Home and Community Based Services for Married Couples Seeking Nursing Home Alternative Covered by Medi-Cal

California Advocates for Nursing Home Reform (CANHR) is a resource any individual wanting to understand Medi-Cal should use. Their Fall-2017 “Advocate” gives information regarding the Impoverishment Protections to Medi-Cal applicants eligible for Home and Community-Based Services (HCBS). Medi-Cal HCBS programs/waivers are alternative to nursing homes, for individuals who would otherwise require care in a skilled nursing facility or hospital. To access Spouse Impoverishment under the HCBS programs/waivers, the applicant must:
1. Already be on Medi-Cal or applying for Medi-Cal;
2. Notify Medi-Cal they need HCBS or be in the process of applying for a HCBS waiver; and
3. Prove they meet the clinical criteria for skilled nursing care by a) an approved assessment from a HCBS program or b) submit a completed Doctor’s Verification Form (form can be found with the All County Welfare Director’s Letter 17-25).
Under California law, Spouse Impoverishment Protections allow the spouse of a Medi-Cal beneficiary receiving HCBS to retain additional assets, i.e., a “Community spouse Resource Allowance (CSRA) of up to $120,900. The Community Spouse may also keep all income in his/her name, without it going toward Share of Cost. If the Community Spouse’s income is less than $3,023, he/she may be receiving an allocation from the Medi-Cal spouse’s income to reach $3,023
For more information about individual programs visit DHCS.CA.GOV.
Ms. MacDonald’s practice is limited to Estate Planning, Probate & Trust Administration. Ms. MacDonald maintains her practice in the Santa Clarita Valley at 25115 Avenue Stanford, Suite A-209, Valencia, California. She can be reached at 661-294-6464.