WAC 388-513-1330 Determining available income for legally married couples for long-term care (LTC) services

This section describes income the department considers available when determining a legally married client's eligibility for LTC services.   

1. The department must apply the following rules when determining income eligibility for LTC services:
   1. WAC 388-475-0650  Available income;
   2. WAC 388-475-0700  Income eligibility;
   3. WAC 388-475-0750 Countable unearned income;
   4. WAC 388-475-0840  (3) Self employment income-allowance expenses;
   5. WAC 388-506-0620  SSI related medical clients; and
   6. WAC 388-513-1315 (15 and (16) Eligibility for long-term care (institutional, waivered, and hospice) services.
2. For an institutionalized client married to a community spouse who is not applying or approved for LTC services, the department considers the following income available, unless subsection (4) applies:
   1. Income received in the client’s name;
   2. Income paid to a representative on the client’s behalf;
   3. One-half of the income received in the names of both spouses; and
   4. Income from a trust as provided by the trust.
3. The department considers the following income unavailable to an institutionalized client:
   1. Separate or community income received in the name of the community spouse; and
   2. Income established as unavailable through a fair hearing.
4. For the determination of eligibility only, if available income described in subsections (2) (a) through (d) minus income exclusions described in WAC 388-513-1340 exceeds the special income level (SIL), then:
   1. The department follows community property law when determining ownership of income;
   2. Presumes all income received after marriage by either or both spouses to be community income; and
   3. Considers one-half of all community income available to the institutionalized client.
5. If both spouses are either applying or approved for LTC services, then:
   1. The department allocates one-half of all community income described in subsection (4) to each spouse; and
   2. Adds the separate income of each spouse respectively to determine available income for each of them.
6. The department considers income generated by a transferred resource to be the separate income of the person or entity to which it is transferred.
7. The department considers income not generated by a transferred resource available to the client, even when the client transfers or assigns the rights to the income to:
   1. The spouse; or
   2. A trust for the benefit of the spouse.
8. The department evaluates the transfer of a resource described in subsection (6) according to WAC 388-513-1363, 388-513-1364, 388-513-1365 and WAC 388-513-1366 to determine whether a penalty period of ineligibility is required.