DPSS ePolicy

To convert existing policy to the new webpage - No content changes.

Board and Care (B&C) facilities are licensed, non-medical assisted living facilities that provide room, board, 24-hour staffing, Personal Care Services, and medication management.  Nursing and medical care are not provided in B&C facilities.  Medi-Cal (MC) will pay for medical care and services for MC beneficiaries residing in B&C facilities, but will not pay for “room and board”.

Effective April 1, 2000, MC beneficiaries living in licensed B&C facilities are entitled to receive an income deduction for Personal Care Services.  Personal Care Services are a range of human assistance services such as:  bathing, dressing, eating, etc. that are provided to persons with disabilities.  These services assist the person with accomplishing tasks they would otherwise do for themselves if they did not have a disability.

Personal Care Services Deduction

B&C cases must be processed using the standard $315 Personal Care Services income deduction or the Maintenance Need Deduction, whichever is greater.

• Standard $315 Personal Care Services Income Deduction

The standard deduction of $315 (no less and no more) is the amount allowed for incurred expenses for "Personal Care Services". 

• Maintenance Need Deduction (a.k.a. excess board and care deduction)

The maintenance need deduction is the amount of board and care actually paid by the beneficiary which exceeds the maintenance need level amount for the household size. 

For example:  A single MC beneficiary residing in a B&C facility, pays $800 to the facility.  The maintenance need level for one person is $600.  The amount of B&C that exceeds the maintenance need is $200.

Amount paid by beneficiary, $800, minus Maintenance Need for 1, $600, equals the Maintenance Need Deduction, $200.

Personal Care Services deduction allowance per MC program:

MAGI

Standard $315 Deduction allowed, or Maintenance Need Deduction allowed, whichever is greater.

Non-MAGI

Standard $315 Deduction allowed, or Maintenance Need Deduction allowed, whichever is greater.

Medicare Savings Program (MSP)

Standard $315 Deduction not allowed, nor Maintenance Need Deduction allowed.

Pickle

Standard $315 Deduction not allowed, nor Maintenance Need Deduction allowed.

The Pettit v. Bontá court case allows individuals in licensed B&C facilities the ability to apply incurred expenses for personal care services to their Share-of-Cost (SOC). 

Terms and Descriptions

 Licensed Medical Facility

Private or public institution or agency, licensed by the Department of Health Care Services that furnishes, conducts and operates health services for the diagnosis, treatment and prevention of human disease, pain, injury or physical condition. 

Board and Care (B&C)

Receipt of room, board, 24-hour staffing, Personal Care Services and designated supplemental services in a certified or licensed non-medical facility. 

Board and Care (B&C) Facilities

Homes that provide greater assistance with personal care needs but do not offer nursing or medical care.

Types of B&C Facilities:

• Adult Residential facility;
• Residential Facility for the Chronically Ill; or
• Residential Facility for the Elderly.

Other types of B&C facilities are:

• The home of a relative or legally appointed guardian or conservator, other than the spouse or parent's home;
• The home in which a child is placed by a court under Welfare and Institutions Code 724(a);
• An exclusive use of a home approved by a licensed home finding agency;
• Residential care non-medical facility licensed by the California Department of Social Services Community Care Licensing. 

Nursing Facilities (NF)/Skilled Nursing Facilities (SNF)

Homes that serve as licensed medical facilities for individuals who require a higher level of medical care.  They provide 24-hour medical attention as well as assistance with personal care needs.  Also known as Long-Term Care (LTC) facilities.

Spousal Impoverishment (SI) Provisions

Federal provisions designed to prevent the spouse of an institutionalized person from becoming impoverished due to the high cost of institutionalization.

MC applicants and beneficiaries residing in a B&C facility must provide verification of B&C costs/expenses in order to receive the Personal Care Services deduction.

Board and Care Expense

A letter from the facility can be used to verify the amount of board and care paid by the applicant/beneficiary. 

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