10-148-5 Me. Code R. § V

Current through 2024-51, December 18, 2024

Section 148-5-V - INCOME ELIGIBILITY DETERMINATION, VERIFICATION AND DOCUMENTATION

A. INTRODUCTION

PURPOSE:

The Department of Health and Human Services is committed to utilizing its resources to make social services available to those in the greatest economic need. To assure that services are provided to address economic need for the general population and for specific target populations, income eligibility guidelines have been established by the Department. For selected service areas, individuals must meet income guidelines to be eligible for services. This policy is applicable to all agreements, contracts, and grants containing client income eligibility guidelines. To implement the guidelines, the Department has established definitions of family and gross family income and standards for verification, documentation and treatment of gross family income.

STANDARDS

1.00 DEFINITION OF TERMS

2.00 INCOME GUIDELINE STANDARDS

3.00 DEFINITION OF FAMILY

4.00 INCOME INCLUDED IN FAMILY GROSS INCOME

5.00 ADJUSTMENTS TO FAMILY GROSS INCOME

6.00 INCOME EXCLUDED FROM FAMILY GROSS INCOME

7.00 VERIFICATION, DOCUMENTATION AND TREATMENT OF GROSS FAMILY INCOME

B. DEFINITION OF TERMS

1.00 DEFINITION OF TERMS

1.01 Adult means an individual 18 years of age or older, or court emancipated minor.

1.02 Applicant means the individual applying for services.

1.03 Department means the Department of Health and Human Services.

1.04 Department Approved means approval of the assigned agreement administrator or their supervisor.

1.05 Family - See definition contained in Section V, Sub-Section D.

1.06 Federally Recognized Tribe means the Penobscot Tribe, Passamaquoddy Tribe, Aroostook Band of Micmacs, Houlton Band of Maliseets and other Native American Tribe, band, nation or other organized group or community that is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

1.07 Maine Resident means an applicant who has established Maine as a permanent home, the place where s/he intends to return after any period of absence. Maine residency, once established, continues until a new, fixed and permanent home is acquired. No change of Maine residency results from moving to a new location if the intent is to remain only for a limited time, even if it is for a relatively long duration. Documentation of Maine residency includes a Maine home address where the applicant lives and one or more of the following items: current Maine individual income tax return indicating Maine resident status, valid Maine driver's license, current Maine motor vehicle registration, current Maine hunting/fishing license, proof of undergraduate student instate tuition payment, and other reasonable verification.

Exception: Homeless individuals are exempt from documenting a home address.

1.08 Provider means the community agency or individual who has entered into a contractual agreement with the Department of Health and Human Services, , to provide services.

1.09 Service Area means a type of service purchased by the Department, e.g., child care, homemaker, transportation services.

1.10 Student means an individual enrolled and attending an elementary or secondary educational institution, a program that provides for completion of a secondary diploma or GED, a school for the handicapped, a vocational education program, or post-secondary undergraduate institution.If the student is the applicant, they must be a Maine resident and attending an educational program in Maine. (See definition of Maine Resident)

1.11 Significant Income Change means a change in the source or amount of income which is greater than $25.00 per month and expected to continue into the future for more than one month.

1.12 Special Needs Child means a child who is identified with one or more of the following conditions: (1) Children with a specific diagnosis/disability which, without intervention, may impede or impair the attainment of development milestones; (2) Children who evidence a developmental delay in one or more of the following skill areas: cognitive, fine motor, gross motor, receptive and/or expressive language, social/emotional, or self-care; (3) Children considered to be at-risk for health or developmental problems as a result of established biological risk factors, and/or as a result of identified environmental risk factors. At-risk children must be referred by a third party such as public health agencies, physicians, schools, welfare offices, government agencies, federally recognized Tribes, community social service agencies, and early intervention specialists. Note: If the Department or Tribal referred child is served as a "special needs" child, the family must meet the applicable income eligibility requirements for this target group.

C. INCOME GUIDELINE STANDARDS

2.00 INCOME GUIDELINE STANDARDS

Financial eligibility for clients served with Department funds shall be determined in accordance with the following standards:

2.01 Income eligibility guidelines shall be based upon gross family income, adjusted to family size.

2.02 Income eligibility guidelines shall be annually updated by the Department.

2.03 The basis for establishing gross family income shall be selected by the Department.

2.04 The Department shall identify the service areas (types of services) that have income eligibility guidelines as a condition of eligibility.

2.05 The Department shall identify the target group populations within service areas that are eligible for services based upon income eligibility.

2.06 The Department shall identify the target group populations within service areas that are eligible without regard to income.

2.07 The Department shall adhere to all statutes, rules and regulations for establishing income eligibility applicable to Federal and State funding sources.

2.08 The Provider shall comply with all income eligibility standards contained in this Section and within the applicable service area policies, Section V of this Manual.

D. DEFINITION OF "FAMILY"

3.00 DEFINITION OF 'FAMILY'

In order to determine gross family income, the Provider shall comply with the following standards for defining the family unit:

3.01 A family is a group of related and/or non-related individuals, who are living together as one economic unit. An economic unit shares housing, and significant income and expenses of its members. Generally, individuals residing in the same dwelling are one economic unit. However, if more than one economic unit reside together in the same dwelling, there is typically a written or verbal agreement made between the two parties concerning the sharing of housing expenses such as rent, heat and utilities. The two parties to the agreement are otherwise economically independent from one another.

3.02 An individual living alone shall be a family of one.

3.03 Married couples residing together shall be considered to be family members.

3.04 Couples residing together who are not married to each other, but hold themselves out to the community as husband and wife or life partners by representing themselves as such to relatives, friends, neighbors or trades people; shall be considered to be family members.

3.05 When there are children who reside together with both of their biological or adoptive parents and the parents are not married to each other, both parents of the child(ren) shall be included as family members.

3.06 Family membership includes individuals who reside with the applicant and are claimed as dependents on the applicant's income tax returns. An exception is made for parenting teens (see Standard 3.09), foster children (see Standard 3.12), students (see Standard 3.15), and children living with a court-appointed, legal guardian (see Standard 3.13).

3.07 Family membership may include adults, age 18 and over, who reside with the applicant but are neither married to the applicant nor hold themselves out to be a husband, wife or life partner of the applicant, may or may not be otherwise related to the applicant, but are dependent upon the applicant for all or most their economic needs. Once an individual is claimed as a family member, any income received by that individual while residing with the applicant shall be counted as family income.

3.08 Adults, age 18 and over, who share a dwelling with the applicant but are neither married to the applicant nor hold themselves out to be a husband, wife or life partner of the applicant, may or may not be otherwise related to the applicant, but contribute their agreed upon share of housing expenses such as rent, heat and utilities; shall not be counted as family members. These individuals are likely to have their own checking accounts and file their own income tax returns. Generally, they share a residence out of economic necessity, but are economically independent of the applicant.

3.09 Parenting teens (under 20 years of age), who attend elementary school, high school or a GED program and live with their children and their parents, step-parents, relatives or non-relatives, are considered a separate family unit consisting of the teen parent(s) and their child(ren).

Exception: The school attendance requirement does not apply to child protective referrals from the Department or federally recognized Tribe.

3.10 Biological children, step-children, adopted children and all other children under 18 years of age residing with the applicant, who is maintaining a home for them and assuming parental responsibility, shall be considered to be family members.

Exception: Foster children, parenting teens, and children living with their legal guardian may be considered as separate family units as provided in Standards 3.09, 3.12 and 3.13.

3.11 In cases where joint custody has been awarded and the child physically changes residence between custodial parents, the child is a member of each custodial parent's family for the period of time that the child resides with each parent. Example: The custodial mother applies for child care for a child who resides with her every other week. The child will be included as a member of the mother's family every other week. If the mother is eligible, the child will receive child care every other week. If the custodial father also needs child care, then he may apply for the weeks that the child resides with him.

3.12 For Department and Tribal child custody (foster children) referrals, the foster child shall be considered a family of one. The foster care payment shall not be included as family income. If there is no referral for service from the Department or Tribal caseworker, then the foster child(ren) shall be included as a member of the foster family, but the foster care payment is not included as income.

3.13 Children living with a court-appointed, legal guardian may be considered a family of one. Only the income received in behalf of the child shall be included as family income (e.g., TANF, SSI, Social Security).

3.14 When the biological or adoptive parent of a foster child applies for services, their children in foster care shall not be included as family members.

3.15 Children of the applicant or other family member, who are temporarily away at school (e.g., attending a boarding school, technical school or college) are considered to be family members.

3.16 Service applicants may be residents of a shelter for battered women and their children; a homeless shelter; a semi-independent group living arrangement; an assisted housing program for people with a mental health diagnosis, mental retardation, or people with AIDS. Family membership shall not include other residents of the facility who were not admitted as members of the applicant's family.

3.17 Family members living apart on a temporary basis are considered family members.Temporary means the absent family member's permanent home is with the applicant's family, where they intend to return after any period of absence.

3.18 Residents of a substance abuse treatment program which is time-limited (usually 28 days or less), where the participant is expected to be returning home to live with their family, shall be included as family members.

3.19 Family members living apart for an extended period of time due to employment or educational purposes shall be considered members of the family.

3.20 Individuals who are long-term residents of institutions such as hospitals, skilled nursing facilities, intermediate care facilities and prisons, shall not be counted as family members. Long Term means that the individual is not expected to return home within two months.

3.21 Roomers, boarders and live-in attendants shall not be included as family members.

3.22 The applicant must be a resident of the State of Maine. See definition of Maine Resident.

3.23 Each individual in the family for whom assistance is being requested must be a U.S. citizen, an alien lawfully admitted for permanent residence or otherwise permanently residing in the U.S. under the color of law.

Note: Aliens legally admitted on a temporary basis such as visitors, travelers, crewmen on shore leave, foreign students, and members of the foreign press, radio, etc. are not eligible for services, even if they have authorization to work.

Note: The Jay Treaty of 1794 recognizes the aboriginal right of Native Americans to pass the border of the U.S. and Canada. When a Native American with Canadian citizenship moves to Maine, they are recognized as lawfully admitted for permanent residence.

Note: U.S. born children of illegal immigrants shall not be denied services based upon the citizenship status of their parent(s). Their parent(s), however, are not eligible to receive services.

Exception: This standard does not apply to blended or wrap-around child care for children enrolled in the Head Start Program, and child care provided in a public or private educational setting for out-of-school time (before and after school, school holidays, and summer vacation).

3.24 A family member cannot belong to more than one family at the same time.

E. INCOME INCLUDED IN FAMILY GROSS INCOME

4.00 INCOME INCLUDED IN FAMILY GROSS INCOME

In order to determine gross family income, the Provider shall comply with the following standards for defining what sources of income shall be included in gross family income:

4.01 "Gross family income" is the sum of all money, earned and unearned, already received or reasonably anticipated to be received by all family members during the service eligibility period. Gross family income is calculated before such deductions as income taxes, employee's social security taxes, employee pension contributions, employee deferred compensation plans (IRA accounts, 401K plans, etc.), insurance premiums (including Medicare), bonds, union dues and other employee payroll deductions and benefit deductions. Gross income does not include the employer's fringe benefit contribution/obligation. Gross family income is received or available or earned on a recurring basis. Negative income from business losses or investment/gambling losses shall not be deducted from other sources of earned/unearned income in calculating gross family income. Except for a farm enterprise, a net business, investment, or gambling loss shall have zero value in computing gross family income.

4.02 Gross family income shall include Earned Income from all sources, except for excluded income as set forth in Standard 6.01 Earned income includes:

a. Wages, salaries, commissions or fees, tips, piece-rate payment and cash bonuses before any payroll deductions;

b. Gross income from self-employment, excluding mostIRS deductible business expenses (see Standard 7.10(d)(3). Types of self-employment include but are not limited to:

1 Independent contractors, franchise holders, owners/operators, farmers, people who produce and sell a product, and service-type businesses;

2 Seasonal self-employment such as fishing, clamming, worm digging, logging, harvesting, etc.;

3 Income from boarders (not included as family members)

4 Income from roomers (not included as family members);

5 Income from ownership of rental property.

c. That portion of training allowances or training stipends which exceeds expenses, and represents a gain or benefit to the family;

d. On-the-job training JTPA (Job Training Partnership Act) earnings of family members.

Exception: Earnings of dependents less than 19 years of age, and all earnings under the JTPA-Summer Youth Employment and Training Program and comparable summer youth employment programs under Americorps are exempt (See Standard 6.01b.)

4.03 Gross family income shall include Unearned Income from all sources, except for excluded income as set forth in Standard 6.01. Unearned income includes:

a. Pension and retirement benefits such as government employee pensions, military retirement/pensions, railroad retirement, private pensions, annuities, IRA accounts, 401K plans and so forth;

b. Social Security benefits including pensions, survivor's benefits, and permanent disability insurance payments;

c. Assistance program payments such as SSI (Supplemental Security Income), TANF (Temporary Assistance for Needy Families), PaS (Parents as Scholars), Refugee Cash Assistance, and other means tested assistance. TANF payments which are diverted to a third party shall be counted as income. Assistance payments from programs which require the performance of work without compensation other than the assistance payment shall be considered unearned income;

d. Veteran's benefits including money paid periodically by the Veterans Administration to disabled members of the Armed Forces or survivors of deceased veterans; Aid and Attendance portion of veteran's benefits, subsistence allowances paid to veterans for education and on-the-job training, as well as so-called refunds of GI insurance premiums;

e. Military family allotments or other regular support from an absent family member or someone not living in the household;

f. Unemployment insurance and worker's compensation;

g. Strike benefits from union funds;

h. Regular cash income received from earned interest, dividends, royalties, estates and trusts;

i. Interest income received from all loans and notes such as personal loans, secured loans (includes real estate mortgages), installment contracts and interest-only loans. Loans of this nature usually require periodic payments of constant amounts over the life of the loan. The amount of the loan principal (return of capital) is considered an asset and shall not be included in gross income. The recognized gain on sale amount of the loan repayment shall be included in gross income. This determination shall be made in accordance with IRS regulations;

j. Child support and alimony payments made directly to the family, including the pass through and gap supplements received by TANF clients. Money deducted or diverted from court-ordered support or alimony to pay household expenses is also counted as income;

k. Income from ownership of rental property, excluding most IRS deductible business expenses. The business expenses disallowed are the same costs that are not allowed for self-employed individuals as set forth in Standard 7.10(d)(3).

l. Income from capital gains as defined and calculated in accordance with IRS regulations. Capital gains is the profit from the sale of real and personal property such as the sale of a residence, land, income producing property, investment property, capital equipment, stocks and bonds. Generally, profits resulting from disposal of business inventory of real and personal property are included as income from self-employment as opposed to being separately classified as capital gains;

m. Regular general assistance cash payments from municipalities that are not made directly to vendors such as a landlord;

n. Regular money contributions from persons determined not to be family members;

o. The portion of all educational grants, scholarships and other awards available to pay for living expenses . All fees assessed by the educational institution are not counted as income. If a student is not enrolled in a recognized institution of post-secondary education, a school for the handicapped, a vocational educational program or a program that provides for completion of a secondary school diploma or equivalent, the full amount of educational assistance is counted as income. Income from student loans shall be counted only if there are no repayment terms as a condition of the loan. This standard does not apply to educational assistance which is totally excluded under Federal statute as set forth in Standards 6.01(k) and 6.01(l);

p. Regular income received from lottery and sweepstakes winnings. Lump sum lottery and sweepstakes winnings are counted within the eligibility period they are received.

q. Net income from gambling;

r. Money that is legally due the family which is diverted to a third party to pay household expenses, such as: diversion of all or part of a TANF grant to a landlord; and that portion of an unemployment insurance benefit check intercepted by the State (SELU) commonly referred to as garnished wages. See Standard 5.01 applicable to adjustments for court ordered child support payments. General Assistance vendor payments are excluded;

s. Income that is legally due a family member but is received and used for that family member by a non-family member;

t. Income from sponsors of aliens lawfully admitted for permanent residence in the U.S. A sponsor is a person or organization signing an affidavit or document on behalf of the alien as a condition of entry;

u. All other income from government programs not specifically excluded by law.

F. ADJUSTMENTS TO FAMILY GROSS INCOME

5.00 ADJUSTMENTS TO FAMILY GROSS INCOME

Gross family income from earned and unearned sources shall be adjusted downward by the subtraction of certain expenses incurred in behalf of family members and paid from family income. The following expenses are subtracted from gross family income:

5.01 The actual amount of court-ordered child support payments made to another family shall be subtracted from gross family income. The deduction shall not include payments in arrears or other court-ordered payments. Payments shall be verified and documented as set forth in Standards 7.00.

5.02 Recurring expenses for medical care or prescribed adaptive equipment for special needs children shall be subtracted from gross family income. The expenses must be attributable to the child's diagnosis or disability. The expenses must be paid by the family and are not reimbursed by insurance, Medicaid or other sources. Payments shall be verified and documented in the client's case file. This deduction applies only to families who would, without this deduction, be ineligible for services based upon the income guidelines as established by the Department. For this deduction, prior approval shall be obtained from the Department.

G. INCOME EXCLUDED FROM FAMILY GROSS INCOME

6.00 INCOME EXCLUDED FROM FAMILY GROSS INCOME

In order to determine gross family income, the Provider shall comply with the following standards for defining what sources of income shall be excluded from gross family income:

6.01 Certain income shall be excluded from gross family income as follows:

a. Energy Assistance Program payments or allowances made under any federal energy assistance law. Note: Department of Housing and Urban Development (HUD) and Farmer's Home Administration (FmHA) utility payments and reimbursements are considered federal energy assistance;

b. Job Training Partnership Act (JTPA) payments and JTPA on-the-job training income received by participants (regardless of age) in the Summer Youth Employment and Training Program and comparable summer youth employment and training programs under Americorps. All other payments from JTPA's on-the-job training program (OJT) count as income unless they are received by dependents less than 19 years old;

c. VISTA payments only if excluded as income for Public Assistance or Food Stamp eligibility;

d. National Older Americans Volunteer Programs payments, including (but not limited to): Retired Senior Volunteer Program (RSVP), Foster Grandparent Program, Older American Community Service Programs, Senior Health Aides and Senior Companions, Service Corps of Retired Executive (SCORE) and Service Corps of Executives (ACE);

e. Payments under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of l970;

f. Women, Infants and Children Program (WIC) vouchers;

g. Special payments to Native Americans excluded by law, e.g., payments under the Maine Indian Land Claims Settlement Act;

h. Wages under the Community Service Employment Program of the Older Americans Act;

i. Payments made from the Agent Orange Settlement Fund or any other fund established pursuant to the settlement in the Agent Orange product liability litigation;

j. Federal Earned Income Tax Credit (EITC) is excluded whether received as advanced payment in weekly wages or received in one sum after filing annual income tax return. State and local EITC is not excluded as income.

k. Excluded educational assistance authorized under Title IV of the Higher Education Act, including:

1 Basic Educational Opportunity Grants (GEOG or PELL Grants);

2 Presidential Access Scholarships (Super PELL Grants);

3 Federal Supplemental Educational Opportunity Grants (SEOG);

4 State Student Incentives Grants (SSIG; Maine State Incentive Grant);

5 Federal Direct Student Loan Program (FDSLP), formerly GSL and FFELP;

6 Federal Direct Supplemental Loan Program (provides loans to students);

7 Federal Direct PLUS Program (provides loans to parents);

8 Federal Direct Stafford Loan Program;

9 Federal Direct Unsubsidized Stafford Loan Program;

10 Federal Consolidated Loan Program;

11 Federal Perkins Loan Program (direct loans to students in institutions of higher education) (Perkins Loans, formerly NDSL);

12 Federal Work Study Funds (Note: Not all Federal work study funds come under Title IV of the Higher Education Act.);

13 TRIO Grants (go to organization or institutions for students from disadvantaged backgrounds);

14 Upward Bound (some stipends go to students);

15 Student Support Services;

16 Robert E. McNair Post-Baccalaureate Achievement;

17 Robert C. Byrd Honors Scholarship Program;

18 College Assistance Migrant Program (CAMP) for students whose families are engaged in migrant and seasonal farm work;

19 High School Equivalency Program (HEP);

20 National Early Intervention Scholarship and Partnership Program.

l. Bureau of Indian Affairs (BIA) student assistance, education or training assistance, and employment assistance programs. Each Tribe has a BIA agency that may be contacted for more information about education and training assistance. BIA student assistance is provided by the Tribes, is not denoted by any particular name, and is not usually listed on institutions' financial aid statements.

m. Value of supplemental food assistance received under the Child Nutrition Act or the National School Lunch Act;

n. Value of USDA Food Stamps and/or Donated Commodities;

o. Earned income of a student 19 years of age or younger who is attending an elementary school or secondary school and resides with the applicant. An elementary or secondary school student is someone who attends elementary or secondary school enough time for that person's state or local school district to consider the person a "student". This includes a student who attends GED or home-school classes recognized, operated, or supervised by the student's state or local school district. The exclusion of this income shall not be altered by semester breaks, summer vacations, etc., provided the student resumes enrollment after the break.

p. When a parenting teen is the applicant, the income of the teen's parents, step-parents, other relatives or non-relatives who provide a home for the parenting teen(s) shall be excluded. The teen parent must be attending elementary school, high school, or a GED program or they must be Department/Tribal referrals. (See Standard3.09.)

q. Foster care payments from the Department of Health and Human Services or federally recognized Tribe;

r. Income of a court-appointed, legal guardian when services are provided to a child in their guardianship. The child is the service recipient or client. The child may be considered a family of one. Count only the income received on behalf of the child (e.g., TANF, SSI, Social Security).

s. Nonrecurring lump sum payments such as income tax refunds; and the portion of retroactive, lump-sum Social Security, SSI, railroad retirement or insurance settlements intended to cover a period prior to the current eligibility period;

t. State or federal one-time assistance for weatherization or emergency repair or replacement of an unsafe or inoperative heating or cooling device;

u. All loans, including student educational loans, bank loans, loans from private individuals, and other types of loans where there exists a written agreement with repayment terms as a condition of the loan;

v. The value of noncash benefits or gains from an employer; such as shelter, food and clothing provided by an employer. Military base housing is an example of employer-provided benefits. This exclusion shall not include money that is legally due the family which is diverted to pay for household expenses (see Standard 4.03r.)

w. The value of noncash benefits such as subsidized housing, general assistance voucher payments, medical and dental services, donated commodities, and food;

x. Certain vendor payments made on behalf of the applicant, including:

1 Money payments by a non-family member which are not legally due the household and are paid directly to a third party for a household's expense, such as a relative pays the rent or an employer pays the rent in addition to wages;

2 Vendored assistance from state or local programs which provide no cash assistance. This includes General Assistance vendor payments made to a third party.

y. Monies withheld or returned from an assistance payment, earnings or other source to repay a prior overpayment. Count the gross amount when the overpayment is the result of an intentional violation as determined by TANF, SSI or other means-tested program;

z. Child support payments received by TANF recipients that are turned over to the Department of Health and Human Services;

aa. Reimbursements and allowances which do not exceed the actual costs for job-related or training-related expenses, medical expenses, or dependent care expenses. This includes allowances from ASPIRE/JET and JTPA.

bb. Third-party payments received and used for the care of a third-party beneficiary who is not a family member;

cc. Withdrawals from bank deposits and credit union deposits;

dd. Lump sum cash inheritances or gifts;

ee. The portion of loan or note repayments which is determined to be the loan principal (return of capital) in accordance with IRS regulations (See Standard 4.03(i.));

ff. Losses from a farming enterprise shall be deducted from any other countable household income. This special consideration applies only to farms with annual gross sales of $1,000 or more.

gg. Wages from Youth Employment and Training programs under Title IV of CETA.

hh. Certain cash donations, based on need, received from one or more private, nonprofit charitable organizations.

H. VERIFICATION, DOCUMENTATION AND TREATMENT OF GROSS FAMILY INCOME

7.00 VERIFICATION, DOCUMENTATION AND TREATMENT OF GROSS FAMILY INCOME

The Provider shall comply with the following standards for verification and documentation of gross family income:

7.01 The applicant or other family member shall have the primary responsibility to provide verification of family income.

7.02 Except for clients who are eligible without regard to income, the Provider shall request income verification from all program applicants. Eligibility cannot be determined prior to income verification; and services shall not be provided prior to verification. If there is a fee assessment to individuals who are eligible without regard to income and the basis for the assessment is family income, then the Provider shall request income verification.

7.03 Income verification shall be documented and retained in the client's record.

7.04 If income verification has not been provided within 30 days of the application date, the Provider shall deny the application.

7.05 The Provider shall request income verification from program recipients prior to redetermination of eligibility. Program recipients are redetermined for service eligibility at least once every six months. Redetermination may be for less than a six-month period when significant changes are expected to occur affecting program eligibility or when funding is not available for a full six-month period. A thirty to forty-five day advance notification of eligibility redetermination is required. Services shall not be continued into a new eligibility period without income verification.

7.06 The Provider shall request income verification from program recipients who report a change in family income. For clients who fail to provide the requested verification, the Provider shall give the client written notification that services will be terminated if verification is not received within fifteen days from the date that notice is sent.

7.07 Acceptable verification of earned income includes one or more of the following as requested by the Provider:

a. Four or more current, consecutive and complete pay stubs;

b. Four or more current, consecutive and complete pay envelopes;

c. W-2 Form (if representative of current and future earnings);

d. State and/or Federal Income Tax Return;

e. Self-employment bookkeeping records;

f. Sales and expenditure records;

g. Statement of gross earnings for the past four or more weeks, signed and dated by the employer on company letterhead;

h. Employer's wage record;

i. Employment Security Office records;

j. Verbal verification from caseworker for Department/Tribal referrals.

k. A signed release of information from the applicant which authorizes the Provider to pursue verification or further clarification.

7.08 Documentary evidence is the primary source of verification of unearned income. Whenever attempts to verify income have failed for reasons other than client non-cooperation, an amount to be used shall be determined based on the best available information. If verification (other than documentary evidence) is used, the reason why shall be explained in the client's record. Acceptable verification of unearnedincome includes, but is not limited to the following:

a. Benefit check (viewed and photocopied by the Provider);

b. All types of award letters;

c. Income tax records (interest income, dividends, royalties, estates, trusts, deferred compensation plans, capital gains, etc.);

d. Support and alimony payments evidenced by court order, divorce or separation papers, or check copies;

e. Social Security Query Card Response;

f. Social Security District Office verification;

g. Bank Statement;

h. Maine Employment Security Commission verification;

i. Worker's Compensation verification;

j. Insurance company verification;

k. Verbal verification from caseworker for Department/Tribal referrals;

l. A signed release of information from the applicant which authorizes the Provider to pursue verification or further clarification.

7.09 The calculation of family gross family income is based on the best estimate of the family's income and other circumstances expected to exist until the next eligibility period. The best estimate is based on the client's and the Provider's reasonable expectations and knowledge of current, past and future circumstances.

7.10 A best estimate is determined by the following steps:

a. Income received within four or more weeks immediately preceding application or redetermination must be verified.

b. Determine, through a careful review of the income documentation and discussion with the client, if there have been any significant income changes during this period. If there have been, and the change is of a continuous nature, the changes must be taken into consideration when determining the best estimate. See definition of Significant Income Change.

c. Self-employment income shall be averaged over a twelve-month period when it represents the family's major source of support. This applies even when it is received in a shorter period of time. If the twelve-month average is not an accurate reflection of circumstance or a business has been in operation only a part of a year, income will be averaged for the months in operation or the Provider may calculate the self-employment income based on anticipated earnings. Seasonal self-employment income which supplements other income shall be averaged over the season.

d. Income from self-employment shall be calculated as follows:

1 Add all gross self-employment income together including the full amount of capital gains. This means that a family with more than one self-employment enterprise shall have all self-employment gross income added together;

2 Add all costs of producing income together. This means that a family with more than one self-employment enterprise shall have all self-employment costs added together;

3 Costs not allowed (do not deduct from gross self-employment income) are: (a) Payments on the principal of the purchase price of income producing real estate, capital assets, equipment, machinery or other durable goods; (b) Net losses from previous periods; (c)Federal, state and local income taxes, retirement plans applicable to family members only, and work-related personal expenses; and (d) Depreciation expense. Note: The employer's share of FICA tax is an allowable deduction.

4 Subtract the total costs of producing the income from the total gross income of the self-employment enterprise(s);

5 Divide net earnings by number of months over which income has been averaged, when appropriate. (See Standard 7.10(c.))

6 Add self-employment income to any other income received by the household. Losses from a farm enterprise shall be deducted from any other countable family income. This special consideration applies only to farms with annual gross sales of $1,000 or more. Otherwise, losses from self-employment shall not be subtracted from any other countable family income.

e. Determine if any significant income changes are expected in the future. If yes, and the exact nature of the significant income change is known, the Provider shall use that information in determining the best estimate of income. If the exact nature of the anticipated change is not known, a redetermination shall be scheduled to coincide with the expected date.

f. Determine if any of the income received is not expected to be representative of the future. Sporadic fluctuations in income are not used in calculating the best estimate (Example: Christmas bonus or a one-week plant shutdown). The client file must explain how the best estimate was figured and, if applicable, why any income was not used.

g. If income fluctuates to the extent that a four week period does not provide the best estimate of income for the future eligibility period, the Provider can use information covering a longer period of time. Similarly, if income fluctuates seasonally, it may be more appropriate to use the most recent season comparable to the upcoming eligibility period as a basis to determine the best estimate taking into account any anticipated changes.

h. The final step is to calculate the average monthly income as follows:

a Weekly income is converted to monthly income by multiplying the weekly amount by 4.3.

b Biweekly income is converted to monthly income by multiplying the biweekly amount by 2.15.

c Average monthly income from self-employment is added to all other earned and unearned income as provided in Standard 7.10c. and 7.10d.

i. To arrive at weekly income for fee determination purposes, monthly income is converted to weekly income by dividing the monthly amount by 4.3. Biweekly income is converted to weekly income by dividing the biweekly amount by 2.15.

10-148 C.M.R. ch. 5, § V