Statutes, codes, and regulations
California Code Of Regulations
Title 22 - Social SecurityDivision 3 - Health Care ServicesSubdivision 1 - California Medical Assistance ProgramChapter 2 - Determination of Medi-Cal Eligibility and Share of Cost
Article 11 - MAINTENANCE NEED
Section 50605 - Maintenance Need - Persons in Long-Term Care

Cal. Code Regs. tit. 22 § 50605

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Current through Register 2024 Notice Reg. No. 45, November 8, 2024
Section 50605 - Maintenance Need - Persons in Long-Term Care
(a) The maintenance need for a member of the MFBU in long-term care shall be either of the following:
(1) Thirty-five dollars for personal and incidental needs, when the beneficiary will remain in long-term care for the entire calendar month.
(2) For individuals with therapeutic wages, thirty-five dollars plus an additional amount equal to either a) 70 percent of the gross therapeutic earnings; or, b) 70 percent of the maintenance need level allowed for a noninstitutionalized person or family of corresponding size, as described in Section 50603, whichever is less.
(A) The provisions of subsection (a)(2) of this regulation also apply to eligibility determinations or redeterminations made retroactively to October 1, 1984.
(3) The appropriate maintenance need determined in accordance with Section 50603, if the person will be in long-term care for only a portion of the month.
(b) An LTC patient shall retain an amount of income for upkeep of a home in addition to the amount specified for personal and incidental needs in (a) (1) if all of the following conditions are met.
(1) The LTC patient's spouse or a family member of the LTC patient is not living in the home.
(2) The home, whether rented or owned by the LTC patient, is actually being maintained for the return of the LTC patient.
(3) There is a verified medical determination that the LTC patient, or when both spouses are in LTC, either spouse, is likely to return home within six months of the date LTC patient status was established.
(4) The income is deducted for not more than the six-month period referenced in (3).
(c) The amount allowed for upkeep of the home, if the conditions specified in (b) are met, shall be:
(1) One hundred thirty-three and one-third percent of the income in kind value of housing for one person pursuant to Section 50511(a) and (b), if the applicant or beneficiary has been living alone in the home.
(2) One hundred thirty-three and one-third percent of the income in kind value of housing for 2 persons pursuant to Section 50511(a) and (b) divided by 2, if the home is shared with persons for whom the applicant or beneficiary has no legal responsibility for support.
(3) One hundred thirty-three and one-third percent of the income in kind value of housing for 2 persons pursuant to Section 50511(a) and (b) divided by 2 for each spouse, if the beneficiary and spouse were living together at the time either or both became inpatients and both have become LTC patients and either is likely to return home within six months of the date LTC status was established.
(4) The amount allowed for upkeep of the home as determined according to (1) through (3) shall be calculated on an annual basis, rounded to the next higher multiple of $100, and then prorated.
(d) The LTC patient shall also retain an amount of income to pay for the support of a disabled relative if all of the following conditions are met.
(1) The disabled relative is not the LTC patient's:
(A) Spouse.
(B) Child, as defined in Section 50030.
(2) The LTC patient has contributed and will continue to contribute to the support of the disabled relative on a regular basis.
(e) The amount allowed for the support of a disabled relative, if the conditions specified in (d) are met, shall be the lesser of:
(1) The actual amount contributed.
(2) The maintenance need level for one person established in accordance with Section 50603(a)(1), minus the disabled relative's net income.

Cal. Code Regs. Tit. 22, § 50605

1. Amendment of subsections (c) and (e) filed 8-18-82 as an emergency; effective upon filing (Register 82, No. 34). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-16-82. For prior history, see Register 82, No. 13.
2. Amendment of subsections (c) and (e) refiled 12-16-82 as an emergency; effective upon filing (Register 82, No. 51). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 4-15-83.
3. Certificate of Compliance as to 8-18-82 and 12-16-82 orders transmitted to OAL 12-31-82 and filed 2-1-83 (Register 83, No. 6).
4. Amendment of subsections (c) and (e)(1) filed 2-1-83; effective upon filing pursuant to Government Code Section 11346.2(d) (Register 83, No. 6).
5. Amendment of subsections (c) and (e) filed 11-17-83 as an emergency; effective upon filing (Register 83, No. 49). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 3-17-84.
6. Certificate of Compliance as to 11-17-83 order transmitted to OAL 3-16-84 and filed 4-17-84 (Register 84, No. 16).
7. Amendment of subsection (a)(1) filed 4-4-85 as an emergency; effective upon filing (Register 85, No. 15). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 8-2-85.
8. Amendment of subsection (a)(2) filed 8-9-85 as an emergency, effective on filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-9-85.
9. Certificate of Compliance as to 4-4-85 order transmitted to OAL 7-30-85 and filed 8-29-85 (Register 85, No. 36).
10. Certificate of Compliance as to 8-9-85 order transmitted to OAL 11-13-85 and filed 12-11-85 (Register 85, No. 50).
11. Amendment of subsection (c) filed 4-16-86; effective thirtieth day thereafter (Register 86, No. 16).
12. Amendment of subsections (b)(1) and (b)(3), new subsection (b)(4), amendment of subsections (c)(3) and (d) and amendment of NOTE filed 9-13-2011; operative 10-13-2011 (Register 2011, No. 37).

Note: Authority cited: Section 20, Health and Safety Code; and Sections 10725, 14005.13 and 14124.5, Welfare and Institutions Code. Reference: Title 42, Code of Federal Regulations, Section 435.725(d); and Sections 14005.7, 14005.12 and 14005.13, Welfare and Institutions Code.

1. Amendment of subsections (c) and (e) filed 8-18-82 as an emergency; effective upon filing (Register 82, No. 34). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-16-82. For prior history, see Register 82, No. 13.
2. Amendment of subsections (c) and (e) refiled 12-16-82 as an emergency; effective upon filing (Register 82, No. 51). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 4-15-83.
3. Certificate of Compliance as to 8-18-82 and 12-16-82 orders transmitted to OAL 12-31-82 and filed 2-1-83 (Register 83, No. 6).
4. Amendment of subsections (c) and (e)(1) filed 2-1-83; effective upon filing pursuant to Government Code Section 11346.2(d) (Register 83, No. 6).
5. Amendment of subsections (c) and (e) filed 11-17-83 as an emergency; effective upon filing (Register 83, No. 49). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 3-17-84.
6. Certificate of Compliance as to 11-17-83 order transmitted to OAL 3-16-84 and filed 4-17-84 (Register 84, No. 16).
7. Amendment of subsection (a)(1) filed 4-4-85 as an emergency; effective upon filing (Register 85, No. 15). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 8-2-85.
8. Amendment of subsection (a)(2) filed 8-9-85 as an emergency, effective on filing (Register 85, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-9-85.
9. Certificate of Compliance as to 4-4-85 order transmitted to OAL 7-30-85 and filed 8-29-85 (Register 85, No. 36).
10. Certificate of Compliance as to 8-9-85 order transmitted to OAL 11-13-85 and filed 12-11-85 (Register 85, No. 50).
11. Amendment of subsection (c) filed 4-16-86; effective thirtieth day thereafter (Register 86, No. 16).
12. Amendment of subsections (b)(1) and (b)(3), new subsection (b)(4), amendment of subsections (c)(3) and (d) and amendment of Note filed 9-13-2011; operative 10-13-2011 (Register 2011, No. 37).