Dependent/family allocation used in CN Waiver or Institutional participation calculation
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Dependent/family allocation used in CN Waiver or Institutional participation calculation

Revised January 17, 2012

Long-term care
Purpose: Describes how the dependent allocation is determined in post eligibility for institutional and CN waiver programs.

WAC 388-515-1509 for HCS CN Waiver programs (Commonly referred as the COPES WAC)

WAC 388-515-1514 for DDD CN Waiver programs

WAC 388-513-1380 Participation (residing in medical institutions)

In post eligibility, the community spouse and family allocation is allowed as a deduction when determining participation.  The basic community spouse maintenance and family allocation standard i is 150% of the 2-person FPL increases annually on July 1. 

The rule states:

A monthly maintenance needs amount  for each minor or dependent child, dependent parent, or dependent sibling of your community or institutional spouse. The amount the department allows is based on the living arrangement of the dependent. If the dependent:

  1. Resides with your community spouse, the amount is equal to one-third of the community spouse allocation as described in WAC 388-513-1380 (5)(b)(i)(A) that exceeds the dependent family member's income (child support received from a noncustodial parent is considered the child's income);
  2. Does not reside with the community spouse, the amount is equal to the MNIL  based on the number of dependent family members in the home less their separate income (child support received from a noncustodial parent is considered the child's income).

What is a dependent?

A dependent for deeming purposes is the same as a dependent for Federal income tax purposes.  If a dependent is claimed on the community spouse or institutional spouse's personal income tax return, a family allocation can be considered.

A dependent does not need to be living with the client or the community spouse to be considered for a family allocation.

 

Dependent residing with the community spouse

For each dependent we take the community spouse income and family allocation standard (150% of the 2 person FPL) minus THAT dependents income.  Then we divide that figure by 3.  The result is the dependent allocation allowed for that dependent.

For more than one dependent we do the same computation indicated above for each dependent. 


EXAMPLE

Example #1.

COPES client living with the community spouse and 3 minor children.

Child #1 has $300 Social Security and $300 child support

Child #2 has $300 Social Security

Child #3 has $300 Social Security

Computation for the dependent deeming based on the 7/1/2009 community spouse income and family allocation of $1822.  (see LTC standard chart for current CS income and family allocation):

Child #1

$1,822 (7/1/2009 CS and family allocation standard)

-$600 child's income

= $1,222 divided by 3 = $407.33 available to deem to child #1

Child #2

$1,822

- $300 child's income

= $1,522 divided by 3 =  $507.33 available to deem to child #2.

Child #3

$1,822

-$300

= $1,522 divided by 3 = $507.33 available to deem to child #3

EXAMPLE

Example #2

Nursing Home client.  Community spouse has a dependent sibling residing with her that is claimed on the income tax return.  She also has a 19 year old and 14 year old child living with her.

Dependent #1 sibling has $100 per month gross earnings

Dependent #2 19 year old child has $500 per month gross earnings

Dependent #3 14 year old child has no income

Computation:

Dependent #1

$1,822 CS income and family allocation

- $100 income

= $1,722 divided by 3 = $574 available to deem to dependent #1

Dependent #2

$1,822

- $500 income

=  $1,322 divided 3 = $440.47 available to deem to dependent #2

Dependent #3

$1,822 divided by 3 =  $607.33 available to deem to dependent #3

 

NOTE:

The dependent and their income is coded on the LTCX screen in ACES.

The correct deemor must be indicated on the LTCD screen in ACES in order for the family allocation computation to be determined correctly.

The family size is indicated on the LTCD screen.  Count the community spouse and dependents in the family size, do not count the institutional client.

Remember, the LTCX AND LTCD screen must be completed whenever doing a dependent allocation.

LTC ACES Information

Dependent not residing with the community spouse

When the dependent does not reside with the community spouse the calculation standard is the MNIL and based on the number of dependents minus the dependents income.


EXAMPLE

Example #1.

COPES client with 2 dependent children.  Child #1 is 18 and has $100 income.  Child #2 is 15 and has $300 child support income.

Calculation:

MNIL/$674.00 (Standard is based on 1/2009 standards, see LTC standard chart for current MNIL)

- both dependents total income of $400

= $274.00 available to deem to the 2 dependents

Why are the 2 calculations so different?

The calculation when the dependents are living with the community spouse are based on the spousal impoverishment act.  When there is no community spouse as part of the household, the spousal impoverishment rules do not apply. 

CMS standards including spousal impoverishment

Spousal Impoverishment

Things to remember about the dependent allocation

  1. If the dependent is applying for their own medical benefits, any actual income deemed from the institutional individual to the dependent is considered the dependent's income.  Code the deemed income as OC on the ACES UNER screen and document this is deemed income from the institutional individual in the remarks.
  2. The dependent allocation follows the order of post eligibility deductions in WAC 388-513-1380 for institutional (residing in a medical institution) services, WAC 388-515-1509 for HCS CN Waiver programs, or WAC 388-515-1514 for DDD Waiver programs.  The institutional individual may not have enough income to deem the maximum amount available for the family allocation based on the amount of income and the deductions allowed.  For cases with a community spouse, the community spouse (CS) is allowed up to the CS income and family allocation minus the CS income before the dependent deduction.  In addition the CS may get additional deeming up to the CS maintenance standard due to excess shelter.   

Child Support received by the institutionalized individual

WAC 388-513-1340 (10) states child support payments received from an absent parent for a child living in the home is income of the child.

Back child support received for a child no longer living in the home is considered income. 

Modification Date: January 17, 2012