MR #12.18: LTC and Community AABD Changes including those to Comply with the Deficit Reduction Act of 2005 and the 2012 Illinois SMART Act

MR #12.18: LTC and Community AABD Changes including those to Comply with the Deficit Reduction Act of 2005 and the 2012 Illinois SMART Act

Summary:

This Manual Release introduces changes in community AABD and long term care policy resulting from the federal Deficit Reduction Act of 2005, the Illinois SMART Act (PA 097-0689) and other changes to conform with federal and state regulations. These changes apply to new applications and redeterminations. Major changes include:

  • Change in how resources necessary for self-support are considered;
  • Change in exemption for funeral/burial contracts;
  • Reduction of the Community Spouse Resource Allowance (CSRA) and Community Spouse Maintenance Needs Allowance (CSMNA) limits;
  • Change in cooperation requirements for determining financial eligibility;
  • Enhancement of the Department's ability to pursue and establish support orders;
  • Expanded role for Long Term Care - Asset Discovery Investigation (LTC-ADI);
  • The "lookback period" for determining the allowability of transfers of resources and income is changed to 60 months for all transfers occurring on or after 01/01/07;
  • Introduction of a two-step financial eligibility process;
  • Change in the time allowed for the transfer of resources to the community spouse;
  • All resources in excess of the CSRA are now considered available to the spouse receiving long term care;
  • Implementation of "income first" rule when the community spouse appeals for an increase in the CSRA;
  • Changes in the method of calculating the penalty period for non-allowable transfers;
  • Establishment of a hardship waiver process;
  • Home equity value in excess of $525,000 makes a person ineligible for long term care services, with certain exceptions.

"Long term care" and "LTC" are now used as all-inclusive terms for Nursing Home (NH) cases, Supportive Living Facility (SLF) cases, and Department on Aging Home and Community Based Services (HCBS) waiver cases.