8160 Income Standards

8160 Income Standards

Standards have been established which are the amounts of monthly income protected from medical expenses to allow applicants/recipients to meet their maintenance needs. Persons receiving treatment in general medical hospitals are considered to maintain their previous living arrangements for medical budgeting purposes if the stay will not exceed the temporary stay period as defined in 8113 and the spousal impoverishment income provisions of 8144 are not applicable. The following provisions apply to persons who are institutionalized.

1. The independent living standards reflected in the F-8, Kansas Medical Assistance Standards document shall be applicable to  
   1. The month of entrance for adults entering long term care in a Medicaid approved institution and for whom the spousal impoverishment provisions are not applicable (see 8113), 
   2. Anyone residing in a non-Medicaid approved institution as defined in 8111, and  
   3. Anyone residing in an adult care home whose financial eligibility is determined based on the spenddown provisions of 8172.2 (2).  

   An adult applicant and/or recipient entering a medical institution (including a state institution even if no FFP is available) from an independent-living situation for a temporary stay as defined in 8113 may be budgeted for independent living for a period not to exceed the two calendar months following the month of admission to allow for maintaining current living arrangements.

   For persons moving from a long term care arrangement in a Medicaid approved institution to independent living, the independent living standard shall also be budgeted beginning with the month following the month of discharge for children and for persons for whom the spousal impoverishment income provisions of 8144 been applied or the month of discharge for all others. (See 8173)

   NOTE: For children under age 18 who enter an institution for less than 30 days, independent living methodologies for the specific medical assistance program are applicable as the stay is regarded as a temporary absence. This includes consideration of parental income and assets, if the child was residing with the parents outside of the institution. If all screening and other eligibility criteria are met for payment in the institution (see 8112) payment may be authorized for the time frame. No patient liability is applicable unless used to meet a spenddown under a Medically Needy program.

2. For persons receiving long term care in a Medicaid approved institution, a standard of $62/month shall be applicable beginning either in the month the care begins or a following month as specified in 8113. The standard includes only personal needs and is applicable regardless of the categorical relationship of the plan. It does not apply to persons in adult care homes whose financial eligibility is determined based on the spenddown provisions of 8172.2 (2). Independent living standards shall be used in these instances. Each individual is considered a separate household of one for budgeting purposes except as provided in 8143 . The legal responsibility of parent for child is not negated. Adults may allocate a portion of their income for the support of their dependents. (See 8143 (4) or the spousal impoverishment income provisions of 8144.2.
3. For persons receiving long term care in a Medicaid approved institution who fail the 300% special income test described in 7430 (4), a standard of $62/month shall be applicable if the patient liability does not exceed the monthly cost of care in the facility. If the patient liability exceeds the cost of care, the independent living standard, budgeting methodology and base period shall be applicable. See 8172.2.