Skip to Page Content
Delaware.gov  |  Text OnlyGovernor | General Assembly | Courts | Elected Officials | State Agencies
 Photo: Featured Delaware Photo
 
 
 Phone Numbers Mobile Help Size Print Email

Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsApril 2016

Table of Contents Previous Next

Regulatory Flexibility Act Form

Authenticated PDF Version

§1902(a)(50), (q) of the Social Security Act, A State Plan for medical assistance must
§1924(d)(1) of the Social Security Act, Allowances to be offset from income of institutionalized spouse
42 CFR §435.725, Post-eligibility treatment of income of institutionalized individuals in SSI States: Application of patient income to the cost of care
42 CFR §435.733, Post-eligibility treatment of income of institutionalized individuals in States using more restrictive requirements than SSI: Application of patient income to the cost of care
42 CFR §435.832, Post-eligibility treatment of income of institutionalized individuals: Application of patient income to the cost of care
In accordance with the federal public notice requirements established at Section 1902(a)(13)(A) of the Social Security Act and 42 CFR 447.205 and the state public notice requirements of Title 29, Chapter 101 of the Delaware Code, Delaware Health and Social Services (DHSS)/Division of Medicaid and Medical Assistance (DMMA) gives public notice and provides an open comment period for thirty (30) days to allow all stakeholders an opportunity to provide input on the agency's decision to increase the personal needs allowance for individuals institutionalized in long-term care facilities. Comments must be received by 4:30 p.m. on Monday May 2, 2016.
Federal Fiscal Year 20161

1

STATE: DELAWARE
Couples $88 $100
See Page 4 Addendum
Children $44 $50
Adults $44 $50
STATE: DELAWARE
d. $50/month for NF and ICF/MR residents engaging in frequent and regular rehabilitation out-of-facility activities.
e. For nursing facility residents who are participating in gainful employment, the following amounts, not to exceed the adult foster care rate (SSI benefit amount + $140), will be deducted from gross earned income:
i. Mandatory payroll deductions that are a condition of employment including, but not limited to:
* 1. Federal, State, and Local taxes
* 2. FICA
* 3. Union Dues
* 4. Insurance Premiums
* 5. Pension Contributions.
ii. Transportation costs as paid to and from employment.
Iii. Clothing and personal needs allowance of $75/month.
42 CFR §435.725; 42 CFR §435.733; 42 CFR §435.832
The total income to be used in the post-eligibility process will include all amounts that meet the definition of income. This includes both income that is counted for eligibility, and as well as income that is excluded for eligibility.
a) 20620.1.1 $44.00 $50.00 per month of available income is to be protected for the Medicaid recipients recipient's direct personal needs; or
b) 20620.1.2 If the recipient regularly attends a rehab/educational program off the grounds of his nursing or her long-term care facility, including employment for the purpose of rehabilitation in a sheltered workshop off the grounds of the facility, $50.00 per month (rather than $44) will be protected; or
c) 20620.1.3 For nursing long-term care facility residents who are participating in substantial gainful activity (SGA) (20 CFR 416.971), the following amounts, not to exceed the Adult Foster Care rate will be deducted from gross earned income:
20620.1.3.1 Mandatory payroll deductions that are a condition of employment including, but not limited to:
20620.1.3.2 If earnings average more than $700 a month in a calendar year, this is considered SGA and DSS Department of Social Services (DSS) can allow a personal needs allowance of up to the AFC rate.
20620.1.3.3 If earnings average less than $300 a month in a calendar year, this is not ordinarily considered SGA and DSS can allow the $44 or $50 personal needs allowance.
20620.1.3.4 If average earnings are between $300 and $700, DSS must consider other factors to determine whether or not the work constitutes SGA. Other factors include considering if the work is comparable to unimpaired people in the community performing similar jobs.
42 CFR §435.725; 42 CFR §435.733; 42 CFR §435.832
a. 20995.1.1 Personal Needs Allowance for the institutional spouse
The personal needs allowance amount is $30 per month for SSI recipients, and $44 $50 per month for all others. If the institutionalized spouse is employed, personal needs may range from $50 up to the Adult Foster Care rate per month.
b. 20995.1.2 Community Spouse Income Allowance
The community spouse monthly income allowance is the amount of income necessary to bring the spouse's monthly otherwise available income up to:
20995.1.2.2 The total amount available to the community spouse may not exceed "Cap for Minimum Monthly Maintenance Standard. This standard usually changes each January based on the Consumer Price Index for Urban Consumers.
c. 20995.1.3 Family Allowance
d. 20995.1.4 Items for which protection of income has been approved by the Long Term Long-Term Care Operation's Administrator and/or incurred medical expenses of the institutionalized spouse.
Last Updated: December 31 1969 19:00:00.
site map   |   about this site   |    contact us   |    translate   |    delaware.gov