PM 09-02-04-b: AABD Cases

WAG 09-02-04-b

For a responsible relative who is not living with the customer, the FRU determines the relative's ability to support using Standard A.

Consider the responsible relative as not living with the customer for any month in which the customer is:

  • hospitalized; or
  • a resident of a medical facility (including a nursing home), or a supportive living facility from the first day of the month through the last day of the month.

Consider the responsible relative as not living with the customer for the entire month:

  • if an infant is hospitalized from the date of birth through the last day of the calendar month; or
  • if a customer is in a medical facility on the first day of the calendar month and dies before the last day of the calendar month.

When a customer shares the same room in a facility with a responsible relative, they are not considered to be living together.

If residents of a medical facility (including a nursing home) or a supportive living facility go home for a visit, they are still not living with the persons at home. If a responsible relative or customer returns home and intends to remain at home, they are living together again.

Consider a Medical Only customer applying for or receiving DoA HCBS waiver services as living apart from a responsible relative beginning with the first full month that the customer applies for or receives DoA waiver services. Do not consider the customer as living apart from a responsible relative if:

  • the customer with a community spouse is enrolled with a spenddown and countable monthly excess income to apply to medical costs is greater than $1,800 (after allowing for the Community Spouse Maintenance Needs Allowance and/or the Family Maintenance Needs Allowance); or
  • the customer with a community spouse is enrolled with a spenddown and excess nonexempt resources are greater than $17,500 (after allowing for the Community Spouse Resource Allowance and the $2,000 resource limit); or
  • the customer is subject to a penalty period due to a non-allowable resource transfer.

Refer to FRU

Refer all responsible relatives not living with an AABD cash or AABD Medical customer to the FRU (except as noted below). This includes responsible relatives of children under 18 who are also DHS patients or under the control of DCFS. Refer responsible relatives of children under 18 to both FRU and DCSE. Refer Medical children under 18 to DCSE.

Refer responsible relatives when:

  • approving an AABD Cash or AABD Medical application; or
  • a legally responsible relative deserts, abandons or otherwise leaves the unit; or
  • a person becomes a responsible relative.

Also notify the FRU of any changes in the responsible relative's status.

Who Not to Refer

Do not refer to FRU:

  • a stepparent; or
  • a responsible relative who is living out of state; or
  • a responsible relative whose address is unknown; or
  • a responsible relative who is receiving SSI; or
  • a responsible relative who is deceased; or
  • a responsible relative who lives with a child under 18 years of age; or
  • the community spouse of a resident of a nursing home, supportive living facility, or Medical customer applying for or receiving DoA HCBS waiver services, if the community spouse's income is less than or equal to the maintenance needs standard (see PM 15-04-04). If the community spouse fails to disclose information regarding income, Revised textdeny the case.

Do not refer a responsible relative if:

  • the relative lives with a customer who is temporarily away from home for medical reasons; and
  • the customer is expected to return home within 3 months.

If the customer has not returned home after 3 months, refer the responsible relative to FRU.

Responsible relatives not living with the customer may be directed by an Administrative Support Order (ASO) to make support payments directly to Springfield. Consider any payment made to the customer as unearned income until the ASO is sent to the responsible relative. Do not budget payments made directly to Springfield.