DHS 103.075(6)(b)1.1. Community spouse income allowance. An MA-eligible institutionalized spouse may allocate income to his or her community spouse to provide for the monthly maintenance of the community spouse. An institutionalized spouse may allocate enough of his or her income, after deducting a personal needs allowance as provided under s. 49.45 (7) (a), Stats., or 42 CFR 435.726 (c) in the case of an institutionalized spouse participating in a home and community-based care waiver program under s. 46.277, Stats., to bring the community spouse’s monthly income up to the amount specified in s. 49.455 (4) (b), Stats., or an amount ordered by a court, whichever is greater. The community spouse’s monthly gross income shall be determined by the agency as provided under s. 49.47 (4) (c), Stats., without regard to the SSI-related MA deductions.

DHS 103.075(6)(b)2.2. Family member income allowance. An MA-eligible institutionalized spouse may deduct from his or her income, sufficient funds to bring each dependent family member’s monthly income up to the amount specified in s. 49.455 (4) (a) 3., Stats., or an amount ordered by a court, whichever is greater. A dependent family member is:

DHS 103.075(6)(b)2.a.a. Any minor natural or adopted child or step-child of either the institutionalized spouse or the community spouse who resides with the community spouse;

DHS 103.075(6)(b)2.b.b. Any adult natural or adopted child or step-child of either the institutionalized spouse or the community spouse who is claimed as a dependent by either the institutionalized spouse or the community spouse for tax purposes under the internal revenue service code or who could be claimed as a dependent for tax purposes if a tax return were filed and who resides with the community spouse;

DHS 103.075(6)(b)2.c.c. A sibling of either the institutionalized spouse or the community spouse who is claimed as a dependent by either the institutionalized spouse or the community spouse for tax purposes under the internal revenue service code or who could be claimed as a dependent for tax purposes if a tax return were filed and who resides with the community spouse; or

DHS 103.075(6)(b)2.d.d. A parent of either the institutionalized spouse or the community spouse who is claimed as a dependent by either the institutionalized spouse or the community spouse for tax purposes under the internal revenue service code or who could be claimed as a dependent for tax purposes if a tax return were filed and who resides with the community spouse.

DHS 103.075(6)(c)(c) Computing income available towards the cost of care. An institutionalized recipient shall apply his or her available income toward the cost of his or her care. In this paragraph, “available income” means any income remaining after the following deductions are made from the recipient’s gross monthly income:

DHS 103.075(6)(c)1.1. A personal needs allowance as provided under s. 49.45 (7) (a), Stats., or 42 CFR 435.726 (c), as appropriate;

DHS 103.075(6)(c)2.2. The community spouse monthly income allowance under par. (b) 1. that is actually made available by the institutionalized spouse to the community spouse or to another individual for the benefit of the community spouse;

DHS 103.075(6)(c)3.3. The total family member income allowance calculated under par. (b) 2., whether or not actually made available by the institutionalized spouse to a family member; and

DHS 103.075(6)(c)4.4. The amount incurred as expenses for remedial or medical care for the institutionalized spouse as follows:

DHS 103.075(6)(c)4.a.a. For an individual participating in a community-based care waiver program, the amount incurred as expenses for remedial or medical care and the cost of the individual’s health insurance premiums; and

DHS 103.075(7)(7) Notice. The agency shall notify both spouses when it determines that an institutionalized spouse is eligible for MA, or it shall notify the spouse who requested a determination of MA eligibility. The notice shall be in writing and shall include the following information:

DHS 103.075(7)(f)(f) Each spouse’s right to a fair hearing under sub. (8) concerning ownership or availability of income or resources and the determination of the community spouse monthly income or resource allowance.

DHS 103.075(8)(a)(a) An institutionalized spouse or a community spouse may request a fair hearing in accordance with the procedures set out in s. DHS 104.01 (5) in regard to any of the following:

DHS 103.075(8)(a)1.1. The determination of the community spouse monthly income allowance under sub. (6) (b) 1.;

DHS 103.075(8)(a)2.2. The determination of the amount of the monthly income otherwise available to the community spouse used in the calculation under sub. (6) (b) 1.;

DHS 103.075(8)(a)3.3. The amount of the couple’s total countable assets determined under sub. (4) (c);

DHS 103.075(8)(a)4.4. The determination of the spousal share of resources under sub. (4) (c) 3.; and

DHS 103.075(8)(a)5.5. The determination of the community spouse resource allowance under sub. (4) (c) 3.

DHS 103.075(8)(b)(b) If the institutionalized spouse has made an application for MA and a fair hearing is requested under par. (a), the agency shall hold the hearing within 30 days after the request.