Title: Par
Author: dmasad
Last saved by: raddington
Company: NDDHS

Bismarck, North Dakota	MANUAL LETTER #3056	January 1, 2007

Par.1.  Material Transmitted and Purpose – Transmitted with this Manual Letter are changes to Service Chapter 510-05 – Medicaid Eligibility Factors.

510-05-65-20.  Community Spouse Asset Allowance

Subsection 2 has been updated with the new asset levels for the Community Spouse Asset Allowance.

2.	The community spouse asset allowance is determined by first establishing a spousal share.  The spousal share is an amount equal to one half of the total value of all countable assets owned (individually or jointly) by the institutionalized, HCBS, or community spouse.

Example:
If the couple's countable assets are: | The community spouse share is:
$25,000 | $12,500
$90,000 | $45,000
$2~~0~~50,000 | $1~~00~~25,000
From the spousal share, the community spouse asset allowance is established, and is an amount that is equal to the community spouse share, but not less than ~~$19,908~~ $20,328, and not more than ~~$99,540~~ $101,640, effective January ~~2006~~ 2007 ~~($19,020~~  ($19,908 and ~~$95,100~~ $99,540 effective January ~~2005~~ 2006.) 

Example:
If_the_spousal share is: | The community spouse asset allowance is:
$12,500 | ~~$19,908~~ $20,328 (at least the minimum)
$45,000 | $45,000
~~$100,000~~ $125,000 | ~~$99,540~~  $101,640 (one-half is more than the maximum allowed, so the community spouse gets the maximum)

The community spouse asset allowance may be adjusted by any additional amount transferred under a court order or established through a fair hearing.  Adjustments in the minimum and maximum allowed for a community spouse may also adjust the community spouse asset allowance.

510-05-70-45-20. Annuities Purchased Before August 1, 2005

Subsection 2(c)(v) has been updated to reflect the changes in the spousal impoverishment income levels effective January 1, 2007.

2.	An annuity in which a payment option was selected before 
August 1, 2005 is counted as an available asset in the asset test unless:
c.	The annuity meets all of the following conditions:
i.	The annuity is irrevocable and cannot be assigned to another person;
ii.	The issuing entity is an insurance company or other commercial company that sells annuities as part of the normal course of business;
iii.	The annuity provides for level monthly payments;
iv.	The annuity will return the full purchase price and interest within the purchaser's life expectancy; and
Unless specifically ordered otherwise by a court of competent jurisdiction acting to increase the amount of spousal support paid on behalf of a community spouse by an institutionalized spouse or a home and community based services (HCBS) spouse, the monthly payments from the annuity do not exceed ~~$2488~~ $2541 effective January ~~2006~~ 2007 ~~($2378~~ $2488 ~~effective~~ ~~August~~ ~~2005~~ for 2006).  

Annuities Purchased from August 1, 2005 Through February 7, 2006 510-05-70-45-25

Subsection 2(c)(v) has been updated to reflect the changes in the spousal impoverishment income levels effective January 1, 2007.

2.	The annuity is counted as an available asset in the asset test unless:
c.	The annuity meets all of the following conditions:
i.	The annuity is irrevocable and cannot be assigned to another person;
ii.	The issuing entity is an insurance company or other commercial company that sells annuities as part of the normal course of business;
iii.	The annuity provides for level monthly payments;
iv.	The annuity will return the full principle and has a guaranteed period that is equal to at least 85% of the annuitant’s life expectancy;
v.	The monthly payments from all annuities that meet the requirements of this subsection do not exceed ~~$2488~~ $2541 effective January 2007 ($2488 for 2006) and, when combined with the annuitant’s other income at the time of application for Medicaid, does not exceed ~~$3732~~ $3811 effective January 2007 ($3732 for 2006); and.…

Annuities Purchased or Changed on or After February 8, 2006 510-05-70-45-30

Subsection 3(c)(v) has been updated to reflect the changes in the spousal impoverishment income levels effective January 1, 2007.

3.	The annuity is counted as an available asset in the asset test unless:
c.	The annuity meets all of the following conditions:
i.	The annuity is irrevocable and cannot be assigned to another person;
ii.	The issuing entity is an insurance company or other commercial company that sells annuities as part of the normal course of business;
iii.	The annuity provides for level monthly payments;
iv.	The annuity will return the full principle and has a guaranteed period that is equal to at least 85% of the annuitant’s life expectancy;
v.	The monthly payments from all annuities that meet the requirements of this subsection do not exceed ~~$2488~~ $2541 effective January 2007 ($2488 for 2006) and, when combined with the annuitant’s other income at the time of application for Medicaid, does not exceed ~~$3732~~ $3811 effective January 2007 ($3732 for 2006); and. . . .

Exceptions to Disqualifying Transfer Provision 510-05-80-25

Subsection 2 has been updated to not allow excluded annuities to be transferred. 

2.	A transfer is not disqualifying to the extent that the asset transferred was any Medicaid exempt or excluded asset other than:
a.	The home or residence;
b.	Property which is not saleable without working an undue hardship;
c.	Excluded home replacement funds;
d.	Excluded payments, excluded interest earned on the payments, and excluded in-kind items received for the repair or replacement of lost, damaged, or stolen exempt or excluded assets;
e.	Life estate interests; ~~or~~
f.	Mineral acres; ~~or~~
g.	Inheritances, during the six months in which they are excluded; or
h.	Annuities

Unearned Income 510-05-85-15

AmeriCorps clothing allowance payments have been added as a type of unearned income to subsection 5. 

5.	Types of unearned income include but are not limited to:

n.	Payment of proceeds or profits to enrolled tribal members from tribal gaming/gambling establishments; ~~and~~
o.	Clothing allowance payments received by a volunteer in the AmeriCorps program; and

p.	Payments, not otherwise disregarded . . . .

Earned Income 510-05-85-20

Language has been added to subsection 3(m) to clarify that stipends and “living allowances” paid by AmeriCorps are considered earned income. These payments are not to be confused with those from AmeriCorps*VISTA.

3.	Types of earned income include:

m.	Stipends and the "living allowance" portion of earnings from AmeriCorps (not to be confused with AmeriCorps*VISTA); and

Disregarded Income 510-05-85-30

Language has been added to subsection 16 to reflect a clarification between AmeriCorps and AmeriCorps*VISTA and items have been rearranged by funding source and up-dated to reflect the revised program names.

The following types of income must be disregarded in determining Medicaid eligibility:

16.	Compensation received by volunteers participating in the ~~action~~ ACTION program as stipulated in the Domestic Volunteer Service Act of 1973, including ~~Foster Grandparents~~, ~~the Older American Community Service Program,~~ the National Senior Volunteer Corps, including Retired Senior Volunteer Program (RSVP), ~~Service Corps of Retired Executives,~~ Foster Grandparents and Senior Companion Program; National Volunteer Programs to Assist Small Businesses and Promote Volunteer Services by Persons with Business Experience; Volunteers in Service to America (VISTA) (now AmeriCorps*VISTA, not to be confused with AmeriCorps, a separate program), ~~Senior Companion Program,~~ VISTA Literary Corps, and University Year for ~~Action~~ VISTA;

Carol K. Olson, Executive Director	Manual Letter #3056 
North Dakota Department of Human Services	Page  of  Pages