PM 15-06-02-d: Client Applying for or Receiving DoA Services

WAG 15-06-02-d.

Starting with the first full month that a client applies for or receives DoA services and for following months, use the one-person Community Standard. Use the one-person Community Standard whether or not there is a community spouse. Also use the one-person Community Standard for married clients when both spouses apply for or receive DoA services.

When a client applies for or receives DoA services, determine eligibility separately from any other persons in the home. If a spouse is also a client, determine eligibility of the spouse separately from the person applying for or receiving DoA services.

Do not apply the income or assets of any persons in the home to the needs of the client applying for or receiving DoA services. However, certain case situations require a 2nd determination using the appropriate Community Standard rather than the one-person standard. For these cases, do not determine eligibility separately from any persons in the home. Do not allow deductions from income for the Community Spouse Maintenance Needs Allowance or the Family Maintenance Needs Allowance. Do not treat the person as applying for or receiving DoA services. Complete a 2nd determination using the appropriate Community Standard, rather than the one-person standard, when:

  • the client with a community spouse would be enrolled with a spenddown and countable monthly excess income to apply to medical care costs is greater than $1,800 (after allowing for the Community Spouse Maintenance Needs Allowance and/or the Family Maintenance Needs Allowance); or
  • the client with a community spouse would be enrolled with a spenddown and excess nonexempt assets are greater than $10,500 (after allowing for the Community Spouse Asset Allowance and the $2,000 asset limit); or
  • the client is subject to a penalty period due to a nonallowable asset transfer.