DAR File No. 27923

Health, Health Care Financing, Coverage and Reimbursement Policy

R414-304

Income and Budgeting

NOTICE OF PROPOSED RULE

DAR File No.: 27923
Filed: 05/16/2005, 04:07
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rulemaking is necessary to add some income exclusions for Family Medicaid such as excluding hostile fire pay for military personnel serving in combat zones and interest income earned on certain resources. These changes make Family Medicaid policy consistent with policy for Aged, Blind or Disabled Medicaid. Many provisions have been reworded and rearranged both for Family Medicaid rules and for Aged, Blind or Disabled Medicaid rules, to make them easier to understand.

Summary of the rule or change:

Some citations have been corrected, updated, and obsolete citations removed. Much of the language has been reworded to put statements in active voice, to improve clarity, and for simplification. Many provisions have been rearranged so that rules regarding "uncounted income" are grouped together and rules regarding "counted income" are grouped together as much as possible. A new Subsection R414-304-2(5) has been added to better explain how veteran's benefits are counted and to be consistent with the same provision modified in Section R414-304-4. The new Subsection R414-304-2(13) has been modified to follow educational income changes made to the Supplemental Security Income program. Changes in Section R414-304-3 are mostly rewording to make the rules easier to read and understand. In Subsection R414-304-4(3), deletes definitions that are no longer applicable in this rule. In Subsection R414-304-4(8), clarifies that deductions from benefit income to repay overpayments of the benefit income are not counted as income. Subsection R414-304-4(15) is a new income exclusion for interest earned on countable resources and specific excluded resources. Subsection R414-304-4(16) is a new income exclusion for the additional hostile fire pay or imminent danger pay that is received by individuals in the armed forces serving in combat zones. Subsection R414-304-4(18) is a clarification that either $30 or actual expenses, if greater, will be deducted from rental income. Subsection R414-304-4(19) is a clarification about when deferred income is counted or not counted, and that deductions from income such as health insurance premiums, child care, etc., are counted as income when they could have been received. Subsection R414-304-4(20) is a further clarification that deductions from income to pay obligations such as child support, alimony or other debts are counted as income when the amount being deducted would have been received except for the obligation to make such a payment. Subsection R414-304-4(22) includes a clarification about how the portion of veteran's benefits for dependents is counted.

State statutory or constitutional authorization for this rule:

Title 26, Chapter 18

42 CFR 435.725, 435.726, 435.811 through 435.832, 2004 ed.; 45 CFR 233.20(a)(1), 233.20(a)(3)(iv), 233.20(a)(3)(vi)(A), 233.20(a)(4)(ii), 2004 ed.; 20 CFR 416.1102, 416.1103, 416.1120 through 416.1148, 416.1150, 416.1151, 416.1163 through 416.1166, and Appendix to Subpart K of 416, 2004 ed.; and Subsection 404(h)(4) and 1612(b)(22) of the Compilation of the Social Security Laws, in effect January 1, 2003

Anticipated cost or savings to:

the state budget:

No cost or savings because this rulemaking mostly clarifies and rewords rules. The new income exclusions for hostile fire pay are expected to allow currently eligible families to remain eligible while a household member is serving in a combat zone. The income exclusion of certain interest income allows exclusion of small amounts of income that usually could have been excluded as infrequent income.

local governments:

No cost or savings as this rulemaking does not impact local governments.

other persons:

No cost or savings as this rulemaking does not add any new requirements or take away any benefits. There may be some savings to individuals because some of their income will not be counted in determining eligibility.

Compliance costs for affected persons:

There are no compliance costs for affected persons as this rulemaking does not add any new requirements for eligibility or take away any benefits.

Comments by the department head on the fiscal impact the rule may have on businesses:

These rule changes add clarity to the rule and maintain the status quo for eligibility in these programs. No fiscal impact is anticipated. David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/01/2005

This rule may become effective on:

07/02/2005

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-304. Income and Budgeting.

R414-304-2. A, B and D Medicaid and A, B and D Institutional Medicaid Unearned Income Provisions.

(1) This rule establishes how the Department treats unearned income to determine eligibility for Aged, Blind and Disabled Medicaid and Aged, Blind and Disabled Institutional Medicaid coverage groups.

([1]2) The Department adopts 42 CFR 435.725, 435.726, 435.811 through 435.832, [2001]2004 ed., and 20 CFR 416.1102, 416.1103, 416.1120 through 416.1148, 416.1150, 416.1151, 416.1163 through 416.1166, and Appendix to Subpart K of 416, [2002]2004 ed., which are incorporated by reference. The Department adopts Subsection 404(h)(4) and 1612(b)(22) of the Compilation of the Social Security Laws in effect January 1, [2001]2003, which are incorporated by reference. The Department [shall]does not count as income any payments from sources that [are prohibited under other ]federal laws specifically prohibit from being counted as income to determine eligibility for federally-funded medical assistance programs.

([2]3) The following definitions apply to this section:

(a) "Eligible spouse" means the member of a married couple who is either aged, blind, or disabled.

(b) "In-kind support donor" means an individual who provides food or shelter without receiving full market value compensation in return.

(c) "Presumed maximum value" means the allowed maximum amount an individual is charged for the receipt of food and shelter. This amount [shall]will not exceed 1/3 of the SSI federal benefit rate plus $20.

([3]4) [Only the portion of a VA check to which the client is legally entitled is countable income. ]The agency does not count VA (Veteran's Administration) payments for aid and attendance [ do not count as income. T]or the portion of a VA payment that is made because of unusual medical expenses[ is not countable income]. Other VA income based on need is countable income, but is not subject to the $20 general income disregard.

(5) The agency only counts as income the portion of a VA check to which the client is legally entitled. If the payment includes an amount for a dependent, that amount counts as income for the dependent. If the dependent does not live with the veteran or surviving spouse, the portion for the dependent counts as the dependent's income unless the dependent has applied to VA to receive the payment directly, VA has denied that request, and the dependent does not receive the payment. In this case, the amount for a dependent also counts as income of the veteran or surviving spouse who receives the payment.

(6) SSA reimbursements of Medicare premiums are not countable income.

([4]7) The agency does not count as income, the value of special circumstance items [is not countable income ]if the items are paid for by donors.

([5]8) For A, B and D Medicaid, the agency counts as income two-thirds of current child support received in a month for the disabled child[ is countable unearned income]. It does not matter if the payments are voluntary or court-ordered. It does not matter if the child support is received in cash or in-kind. If there is more than one child for whom the payment is made, the amount is divided equally among the children unless a court order indicates a different division. Child support payments that are payments owed for past months or years are countable income to determine eligibility for the parent or guardian receiving the payments.

([6]9) For A, B and D Institutional Medicaid, court-ordered child support payments must be paid to the Office of Recovery Services (ORS) when the child resides out-of-home in a Medicaid 24-hour care facility. If the child has no income or insufficient income to provide for a personal needs allowance, ORS will allow the parent to retain up to the amount of the personal needs allowance to send to the child for personal needs. All other current child support payments received by the child or guardian that are not subject to collection by ORS [shall ]count as unearned income to the child.

([7]10) The agency counts as unearned income, the interest earned from a sales contract on either or both the lump sum and installment payments [is countable unearned income ]when it is received or made available to the client.

([8]11) If the client, or the client and spouse do not live with an in-kind support donor, in-kind support and maintenance is the lesser of the value or the presumed maximum value of food or shelter received. If the client, or the client and spouse live with an in-kind support donor and do not pay a prorated share of household operating expenses, in-kind support and maintenance is the difference between the prorated share of household operating expenses and the amount the client, or the client and spouse actually pay, or the presumed maximum value, whichever is less.

([9) SSA reimbursements of Medicare premiums are not countable income.

(10]12) Payments under a contract, retroactive payments from SSI and SSA reimbursements of Medicare premiums are not considered lump sum payments.

([11]13) The agency does not count as income [E]educational loans, grants, and scholarships received from Title IV programs of the Higher Education Act or from Bureau of Indian Affairs educational programs.[guaranteed by the U.S. Department of Education are not countable income if the recipient is an undergraduate. Income from service learning programs is not countable income if the recipient is an undergraduate.] The agency does not count as income grants, scholarships, fellowships, or gifts from other sources that are actually used to pay, or will be used to pay, allowable educational expenses.[Deductions are allowed from countable educational income if receipt of the income depends on school attendance and if the client pays the expense. ] Any amount of grants, scholarships, fellowships, or gifts from other sources that are used or will be used for non-educational expenses including food and shelter expenses, counts as income in the month received. Allowable [deductions]educational expenses include:

(a) tuition;

(b) fees;

(c) books;

(d) equipment;

(e) special clothing needed for classes;

(f) travel to and from school at a rate of 21 cents a mile, unless the grant identifies a larger amount;

(g) child care necessary for school attendance.

([12]14) Except for an individual eligible for the Medicaid Work Incentive Program, the following provisions apply to non-institutional medical assistance:

(a) For A, B, or D Medicaid, the agency does not count income of a spouse or a parent [shall not be considered in determining]to determine Medicaid eligibility of a person who receives SSI or meets 1619(b) criteria. SSI recipients and 1619(b) status individuals who meet all other Medicaid eligibility factors [shall be]are eligible for Medicaid without spending down.

(b) If an ineligible spouse of an aged, blind, or disabled person has more income after deductions than the allocation for a spouse, [that income shall be deemed to be income]the agency deems the spouse's income to the aged, blind, or disabled spouse to determine eligibility.

(c) The [Department shall]agency determines household size and whose income counts for A, B or D Medicaid as described below.

(i) If only one spouse is aged, blind or disabled:

(A) the agency deems income of the ineligible spouse [shall be deemed to be income ]to the eligible spouse when [it]that income exceeds the allocation for a spouse. The agency compares the combined income [shall then be compared ]to 100% of the federal poverty guideline for a two-person household. If the combined income exceeds that amount, the agency compares it[ shall be compared], after allowable deductions, to the BMS for two to calculate the spenddown.

(B) If the ineligible spouse's income does not exceed the allocation for a spouse, the agency does not count the ineligible spouse's income [shall not be counted ]and does not include the ineligible spouse [shall not be included ]in the household size. Only the eligible spouse's income [shall be]is compared to 100% of the federal poverty guideline for one. If the income exceeds that amount, it [shall be]is compared, after allowable deductions, to the BMS for one to calculate the spenddown.

(ii) If both spouses are either aged, blind or disabled, the income of both spouses is combined and compared to 100% of the federal poverty guideline for a two-person household. SSI income is not counted.

(A) If the combined income exceeds that amount, and one spouse receives SSI, only the income of the non-SSI spouse, after allowable deductions, [shall be]is compared to the BMS for a one-person household to calculate the spenddown.

(B) If neither spouse receives SSI and their combined income exceeds 100% of the federal poverty guideline, then the income of both spouses, after allowable deductions, [shall be]is compared to the BMS for a two-person household to calculate the spenddown.

(C) If neither spouse receives SSI and only one spouse will be covered under the applicable program, the agency deems income of the non-covered spouse [shall be deemed ]to the covered spouse when [it]that income exceeds the spousal allocation. If the non-covered spouse's income does not exceed the spousal allocation, then the agency counts only the covered spouse's income[ shall be counted]. In both cases, the countable income [shall be]is compared to 100% of the two-person poverty guideline. If it exceeds the limit, then income, after allowable deductions, [shall be]is compared to the BMS.

(I) If the non-covered spouse has deemable income, the countable income, after allowable deductions, [shall be]is compared to a two-person BMS to calculate a spenddown.

(II) If the non-covered spouse does not have deemable income, then only the covered spouse's income, after allowable deductions, [shall be]is compared to a one-person BMS to calculate the spenddown.

(iii) In determining eligibility under (c) for an aged or disabled person whose spouse is blind, both spouses' income is combined.

(A) If the combined income after allowable deductions is under 100% of the federal poverty guideline, the aged or disabled spouse will be eligible under the 100% poverty group defined in 1902(a)(10)(A)(ii) of the Social Security Act, and the blind spouse is eligible without a spenddown under the medically needy group defined in 42 CFR 435.301.

(B) If the combined income after allowable deductions is over 100% of poverty, both spouses are eligible with a spenddown under the medically needy group defined in 42 CFR 435.301.

(iv) If one spouse is disabled and working, [and ]the other is aged, blind, or disabled and not working, [but is ]and neither spouse is an SSI recipient nor a 1619(b) eligible individual[ and is not working], the working disabled spouse may choose to receive coverage under the Medicaid Work Incentive program. If both spouses want coverage, however, the [Department shall]agency first determines eligibility for them as a couple. If a spenddown is owed for them as a couple, they must meet the spenddown to receive coverage for both of them.

(e) Except when determining countable income for the 100% poverty-related Aged and Disabled Medicaid programs, income will not be deemed from a spouse who meets 1619(b) protected group criteria.

(f) The [Department shall]agency determines household size and whose income counts for QMB, SLMB, and QI-1 assistance as described below.

(i) If both spouses receive Part A Medicare and both want coverage, the agency combines income of both spouses[shall be combined] and [compared]compares it to the applicable percentage of the poverty guideline for a two-person household.

(ii) If one spouse receives Part A Medicare, and the other spouse is aged, blind, or disabled and that spouse either does not receive Part A Medicare or does not want coverage, then the agency deems income of the ineligible spouse [shall be deemed ]to the eligible spouse when [it]that income exceeds the allocation for a spouse. If the income of the ineligible spouse does not exceed the allocation for a spouse, then only the income of the eligible spouse [shall be]is counted. In both cases, the countable income [shall be]is compared to the applicable percentage of the federal poverty guideline for a two-person household.

(iii) If one spouse receives Part A Medicare and the other spouse is not aged, blind or disabled, the agency deems income of the ineligible spouse [shall be deemed ]to the eligible spouse when [it]that income exceeds the allocation for a spouse. The combined countable income [shall be]is compared to the applicable percentage of the federal poverty guideline for a two-person household. If the ineligible spouse's deemable income does not exceed the allocation for a spouse, only the eligible spouse's income [shall be]is counted, and compared to the applicable percentage of the poverty guideline for a one-person household.

(iv) SSI income will not be counted to determine eligibility for QMB, SLMB or QI-1 assistance.

(g) If any parent in the home receives SSI or is eligible for 1619(b) protected group coverage, the agency will not count the income of [n]either parent [shall be considered ]to determine a child's eligibility for B or D Medicaid.

(h) Payments for providing foster care to a child are countable income. The portion of the payment that represents a reimbursement for the expenses related to providing foster care is not countable income.

([13]15) For institutional Medicaid including home and community based waiver programs, the agency[Department shall only] counts only the client in the household size, and [only ]counts only the client's income[,] and income deemed from an alien client's sponsor, to determine contribution to cost of care.

([14]16) [I]The agency does not count interest accrued on an Individual Development Account as defined in Sections 404-416 of Pub. L. No. 105-285 effective October 27, 1998[, shall not count as income].

([15]17) [I]The agency deems income, unearned and earned, [shall be deemed ]from an alien's sponsor, and the sponsor's spouse, if any, when the sponsor has signed an Affidavit of Support pursuant to Section 213A of the Immigration and Nationality Act on or after December 19, 1997.

([16]18) Sponsor deeming will end when the alien becomes a naturalized U.S. citizen, or has worked 40 qualifying quarters as defined under Title II of the Social Security Act or can be credited with 40 qualifying work quarters. Beginning after December 31, 1996, a creditable qualifying work quarter is one during which the alien did not receive any federal means-tested public benefit.

([17]19) Sponsor deeming does not apply to applicants who are eligible for Medicaid for emergency services only.

([18]20) If income such as retirement income has been divided between divorced spouses by the divorce decree pursuant to a Qualified Domestic Relations Order, only the amount paid to the individual is counted as income.

R414-304-3. Medicaid Work Incentive Program Unearned Income Provisions.

(1) This rule establishes how the Department treats unearned income for the Medicaid Work Incentive program.

([1]2) The Department adopts 20 CFR 416.1102, 416.1103, 416.1120 through 416.1148, 416.1150, 416.1151, and Appendix to Subpart K of 416, [2002]2004 ed., which are incorporated by reference. The Department adopts Subsection 404(h)(4) and 1612(b)(22) of the Compilation of the Social Security Laws in effect January 1, [2001]2003. The Department [shall]does not count as income any payments from sources that [are prohibited under other ]federal laws specifically prohibit from being counted as income to determine eligibility for federally-funded medical assistance programs.

([2]3) The Department [shall ]allows the provisions found in R414-304-2 ([3]4) through ([11]13), and ([14]16) through ([18]20).

([3]4) The agency determines income from an ineligible spouse or parent [shall be determined ]by the total of the earned and unearned income using the appropriate exclusions in 20 CFR 416.1161, except that court ordered support payments [would]are not [be ]allowed as an income deduction.

([4]5) For the Medicaid Work Incentive Program, the income of a spouse or parent [shall not be ]is not considered in determining eligibility of a person who receives SSI. SSI recipients who meet all other Medicaid Work Incentive Program eligibility factors [shall be]are eligible without paying a Medicaid buy-in premium.

([5]6) The [Department shall]agency determines household size and whose income counts for the Medicaid Work Incentive Program as described below:

(a) If the Medicaid Work Incentive Program individual is an adult and is not living with a spouse, the agency counts only the income of the individual. [Include in]The agency includes in the household size, any dependent children under age 18, or who are 18, 19, or 20 and are full-time students. These dependent children must be living in the home or be temporarily absent. After allowable deductions, the net income [shall be]is compared to 250% of the federal poverty guideline for the household size involved.

(b) If the Medicaid Work Incentive Program individual is living with a spouse, the agency combines their income before allowing any deductions. [Include in]The agency includes in the household size the spouse and any children under age 18, or who are 18, 19, or 20 and are full-time students. These dependent children must be living in the home or be temporarily absent. [C]The agency compares the net income of the Medicaid Work Incentive Program individual and spouse to 250% of the federal poverty guideline for the household size involved.

(c) If the Medicaid Work Incentive Program individual is a child living with a parent, the agency combines the income of the Medicaid Work Incentive Program individual and the parents before allowing any deductions. [Include in]The agency includes in the household size the parents, any minor siblings, and siblings who are age 18, 19, or 20 and are full-time students, who are living in the home or temporarily absent. [C]The agency compares the net income of the Medicaid Work Incentive Program individual and the individual's parents to 250% of the federal poverty guideline for the household size involved.

R414-304-4. Family Medicaid and Institutional Family Medicaid Unearned Income Provisions.

(1) This rule establishes how the Department treats[section provides eligibility criteria governing ]unearned income [for the]to determine[ation of] eligibility for Family Medicaid and Institutional Family Medicaid coverage groups.

([1]2) The Department adopts 42 CFR 435.725, 435.726, 435.811 through 435.832, [2001]2004 ed., and 45 CFR 233.20(a)(1), 233.20(a)(3)(iv), 233.20(a)(3)(vi)(A), [233.20(a)(3)(xxi),]and 233.20(a)(4)(ii), [and 233.51, 2003]2004 ed., which are incorporated by reference. The Department adopts Subsection 404(h)(4) of the Compilation of the Social Security Laws in effect January 1, 2003, which is incorporated by reference. The Department [shall]does not count as income any payments from sources that [are prohibited under other ]federal laws specifically prohibit from being counted as income to determine eligibility for federally-funded medical assistance programs.

([2]3) The [following definitions apply to this section:

(a) A "bona fide loan" is a loan that has been contracted in good faith without fraud or deceit and genuinely endorsed in writing for repayment.

(b) "Unearned ]term "unearned income" means cash received for which the individual performs no service.[

(c) "Quarter" means any three-month period that includes January through March, April through June, July through September or October through December.]

([3]4) [Bona fide loans are not countable income]The agency does not count as income money loaned to the individual if the individual proves the money is from a loan that the individual is expected to repay.

([4]5) The agency does not count as income [S]support and maintenance assistance provided in-kind by a non-profit organization certified by the Department of Human Services[ is not countable income].

([5]6) The agency does not count as income [T]the value of food stamp assistance, USDA food donations or WIC vouchers received by members of the household[ is not countable income].

[ (6) SSI and State Supplemental Payments are income for children receiving Child, Family, Newborn, or Newborn Plus Medicaid.

(7) If rental income is unearned income, deduct $30. If the rental income is consistent with community standards, additional deductions are allowed if the client can prove greater expenses. The following expenses in excess of $30 may be allowed:

(a) taxes and attorney fees needed to make the income available;

(b) upkeep and repair costs necessary to maintain the current value of the property. This includes utility costs.

(c) only the interest can be deducted on a loan or mortgage made for upkeep or repair;

(d) if meals are provided to a boarder, the value of a one-person food stamp allotment.]

([8]7) The agency does not count income that is received too irregularly or infrequently to count as regular income, such as [C]cash gifts, [that do not exceed]up to $30 a calendar quarter per [person in the assistance unit ]household member[ are not countable income]. Any amount that exceeds $30 a calendar quarter per household member counts as income when received. [A cash gift]Irregular or infrequent income may be divided equally among all members of the [assistance unit]household.

[ (9) Deferred income that was not deferred by choice is countable income when it is received by the client if receipt can be reasonably anticipated. If the income was deferred by choice, count it as income when it could have been received.]

(8) The agency does not count as income the amount deducted from benefit income that is to repay an overpayment of such benefit income.

([10]9) The agency does not count as income the value of special circumstance items [is not countable income if the items are ]paid for by donors.

([11]10) The agency does not count as income [H]home energy assistance[ is not countable income].

([12]11) The agency does[Do] not count payments from any source that are to repair or replace lost, stolen or damaged exempt property. If the payments include an amount for temporary housing, the agency only counts [only ]the amount that the client does not intend to use or that is more than what is needed for temporary housing.

([13]12) The agency does not count as income SSA reimbursements of Medicare premiums[ are not countable income].

[ (14) Payments from trust funds are countable income in the month the payment is received or made available to the individual.]

([15]13) The agency does not count as income [P]payments from the Department of Workforce Services under the Family Employment program, the Working Toward Employment Program, and the Refugee Cash Assistance program[ are not countable income]. To determine eligibility for Medicaid, the agency counts [I]income used to determine the amount of these payments[ is counted to determine eligibility for Medicaid], unless the income is an excluded income under other laws or regulations.

[ (16) Only the portion of a Veteran's Administration check to which the client is legally entitled is countable income.

(17) If the entitlement amount of a benefit differs from the payment, the full entitlement amount is counted as income unless the amount being withheld from the entitlement is due to an overpayment of such benefits, in which case the entitlement less the amount withheld to repay the overpayment is counted. If deductions are being withheld that are purely voluntary, or are to repay a debt or meet a legal obligation other than an overpayment of the benefit, the full entitlement is counted as income.

(18) Deposits to joint checking or savings accounts are countable income, even if the deposits are made by a non-household member. Clients who dispute ownership of deposits to joint checking or savings accounts shall be given an opportunity to prove that the deposits do not represent income to them. Funds that are successfully disputed are not countable income.

(19) Income, unearned and earned, is deemed from an alien's sponsor, and the sponsor's spouse, if any, when the sponsor has signed an Affidavit of Support pursuant to Section 213A of the Immigration and Nationality Act on or after December 19, 1997.

(20) Sponsor deeming ends when the alien becomes a naturalized U.S. citizen, or has worked 40 qualifying quarters as defined under Title II of the Social Security Act or can be credited with 40 qualifying work quarters. Beginning after December 31, 1996, a creditable qualifying work quarter is one during which the alien did not receive any federal means-tested public benefit.

(21) Sponsor deeming does not apply to applicants who are eligible for Medicaid for emergency services only.

(22) The interest earned from a sales contract on either or both the lump sum and installment payments is countable unearned income when it is received or made available to the client.]

([23]14) The agency does not count as income the [I]interest accrued on an Individual Development Account as defined in 42 U.S.C. 604(h)[ does not count as income].

(15) The agency does not count as income interest or dividends earned on countable resources. The agency does not count as income interest or dividends earned on resources that are specifically excluded by federal laws from being counted as available resources to determine eligibility for federally-funded, means-tested medical assistance programs, other than resources excluded by 42 U.S.C. 1382b(a).

(16) The agency does not count as income the increase in pay for a member of the armed forces that is called "hostile fire pay" or "imminent danger pay," which is compensation for active military duty in a combat zone.

(17) The agency counts as income SSI and State Supplemental payments received by children who are included in the coverage under Child, Family, Newborn, or Newborn Plus Medicaid.

(18) The agency counts unearned rental income. The agency deducts $30 a month from the rental income. If the amount charged for the rental is consistent with community standards, the agency deducts the greater of either $30 or the following actual expenses that the client can verify.

(a) taxes and attorney fees needed to make the income available;

(b) upkeep and repair costs necessary to maintain the current value of the property, including utility costs paid by the applicant or recipient;

(c) interest paid on a loan or mortgage made for upkeep or repair; and,

(d) the value of a one-person food stamp allotment, if meals are provided to a boarder.

(19) The agency counts deferred income when it is received by the client if it was not deferred by choice and receipt can be reasonably anticipated. If the income was deferred by choice, it counts as income when it could have been received. The amount deducted from income to pay for benefits like health insurance, medical expenses or child care counts as income in the month the income could have been received.

(20) The agency counts the amount deducted from income that is to pay an obligation such as child support, alimony or debts in the month the income could have been received.

(21) The agency counts payments from trust funds as income in the month the payment is received by the individual or made available for the individual's use.

(22) The agency only counts as income the portion of a Veterans Administration check to which the client is legally entitled. If the payment includes an amount for a dependent, that amount counts as income for the dependent. If the dependent does not live with the veteran or surviving spouse, the portion for the dependent counts as the dependent's income unless the dependent has applied to VA to receive the payment directly, VA has denied that request, and the dependent does not receive the payment. In this case, the amount for a dependent counts as income of the veteran or surviving spouse who receives the payment.

(23) The agency counts as income deposits to financial accounts jointly owned between the client and one or more other individuals, even if the deposits are made by a non-household member. If the client disputes ownership of the deposits and provides adequate proof that the deposits do not represent income to the client, the agency does not count those funds as income. The agency may require the client to terminate access to the jointly held accounts.

(24) The agency counts as unearned income the interest earned from a sales contract on lump sum payments and installment payments when the interest payment is received by or made available to the client.

([24]25) The agency counts [C]current child support payments [are countable]as income to the child for whom the payments are being made. If a payment is for more than one child, the amount is divided equally among the children unless a court order indicates a different division. Child support payments made for past months or years (arrearages) are countable income to determine eligibility of the parent or guardian who is receiving the payment. Arrearages are payments collected for past months or years that were not paid on time and are like repayments for past-due debts. If [ORS]the Office of Recovery Services is collecting [the]current child support, it is counted as current even if [it is mailed late by ORS]the Office of Recovery Services mails the payment to the client after the month it is collected.[ Arrearages are payments collected for past months or years that were not paid on time and are like repayments for past-due debts. ORS may be collecting both current child support and arrearages.]

([25]26) The agency counts [P]payments from annuities [count ]as unearned income in the month the payment is received.

([26]27) If income such as retirement income has been divided between divorced spouses by the divorce decree pursuant to a Qualified Domestic Relations Order, the agency only counts [only ]the amount paid to the individual.

(28) The agency deems both unearned and earned income from an alien's sponsor, and the sponsor's spouse, if any, when the sponsor has signed an Affidavit of Support pursuant to Section 213A of the Immigration and Nationality Act on or after December 19, 1997.

(29) The agency stops deeming income from a sponsor when the alien becomes a naturalized U.S. citizen, or has worked 40 qualifying quarters as defined under Title II of the Social Security Act or can be credited with 40 qualifying work quarters. Beginning after December 31, 1996, a creditable qualifying work quarter is one during which the alien did not receive any federal means-tested public benefit.

(30) Sponsor deeming does not apply to applicants who are eligible for Medicaid for emergency services only.

KEY: financial disclosures, income, budgeting

[October 16, 2004]2005

Notice of Continuation January 31, 2003

26-18-1

ADDITIONAL INFORMATION

PLEASE NOTE:

• Text to be deleted is struck through and surrounded by brackets (e.g., [example]). Text to be added is underlined (e.g., example). Some browsers may not depict some or any of these attributes on the screen or when the document is printed.
• Please see the DISCLAIMER regarding information available from state web pages.

For questions regarding the content or application of this rule, please contact Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.