Provider Notice issued 01/09/04

Increase in Prevention of Spousal Impoverishment Standards

This is to inform you of increased standards for the prevention of spousal impoverishment effective January 1, 2004. The term "spousal impoverishment" includes the standards for the Community Spouse Asset Allowance (CSAA) and the Community Spouse Maintenance Needs Allowance (CSMNA). The prevention of spousal impoverishment standards should be included in the oral and written information that must be provided to residents and potential residents about how to apply for and use Medicaid benefits. Facilities are required by federal regulations (42 CFR 483.10) and state statute (210 ILCS 45/2-211) to give an explanation of resident rights at the time of admission and at least annually thereafter.

The CSAA standard is increased from $90,660 to $92,760. This is the maximum amount of assets a resident may transfer to a community spouse or to another for the sole benefit of a community spouse. The actual amount a resident may transfer is determined by deducting non-exempt assets of the community spouse from the standard of $92,760.

The CSMNA standard is increased from $2,267 to $2,319. This is the maximum amount of monthly income a resident may give to a community spouse. The actual amount a resident may give is determined by deducting any gross income of the community spouse from the standard of $2,319.

Facilities may also request from the Department a brochure, DPA 3191, Nursing Home Services and Information for Couples, which gives additional information relating to the prevention of spousal impoverishment. To order this brochure, the facility must complete and send Form DPA 1517 or DPA 1517A, Provider Forms Request, to the following fax or address, as appropriate.

Providers located in Cook, DuPage, Kane, Kankakee, Lake Will and Winnebago counties are to complete Form DPA 1517A and fax to 773-854-5174 or mail to:

Illinois Department of Healthcare and Family Services

Quad County Warehouse and Facilities

5150 West Roosevelt Road

Chicago, Illinois 60644-1473

Providers located in all other counties and out-of-state are to complete Form DPA 1517 and fax to 217-

557-6800 or mail to:

Illinois Department of Healthcare and Family Services
Downstate Warehouse and Facilities
2946 Old Rochester Road
Springfield, Illinois 62703-5659

If you have any questions concerning this notice, contact the Bureau of Long Term Care at 217-524-7244.

Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs