The purpose of these proposed amendments is to align policies and procedures for income and asset exclusions for Medicaid coverage groups. The Social Security Protection Act of 2004 included several policy changes for income and asset exclusions for ...

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency Program

RULE NO: RULE TITLE
65A-1.707: Family-Related Medicaid Income and Resource Criteria
65A-1.713: SSI-Related Medicaid Income Eligibility Criteria
PURPOSE AND EFFECT: The purpose of these proposed amendments is to align policies and procedures for income and asset exclusions for Medicaid coverage groups. The Social Security Protection Act of 2004 included several policy changes for income and asset exclusions for the Supplemental Security Income (SSI) program. By law these provisions must also apply to SSI-related Medicaid programs and state funded programs (Optional State Supplementation and Home Care for Disabled Adults). The Farm Bill of 2002 allows flexibility to align food stamp income-related policies to those used by TANF and 1931 Medicaid programs. Florida is aligning the policies to further simplify program policies and procedures.
SUMMARY: The proposed amendments specify the provisions for income exclusions for infrequent or irregular earned and unearned income; interest and dividends; and educational grants, loans, scholarships, fellowships and gifts.
SUMMARY OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.903, 409.918, 409.919 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: December 4, 2006, 3:00 p.m.
PLACE: 1317 Winewood Boulevard, Building 3, Room 455, Tallahassee, FL 32399
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Pat Whitford, Economic Self-Sufficiency, Telephone [phone]

THE FULL TEXT OF THE PROPOSED RULE IS:

65A-1.707 Family-Related Medicaid Income and Resource Criteria.

(1) Family-related Medicaid income is based on the definitions of income, resources (assets), verification and documentation requirements as follows.

(a) No change.

(b) Resources. Resources are items of value that are owned singly or jointly by an individual who has access to the cash value upon disposition. To be financially eligible for family-related Medicaid, the coverage group’s resources cannot exceed the limits specified in subsection 65A-1.716(4), F.A.C. If countable resources are below the resource limit at any time during the month, the coverage group is eligible on the factor of resources for that month. The following resources are excluded in determining the coverage group’s eligibility:

1. through 5. No change.

6. Any portion of sStudent grants, loans, and scholarships, fellowships, or gifts used to pay tuition, fees or other necessary educational expenses; and

7. No change.

(c) No change.

(d) Income Disregards. Only the income remaining after the following disregards are applied is counted in the eligibility determination:

1. through 6. No change.

7. Total of infrequent or irregular unearned income if it does Small nonrecurring gifts which do not exceed $60 30 per recipient in a calendar quarter is excluded  are not considered as income; for example, gifts for Christmas, birthdays and graduations.

8. Total of infrequent or irregular earned income if it does not exceed $30 in a calendar quarter is excluded.

9. Interest and dividends on countable assets are excluded.

Specific Authority 409.919 FS. Law Implemented 409.903, 409.918, 409.919 FS. History–New 10-8-97, Amended 2-15-01, 11-23-04,________.

 

65A-1.713 SSI-Related Medicaid Income Eligibility Criteria.

(1) No change.

(2) Included and Excluded Income. For all SSI-related coverage groups the department follows the SSI policy specified in 20 C.F.R. 416.1100, et seq., including exclusionary policies regarding Veterans Administration benefits such as VA Aid and Attendance, unreimbursed Medical Expenses, and reduced VA Improved pensions, to determine what counts as income and what is excluded as income with the following exceptions:

(a) No change.

(b) Exclude Income which is considered total of irregular or infrequent earned income if it does not exceed $30 per calendar quarter is not considered in determining income eligibility.

(c) Exclude total of irregular or infrequent unearned income if it does not exceed $60 per calendar quarter.

(d)(c) Income placed into a qualified income trust is not considered when determining if an individual meets the income standard for ICP, institutional Hospice program or HCBS.

(e) Interest and dividends on countable assets are excluded, except when determining patient responsibility for ICP, HCBS and other institutional programs.

(3) through (4) No change.

Specific Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06(1), (4), 8-10-06(1), ________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Nathan Lewis
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Jennifer Lange
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 18, 2006
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: July 28, 2006