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.
The independent living standards
reflected in the F-8
Kansas Medical Assistance Standards
document shall be applicable to
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),
Anyone residing in a non-Medicaid
approved institution as defined in 8111,
and
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
have 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.
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.)
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.