WAC 182-513-1330 Determining available income for legally married couples for long-term care (LTC) services.
Effective August 26, 2018
This section describes income the agency or its designee determines available when evaluating a legally married person's eligibility for long-term care (LTC) services.
- The agency or the agency's designee applies the following rules when determining income eligibility for LTC services:
- WAC 182-512-0600 SSI-related medical—Definition of income;
- WAC 182-512-0650 SSI-related medical—Available income;
- WAC 182-512-0700 SSI-related medical—Income eligibility;
- WAC 182-512-0750 SSI-related medical—Countable unearned income;
- WAC 182-512-0840(3), self-employment income-allowance expenses;
- WAC 182-512-0960 SSI-related medical —Allocating income—Determining eligibility for a spouse when the other spouse receives long-term services and supports (LTSS);
- WAC 182-512-0785, 182-512-0790, and 182-512-0795 for sponsored immigrants and how to determine if the sponsors' income counts in determining benefits.
- In initial categorically needy income eligibility for LTC, the agency does not allow any deductions listed in 1612(b) of the Social Security Act, for example:
- The following income is available to an institutionalized spouse, unless subsections (5) and (6) apply:
- Income received in the institutionalized spouse's name;
- Income paid to a representative on the institutionalized spouse's behalf; and
- One-half of the income received in the names of both spouses.
- The following income is unavailable to an institutionalized spouse:
- Separate income received in the name of the community spouse; and
- Income established as unavailable through a court order.
- For the determination of eligibility only, if available income under subsection (3)(a) through (c) of this section, minus income exclusions under WAC 182-513-1340, exceeds the special income level (SIL), defined under WAC 182-513-1100, the agency or its designee:
- Follows Washington state community property law when determining ownership of income;
- Presumes all income received after the marriage by either spouse to be community income;
- Considers one-half of all community income available to the institutionalized spouse.
- If the total of subsection (5)(c) of this section plus the institutionalized spouse's separate income is over the SIL, determine available income using subsection (3) of this section.
- A stream of income, not generated by a transferred resource, is available to the institutionalized spouse, even if the institutionalized spouse transfers or assigns the rights to the stream of income to one of the following:
- The community spouse; or
- A trust for the benefit of the community spouse.