Appendix 3 - Summary Chart for Institutional Income Eligibility Process

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Revised March 25, 2011

Purpose:

SUMMARY CHART FOR INSTITUTIONAL INCOME ELIGIBILITY PROCESS

STEP	TANF/SSI Related	DETERMINE	COMPARE TO	IF BELOW	IF ABOVE
1	SSI related	Gross income	Medicaid SIL	Eligible for CN and institutional care. Go to Step 3.	Go to Step 2 ***
1	TANF related	Countable income *	TANF grant payment standard	Eligible for CN and institutional care. Go to Step 3.	Go to Step 2
2	SSI related and TANF related	Countable income *	Facility's private rate and client's recurring medical expenses	Eligible for institutional care. Go to Step 3 to determine if MN with or without spenddown.	Not eligible for institutional care. Determine MN eligibility as if living in own home.
3	SSI related and TANF related	Available income **	Facility's DSHS contracted rate	Eligible for CN or MN without spenddown	Must spenddown to be eligible for MN The NF is "locked-in" and must accept the DSHS contracted rate, instead of private rate from the client.

* Determine countable income by subtracting exemptions and disregards from gross income.

** Determine available income by adding income disregarded in Steps 1 and 2 back in to countable income then deducting post-eligibility income allocations and exemptions].

*** If married with community spouse, redetermine income eligibility using "community income" rule.