The California Department of Health Care Services has issued long-awaited guidance letters on how counties are to determine Medi-Cal (Medicaid) eligibility for those who are registered domestic partners (RDPs) under the state's Domestic Partner Rights and Responsibilities Act of 2003. The guidance appears to prevent RDPs applying for Medi-Cal coverage of long-term care to take advantage of spousal impoverishment protections, at least as long as the coverage has a federal component.
The guidance is in the form of "All County Welfare Directors' Letters" 09-03 and 09-04. Letter 09-03 recites that:
". . . RDP rights and responsibilities under AB 205 [California's law which extends rights and responsibilities of a spouse under state law to registered domestic partners] apply for State-only funded Medi-Cal programs that are not based on federal law. . .
"If one RDP is applying for Medi-Cal and is in an LTC facility and he/she is not federally eligible (e.g., aged, blind or disabled), then he/she should be placed in the state-only LTC program for Medically Indigent Adults if otherwise eligible . . . If his/her RDP is not an inpatient in a medical institution of [sic] nursing facility, then the Medi-Cal EW [Eligibility Worker] shall apply the spousal impoverishment provisions as if the RDP is a community spouse (see ACWDL 91-28). If the institutionalized RDP later turns 65 or is determined to be disabled, then he/she can no longer be eligible under the state-only LTC program and spousal impoverishment would no longer apply. Because the Community Spousal Resource Allowance is determined for the initial month for which Medi-Cal is being requested, the property transferred to the community RDP becomes the property of the community RDP and is not counted again. The spousal income allocation will no longer be deducted from the income of the institutionalized RDP.
"If an application is made for two institutionalized RDPs, then the spousal impoverishment provisions would not apply and the division of community property rules would apply."
Although he notes he is awaiting a detailed analysis of these guidance letters, Hayward, California, ElderLawAnswers member Gene Osofsky says that "it seems that the letters will not assist RDPs who would otherwise wish to invoke the spousal impoverishment rules when applying for a Medi-Cal LT subsidy, at least for 'regular' Medi-Cal LTC, which has a federal component."
Following are links to the two guidance letters:
https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/c09-03.pdf
https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/c09-04.pdf
Our thanks to Attorney Osofsky for alerting us to this development.
Subscribe to the Knowledge Bank.
