Budgeting

CalSAWS automatically computes the budget based on the information entered.

LTC Person with a Community Spouse

An Institutionalized Spouse must be in his/her own MFBU at the beginning of the continuous period of institutionalization.

The Institutionalized Spouse may provide an income allocation to the Community Spouse beginning with the month of admission to the long term care facility.
The spouse/same-sex spouse/RDPs are in separate budget units beginning with the month of admission.
The Maintenance Need for the Institutionalized Spouse is $35 (the personal needs allowance) beginning with the first month of admission.
When the Institutionalized Spouse and the Community Spouse are both recipients and their budgets are being revised at the beginning of the continuous period of institutionalization, there can be no increase in the share of cost until a 10-day notice of action (NOA) is issued, even though an allocation to the Community Spouse/same-sex spouse/RDP has been given.

Hand Budgets

MC 176 M-LTC

The “Share of Cost Determination-MFBUs With LTC Person Included”

(MC 176 M-LTC) is used in computing the SOC for all MFBUs which include a person in LTC.

MC 176 W Worksheet A

The MC 176 Worksheet A is used when:

An ABD-MN person with LTC status has children, but no Community Spouse or,
An MI person has LTC status and has a spouse/same-sex spouse/RDP and/or children living in the home, but no Community Spouse.

MC 176 W Worksheet B

Long Term Care SOC Re-Computation

When an LTC individual is discharged from a long term care facility, a re-computation of the SOC must be completed using the appropriate non-LTC maintenance need level.

The EW must verify that the individual is no longer in LTC.

When the SOC is recomputed, send the original “SOC Medi-Cal Provider Letter” (MC 1054) to the provider.