WAC 388-513-1330
Determining available income for
legally married couples for long-term care (LTC) services. This section describes income the department considers
available when determining a legally married client's
eligibility for LTC services.
(1) The department must apply the following rules when
determining income eligibility for LTC services:
(a) WAC 388-475-0600 Definition of income SSI-related
medical;
(b) WAC 388-475-0650 Available income;
(c) WAC 388-475-7000 Income eligibility;
(d) WAC 388-475-0750 Countable unearned income;
(e) WAC 388-475-0840(3) Self employment income-allowance
expenses;
(f) WAC 388-506-0620, SSI-related medical clients; and
(g) WAC 388-513-1315 (15) and (16), Eligibility for
long-term care (institutional, waiver, and hospice) services.
(2) For an institutionalized client married to a
community spouse who is not applying or approved for LTC
services, the department considers the following income
available, unless subsection (4) applies:
(a) Income received in the client's name;
(b) Income paid to a representative on the client's
behalf;
(c) One-half of the income received in the names of both
spouses; and
(d) Income from a trust as provided by the trust.
(3) The department considers the following income
unavailable to an institutionalized client:
(a) Separate or community income received in the name of
the community spouse; and
(b) Income established as unavailable through a fair
hearing.
(4) For the determination of eligibility only, if
available income described in subsections (2)(a) through (d)
minus income exclusions described in WAC 388-513-1340 exceeds
the special income level (SIL), then:
(a) The department follows community property law when
determining ownership of income;
(b) Presumes all income received after marriage by either
or both spouses to be community income; and
(c) Considers one-half of all community income available
to the institutionalized client.
(5) If both spouses are either applying or approved for
LTC services, then:
(a) The department allocates one-half of all community
income described in subsection (4) to each spouse; and
(b) Adds the separate income of each spouse respectively
to determine available income for each of them.
(6) The department considers income generated by a
transferred resource to be the separate income of the person
or entity to which it is transferred.
(7) The department considers income not generated by a
transferred resource available to the client, even when the
client transfers or assigns the rights to the income to:
(a) The spouse; or
(b) A trust for the benefit of the spouse.
(8) The department evaluates the transfer of a resource
described in subsection (6) according to WAC 388-513-1363,
388-513-1364, 388-513-1365 and 388-513-1366 to determine
whether a penalty period of ineligibility is required.
[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090,
74.09.575, and 2005 federal Deficit Reduction Act (DRA),
Public Law 109-171. 07-17-152, § 388-513-1330, filed 8/21/07,
effective 10/1/07. Statutory Authority: RCW 74.08.090. 06-07-077, § 388-513-1330, filed 3/13/06, effective 4/13/06. Statutory Authority: RCW 11.92.180, 43.20B.460, 48.85.020,
74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530,
74.[09.]575, 74.09.585; 20 C.F.R. 416.1110-1112, 1123 and
1160; 42 C.F.R. 435.403 (j)(2) and 1005; and Sections 17,
1915(c), and 1924 (42 U.S.C. 1396) of the Social Security Act.
00-01-051, § 388-513-1330, filed 12/8/99, effective 1/8/00. Statutory Authority: RCW 74.08.090 and 74.09.500. 99-06-045,
§ 388-513-1330, filed 2/26/99, effective 3/29/99. Statutory
Authority: RCW 74.08.090, 74.05.040 and 20 CFR 416.1110-1112,
1123 and 1160. 97-10-022, § 388-513-1330, filed 4/28/97,
effective 5/29/97. Statutory Authority: RCW 74.08.090 and
Title XIX State Agency Letter #94-33. 95-02-028 (Order 3819),
§ 388-513-1330, filed 12/28/94, effective 1/28/95. Statutory
Authority: RCW 74.08.090. 94-10-065 (Order 3732), §
388-513-1330, filed 5/3/94, effective 6/3/94. Formerly parts
of WAC 388-95-335 and 388-95-340.]