GIS 13 MA/04: 2013 Special Income Standards for Housing Expenses

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director - Division of Health Reform and Health Insurance Exchange Integration

Subject: Medicaid Regional Rates for Calculating Transfer Penalty Periods for 2013

Effective Date: January 1, 2013

Contact Person: Local District Support Unit - Upstate (518) 474-8887, New York City (212) 417-4500

The purpose of this General Information System (GIS) message is to inform local departments of social services (LDSS) of the revised 2013 special income standards for housing expenses which are available to individuals who are discharged from a nursing facility and enroll into the Managed Long Term Care (MLTC) program (see 12 OHIP/ADM-5 for further information).

The special income standard amount varies based on seven regions of the State. Within each region, the Housing and Urban Development (HUD) Fair Market Rent (FMR) dollar amounts for a one bedroom apartment are averaged. From this amount, 30 percent of the Medicaid income level for a one person household is subtracted (30% of $800 is $240). A decrease in the HUD FMR dollar amounts and an increase in the Medicaid income level has resulted in a decrease in the amounts of the special income standard for housing expenses. For 2013, the amounts for the seven regions are:

Central $368

  • Broome
  • Cayuga
  • Chenango
  • Cortland
  • Herkimer
  • Jefferson
  • Lewis
  • Madison
  • Oneida
  • Onondaga
  • St. Lawrence
  • Tioga
  • Tompkins

Northeastern $408

  • Albany
  • Clinton
  • Columbia
  • Delaware
  • Essex
  • Franklin
  • Fulton
  • Greene
  • Hamilton
  • Montgomery
  • Otsego
  • Rensselaer
  • Saratoga
  • Schenectady
  • Schoharie
  • Warren
  • Washington

Western $338

  • Allegany
  • Cattaraugus
  • Chauatauqua
  • Erie
  • Genesee
  • Niagara
  • Orleans
  • Wyoming

Northern Metropolitan $805

  • Dutchess
  • Orange
  • Putnam
  • Rockland
  • Sullivan
  • Ulster
  • Westchester

New York City $1,003

  • Bronx
  • Kings (Brooklyn)
  • New York (Manhattan)
  • Queens
  • Richmond (Staten Island)

Long Island $1,045

  • Nassau
  • Suffolk

Rochester $380

  • Chemung
  • Livingston
  • Monroe
  • Ontario
  • Schuyler
  • Seneca
  • Steuben
  • Wayne
  • Yates

The new levels for the special income standards for housing expenses are effective for cases with budget “From” dates of January 1, 2013 or later.

Reminder: The rate for the special income standard for housing expenses is based on the region in the State where the individual is actually residing, which may not be the same region of the district of fiscal responsibility.