Section 144-332-12-5 - SPOUSAL LIVING ALLOWANCE (SLA)I. Aspousal living allowance can be given to the spouse of an individual who is residing in a Cost Reimbursed Boarding Home (CRBH)/Adult Family Care Home AFCH)/Residential Care Facility (RCF).II. In this section, the term "individual" refers to the spouse residing in a CRBH, AFCH, or RCF. The term "at home spouse" refers to the spouse applying for or receiving the spousal living allowance. The "at home spouse" must be legally married under State of Maine law to the individual.III. When an individual is getting help from Medicaid with their expenses in a CRBH, AFCH, or RCF, the at home spouse may be eligible for a spousal living allowance. This is a payment that is made directly to the at home spouse. The living allowance starts the month of application by the at home spouse or the first full calendar month the individual is residing in a CRBH, AFCH, or RCF, whichever is later.
Example
The at home spouse applies in 10/08 but 11/08 is the first full calendar month his/her spouse is residing in a Residential Care Facility. 11/08 is the first month of payment.
IV. An application is considered to be filed for the living allowance when: A. the individual residing in the CRBH/AFCH/RCF files an application for help to pay for their residential care expenses or;B. the at home spouse requests a spousal living allowance and s/he is receiving assistance through the Food Supplement Program, Medicaid, SSI or the State Supplement. If none of the above applies, the at home spouse must file a separate application with OFI.
Section 5.1:EligibilityI.Non-Financial CriteriaA. The at home spouse must be living alone or with others (living arrangement A) or living in the household of another (livingarrangement C). The spouse cannot be living in a residential care facility or medical institution. Living arrangements are further defined in Part 11, Section 5. B. If the at home spouse is not otherwise covered by Medicaid s/he must meet the basic eligibility requirements identified in Part 2 regarding citizenship, residency and providing a Social Security Number.C. The at home spouse does not need to meet the SSI - Related rule of being aged, blind or disabled.II.Financial CriteriaA. countable assets must be less than $2,000. The rules on treatment of assets are the same as the SSI - Related rules that are outlined in Part 7, Section 1 and Part 16;B. countable income of the at home spouse must be less than 100% of the Federal Poverty Level for one; andC. countable income is determined using the SSI - Related rules that are identified in Part 7, Section 2 and Part 17.Section 5.2: BenefitsI. The at home spouse may be eligible for a payment of up to 100% of the Federal Poverty Level for one. There are no partial month benefits. If eligible for part of the month, then benefits will be authorized for the entire month. A. If the at home spouse is receiving an SSI payment, the monthly living allowance for SSI recipients is the amount listed in Chart 3.11. This amount is authorized in place of the $10.00/$8.00 State Supplement and is considered a State Supplement.B. If the at home spouse is receiving the State Supplement only (not SSI) the living allowance will be the difference between countable income and 100% of the Federal Poverty Level for one. This will be authorized in place of the $10.00/$8.00 State Supplement and is considered a State Supplement.C. If the at home spouse is receiving Medicaid but not SSI or State Supplement, the living allowance will be the difference between the spouse's countable income and 100% of the Federal Poverty Level for one.D. If the at home spouse is not receiving SSI, State Supplement or Medicaid, the living allowance will be the difference between the spouse's countable income and 100% of the Federal Poverty Level for one. Example
Mr. Komart enters a Residential Care Facility in 7/08.Mrs. Komart meets all non-financial and financial rules to receive a spousal living allowance effective 8/08. Her only income is Social Security Retirement of $775 monthly. Her spousal living allowance is determined as follows:
Step 1 | $ 775 | (gross income) |
- $20 | (federal disregard) |
- $55 ____________ | (state disregard) |
$ 700 | (countable income |
Step 2 | $867 | (100% FPL for one) |
- $ 700 ________ | (countable income) |
$ 167 | (spousal living allowance) |
II. The Spousal Living Allowance continues as long as the at home spouse is financially and otherwise eligible and as long as s/he has a spouse residing in a CRBH, AFCH, or RCF who is being helped with their expenses by Medicaid.10- 144 C.M.R. ch. 332, § 12-5