Substitute Bill No. 58 is a legislative proposal that aims to amend Medicaid state plan provisions related to the calculation of applied income for Medicaid applicants and recipients. The bill, effective October 1, 2023, would allow for qualified deductions for expenses related to the representation of a Medicaid applicant or recipient. These expenses include compensation for a conservator approved by the Probate Court or a minimum of $125 per month for any accounting period lasting at least a year, Probate Court filing fees and expenses, premiums for any probate bond required by the Probate Court, and any other fiduciary expenses approved by the Probate Court. The bill specifies that these deductions are permissible under federal law and should be taken from applied income after all other Medicaid state plan deductions.

Additionally, the bill requires the Commissioner of Social Services to calculate the total amount deducted from the applied income of Medicaid applicants and recipients under these provisions annually and inform the Probate Court Administrator. The Probate Court Administrator must then transfer funds equal to half of the total amount deducted from the Probate Court Administration Fund to the Department of Social Services. The bill also includes language that prevents the Commissioner of Social Services from treating conservator compensation, fiduciary fees, and expenses approved by the Probate Court as an improper transfer of assets for Medicaid eligibility, provided that the applicant or recipient submits documentation demonstrating that the services were in accordance with Probate Court regulations and were for fair market value. Furthermore, the bill increases the minimum compensation payable to conservators or guardians from $50 to $125 for any accounting period lasting at least a year.