Increasing the Community Spouse Income Allowance Through Judicial Process: What Standard Applies?

In Florida, the community spouse of a Medicaid recipient can get a minimum monthly allowance of $1,295. But if they can prove they’re in a tough financial situation, they might be able to get more money through a fair hearing process or a court order. The maximum allowance is $1,919, but the court can decide to give more if needed. In the case of Gombrecht v. Sabol, the court decided that a community spouse could only receive a certain amount of monthly income allowance, and not more, based on social services laws. Even if the family court has discretion to grant support, it cannot exceed the allowance set by the social services legislation. The purpose is to prevent the community spouse from being impoverished while still ensuring they have enough income. Without exceptional circumstances, the court cannot award more than the allowed amount. In response to a legal ruling, a lawsuit was filed in federal court to stop New York state courts from using a tough standard to determine support payments. The court ultimately decided that Congress only meant for state courts to have the option to use a more lenient standard. In Florida, if one spouse fails to support the other, the court can order them to pay alimony, even if they’re not getting divorced. The amount of support is based on the need of the spouse asking for it and the ability of the other spouse to pay. In a case called Crider v. HRS, the court had to decide if a person was eligible for Medicaid benefits. The person had applied for benefits, but then a court ordered them to pay support to their spouse. This support would have lowered their income enough to qualify for Medicaid. However, the Medicaid agency rejected the support order and said the person wasn’t eligible. The court had to decide if this decision was fair. The court didn’t look at the broader issues because there wasn’t enough evidence, and the case was limited. The court was also concerned that the support order may not have been decided properly according to the law. In the case of Crider, the court suggested that support ordered from an institutionalized spouse should be reviewed based on traditional standards. However, the court also expressed doubt about how the support award could be justified, considering the limited financial resources of the institutionalized spouse. It also seemed to allow the department responsible for support enforcement to ignore the support order if it was not validly adjudicated. As a result, future support orders will likely be entered only after proper adjudication, and the department may not be able to easily ignore valid support orders in the future. Despite the available legal authority, there are obstacles to filing support petitions based solely on need and ability to pay. The court may reject the evidence, and the department may initially try to reject orders it doesn’t like. It’s important to be prepared to explain and defend the basis of the support order in any legal challenge. In a recent court case, the author successfully argued for a support order by proving both “exceptional circumstances” and “need and ability to pay” standards. The court agreed and issued the support order. The strategy worked and is recommended for future cases.

Source: https://www.floridabar.org/the-florida-bar-journal/increasing-the-community-spouse-income-allowance-through-judicial-process-what-standard-applies/