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A. SA Basic Rate
The SA facility Basic rate is established by the General Assembly and is reviewed annually. The Division of Aging and Adult Services issues an administrative letter to each county DSS whenever the rate is changed. The SA rate is the maximum monthly amount that an SA facility may charge an SA recipient. The current SA Basic rate, effective October 1, 2009 is $1,182. A facility may choose to offer a lower rate to SA recipients. Should this occur, the actual rate charged to the recipient, rather than the legislative established SA facility rate, is used in the calculations addressed in this chapter.
B. SA Special Care Unit (SCU) Rate
The SA facility SCU rate was established by the General Assembly effective October 2005. The rate is the maximum monthly amount that an SA facility may charge SA recipient in a licensed SA Special Care Unit for recipients with a diagnosis of Alzheimer’s or related disorders. The current rate is $1,515.
A facility may choose to offer a lower rate to SA recipients. Should this occur, the actual rate charged to the recipient, rather than the legislative established SA SCU rate, is used in the calculations addressed in this chapter.
C. Personal Needs Allowance
A $46 personal needs allowance is added to the monthly rate for all SA recipients in SA facilities. These funds (and where applicable the $20 General Income Exclusion) are available to meet the costs of certain expenses not covered by the monthly rate such as personal articles, Medicaid co-payments (Refer to MA-2905, Medicaid Covered Services, for co-payment amounts), clothing, etc. The amount of the monthly personal needs allowance is subject to change by legislative action.
D. Maintenance Amount
1. The maintenance amount is the sum of the SA facility rate and the personal needs allowance. This is the amount keyed into EIS in the Maintenance field.
Example #1: Facility charges the SA facility Basic rate.
Maximum SA facility Basic Rate |
$1,182.00 |
Personal Needs Allowance |
+ 46.00 |
Maintenance Amount |
$1,228.00 |
Example #2: Facility charges the SA facility SCU rate.
Maximum SA facility SCU Rate |
$1,515.00 |
Personal Needs Allowance |
+ 46.00 |
Maintenance Amount |
$1,561.00 |
Example #3: Facility charges a rate less than the SA facility rate.
Rate charged by home |
$ 850.25 |
Personal Needs Allowance |
+ 46.00 |
Maintenance Amount |
$ 896.25 |
2. The maintenance amount for ambulation capacity code “M” recipients can vary, depending on the total amount of verified Medical Care Special (MCS) costs per recipient. The variable maintenance amount for “M” recipients in EIS should always equal the total of the TCMI + the SA payment.
See the DAAS-8190S Attachment A or DAAS-8190NS, Attachment A for complete budgeting instructions.
Note: Only SAB cases that were active with Services for the Blind prior to September 1, 2010, and transferred to the SA Program in September 2010, can have MCS.
Example #1: Facility charges the established SA facility Basic rate
Maximum SA facility Basic Rate |
$1,182.00 |
Personal Needs Allowance |
46.00 |
Medical Care Special Costs |
+ 125.00 |
Variable Maintenance Amount |
$1,353.00 |
Example #2: Facility charges the SA facility SCU rate
Maximum SA facility SCU rate |
$1,515.00 |
Personal Needs Allowance |
46.00 |
Medical Care Special Costs |
+ 125.00 |
Variable Maintenance Amount |
$1,686.00 |
Example #3: Facility charges a rate less than the SA facility rate.
Rate charged by home |
$ 850.25 |
Personal Needs Allowance |
46.00 |
Medical Care Special Costs |
+ 125.00 |
Maintenance Amount |
$ 1021.25 |
E. Income Limits
1. Compute Total Countable Monthly Income (TCMI) after all deductions according to instructions in SA-3210, Income.
2. The $20 general income exclusion, when applicable, is applied when calculating the TCMI. Do not apply this exclusion again when calculating the SA payment.
3. For the SA facility Basic rate, if the a/r’s TCMI is $1,227.51 or more, the a/r is not eligible for Special Assistance.
4. For the SA facility SCU rate, if the a/r’s TCMI is $1,560.51 or more, the a/r is not eligible for Special Assistance.
5. SA recipients with ambulation code “E” are Basic SA cases that were SA eligible effective September 30, 2009. The SA rate was reduced October 1, 2009 from $1, 207 to $1,182. Those SA applicant/recipients eligible as of September 30, 2009 are allowed to remain on SA with a $1.00 payment, and also receive full Medicaid until their income goes over the old SA income limit of $1252.50.
The maintenance amount for “E” cases is the sum of the TCMI plus the payment amount of $1.00. These cases should all be $0.00 money payment cases, as SA does not send checks for less than $5.00.
6. Recipients with ambulation code “M” may have income higher than the Basic or SCU rate if they also have Medical Care Special costs being paid by SA.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office.
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