DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Statutory Authority: 31 Delaware Code, Section 512 (31 Del.C. §512)
Long Term Care Resource Exclusions - Automobiles
In compliance with the State's Administrative Procedures Act (APA - Title 29, Chapter 101 of the Delaware Code) and under the authority of Title 31 of the Delaware Code, Chapter 5, Section 512, Delaware Health and Social Services (DHSS) / Division of Medicaid and Medical Assistance (DMMA) is proposing to amend existing rules in the Division of Social Services Manual (DSSM) used to determine eligibility related to Long Term Care Resource Exclusions – Automobiles.
Any person who wishes to make written suggestions, compilations of data, testimony, briefs or other written materials concerning the proposed new regulations must submit same to Sharon L. Summers, Planning & Policy Development Unit, Division of Medicaid and Medical Assistance, 1901 North DuPont Highway, P.O. Box 906, New Castle, Delaware 19720-0906 or by fax to 302-255-4425 by March 31, 2008.
The action concerning the determination of whether to adopt the proposed regulation will be based upon the results of Department and Division staff analysis and the consideration of the comments and written materials filed by other interested persons.
SUMMARY OF PROPOSAL
The proposed provides notice to the public that the Division of Medicaid and Medical Assistance (DMMA) intends to amend existing rules in the Division of Social Services Manual (DSSM) used to determine eligibility related to Long Term Care Resource Exclusions - Automobiles.
• 42 CFR 416.1218, Exclusion of the Automobile; and,
• POMS Section SI 01130.200, Automobiles and Other Vehicles Used for Transportation.
Summary of Proposal
DSSM 20310.5 and 20330.1, Automobiles: One vehicle, regardless of the value, will be totally excluded if used for transportation of the eligible individual or a member of the eligible individual’s household.
DMMA PROPOSED REGULATION #08-05
20310.5 Automobiles One automobile, regardless of value, if, for the individual or a member of the individual's household (member of a household is one who receives food, clothing and shelter at the applicant's residence at time of institutionalization) if it fits the exclusions listed in Sections 20310.5.1 -20310.5.4. 20310.5.1 Employment The automobile is excluded if necessary for employment. 20310.5.2 Medical Use If the automobile is necessary for the medical treatment of a specific or regular medical problem, it may be excluded. 20310.5.3 Modifications An exclusion may be used if the vehicle is modified for operation by or transportation of a disabled person. 20310.5.4 Essential Daily Activities The automobile may be excluded if it is necessary because of climate, terrain, distance, or similar factors to provide necessary transportation to perform essential daily activities. 20310.6 Joint Ownership If the automobile is jointly owned and if a co-owner refuses to sell it may be excluded.
20 CFR 416.1218
An automobile is any registered or non-registered vehicle that is used for transportation.
One automobile, per household, is excluded if:
• Used for transportation of the eligible individual or
• Used for transportation of a member of the eligible individual’s household.
If there is more than one vehicle used for transportation, the automobile with the greatest equity value will be excluded.
The equity value of all additional automobiles will be evaluated as a resource.
(Break In Continuity of Sections)
20330.1 Vehicles Vehicles are defined as automobiles, boats, travel trailers, motorcycles etc. The current market value of a vehicle is the average price that it will sell for (based on year, make, model and condition) on the open market in a certain geographic area. Current market value can be determined by using the NADA book (trade in value) or a written appraisal from a disinterested, knowledgeable source. One vehicle may be excluded under Section 20310.5. Only one vehicle may be excluded for a married couple. If NO vehicle is excluded per Section 20310.5, up to $4650 of the CMV of ONE vehicle is excluded. If the CMV exceeds $4650, the excess counts as a resource, unless the vehicle can be excluded under some other provision (i.e., co-owner refuses to sell). It is unlikely the $4650 exclusion will be used. This is because most vehicles are used for either a medical problem or for essential daily activities and can be excluded per Section 20310.5. Any vehicle an individual owns in addition to the vehicle that was totally or partly excluded (up to $4650), is a resource in the amount of its equity value. The equity value is the CMV minus amount owed on the vehicle. The exclusion is applied in the manner most advantageous to the individual. If one of two vehicles can be excluded as necessary for medical treatment, the exclusion is applied to the vehicle with the greater equity value regardless of which vehicle is used to obtain medical treatment.
For the purpose of Medicaid, automobile is defined as any registered or unregistered vehicle used for transportation.
One vehicle may be excluded under Section 20310.5.
Only one vehicle may be excluded per married couple/household.
If one vehicle can not be excluded under Section 20310.5, or there is more than one vehicle, the equity value is a resource if:
• Is owned by an eligible individual/spouse
• Cannot be excluded under another provision (e.g. property essential to self support - DSSM 20320.5; co-owner refuses to sell) or conditional benefits do not apply (DSSM 20360).
The equity value is the price it can reasonably sell for on the open market minus any encumbrances.
11 DE Reg. 1191 (03/01/08) (Prop.)