Iowa Admin. Code r. 441-75.57 - Income
When determining initial and
1. Unless
otherwise specified at rule
441-75.1 (249A),
the determination of initial eligibility is a three-step process. Initial
eligibility shall be granted only when (1) the countable gross nonexempt
unearned and earned income received by the eligible group and available to meet
the current month's needs is no more than 185 percent of living costs as
identified in the schedule of needs at subrule 75.58(2) for the eligible group
(Test 1); (2) the countable net earned and unearned income is less than the
schedule of living costs as identified in the schedule of needs at subrule
75.58(2) for the eligible group (Test 2); and (3) the countable net unearned
and earned income, after applying allowable disregards, is less than the
schedule of basic needs as identified at subrule 75.58(2) for the eligible
group (Test 3).
2. The
determination of continuing eligibility is a two-step process. Continuing
eligibility shall be granted only when (1) countable gross nonexempt income, as
described for initial eligibility, does not exceed 185 percent of the living
costs as identified in the schedule of needs at subrule 75.58(2) for the
eligible group (Test 1); and (2) countable net unearned and earned income is
less than the schedule of basic needs as identified in the schedule of needs at
subrule 75.58(2) for the eligible group (Test 3).
3. Child support assigned to the department
in accordance with 441-subrule 41.22(7) shall be considered unearned income for
the purpose of determining continuing eligibility, except as specified at
paragraphs 75.57(1)"e, '15.51(6) "u, " and 75.57(7)"o.
" Expenses for care of children or disabled adults, deductions, and
diversions shall be allowed when verification is provided.
(1)
Unearned income.
Unearned income is any income in cash that is not gained by labor or service.
When taxes are withheld from unearned income, the amount considered will be the
net income after the withholding of taxes (Federal Insurance Contribution Act,
state and federal income taxes). Net unearned income shall be determined by
deducting reasonable income-producing costs from the gross unearned income.
Money left after this deduction shall be considered gross income available to
meet the needs of the eligible group.
a.
Social security income is the amount of the entitlement before withholding of a
Medicare premium.
b. Financial
assistance received for education or training. Rescinded lAB 2/11/98, effective
2/1/98.
c. Rescinded lAB 2/11/98,
effective 2/1/98.
d. When the
client sells property on contract, proceeds from the sale shall be considered
exempt as income. The portion of any payment that represents principal is
considered a resource upon receipt as defined in subrule 75.56(4). The interest
portion of the payment is considered a resource the month following the month
of receipt.
e. Support payments in
cash shall be considered as unearned income in determining initial and
continuing eligibility.
(1) Any nonexempt
cash support payment, for a member of the eligible group, made while the
application is pending shall be treated as unearned income.
(2) Support payments shall be considered as
unearned income in the month in which the IV-A agency (income maintenance) is
notified of the payment by the IV-D agency (child support recovery unit).
The amount of income to consider shall be the actual amount paid or the monthly entitlement, whichever is less.
(3) Support payments reported by child
support recovery during a past month for which eligibility is being determined
shall be used to determine eligibility for the month. Support payments
anticipated to be received in future months shall be used to determine
eligibility for future months. When support payments terminate in the month of
decision of an FMAP-related Medicaid application, both support payments already
received and support payments anticipated to be received in the month of
decision shall be used to determine eligibility for that month.
(4) When the reported support payment,
combined with other income, creates ineligibility under the current coverage
group , an automatic redetermination of eligibility shall be conducted in
accordance with the provisions of rule
441-76.11 (249A). Persons receiving Medicaid under the family medical assistance program
in accordance with subrule 75.1(14) may be entitled to continued coverage under
the provisions of subrule 75.1(21). Eligibility may be reestablished for any
month in which the countable support payment combined with other income meets
the eligibility test.
f.
The client shall cooperate in supplying verification of all unearned income and
of any change in income , as defined at rule
441-75.50 (249A).
(1) When the information is available, the
department shall verify job insurance benefits by using information supplied to
the department by Iowa workforce development. When the department uses this
information as verification, job insurance benefits shall be considered
received the second day after the date that the check was mailed by Iowa
workforce development. When the second day falls on a sunday or federal legal
holiday, the time shall be extended to the next mail delivery day.
(2) When the client notifies the department
that the amount of job insurance benefits used is incorrect, the client shall
be allowed to verify the discrepancy. The client must report the discrepancy
before the eligibility month or within ten days of the date on the Notice of
Decision, Form 470-0485, 470-0485(8), 470-0486, or 470-0486(8), applicable to
the eligibility month, whichever is later
(2)
Earned income. Earned
income is defined as income in the form of a salary, wages, tips, bonuses,
commission earned as an employee, income from Job Corps, or profit from
self-employment. Earned income from commissions, wages, tips, bonuses. Job
Corps, or salary means the total gross amount irrespective of the expenses of
employment. With respect to self-employment, earned income means the net profit
from self-employment, defined as gross income less the allowable costs of
producing the income. Income shall be considered earned income when it is
produced as a result of the performance of services by an individual.
a. Each person in the assistance unit whose
gross nonexempt earned income, earned as an employee or net profit from
self-employment, considered in determining eligibility is entitled to one 20
percent earned income deduction of nonexempt monthly gross earnings. The
deduction is intended to include work-related expenses other than child care.
These expenses shall include, but are not limited to, all of the following:
taxes, transportation, meals, uniforms, and other work-related
expenses.
b. Each person in the
assistance unit is entitled to a deduction for care expenses subject to the
following limitations.
(1) Persons in the
eligible group and excluded parents shall be allowed care expenses for a child
or incapacitated adult in the eligible group.
(2) Stepparents as described at paragraph
75.57(8) "b" and self-supporting parents on underage parent
cases as described at paragraph 75.57(8)"c" shall be allowed
incapacitated adult care or child care expenses for the ineligible dependents
of the stepparent or self-supporting parent .
(3) Unless both parents are in the home and
one parent is physically and mentally able to provide the care, child care or
care for an incapacitated adult shall be considered a work expense in the
amount paid for care of each child or incapacitated adult, not to exceed $175
per month, or $200 per month for a child under the age of two, or the going
rate in the community, whichever is less.
(4) If both parents are in the home, adult or
child care expenses shall not be allowed when one parent is unemployed and is
physically and mentally able to provide the care.
(5) The deduction is allowable only when the
care covers the actual hours of the individual's employment plus a reasonable
period of time for commuting; or the period of time when the individual who
would normally care for the child or incapacitated adult is employed at such
hours that the individual is required to sleep during the waking hours of the
child or incapacitated adult, excluding any hours a child is in
school.
(6) Any special needs of a
physically or mentally handicapped child or adult shall be taken into
consideration in determining the deduction allowed.
(7) If the amount claimed is questionable,
the expense shall be verified by a receipt or a statement from the provider of
care. The expense shall be allowed when paid to any person except a parent or
legal guardian of the child, another member of the eligible group, or any
person whose needs are met by diversion of income from any person in the
eligible group.
c. Work
incentive disregard. After deducting the allowable work-related expenses as
defined at paragraphs 75.57(2)"a" and"b" and income diversions
as defined at subrule 75.57(4), 58 percent of the total of the remaining
monthly nonexempt earned income, earned as an employee or the net profit from
self-employment, of each person whose income must be considered is disregarded
in determining eligibility for the family medical assistance program (FMAP) and
those FMAP-related coverage groups subject to the three-step process for
determining initial eligibility as described at rule
441-75.57 (249A).
(1) The work incentive disregard is not
time-limited.
(2) Initial
eligibility under the first two steps of the three-step process is determined
without the application of the work incentive disregard as described at
subparagraphs 75.57(9)"a"(2) and (3).
d. Rescinded lAB 6/30/99, effective
9/1/99.
e. A person is considered
self-employed when the person:
(1) Is not
required to report to the office regularly except for specific purposes such as
sales training meetings, administrative meetings, or evaluation
sessions.
(2) Establishes the
person's own working hours, territory, and methods of work.
(3) Files quarterly reports of earnings,
withholding payments, and FICA payments to the Internal Revenue
Service.
f. The net
profit from self-employment income in a non-home-based operation shall be
determined by deducting only the following expenses that are directly related
to the production of the income:
(1) The cost
of inventories and supplies purchased that are required for the business, such
as items for sale or consumption and raw materials.
(2) Wages, commissions, and mandated costs
relating to the wages for employees of the self-employed.
(3) The cost of shelter in the form of rent,
the interest on mortgage or contract payments; taxes; and utilities.
(4) The cost of machinery and equipment in
the form of rent or the interest on mortgage or contract payments.
(5) Insurance on the real or personal
property involved.
(6) The cost of
any repairs needed.
(7) The cost of
any travel required.
(8) Any other
expense directly related to the production of income, except the purchase of
capital equipment and payment on the principal of loans for capital assets and
durable goods or any cost of depreciation.
g. When the client is renting out apartments
in the client 's home, the following shall be deducted from the gross rentals
received to determine the profit:
(1) Shelter
expense in excess of that set forth on the chart of basic needs components at
subrule 75.58(2) for the eligible group.
(2) That portion of expense for utilities
furnished to tenants which exceeds the amount set forth on the chart of basic
needs components at subrule 75.58(2).
(3) Ten percent of gross rentals to cover the
cost of upkeep.
h. In
determining profit from furnishing board, room, operating a family life home,
or providing nursing care, the following amounts shall be deducted from the
payments received:
(1) $41 plus an amount
equivalent to the monthly maximum food assistance program benefit for a
one-member household for a boarder and roomer or an individual in the home to
receive nursing care, or $41 for a roomer, or an amount equivalent to the
monthly maximum food assistance program benefit for a one-member household for
a boarder.
(2) Ten percent of the
total payment to cover the cost of upkeep for individuals receiving a room or
nursing care.
i. Gross
income from providing child care in the applicant 's or member 's own home shall
include the total payments received for the service and any payment received
due to the Child Nutrition Amendments of 1978 for the cost of providing meals
to children.
(1) In determining profit from
providing child care services in the applicant 's or member 's own home, 40
percent of the total gross income received shall be deducted to cover the costs
of producing the income, unless the applicant or member requests to have actual
expenses in excess of the 40 percent considered.
(2) When the applicant or member requests to
have expenses in excess of the 40 percent considered, profit shall be
determined in the same manner as specified at paragraph 75.57(2)"j.
"
j. In
determining profit for a self-employed enterprise in the home other than
providing room and board, renting apartments or providing child care services,
the following expenses shall be deducted from the income received:
(1) The cost of inventories and supplies
purchased that are required for the business, such as items for sale or
consumption and raw materials.
(2)
Wages, commissions, and mandated costs relating to the wages for
employees.
(3) The cost of
machinery and equipment in the form of rent; or the interest on mortgage or
contract payment; and any insurance on such machinery equipment.
(4) Ten percent of the total gross income to
cover the costs of upkeep when the work is performed in the home.
(5) Any other direct cost involved in the
production of the income, except the purchase of capital equipment and payment
on the principal of loans for capital equipment and payment on the principal of
loans for capital assets and durable goods or any cost of
depreciation.
k.
Rescinded lAB 6/30/99, effective 9/1/99.
l.The applicant or member shall cooperate in
supplying verification of all earned income and of any change in income , as
defined at rule
441-75.50 (249A). A
self-employed applicant or member shall keep any records necessary to establish
eligibility.
(3)
Shared living arrangements. When an applicant or member shares
living arrangements with another family or person, funds combined to meet
mutual obligations for shelter and other basic needs are not income. Funds made
available to the applicant or member , exclusively for the applicant 's or
member 's needs, are considered income.
(4)
Diversion of income.
a. Nonexempt earned and unearned income of
the parent shall be diverted to meet the unmet needs of the ineligible children
of the parent living in the family group who meet the age and school attendance
requirements specified in subrule 75.54(1). Income of the parent shall be
diverted to meet the unmet needs of the ineligible children of the parent and a
companion in the home only when the income and resources of the companion and
the children are within family medical assistance program standards. The
maximum income that shall be diverted to meet the needs of the ineligible
children shall be the difference between the needs of the eligible group if the
ineligible children were included and the needs of the eligible group with the
ineligible children excluded, except as specified at paragraph 75.57(8)
"b."
b. Nonexempt
earned and unearned income of the parent shall be diverted to permit payment of
court-ordered support to children not living with the parent when the payment
is actually being made.
(5)
Income of unmarried specified
relatives under the age of 19.
a.
Income of the immarried specified relative under the age of 19 when that
specified relative lives with a parent who receives coverage under family
medical assistance-related programs or lives with a nonparental relative or in
an independent living arrangement.
(1) The
income of the unmarried, underage specified relative who is also an eligible
child in the eligible group of the specified relative's parent shall be treated
in the same manner as that of any other child. The income for the unmarried,
underage specified relative who is not an eligible child in the eligible group
of the specified relative's parent shall be treated in the same manner as
though the specified relative had attained majority.
(2) The income of the unmarried, underage
specified relative living with a nonparental relative or in an independent
living arrangement shall be treated in the same manner as though the specified
relative had attained majority.
b. Income of the unmarried specified relative
under the age of 19 who lives in the same home as a self-supporting parent . The
income of the unmarried specified relative under the age of 19 living in the
same home as a self-supporting parent shall be treated in accordance with
subparagraphs (I), (2), and (3) below.
(1)
When the unmarried specified relative is under the age of 18 and not a parent
of the dependent child , the income of the specified relative shall be
exempt.
(2) When the immarried
specified relative is under the age of 18 and a parent of the dependent child ,
the income of the specified relative shall be treated in the same manner as
though the specified relative had attained majority. The income of the
specified relative's self-supporting parents shall be treated in accordance
with paragraph 75.57(8)"c. "
(3) When the unmarried specified relative is
18 years of age, the specified relative's income shall be treated in the same
manner as though the specified relative had attained majority.
(6)
Exempt as
income and resources. The following shall be exempt as income and
resources:
a. Food reserves from
home-produced garden products, orchards, domestic animals, and the like, when
used by the household for its own consumption.
b. The value of the food assistance program
benefit.
c. The value of the United
States Department of Agriculture donated foods (surplus commodities).
d. The value of supplemental food assistance
received under the Child Nutrition Act and the special food service program for
children under the National School Lunch Act.
e. Any benefits received under Title III-C,
Nutrition Program for the Elderly, of the Older Americans Act.
f.Benefits paid to eligible households under
the Low Income Home Energy Assistance Act of I98I.
g. Any payment received under Title II of the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 and the Federal-Aid Highway Act of 1968.
h. Any judgment funds that have been or will
be distributed per capita or held in trust for members of any Indian tribe.
When the payment, in all or part, is converted to another type of resource,
that resource is also exempt.
i.
Payments to volunteers participating in the Volunteers in Service to America
(VISTA) program, except that this exemption will not be applied when the
director of ACTION determines that the value of all VISTA payments, adjusted to
reflect the number of hours the volunteers are serving, is equivalent to or
greater than the minimum wage then in effect under the Fair Labor Standards Act
of 1938, or the minimum wage under the laws of the state where the volunteers
are serving, whichever is greater
j. Payments for supporting services or
reimbursement of out-of-pocket expenses received by volunteers in any of the
programs established under Titles II and III of the Domestic Volunteer Services
Act.
k. Tax-exempt portions of
payments made pursuant to the Alaskan Native Claims Settlement Act.
l. Experimental housing allowance program
payments made under annual contribution contracts entered into prior to January
I, 1975, under Section 23 of the U.S. Housing Act of 1936 as amended.
m. The income of a supplemental security
income recipient .
n. Income of an
ineligible child.
o. Income
in-kind .
p. Family support subsidy
program payments.
q. Grants
obtained and used under conditions that preclude their use for current living
costs.
r. All earned and unearned
educational funds of an undergraduate or graduate student or a person in
training. Any extended social security or veterans benefits received by a
parent or nonparental relative as defined at subrule 75.55(1), conditional to
school attendance, shall be exempt. However, any additional amount received for
the person's dependents who are in the eligible group shall be counted as
nonexempt income.
s. Subsidized
guardianship program payments.
t.
Any income restricted by law or regulation which is paid to a representative
payee living outside the home, unless the income is actually made available to
the applicant or member by the representative payee .
u. The first $50 received by the eligible
group which represents a current monthly support obligation or a voluntary
support payment, paid by a legally responsible individual, but in no case shall
the total amount exempted exceed $50 per month per eligible group.
v. Bona fide loans. Evidence of a bona fide
loan may include any of the following:
(1)
The loan is obtained from an institution or person engaged in the business of
making loans.
(2) There is a
written agreement to repay the money within a specified time.
(3) If the loan is obtained from a person not
normally engaged in the business of making a loan, there is borrower's
acknowledgment of obligation to repay (with or without interest), or the
borrower expresses intent to repay the loan when funds become available in the
future, or there is a timetable and plan for repayment.
w. Payments made from the Agent Orange
Settlement Fund or any other fund established pursuant to the settlement in the
In re Agent Orange product liability litigation, M.D.L. No. 381
(E.D.N.Y).
x. The income of a
person ineligible due to receipt of state-funded foster care, IV-E foster care,
or subsidized adoption assistance.
y. Payments for major disaster and emergency
assistance provided under the Disaster Relief Act of 1974 as amended by Public
Law 100-707, the Disaster Relief and Emergency Assistance Amendments of
1988.
z. Payments made to certain
United States citizens of Japanese ancestry and resident Japanese aliens under
Section 105 of Public Law 100-383, and payments made to certain eligible Aleuts
under Section 206 of Public Law 100-383, entitled "Wartime Relocation of
Civilians."
aa. Payments received
from the Radiation Exposure Compensation Act.
ab. Deposits into an individual development
account (IDA) when determining eligibility. The amount of the deposit is exempt
as income and shall not be used in the 185 percent eligibility test. Deposits
shall be deducted from nonexempt earned and unearned income beginning with the
month following the month in which verification that deposits have begun is
received. The client shall be allowed a deduction only when the deposit is made
from the client 's money. The earned income deductions at paragraphs
75.57(2)"a,""b," and"c" shall be applied to
nonexempt earnings from employment or net profit from self-employment that
remains after deducting the amount deposited into the account. Allowable
deductions shall be applied to any nonexempt unearned income that remains after
deducting the amount of the deposit. If the client has both nonexempt earned
and unearned income, the amount deposited into the IDA account shall first be
deducted from the client 's nonexempt unearned income. Deposits shall not be
deducted from earned or unearned income that is exempt. 75.57
(7).Exempt as
income. The following are exempt as income.
a. Reimbursements from a third
party.
b. Reimbursement from the
employer for a job-related expense.
c. The following nonrecurring lump sum
payments:
(1) Income tax refund.
(2) Retroactive supplemental security income
benefits.
(3) Settlements for the
payment of medical expenses.
(4)
Refunds of security deposits on rental property or utilities.
(5) That part of a lump sum received and
expended for funeral and burial expenses.
(6) That part of a lump sum both received and
expended for the repair or replacement of resources.
d. Payments received by the family for
providing foster care when the family is operating a licensed foster
home.
e. A small monetary
nonrecurring gift, such as a Christmas, birthday or graduation gift, not to
exceed $30 per person per calendar quarter
When a monetary gift from any one source is in excess of $30, the total gift is countable as unearned income. When monetary gifts from several sources are each $30 or less, and the total of all gifts exceeds $30, only the amount in excess of $30 is countable as unearned income.
f.Federal or state earned income
tax credit.
g. Supplementation from
county funds, providing:
(1) The assistance
does not duplicate any of the basic needs as recognized by the chart of basic
needs components in accordance with subrule 75.58(2), or
(2) The assistance, if a duplication of any
of the basic needs, is made on an emergency basis, not as ongoing
supplementation.
h. Any
payment received as a result of an urban renewal or low-cost housing project
from any governmental agency.
i. A
retroactive corrective family investment program (FIP) payment.
j.The training allowance issued by the
division of vocational rehabilitation, department of education.
k. Payments from the PROMISE JOBS
program.
l. The training allowance
issued by the department for the blind .
m. Payments from passengers in a car
pool.
n. Support refunded by the
child support recovery unit for the first month of termination of eligibility
and the family does not receive the family investment program.
o. Rescinded lAB 10/4/00, effective
10/1/00.
p. Rescinded lAB 10/4/00,
effective 10/1/00.
q. Income of a
nonparental relative as defined at subrule 75.55(1) except when the relative is
included in the eligible group.
r.
Rescinded lAB 10/4/00, effective 10/1/00.
s. Compensation in lieu of wages received by
a child funded through an employment and training program of the U.S.
Department of Labor.
t. Any amount
for training expenses included in a payment funded through an employment and
training program of the U.S. Department of Labor
u. Earnings of a person aged 19 or younger
who is a full-time student as defined at subparagraphs 75.54(1) "b
"(1) and (2). The exemption applies through the entire month of the
person's twentieth birthday.
EXCEPTION: When the twentieth birthday falls on the first day of the month, the exemption stops on the first day of that month.
v. Income attributed to an
unmarried, underage parent in accordance with paragraph 75.5 7(8)"c
" effective the first day of the month following the month in which
the immarried, underage parent turns age 18 or reaches majority through
marriage. When the unmarried, underage parent turns 18 on the first day of a
month, the income of the self-supporting parents becomes exempt as of the first
day of that month.
w. Incentive
payments received from participation in the adolescent pregnancy prevention
programs.
x. Payments received from
the comprehensive child development program, funded by the Administration for
Children, Youth, and Families, provided the payments are considered
complimentary assistance by federal regulation.
y. Incentive allowance payments received from
the work force investment project, provided the payments are considered
complimentary assistance by federal regulation.
z. Interest and dividend income.
aa. Rescinded lAB 10/4/00, effective
lO/I/OO.
ab. Honorarium income. All
moneys paid to an eligible household in connection with the welfare reform
demonstration longitudinal study or focus groups shall be exempted.
ac. Income that an individual contributes to
a trust as specified at paragraph 75.24(3)"b " shall not be
considered for purposes of determining eligibility for the family medical
assistance program (FMAP) or FMAP-related Medicaid coverage groups.
ad. Benefits paid to the eligible household
under the family investment program (FIP).
ae. Moneys received through the pilot
self-sufficiency grants program or through the pilot diversion
program.
af. Earnings from new
employment of any person whose income is considered when determining
eligibility during the first four calendar months of the new employment. The
date the new employment or self-employment begins shall be verified before
approval of the exemption. This four-month period shall be referred to as the
work transition period (WTP).
(1) The exempt
period starts the first day of the month in which the client receives the first
pay from the new employment and continues through the next three benefit
months, regardless if the job ends during the four-month period.
(2) To qualify for this disregard, the person
shall not have earned more than $1,200 in the 12 calendar months prior to the
month in which the new job begins, the income must be reported timely in
accordance with rule
441-76.10 (249A), and the new job must have started after the date the application is
filed. For purposes of this policy, the $1,200 earnings limit applies to the
gross amount of income without any allowance for exemptions, disregards, work
deductions, diversions, or the costs of doing business used in determining net
profit from any income test in rule
441-75.57 (249A).
(3) If another new job or
self-employment enterprise starts while a WTP is in progress, the exemption
shall also be applied to earnings from the new source that are received during
the original 4-month period, provided that the earnings were less than $1,200
in the 12-month period before the month the other new job or self-employment
enterprise begins.
(4) An
individual is allowed the 4-month exemption period only once in a 12-month
period. An additional 4-month exemption shall not be granted until the month
after the previous 12-month period has expired.
(5) If a person whose income is considered
enters the household, the new job must start after the date the person enters
the home or after the person is reported in the home, whichever is later, in
order for that person to qualify for the exemption.
(6) When a person living in the home whose
income is not considered subsequently becomes an assistance unit member whose
income is considered, the new job must start after the date of the change that
causes the person's income to be considered in order for that person to qualify
for the exemption.
(7) A person who
begins new employment or self-employment that is intermittent in nature may
qualify for the WTP. "Intermittent" includes, but is not limited to, working
for a temporary agency that places the person in different job assignments on
an as-needed or on-call basis, or self-employment from providing child care for
one or more families. However, a person is not considered as starting new
employment or self-employment each time intermittent employment restarts or
changes such as when the same temporary agency places the person in a new
assignment or a child care provider acquires another child care
client .
ag. Payments
from property sold under an installment contract as specified in paragraphs
75.56(4) "b" and 75.57(1) "d. "
ah. All census earnings received by temporary
workers from the Bureau of the Census.
ai. Payments received through participation
in the preparation for adult living program pursuant to 441-Chapter 187.
(8)
Treatment of
income in excluded parent cases, stepparent cases, and underage parent
cases.
a.
Treatment of
income in excluded parent cases. A parent who is living in the home
with the eligible children but who is not eligible for Medicaid is eligible for
the 20 percent earned income deduction, child care expenses for children in the
eligible group, the 58 percent work incentive disregard described at paragraphs
75.57(2) "a, ""b, " and"c, " and diversions
described at subrule 75.57(4). All remaining nonexempt income of the parent
shall be applied against the needs of the eligible group.
b.
Treatment of income in stepparent
cases. The income of a stepparent who is not included in the eligible
group but who is living with the parent in the home of an eligible child shall
be given the same consideration and treatment as that of a parent subject to
the limitations of subparagraphs (1) through (10) below.
(1) The stepparent 's monthly gross nonexempt
earned income, earned as an employee or monthly net profit from
self-employment, shall receive a 20 percent earned income deduction.
(2) The stepparent 's monthly nonexempt earned
income remaining after the 20 percent earned income deduction shall be allowed
child care expenses for the stepparent 's ineligible dependents in the home,
subject to the restrictions described at subparagraphs
75.57(2)"b "(1) through (5).
(3) Any amounts actually paid by the
stepparent to individuals not living in the home, who are claimed or could be
claimed by the stepparent as dependents for federal income tax purposes, shall
be deducted from nonexempt monthly earned and unearned income of the
stepparent .
(4) The stepparent
shall also be allowed a deduction from nonexempt monthly earned and unearned
income for alimony and child support payments made to individuals not living in
the home with the stepparent .
(5)
Except as described at subrule 75.57(10), the nonexempt monthly earned and
unearned income of the stepparent remaining after application of the deductions
at subparagraphs 75.57(8)"b "(1) through (4) above shall be
used to meet the needs of the stepparent and the stepparent 's dependents living
in the home, when the dependents' needs are not included in the eligible group
and the stepparent claims or could claim the dependents for federal income tax
purposes. These needs shall be determined in accordance with the schedule of
needs for a family group of the same composition in accordance with subrule
75.58(2).
(6) The stepparent shall
be allowed the 58 percent work incentive disregard from monthly earnings. The
disregard shall be applied to earnings that remain after all other deductions
at subparagraphs 75.57(8)"b "(1) through (5) have been
subtracted from the earnings. However, the work incentive disregard is not
allowed when determining initial eligibility as described at subparagraphs
75.57(9)"a"(2) and (3).
(7) The deductions described in subparagraphs
(1) through (6) shall first be subtracted from earned income in the same order
as they appear above.
When the
If the
(8) A nonexempt,
nonrecurring lump sum received by a stepparent shall be considered as income
and counted in computing eligibility in the same manner as it would be treated
for a parent . Any portion of the nonrecurring lump sum retained by the
stepparent in the month following the month of receipt shall be considered a
resource to the stepparent if that portion is not exempted according to
paragraph 75.56(1)"f"
(9) When the income of the stepparent , not in
the eligible group, is insufficient to meet the needs of the stepparent and the
stepparent 's dependents living in the home who are not eligible for
FMAP-related Medicaid, the income of the parent may be diverted to meet the
unmet needs of the children of the current marriage except as described at
subrule 75.57(10).
(10) When the
needs of the stepparent , living in the home, are not included in the eligible
group, the eligible group and any children of the parent living in the home who
are not eligible for FMAP-related Medicaid shall be considered as one unit, and
the stepparent and the stepparent 's dependents, other than the spouse, shall be
considered a separate unit.
(11)
Rescinded lAB 6/30/99, effective 9/1/99.
c.
Treatment of income in underage
parent cases. In the case of a dependent child whose unmarried parent
is under the age of 18 and living in the same home as the unmarried, underage
parent 's own self-supporting parents, the income of each self-supporting parent
shall be considered available to the eligible group after appropriate
deductions unless the provisions of rule
441-75.59 (249A) apply. The deductions to be applied are the same as are applied to the
income of a stepparent pursuant to subparagraphs 75.57(8)
"b"(1) through (7). Child care expenses at subparagraph 75.57(8)
"b"(2) shall be allowed for the self-supporting parent 's
ineligible children. Nonrecurring lump sum income received by the
self-supporting parent (s) shall be treated in accordance with subparagraph
75.57(8)"b "(8).
When the self-supporting spouse of a self-supporting
(9)
Budgeting process.
a. Initial and ongoing eligibility . Both
initial and ongoing eligibility shall be based on a projection of income based
on the best estimate of future income.
(1)
Upon application, the department shall use all earned and unearned income
received by the eligible group to project future income. Allowable work
expenses shall be deducted from earned income, except in determining
eligibility under the 185 percent test defined at rule
441-75.57 (249A). The
determination of initial eligibility is a three-step process as described at
rule
441-75.57 (249A).
(2) Test 1. When countable
gross nonexempt earned and unearned income exceeds 185 percent of the schedule
of living costs (Test 1), as identified at subrule 75.58(2) for the eligible
group, eligibility does not exist under any coverage group for which these
income tests apply. countable gross income means nonexempt gross income, as
defined at rule
441-75.57 (249A), without
application of any disregards, deductions, or diversions.
(3) Test 2. When the countable gross
nonexempt earned and unearned income equals or is less than 185 percent of the
schedule of living costs for the eligible group, initial eligibility under the
schedule of living costs (Test 2) shall then be determined. Initial eligibility
under the schedule of living costs is determined without application of the 58
percent work incentive disregard as specified at paragraph 75.57(2)
"c." All other appropriate exemptions, deductions and
diversions are applied. Countable income is then compared to the schedule of
living costs (Test 2) for the eligible group. When countable net earned and
unearned income equals or exceeds the schedule of living costs for the eligible
group, eligibility does not exist under any coverage group for which these
income tests apply.
(4) Test 3.
After application of Tests 1 and 2 for initial eligibility or of Test 1 for
ongoing eligibility , the 58 percent work incentive disregard at paragraph
75.57(2) "c" shall be applied when there is eligibility for
this disregard. When countable net earned and unearned income, after
application of the work incentive disregard and all other appropriate
exemptions, deductions, and diversions, equals or exceeds the schedule of basic
needs (Test 3) for the eligible group, eligibility does not exist under any
coverage group for which these tests apply. When the countable net income is
less than the schedule of basic needs for the eligible group, the eligible
group meets FMAP or CMAP income requirements.
(5) Rescinded lAB 10/4/00, effective
10/1/00.
(6) When income received
weekly or biweekly (once every two weeks) is projected for future months, it
shall be projected by adding all income received in the time period being used
and dividing the result by the number of instances of income received in that
time period. The result shall be multiplied by four if the income is received
weekly, or by two if the income is received biweekly, regardless of the number
of weekly or biweekly payments to be made in future months.
(7) Rescinded lAB 7/4/07, effective
8/1/07.
(8) When a change in
circumstances that is required to be timely reported by the client pursuant to
paragraphs 75.52(4)"d" and"e" is not reported
as required, eligibility shall be redetermined beginning with the month
following the month in which the change occurred. When a change in
circumstances that is required to be reported by the client at annual review or
upon the addition of an individual to the eligible group pursuant to paragraph
75.52(4) "c" is not reported as required, eligibility shall be redetermined
beginning with the month following the month in which the change was required
to be reported. All other changes shall be acted upon when they are reported or
otherwise become known to the department , allowing for a ten-day notice of
adverse action, if required.
b. Recurring lump-sum income. Recurring
lump-sum earned and unearned income, except for the income of the
self-employed, shall be prorated over the number of months for which the income
was received and applied to the eligibility determination for the same number
of months.
(1) Income received by an
individual employed under a contract shall be prorated over the period of the
contract.
(2) Income received at
periodic intervals or intermittently shall be prorated over the period covered
by the income and applied to the eligibility determination for the same number
of months. Exception: Periodic or intermittent income from self-employment
shall be treated as described at paragraph 75.57(9)
"i."
(3) When the
lump-sum income is earned income, appropriate disregards, deductions and
diversions shall be applied to the monthly prorated income. Income is prorated
when a recurring lump sum is received at any time.
c. Nonrecurring lump-sum income. Moneys
received as a nonrecurring lump sum, except as specified in subrules 75.56(4)
and 75.56(7) and at paragraphs 75.57(8) "b"
and"c," shall be treated in accordance with this rule.
Nonrecurring lump-sum income includes an inheritance, an insurance settlement
or tort recovery, an insurance death benefit, a gift, lottery winnings, or a
retroactive payment of benefits, such as social security, job insurance, or
workers' compensation.
(1) Nonrecurring
lump-sum income shall be considered as income in the month of receipt and
counted in computing eligibility, unless the income is exempt.
(2) When countable income exclusive of any
family investment program grant but including countable lump-sum income exceeds
the needs of the eligible group under their current coverage group , the
countable lump-sum income shall be prorated. The number of full months for
which a monthly amount of the lump sum shall be counted as income in the
eligibility determination is derived by dividing the total of the lump-sum
income and any other countable income received in or projected to be received
in the month the lump sum was received by the schedule of living costs, as
identified at subrule 75.58(2), for the eligible group. This period is referred
to as the period of proration. Any income remaining after this calculation
shall be applied as income to the first month following the period of proration
and disregarded as income thereafter
(3) The period of proration shall begin with
the month when the nonrecurring lump sum was received, whether or not the
receipt of the lump sum was timely reported. If receipt of the lump sum was
reported timely and the calculation was completed timely, no recoupment shall
be made. If receipt of the lump sum was not reported timely or the calculation
was not completed timely, recoupment shall begin with the month of receipt of
the nonrecurring lump sum.
(4) The
period of proration shall be shortened when:
1. The schedule of living costs as defined at
subrule 75.58(2) increases; or
2. A
portion of the lump sum is no longer available to the eligible group due to
loss or theft or because the person controlling the lump sum no longer resides
with the eligible group and the lump sum is no longer available to the eligible
group; or
3. There is an
expenditure of the lump sum made for the following circumstances unless there
was insurance available to meet the expense: Payments made on medical services
for the former eligible group or their dependents for services listed in
441-Chapters 78, 81, 82, and 85 at the time the expense is reported to the
department ; the cost of necessary repairs to maintain habitability of the
homestead requiring the spending of over $25 per incident; cost of replacement
of exempt resources as defined in subrule 75.56(1) due to fire, tornado, or
other natural disaster; or funeral and burial expenses. The expenditure of
these funds shall be verified.
(5) When countable income, including the
lump-sum income, is less than the needs of the eligible group in accordance
with the provisions of their current coverage group , the lump sum shall be
counted as income for the month of receipt.
(6) For purposes of applying the lump-sum
provision, the eligible group is defined as all eligible persons and any other
individual whose lump-sum income is counted in determining the period of
proration.
(7) During the period of
proration, individuals not in the eligible group when the lump-sum income was
received may be eligible as a separate eligible group. Income of this eligible
group plus income of the parent or other legally responsible person in the
home, excluding the lump-sum income already considered, shall be considered as
available in determining eligibility.
d. The third digit to the right of the
decimal point in any calculation of income, hours of employment and work
expenses for care, as defined at paragraph 75.57(2)"b, " shall
be dropped.
e. In any month for
which an individual is determined eligible to be added to a currently active
family medical assistance (FMAP) or FMAP-related Medicaid case, the
individual's needs, income, and resources shall be included. An individual who
is a member of the eligible group and who is determined to be ineligible for
Medicaid shall be canceled prospectively effective the first of the following
month if the timely notice of adverse action requirements as provided at
441-subrule 76.4(1) can be met.
f.
Rescinded lAB 10/4/00, effective lO/I/OO.
g. Rescinded lAB 2/11/98, effective
2/1/98.
h. Income from
self-employment received on a regular weekly, biweekly, semimonthly or monthly
basis shall be budgeted in the same manner as the earnings of an employee. The
countable income shall be the net income.
i. Income from self-employment not received
on a regular weekly, biweekly, semimonthly or monthly basis that represents an
individual's annual income shall be averaged over a 12-month period of time,
even if the income is received within a short period of time during that
12-month period. Any change in self-employment shall be handled in accordance
with subparagraphs (3) through (5) below.
(1)
When a self-employment enterprise which does not produce a regular weekly,
biweekly, semimonthly or monthly income has been in existence for less than a
year, income shall be averaged over the period of time the enterprise has been
in existence and the monthly amount projected for the same period of time. If
the enterprise has been in existence for such a short time that there is very
little income information, the worker shall establish, with the cooperation of
the client , a reasonable estimate which shall be considered accurate and
projected for three months, after which the income shall be averaged and
projected for the same period of time. Any changes in self-employment shall be
considered in accordance with subparagraphs (3) through (5) below.
(2) These policies apply when the
self-employment income is received before the month of decision and the income
is expected to continue, in the month of decision, after assistance is
approved.
(3) A change in the cost
of producing self-employment income is defined as an established permanent
ongoing change in the operating expenses of a self-employment enterprise.
Change in self-employment income is defined as a change in the nature of
business.
(4) When a change in
operating expenses occurs, the department shall recalculate the expenses on the
basis of the change.
(5) When a
change occurs in the nature of the business, the income and expenses shall be
computed on the basis of the change.
(10)
Restriction on diversion of
income. Rescinded lAB 7/11/01, effective 9/1/01.
(11)
Divesting of income.
Assistance shall not be approved when an investigation proves that income was
divested and the action was deliberate and for the primary purpose of
qualifying for assistance or increasing the amount of assistance
paid.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.