, the January 2015 figures and versions of Forms 799 and 799A must be used.

CLIENT NOTIFICATION

In early July, DFA State Office will generate a mailing to all institutionalized individuals with community spouses, and their community spouses, to inform these individuals of the spousal-related increases. A copy of the July 2015 Spousal Letter is attached to this SR for reference. No other client notification is planned.

TRAINING

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

FORMS MANUAL POSTING INSTRUCTIONS

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 manuals.

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 www.dhhs.nh.gov/DFA/publications.htm, effective June 29, 2015. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Forms and Medical Assistance Manuals.

DFA/KD:s