DHS 10.33 HistoryHistory: Cr. Register, October, 2000, No. 538, eff. 11-1-00; CR 04-040: am. (1) (c) and (2) (a), (c) and (d) Register November 2004 No. 587, eff. 12-1-04; CR 22-026: r. (3) Register May 2023 No. 809, eff. 6-1-23; CR 23-046: renum. (1) (a) to (d) to be (1) (c) to (f), cr. (1) (a), (b), am. (2) (c) (intro.), (d) (intro.) Register April 2024 No. 820, eff. 5-1-24. DHS 10.34DHS 10.34 Financial eligibility and cost sharing. DHS 10.34(1)(a)(a) “Actual maintenance costs” means the sum of the following: DHS 10.34(1)(b)(b) “Certification period” means a 12-month period for which financial eligibility and cost sharing requirements for the family care benefit are determined for a non-MA eligible person. DHS 10.34(1)(c)(c) “Consumer price index” means the consumer price index for all urban consumers, U.S. city average, as determined by the U.S. department of labor. DHS 10.34(2)(2) Individuals eligible for medical assistance. A person who is eligible for medical assistance under ch. 49, Stats., and chs. DHS 101 to 108 is financially eligible for the family care benefit. Cost sharing requirements for the family care benefit for a medical assistance-eligible person are those that apply under ch. 49, Stats., and chs. DHS 101 to 108. DHS 10.34(3)(3) Individuals not eligible for medical assistance. DHS 10.34(3)(a)(a) Conditions of financial eligibility. Eligibility under this subsection is effective beginning July 1, 2000. For persons who are not eligible for medical assistance, financial eligibility and cost sharing requirements for the family care benefit shall be determined pursuant to applicable provisions of s. 46.286 (1) (b) and (2), Stats., and this chapter. The maximum cost-sharing requirement for a non-MA-eligible person shall be determined by a county agency using a uniform financial eligibility and cost-sharing screening prescribed by the department. A non-MA-eligible person is financially eligible for the family care benefit if the projected cost of the person’s care plan exceeds the person’s maximum cost-sharing requirement. DHS 10.34(3)(b)(b) Calculation of maximum cost share requirement at initial determination and annual re-determination of eligibility. A non-MA-eligible family care enrollee shall contribute to the cost of his or her care an amount that is calculated as provided under this section. Treatment of assets, including assets in trusts, and income shall be as provided under ss. 49.454 and 49.47, Stats., and ss. DHS 103.06 and 103.07 unless specified otherwise in this section. All dollar amounts specified in this section shall be updated annually based on changes in the consumer price index. The following calculation shall determine the applicant’s or enrollee’s maximum cost-sharing requirement: DHS 10.34(3)(b)1.1. Determine total countable assets according to ss. 49.454 and 49.47, Stats., and s. DHS 103.06. If the applicant or enrollee is legally married, include the countable assets of both members of the couple. DHS 10.34(3)(b)2.2. Determine monthly net countable assets by subtracting from total countable assets the following allowances, as applicable, and dividing the result by 12: DHS 10.34(3)(b)2.a.a. Subject to subd. 6., if the applicant or enrollee is a family care spouse, the amount of the community spouse resource allowance under s. 49.455 (6) (b), Stats. DHS 10.34(3)(b)2.b.b. If the person resides in a nursing home, community-based residential facility or adult family home, an allowance of $9,000. DHS 10.34(3)(b)2.c.c. If the person resides in his or her own home, including a residential care apartment complex or in the private home of a relative or other person, an allowance of $12,000. DHS 10.34(3)(b)3.3. Determine countable monthly income by adding together all of the following: DHS 10.34(3)(b)3.a.a. Monthly unearned income less a $20 disregard from unearned income, or if the person has less than $20 of unearned income, the remainder from earned income. DHS 10.34(3)(b)3.b.b. Total monthly earned income, less the first $200, and then less two-thirds of any remaining earned income. DHS 10.34(3)(b)4.4. Add together the monthly net countable assets and the countable monthly income.