Revision 24-1; Effective March 1, 2024

A personal needs allowance (PNA) is the amount of income a Medicaid recipient in an institutional setting may keep for their personal use. The PNA cannot be applied towards the recipient’s cost of medical assistance furnished by the facility. 

SSI  recipients who live in an institutional setting and receive the $30 reduced federal benefit receive a state supplement. This ensures they receive a PNA equal to the minimum level established by the state.

Beginning Jan.1, 2024, the PNA is $75.

From Jan. 1, 2006, through Dec. 31, 2023, the PNA was $60.

From Sept. 1, 2003, through Dec. 31, 2005, the PNA was $45.

From Sept. 1, 2001, through Aug. 31, 2003, the PNA was $60.

From Sept. 1, 1999, through Aug. 31, 2001, the PNA was $45. Before that, PNA was $30.

Note: Refer to E-4300, VA Benefits, for treatment of payments from the Department of Veterans Affairs. Refer to E-4311.2, $90 VA Pension and Institutional Setting, regarding automation limitations and the VA $90 capped pension.

H-1550 Guardianship Fees

Revision 19-4; Effective December 1, 2019

When determining the co-payment for a person receiving services in an institutional setting, guardianship fees, up to an amount set by the court, are deducted from the person's total countable income.

The allowable court-ordered guardianship fee deduction may include the following:

• Monthly guardianship fees up to $250
• Costs related to establishing the guardianship up to $1,000
• Costs related to terminating the guardianship up to $1,000
• Administrative costs related to the guardianship up to $1,000 over a three-year period

Note: Costs related to establishing or terminating the guardianship can exceed $1,000 if the costs in excess are supported by documentation acceptable to the court and the costs are approved by the court. Costs might include compensation and expenses for an attorney ad litem, guardian ad litem, and reasonable attorney fees for an attorney representing the guardian.

Only allow a deduction for actual amounts in the court order.

Allow the reduction in the person's co-payment to be effective the later of the following:

• the month in which the judge signs the court order awarding guardianship fees;
• the first month of Medicaid eligibility in which the person has a co-payment; or
• the first day of the month the person provides HHSC with a copy of the court order.

Route any administrative cost more than $1,000 over a three-year period, or any cost exceeding the $1,000 for establishing or terminating the guardianship, through the regional attorney for guidance.

Do not allow a reduction in the person's co-payment for guardianship fees ordered after HHSC receives verification that the person has died. If the date of death is not verified, staff must clear the discrepancy. Do not allow the guardianship fees as a deduction in the co-payment until the discrepancy has been cleared.

Related Policy

Date of Death Denials and Verification Sources, B-9300
Guardians and Other Agents, F-1231
Order of Deductions from Countable Income, H-1400