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Sinclair Jefferson

Next, let’s determine Sinclair’s obligation.

To Do: Complete the Elderly, Disabled and Blind Income Computation Worksheets (DHS-0029C) for Sinclair and then answer the questions below.  

Note:  For training purposes, do not deduct the COLA disregard when completing Sinclair’s income calculation, even if you are completing it in January through June. 

1. What is Sinclair’s certification period?

Sinclair’s certification period is LM through CM+4.

2. Did you deem Mary’s income to Sinclair?

Yes, Mary’s income is deemed to Sinclair for last month only, because you are determining basic MA for last month. The LTCC was completed on the first of the current month with CADI waiver services anticipated to begin that same date. Mary’s income will not be deemed for the current month.

3. What income standard did you use?

Standard E (100% FPG. If income exceeds Standard E, Sinclair must spend down to Standard H (100% FPG).

4. Does Sinclair have a spenddown?

Yes. Sinclair’s counted income exceeds Standard E last month and current month. He will spend down to Standard H.

5. Is Sinclair eligible for MA-LTC?

We don’t know yet.  We will be reviewing whether he meets his monthly spenddowns in the MA-LTC Spenddowns and Waiver Obligations course.

6. Is Sinclair eligible for an MSP?

No, Sinclair is not enrolled in Medicare.

To Do:  Update the "Medical Spenddown" line of the "Client Obligation and Service Delivery" section of Sinclair’s MA-LTC Case Checklist (DHS-5590) with his original spenddown amounts for last month and the current month. 

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Community Income Calculation

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