In this case, M is an institutionalized individual who receives Medicaid benefits to cover part of his healthcare costs. His spouse, R, sought a protective order under the Estates and Protected Individuals Code (EPIC), MCL 700.1101 et seq., claiming that she lacked sufficient income to meet her needs and asserting that she was entitled to support from M.
The Department of Health and Human Services (DHHS) opposed the petition, arguing that R did not exhaust available administrative remedies regarding Medicaid determinations, that the proposed order would leave M impoverished and unable to meet his own obligations, and that R did not need additional income from M.
A probate court has the authority to enter a protective order providing support for a community spouse whose institutionalized spouse is receiving Medicaid benefits, but that authority does not include the power to enter an order preserving the community spouse’s standard of living without consideration of the institutionalized spouse’s needs and his or her patient-pay obligations under Medicaid. In order to issue a protective order under MCL 700.5401(3)(b), the spouse requesting support must make a showing of need, not merely a desire to maintain a current standard of living without regard to the other spouse’s circumstances.
Whether the community spouse is entitled to support will depend on all the facts and circumstances, including the incapacitated individual’s financial means and ability to provide assistance. For instance, when crafting a protective order, the probate court should consider the protected individual’s foreseeable needs, the interests of the protected individual’s creditors, and the interests of the protected individual’s dependents.
A probate court’s consideration of the couple’s circumstances cannot involve an assumption that the institutionalized spouse should receive 100% free medical care under Medicaid or an assumption that a community spouse is entitled to maintain his or her standard of living. Medicaid is a need-based program, and a Medicaid recipient is obligated to contribute to his or her care.
Here, the probate court entered an order awarding R 100% of M’s monthly income, thereby leaving M without sufficient income to support himself. In doing so, the court reasoned: It is clear from the record that without the protective order, the joint assets will be depleted to the point that R will not be capable of supporting herself.
The DHHS argued that R was required to exhaust administrative remedies available before seeking a protective order from the probate court, and that the probate court should have declined to exercise jurisdiction until all administrative remedies were exhausted.
Absent from the court’s findings is any indication that it considered (1) whether R needed—as opposed to simply wanted—money and (2) whether R was entitled to M’s support despite the CSMIA provided under Medicaid and M’s patient-pay amount under Medicaid. Because those findings are necessary before a probate court may enter a protective support order under MCL 700.5401(3)(b), the appeals court conclude that the probate court abused its discretion by entering the order awarding R 100% of M’s monthly income.
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