WAG 05-08-09: Allowing Expenses for Group Home Residents

PM 05-08-09

Accept the group home's statement of the amount of the customer's income the group home keeps and what portion of the amount is for shelter expenses. Count the rest of the amount the group home keeps as a medical expense. Accept the group home's statement as verification of shelter expenses.

New Manual MaterialCommunity Integrated Living Arrangement (CILA) Facilities

Accept the CILA facility's statement for the amount of shelter expenses the customer pays each month from their income. Add together the amount the group home states the customer pays for shelter expenses, the telephone standard as a utility expense if the household pays for their own private telephone, the PNA, and all other allowable medical expenses that the customer pays for out of pocket. Subtract the sum from the customer's total gross income. The remaining amount is the amount of the CILA services medical expense that gets entered in IES on the Medical Expenses- Details Page when entering the medical expense for Food Assistance.

Example: Wyatt lives in a CILA facility and receives $2,000 a month in RSDI. He applies for Food Assistance benefits on 02/01/2025. He pays $185 per month for Medicare Part B and does not pay anything for Medicare Part A. The CILA home keeps $500 per month for shelter expense and Wyatt keeps $100 per month for his PNA. Wyatt does not pay for a telephone. His Total Gross Income minus shelter expenses, PNA, and Medicare Part B Premium is $1,215. The caseworker updates the Medical Expenses- Details Page in IES and updates the Medical Expense Type Dropdown to "In-Home care expenses" and the Description of Item/Service Dropdown to "DHS Community Based Services". The caseworker enters $1,215 for both the Total Amount Billed and Client Liability Amount entries and updates Does the client want to opt for the medical standard? to "NO". Because Wyatt's medical expenses are more than the Group Home/SLF Standard Medical Deduction, his actual medical expenses will be budgeted. The Medicare Part B premium is entered on the Medical Expenses Detail Pages as a separate entry and IES Eligibility will sum all allowable medical expenses and apply the actual medical expense deduction in this example.