DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Statutory Authority: 31 Delaware Code, Section 512 (31 Del.C. §512)
20810 Treatment of Couples in Medical Assistance
Long Term Care Program
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 Social Services is proposing to amend the Division of Social Services Manual (DSSM) regarding the Long Term Care Program. This proposal gives direction on Couples Cases for the eligibility process.
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, Policy & Program Development Unit, Division of Social Services, P.O. Box 906, New Castle, Delaware 19720-0906 by May 31, 2005.
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 the Proposed New Rule
• State Medicaid Manual, Section 3597
• DSSM 20810 - Treatment of Couples in Medical Institutions: Adds a new rule that clarifies when a couple is considered a Couples Case and gives direction for the eligibility process. This action incorporates current policy into a rule.
DSS PROPOSED REGULATION #05-19
DSSM 20810 Treatment of Couples in Medical Assistance
A legally married husband and wife who have continuously shared a room in a hospital, nursing home, skilled nursing facility or intermediate care facility for a period of at least 6 months, may be considered a Couples Case and the Couples Case income and resource limits would apply to them. Should a married couple be determined a Couples Case, then spousal rules will not apply. The decision to treat a married couple as a Couples Case or as 2 individuals should be based on the couple’s best interests in regard to the income and resource limits. See DSSM 20100.5.5 and 20300.
8 DE Reg. 1566 (05-01-05)