Spousal Impoverishment Expansion ACWDL 17-25 Released
The Department of Health Care Services released ACWDL 17-25, expanding spousal impoverishment provisions for Home and Community-Based services (HCBS). HCBS waiver programs are for seniors or persons with disabilities who want to stay at home or within their community and who are at high risk for nursing home placement. When one spouse in a married couple applies for an approved HCBS program, the spousal impoverishment provisions apply.
Some exciting major changes are:
- A broadened definition of an institutionalized spouse
- Expanding spousal impoverishment provisions to IHSS beneficiaries enrolled in the Community First Choice Option (CFCO) (Many IHSS beneficiaries are enrollees in Community First choice)
- Expanding provisions to wavier applicants on a waitlist -- i.e., allowing applicants on a waitlist for the NF Waiver, Assisted Living Waiver, or other HCBS waivers to access Medi-Cal benefits under the spousal impoverishment rules.
- Allowing applicants to use a form completed by their physician indicating they meet the required medical criteria instead of an assessment by the waiver program to initiate Medi-Cal eligibility under spousal impoverishment provisions
- Retroactivity for CFCO participants enrolled on or after January 1, 2014, and for those who were denied or discontinued eligibility due to delayed implementation of the new rules
Read the Letter