10-144-332 Me. Code R. § 17-4
Adoption Assistance Payments
Agent Orange Settlements as provided for under PL 100-687 and 101-201.
Exclude all payments made by the ASPIRE-TANF Program.
Interest on funds designated for burial or interest earned on the value of agreements representing the purchase of burial spaces (provided the burial spaces are excluded from assets and provided the interest is left to accrue) as long as there is no break in the receipt of assistance. (See Part 16, Section 2.6).
Portions of IRS Section 125 payments retained by the employer as payment for benefit items chosen by the employee from the Section 125 menu or "cafeteria plan" are excluded.
For all categories
Child support payments are income to the child(ren) for whom the payments are intended. This rule applies even if the child does not reside with the parent receiving the payment or if the payments include arrearages (past due amounts) or if the "child" for whom the payments are intended is now over age 18.
For Family - Related Categories
The first $50.00 per month of current child support payments received by the assistance unit whether received through DSER or direct is excluded.
Child support paid by the Department that is in excess of the monthly obligation is excluded. This applies only to TANF recipients
The following exclusions from the child's income apply:
Income of children not included in the assistance unit is not used to determine eligibility of those in the assistance unit. However, their income may be used to determine the amount of income allocated from the assistance unit (See Part 4 for budgeting).
Hostile fire allotment paid by the Uniformed Services.
The value of a domestic commercial transportation ticket received as a gift by an individual (or his or her spouse) and not converted to cash will be excluded in the determination of the individual's income. Domestic travel is defined as travel among the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
Earnings received under the Compensated Work Therapy Program established by Title 38 U.S.C. Section 1718 and administered by the Department of Veteran Affairs. Monies received under this program are considered a social service benefit and not to be considered countable income.
There are two types of income exclusions associated with annual Cost of Living Adjustments. One exclusion is used for any COLA taking effect in January, February and March (See Section 4.11.1 below), while the other only applies to Social Security and Railroad Retirement benefits (See Section 4.11.2 below).
All annual Cost of Living Adjustments (COLA) that take effect in January, February or March, will be excluded for any individual in a Medicaid coverable group whose income limit is based on the FPL. This exclusion will remain in effect until the month following the month that the new annual Federal Poverty Levels (FPL) are published in the Federal Register. This exclusion also applies to individuals covered by DEL, Maine Rx, Cub Care, and Medicare Buy-In.
Examples
This exclusion also applies in determining retroactive coverage.
This exclusion does not apply to individuals covered under Home and Community Bases Waivers and Medically Needy since the Federal Poverty Levels are not used in determining their eligibility.
If the COLA results in ineligibility for individuals covered under SSI - Related categories, the amount of SSA / RR received prior to the most recent COLA is used to determine eligibility.
This applies to individuals:
This applies to individuals in the following living arrangements when comparing their income to the Medicaid rate for the facility:
* Awaiting Placement for Residential Care,
* residing in Cost Reimbursed Boarding Homes,
* in Residential Care Facilities, and
* in Adult Family Care Homes whose income goes over the Medicaid rate.
This exclusion is not used to determine the cost of care for these facilities.
Example
A disabled individual is eligible and receiving Medicaid. In January he receives his SSDI COLA of $35.00. This increase puts him over the FPL in effect for that month.
The increase will not be counted until the month following the month the new FPL's are published.
In February the new FPL's are published. The individual's countable income is still greater than the new FPL level because of the COLA received in January. The COLA of $35.00 received in January will be excluded to determine the individual's countable income.
This exclusion ends if:
To determine if an individual has lost Medicaid coverage for three consecutive months the retroactive period of a reapplication must be taken into account. If including the retroactive months the individual was not closed for three consecutive months, the disregard will continue.
Example
An individual with a COLA disregard closes in June. He reapplies in November. By applying the COLA disregard in the retroactive month of August, September and October the individual is eligible. The individual will keep the COLA disregard for retroactive and prospective months.
The individual may again be eligible for the disregard in later years if they again become ineligible due to COLA changes in SSA / RR and FPL.
If the individual receives added or increased income from a source other than SSA / RR at the time of the COLA adjustments, this disregard can be used only if ineligibility is caused by the change in SSA/RR income.
When budgeting for a couple this disregard applies to the SSA / RR of both individuals even though disregarding the COLA increase of only one member of the couple would result in keeping Medicaid coverage for the couple.
All payments made on behalf of an individual under a credit life or credit disability insurance policy (i.e. payment of car payments or mortgage when you become disabled).
Social Security benefits received by some disabled widow(er)s who are not receiving Medicare (See Part 6, Section 5.2.9).
In-kind or cash assistance received as the result of a disaster declared by the President of the United States.
Disaster Unemployment Assistance authorized in P.L. 100-707, 42 U.S.C. Section 5155(d) (1988). This is paid to an individual unemployed as a result of a major disaster.
Earned income which is used to meet expenses of producing income by a person who is blind or disabled is excluded. This includes earnings excluded by SSI as part of a PASS plan. These expenses include transportation to and from work (in accordance with IRS guidelines or actual cost if not using own car), cost of caring for a guide dog, child-care, licenses, lunches, Braille instruction, professional association dues, income taxes, tools, union dues and computer training.
EITC received as advance payment in weekly wages or received in one sum.
Any assistance provided in cash or in-kind under the Emergency Conservation Services (ECS) Program (PL 93-644, Sections 222 and 95-568) including cash to prevent fuel cut-offs.
Payments made under Annual Contribution Contracts entered into prior to 1/1/75, under Section 23 of the U. S. Housing Act of 1937, as amended.
The value of benefits under the Food Supplement Program or food distributed by the Department of Agriculture are excluded.
Excluded for Family - Related categories
IV-E Foster Care Maintenance Payments
Payments received from the Department or other agencies for foster children in licensed or approved homes who are not part of the assistance unit.
Excluded for SSI - Related categories
Foster care payments to a provider of foster care for a child or adult who is not an eligible individual but who is living with an eligible individual and who was placed there by a public or private agency.
Goods and services not included in the list of basic requirements (See Chart 1.)
One time cash payment from the Governor Baxter School for the Deaf Compensation Authority. Interest on this compensation is excluded as income and any accrued interest is excluded as an asset.
Family - Related - exclude all
SSI - Related - exclude for all undergraduates and exclude only tuition and fees for graduate students
Family - Related - exclude tuition, fees, other necessary educational expenses, and child care in accord with Part 4, Section 3
SSI - Related - exclude tuition and fees and other necessary educational expenses for undergraduates and count for all other students
Educational expenses include lab fees, student activity fees, transportation, stationary supplies, books, technology fees, and impairment related expenses necessary to attend school or perform school work.
Certain grants, loans and scholarships to the extent that they do not include funds for items such as food, shelter, clothing or personal needs:
The Veterans Administration (VA) sponsors several different educational assistance programs. One does not have to be a veteran to qualify for assistance under some of the programs.
Each individual who qualifies for and receives educational assistance receives an award letter from the VA which indicates the amount to be received and the period of time during which it will be received.
That part of the payment received from the VA for an individual's dependents who are in the assistance unit must be counted as available income to those individuals.
Verification of these conditions must be obtained through the student, the institution or the source prior to disregarding any portion of the funds.
Assistance with fuel bills or weatherization assistance received through the Home Energy Assistance Program (HEAP).
Excluded for all categories
For Family - Related categories only -
HUD community development block grant funds received to finance the rehabilitation of a privately owned residence. HUD monies must be used for major property repairs or capital improvements. HUD payments are made by check payable directly to the contractor or jointly to the contractor and property owner.
Contributions to an Individual Development Account (IDA). See the asset rule for a definition of an IDA.
When withdrawals are used for any other purpose this will result in the fund being considered a countable asset effective the month of the withdrawal. The TANF Program determines if this condition is met.
Income of persons who could be members of the assistance unit except that they are in a hospital, intermediate care facility (ICF) or skilled nursing facility (SNF). In most situations, the income of the individual in the hospital or nursing home is used to determine nursing home eligibility. This also takes place when the individual is in an acute care facility for a period of more than sixty days or immediately upon entering a hospital for a kidney transplant.
Note: These are countable assets on the first day of the month following the month received.
Earned or unearned income, from a single source, which is received irregularly (receipt cannot reasonably be expected) or infrequently (no more than once during a calendar quarter). This amount is not to exceed $60.00 per calendar quarter for unearned income and $30.00 per calendar quarter for earned income. This includes small gifts of income such as those received at Christmas, graduation, birthdays or anniversaries.
Reimbursement for job related expenses such as travel or uniforms to the extent that they do not represent a gain or exceed actual expenses.
Family - Related categories
All JTPA income or Job Corps payments are excluded except on-the-job training income of an individual at least 19 years old who is not a dependent child.
SSI - Related categories
Payment by JTPA for supportive services such as child-care, transportation, medical care, meals and other reasonable expenses are excluded.
Note: All other payments from JTPA are considered income.
Money borrowed by an individual providing there is clear evidence of an agreement to repay. The proceeds of the loan are not income in the month borrowed, however, they are considered countable assets in the following month.
Written statements from both the individual and the party lending the money must be obtained indicating that the funds are a loan, the amount and the plan for repayment. Without verification of the loan the funds will be considered a gift and treated as a lump sum (See Section 4.40 below).
Income that has accumulated and is received in one payment by the individual is considered a lump sum. This includes Worker's Compensation, retroactive Social Security payments, Unemployment Benefits received retroactively due to the result of a hearing, and Veteran's Benefits. Gifts, inheritances, lottery winnings and insurance settlements are also considered to be a lump sum payment.
Lump sum income is counted as income in the month received, and any remaining the next month are counted as an asset. SSI lump sum payments are excluded income.
For Family - Related categories
Deduct the following to determine the amount of countable lump sum income:
Any amount remaining in the month following receipt is a countable asset.
SSI - Related categories
SSI or Social Security retroactive payments are excluded as an asset for nine months. After that, any portion remaining becomes a countable asset.
The exception to the month received rule is direct deposits and other electronic transfers of funds. These are counted for the month they were intended to be received even if they are posted early or late.
Excluded for all categories
Excluded for SSI - Related categories
Payments made to victims of Nazi persecution under Public Law 103-286 (Nazi Persecution Victims Eligibility Benefits).
All payments made to replace income that has been lost, destroyed or stolen.
Money received under the Radiation Exposure Compensation Act for injuries or death resulting from radiation due to nuclear testing and uranium mining.
Rebates by any public agency of taxes or rent rebate on real property.
Money received as the repayment of the principal of a loan (including a promissory note) is not income in the month received. Any amount retained in the following month is considered a countable asset. Money received as interest payments is considered income in the month received.
Example
A couple sells their home and holds a mortgage at 10%. They receive $315 per month as a mortgage payment. Of that amount, $200 is interest and must be counted as income in the month received. The remaining $115 is repayment of the principal and is excluded income for the month. Any portion of the principal remaining in the following month is a countable asset for that month.
Payments received under the Ricky Ray Hemophilia Relief Fund Act of 1998. Interest income generated on these payments is countable income and any accrued interest is excluded as an asset. These payments are not subject to special rules on trusts or a transfer of resource penalty. Payments are not counted in determining a cost of care.
Interest on Series E, EEE and H Savings Bonds is not counted as income at any time. When these bonds are redeemed, the interest is a countable asset.
Interest on Series HH Savings Bonds is paid by direct deposit, semi-annually. The interest would be considered unearned income in the month received.
That portion of earned or unearned income needed to fulfill a plan for self-support approved by Vocational Rehabilitation or the Social Security Administration (including PASS plans) for an individual who is disabled or blind.
Money received as a result of selling, replacing or exchanging an asset is excluded as income. They are assets that have changed their form.
A wage or salary from the Senior Community Service Employment program is earned income. Anything else is excluded. Community Service Employment is a Program for older Americans authorized under Chapter 35, Title 42 of U.S. Code.
SSI benefits received by a spouse, parent or other family member when determining non-nursing care assistance.
Wages of dependent children under the age of 21 as long as they are full-time students or part-time students not employed full time.
Students are considered students throughout the calendar year, including summer months as long as they intend to return to school in the fall.
A student is one who is attending a school, college or university or a course of vocational training designed to prepare the student for gainful employment. This includes a participant in the Job Corps Program.
An individual under the age of 21 may be considered a student regularly attending a school or a training course if:
Payments made from any fund established pursuant to a class settlement in the case of Susan Walker v. Bayer Corp., et al, and payments made pursuant to a release of all claims in a case that is entered into in lieu of the class settlement.
When payments are made in lieu of a class settlement, the agreement must be signed by all parties on or before 12/31/97 or 270 days after the date on which a release is first sent to the persons to whom the payment is to be made.
TANF benefits received by a spouse, parent or other family member are excluded. These people are also not counted as members of the assistance unit during the budgeting process.
VA monthly payments made to or on behalf of Vietnam veterans' natural children regardless of their age or marital status for any disability resulting from spina bifida suffered by such children are excluded from income and resources. Interest earned on unspent payments is not excluded.
partially excluded for SSI - Related categories
There are two exceptions to this rule:
Vendor payments (payments for goods or services provided to an eligible individual or couple which are made directly to a vendor by a third party).
Any payment whether cash or in-kind made under the Domestic Volunteer Service Act Public Laws (93-113)
10-144 C.M.R. ch. 332, § 17-4