Administrative Code

Virginia Administrative Code
12/3/2021

Article 2. Assessments of Couple's Resources

12VAC30-110-741. Resource assessment required.

Article 2
Assessments of Couple's Resources

A resource assessment shall be completed by the entity determining medical assistance eligibility on all medical assistance applications for married institutionalized individuals who have a community spouse. If an applicant alleges that his marital status is unknown, it shall be his responsibility to establish his marital status. It shall be the applicant's responsibility to locate his community spouse. If attempts to establish marital status or locate the separated spouse are unsuccessful or the community spouse does not provide the required information necessary to complete the resource assessment, the medical assistance eligibility application will be denied due to inability to complete the required resource assessment, unless undue hardship, as defined in 12VAC30-110-831, is met.

Statutory Authority

§§ 32.1-324 and 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 17, Issue 13, eff. April 11, 2001; amended, Virginia Register Volume 18, Issue 21, eff. August 1, 2002; Volume 25, Issue 14, eff. April 15, 2009.

12VAC30-110-744. Resource assessment initiated.

A resource assessment shall be initiated by an entity determining medical assistance eligibility:

1. Upon request by either spouse of a couple, or a representative acting on behalf of either spouse, at the beginning of the first continuous period of institutionalization when (i) all relevant documentation of resources has been received and (ii) upon payment of a fee, if any, the amount of which is determined by the entity determining medical assistance eligibility, if the institutionalized spouse has not applied for medical assistance; or

2. Upon application for medical assistance by or on behalf of a married institutionalized individual who has a community spouse.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 17, Issue 13, eff. April 11, 2001.

12VAC30-110-747. Total resources.

There shall be computed as of the beginning of the first continuous period of institutionalization of the institutional spouse, the total value of the couple's resources to the extent either the institutionalized spouse or the community spouse has an ownership interest.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 17, Issue 13, eff. April 11, 2001.

12VAC30-110-750. Notification of documentation required.

When a resource assessment is initiated, the Department of Social Services shall notify the applicant of all relevant documentation required to be submitted for the assessment.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from VR460-04-8.6 § 2.3, eff. October 1, 1991.

12VAC30-110-751. Spousal share.

The total value of the couple's combined resources shall be divided by two to determine the spousal share.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 17, Issue 13, eff. April 11, 2001.

12VAC30-110-760. Failure to provide documentation.

If an applicant fails to provide requested documentation necessary to complete the required resource assessment within 45 days of receipt of notification sent pursuant to 12VAC30-110-750, the department shall notify him that the assessment cannot be completed.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from VR460-04-8.6 § 2.4, eff. October 1, 1991; amended, Virginia Register Volume 17, Issue 13, eff. April 11, 2001.

12VAC30-110-770. Notification of assessment and appeal rights.

The department shall provide each member of a couple with copies of the completed resource assessment and the documentation used to produce it. The department shall notify the couple of the procedure by which to appeal the resource assessment.

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from VR460-04-8.6 § 2.5, eff. October 1, 1991.

12VAC30-110-780. Appeal of resource assessment.

A. Not accompanied by a medical assistance application. If the resource assessment was conducted without a concurrent medical assistance application, an ineligible spouse may not appeal the assessment pursuant to the existing Client Appeals regulations (Part I (12VAC30-110-10 et seq.) of this chapter); however, an ineligible spouse will have an opportunity to appeal assessment findings if and when his institutionalized spouse applies for medical assistance.

B. Medical assistance application. A resource assessment which was conducted pursuant to a medical assistance application submitted by the institutionalized spouse may be appealed by either spouse pursuant to existing Client Appeals regulations (Part I (12VAC30-110-10 et seq.) of this chapter).

Statutory Authority

§ 32.1-325 of the Code of Virginia.

Historical Notes

Derived from VR460-04-8.6 § 2.6, eff. October 1, 1991; amended, Virginia Register Volume 12, Issue 9, eff. March 1, 1996; Volume 17, Issue 13, eff. April 11, 2001.

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