Adult Medicaid Manual MA-2242HOME EQUITY VALUE & ELIGIBILITY FOR INSTITUTIONAL SERVICES

IV. DEMONSTRATED HARDSHIP

The applicant/recipient, spouse or representative may request a demonstrated hardship waiver when excess home equity disqualifies the a/r from receiving institutional services. Demonstrated hardship for excess home equity is different from the undue hardship waiver for transfer of assets. The a/r must request the demonstrated hardship waiver within 12 calendar days from the date of the DMA 5115, Notification of Right to Request a Demonstrated Hardship Waiver (Home Equity Value). Proof must be provided to the county department of social services demonstrating through the greater weight of evidence that a hardship will occur if the a/r is denied institutional services.

A. Use a DMA-5097, Request for Information, to request information needed to evaluate for a demonstrated hardship due to excess home equity. If information is not received by the end of the 12 calendar day period, send a second DMA-5097, Request for Information, and allow an additional 12 calendar days to submit the information. Document the request in the case record.

1. If information is not received by the end of the second 12 calendar day period, deny the request. (See II. above)

2. If information is received, complete the evaluation for demonstrated hardship within 12 calendar days of receipt of the information. Document the decision in the case record.

B. Demonstrated hardship due to excess home equity relates to the a/r, not the relatives or responsible parties of the a/r.

A demonstrated hardship due to excess home equity may exist when:

1. The a/r has no other family or persons to take care of him if discharged from the facility and he has no other assets.

2. The a/r’s family members are too feeble or old to take care of him and his remaining assets have been depleted.

If it is determined that a demonstrated hardship exists, approve the a/r for institutional services providing all other eligibility requirements are met. If it is determined that a demonstrated hardship does not exist, follow procedure in II. above.