J-6300, Expanded SPRA for Home and Community-Based Services Waiver Programs

Revision 15-3; Effective September 1, 2015

In waiver cases with a community spouse, the waiver individual (i.e., the institutionalized spouse) can make a request or file an appeal to increase the SPRA to produce additional income for the community spouse.

Usually in a waiver situation, income-first expanded SPRA is only considered when the individual has a QIT. The expanded SPRA cannot exceed the combined resources as of the SPRA assessment date for a waiver.

An expanded SPRA in a waiver case is available only:

• after the waiver individual (i.e., the institutionalized spouse) diverts all of the waiver individual's available income (i.e., the waiver individual's gross income minus the current special income limit — 300 percent cap for an individual) to the community ineligible spouse, and
• the community ineligible spouse's resulting total income is less than the current minimum monthly maintenance needs allowance (MMMNA).

Do not develop the expanded SPRA for a waiver if, after diverting all of the waiver individual's available income (i.e., the waiver individual's gross income minus the current special income limit — 300 percent cap for an individual) to the community ineligible spouse, the community ineligible spouse's resulting total income is equal to or more than the current MMMNA.

Calculate the expanded SPRA for a waiver if, after diverting all of the waiver individual's available income (i.e., the waiver individual's gross income minus the current special income limit — 300 percent cap for an individual) to the community ineligible spouse, the community spouse's resulting total income is less than the current MMMNA.

See Appendix XXXI, Budget Reference Chart, for the current amounts.

Procedure for Increased SPRA Consideration

J-6310 Expanded SPRA for Home and Community-Based Services Waiver Applicants in an Assisted Living Facility or Adult Foster Care

Revision 15-3; Effective September 1, 2015

If the person is living in an assisted living facility or adult foster care setting and is receiving waiver services from the STAR+PLUS Waiver (SPW) program:

• Do not develop the expanded SPRA for a waiver if, after diverting all of the waiver individual's available income (i.e., the waiver individual's gross income minus the current Supplemental Security Income [SSI] federal benefit rate [FBR] for an individual) to the community ineligible spouse, the community ineligible spouse's resulting total income is equal to or more than the current MMMNA.
• Calculate the expanded SPRA for a waiver if, after diverting all of the waiver individual's available income (i.e., the waiver individual's gross income minus the current SSI FBR for an individual) to the community ineligible spouse, the community ineligible spouse's resulting total income is less than the current MMMNA.

Procedure for Increased SPRA Consideration for SPW in an Assisted Living Facility/Adult Foster Care Setting

See Appendix XXXI, Budget Reference Chart, for the current amounts.