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HB 822

Regards Medicaid personal needs allowance for certain individuals

136th Legislature (2025-2026) Introduced by Gary Click

Raises minimum monthly personal needs allowances for Medicaid residents: $1,100 individual / $2,200 couple in nursing facilities and ICF/IID, plus $100/$200 for assisted living par

Referred to committee
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Bill Summary · HB 822

Summary of HB 822 (Session 136, Ohio)

Purpose

HB 822 seeks to adjust the Medicaid personal needs allowances for individuals and couples in three Medicaid-funded living arrangements:
- Assisted living programs (Medicaid-funded component)
- Nursing facilities
- Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

The bill modifies how monthly personal needs allowances are determined and sets minimums for residents in these settings.

Key Provisions

1) Medicaid-funded Assisted Living Program

  • Eligible individuals must:
    • Need an intermediate level of care per assessment under section 173.546.
    • Reside in a residential care facility authorized to participate in the Medicaid-funded component, including:
    • Facilities owned/operated by a metropolitan housing authority with HUD subsidies or rental assistance.
    • County or district homes licensed as residential care facilities.
    • Meet all other eligibility requirements under rules adopted via section 173.54.
  • Income deduction for services:
    • Counties deduct a monthly personal needs allowance from the participant’s income, in line with SSA 1902(q).
    • The monthly personal needs allowance must be at least:
    • $100 for an individual.
    • $200 for a married couple (if both spouses participate and incomes are counted as available to each other).

2) Nursing Facility or ICF/IID Income Calculation (Section 5163.33)

  • The county Department of Job and Family Services (DJFS) deducts a monthly personal needs allowance from the recipient’s income, per SSA 1902(q).

Nursing Facility

  • Monthly personal needs allowance minimums:
    • At least $1,100 for an individual resident.
    • At least $2,200 for a married couple (if both spouses are residents and incomes are considered available to each other).

ICF/IID

  • Personal needs allowance structure:
    • Before January 1, 2016: $40 (unless the resident has earned income; could be up to $105, determined by Medicaid or its designee).
    • For 2016 and each subsequent year: not less than $1,100 for an individual, and not less than $2,200 for a married couple (if both spouses are residents and incomes are available to each other).

Affected Parties

  • Medicaid recipients in:
    • Medicaid-funded assisted living (residential care facilities).
    • Nursing facilities.
    • ICF/IID facilities.
  • County DJFS offices (administrative responsibility for calculating and deducting the personal needs allowance).
  • Residential care facilities and ICF/IID operators enrolled in Medicaid.
  • Potentially, residents in HUD-subsidized or HUD-assisted facilities under the assisted living component.

Procedural and Timeline Details

  • The bill repeals and replaces existing sections (173.541 and 5163.33) with the revised language.
  • It references adherence to rules adopted under section 173.54 for eligibility in the assisted living component.
  • It incorporates SSA 1902(q) guidance for computing monthly personal needs allowances.
  • The bill’s changes are effective upon passage and enactment (the exact effective date would be codified upon final version).

Practical Implications

  • Increases or guarantees minimum personal needs allowances for residents in nursing facilities ($1,100 individual; $2,200 couple) and standardizes a $100/$200 minimum for assisted living participants.
  • Introduces or clarifies eligibility criteria for assisted living facilities, including HUD-subsidized housing authority facilities.
  • May affect budget planning for counties and the Medicaid program by formalizing higher minimum allowances and clarifying allowed sources of income for eligibility determinations.

Note: The bill is introduced in the 136th General Assembly by Rep. Click (co-sponsor: Gary Click). As introduced, it would replace current provisions and align personal needs allowances with the SSA framework.

Compiled from official sources — confirm details with the bill’s official record.

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