DEPARTMENT OF HEALTH AND SOCIAL SERVICES
Division of Medicaid and Medical Assistance
FINAL
ORDER
Medicaid Long Term Care Program – Community Spouse
NATURE OF THE PROCEEDINGS:
Delaware Health and Social Services (“Department”) / Division of Medicaid and Medical Assistance initiated proceedings to amend Division of Social Services Manual (DSSM) regarding the Medicaid Long Term Care Program, specifically, to determine eligibility for medical assistance. The Department’s proceedings to amend its regulations were initiated pursuant to 29 Delaware Code Section 10114 and its authority as prescribed by 31 Delaware Code Section 512.
The Department published its notice of proposed regulation changes pursuant to 29 Delaware Code Section 10115 in the January 2020 Delaware Register of Regulations, requiring written materials and suggestions from the public concerning the proposed regulations to be produced by January 31, 2020 at which time the Department would receive information, factual evidence and public comment to the said proposed changes to the regulations.
SUMMARY OF PROPOSAL
Effective for services provided on and after April 11, 2020 Delaware Health and Social Services/Division of Medicaid and Medical Assistance (DHSS/DMMA) proposes to amend section 20910.2 of Division of Social Services Manual (DSSM) regarding the Medicaid Long Term Care Program, specifically, to determine eligibility for medical assistance.
Background
DMMA currently applies Spousal Impoverishment regulations to a Community Spouse receiving Home and Community Based Services. The agency implemented this change as published in the Delaware Register of Regulations 10 DE Reg. 1619 (April 2007). Section 20910.2 Community Spouse, was not amended, in error.
Statutory Authority
Purpose
This proposal is to align policy to reflect current practice.
Public Notice
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 proposed regulation. Comments were to have been received by 4:30 p.m. on January 31, 2020.
Provider Manuals and Communications Update
A newsletter system is utilized to distribute new or revised manual material and to provide any other pertinent information regarding manual updates. Updates are available on the Delaware Medical Assistance Portal website: https://medicaid.dhss.delaware.gov/provider
Fiscal Impact Statement
The policy amendment will have no fiscal impact.
Summary of Comments Received with Agency Response and Explanation of Changes
The following summarized comments were received:
Comment: Two commenters support the proposed changes to the Medicaid State Plan.
Agency Response: DMMA appreciates the support.
DMMA is pleased to provide the opportunity to receive public comments and greatly appreciates the thoughtful input given by:
FINDINGS OF FACT:
The Department finds that the proposed changes as set forth in the January 2020 Register of Regulations should be adopted.
THEREFORE, IT IS ORDERED, that the proposed regulation to amend Division of Social Services Manual (DSSM) regarding the Medicaid Long Term Care Program, specifically, to determine eligibility for medical assistance, is adopted and shall be final effective April 11, 2020.
3/10/2020
Date of Signature
Kara Odom Walker, MD, MPH, MSHS, Secretary,
DHSS
20910.2 Community Spouse
An individual who is married to an institutionalized spouse and does not receive HCBS.
