The proposed rules amend the treatment of resources in the Food Stamp and Medicaid eligibility determination.

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Economic Self-Sufficiency Program

RULE NO: RULE TITLE
65A-1.303: Assets
65A-1.707: Family-Related Medicaid Income and Resource Criteria
65A-1.712: SSI-Related Medicaid Resource Eligibility Criteria
PURPOSE AND EFFECT: The proposed rules amend the treatment of resources in the Food Stamp and Medicaid eligibility determination.
SUMMARY: The proposed rules allow for the exclusion of all vehicles as a resource.
SUMMARY OF STATEMENT 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, 414.45 FS.
LAW IMPLEMENTED: 409.902, 409.903, 409.904, 409.906, 409.918, 410.033, 414.075, 414.31 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(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: January 26, 2009, 3:30 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 Services, Telephone [phone]

THE FULL TEXT OF THE PROPOSED RULE IS:

65A-1.303 Assets.

(1) through (3) No change.

(4) Vehicles. The determination of whether a vehicle is an asset for food stamps and/or cash assistance purposes depends on the use of the vehicle, whether the vehicle is licensed or unlicensed, and the vehicle’s equity value. The determination must be made in accordance with Section 414.075, F.S., and 7 CFR 273.8.

Specific Authority 409.919 414.45 FS. Law Implemented 409.903, 409.904, 409.919, 410.033, 414.075, 414.31 FS. History–New 4-9-92, Amended 9-19-94, Formerly 10C-1.303, Amended 8-22-05, ________.

 

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. No change.

2. All vehicles One licensed vehicle valued at not more than $8,500; or, if vehicles are needed for training, employment, or education, one vehicle per employable adult in the coverage group, when the combined value of all vehicles does not exceed $8,500; or any vehicle necessary for transportation of a physically disabled member of the family;

3. through 7. No change.

(c) through (f) No change.

(2) No change.

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, 2-20-07, 5-6-08,________.

 

65A-1.712 SSI-Related Medicaid Resource Eligibility Criteria.

(1) No change.

(a) through (f) No change.

(2) Exclusions. The department follows SSI policy prescribed in 20 C.F.R. Part 416 (2008), incorporated by reference, in determining what is counted as a resource with the following exceptions, as mandated by federal Medicaid policies, or additional exclusions, as adopted by the department under section 42 U.S.C. § 1396a(r)(2) (2006), incorporated by reference. SSI policy requires resources in a blocked account to be countable resources. This applies regardless of whether the individual or their representative is required to petition the court to withdraw funds for the individual’s care. A blocked account is one in which state law protects an individual’s funds by specifically requiring that the funds be made available for the care and maintenance of the individual.

(a) through (d) No change.

(e) All vehicles are excluded One automobile is excluded, regardless of value.

(f) and (g) No change.

(3) Transfer of Resources and Income. According to 42 U.S.C. § 1396p(c) (2006), incorporated by reference, if an individual, the spouse, or their legal representative, disposes of resources or income for less than fair market value on or after the look back date, the department must presume that the disposal of resources or income was to become Medicaid eligible and impose a period of ineligibility for nursing facility care services, institutional hospice or HCBS waiver services. The department will mail a notice to individuals who report a transfer for less than fair market value (Form CF-ES 2264, Feb 2007, Notice of Determination of Assets (Or Income) Transfer, incorporated herein by reference), advising of the opportunity to rebut the presumption and of the opportunity to request and support a claim of undue hardship per subparagraph (c)5. below. If the department determines the individual is eligible for Medicaid on all other factors of eligibility except the transfer, the individual will be approved for general Medicaid services (not long-term care services) and advised of their penalty period (Form 2358, Feb 2007, Medicaid Transfer Disposition Notice, incorporated herein by reference.) The look back period is 36 months prior to the date of application, except in the case of a trust treated as a transfer in which case the look back period is 60 months prior to the date of application.

(a) The department follows the policy for transfer of assets mandated by 42 U.S.C. §§ 1396p and 1396r-5 (2006), incorporated by reference. Transfer policies apply to the transfer of income and resources.

(b) No change.

(c) No penalty or period of ineligibility shall be imposed against an individual for transfers described in 42 U.S.C. § 1396p(c)(2) (2006), incorporated by reference.

1. through 5. No change.

(d) No change.

1. through 3. No change.

4. A life estate interest purchased in another individual’s home after November 1, 2007 is considered a transfer of assets for less than fair market value. If the individual has not lived in the home for at least one year, the full amount of the purchase price paid for the life estate will be considered an uncompensated transfer without considering the value of the life estate. If the individual has resided in the home for at least one continuous year, the value of the life estate will be considered compensation and will be calculated by multiplying the current market value of the property at the time of the purchase by the life estate factor that corresponds to the individual’s age at the time of the purchase. The life estate tables are incorporated by reference from the Social Security Administration’s online Program Operations Manual System (SI 01140.120) (04/99), incorporated by reference, as found in Appendix A-17 of the Department’s online manual located at www.dcf.state.fl.us/ess/. Brief absences from the life estate property such as stays in a rehabilitation facility or vacations may not disrupt the client’s residency in the home. The facts of each absence will be evaluated to determine if the home continued to be the individual’s principal place of residence such as whether the person’s mail was delivered and received there or whether they paid the property taxes.

(e) through (g) No change.

(4) No change.

(5) Other Resource Policies.

(a) No change.

(b) An individual’s entrance fee in a continuing care retirement community or life care community shall be considered a resource, as set forth in 1917(g) of the Social Security Act (2007), which is incorporated herein by reference.

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, 9-28-04, 8-10-06 (1)(a), (f), 8-10-06 (1)(f), 8-10-06 (3)(g)1., 11-1-07,________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Nathan Lewis
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: George H. Sheldon
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 8, 2008
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: October 3, 2008