8250 Determination of Countable Income

8250 Determination of Countable Income - Countable income is that amount of income which is considered in determining eligibility and the amount of obligation for medical expenses.

A portion of all income (earned and unearned) is disregarded from gross nonexempt income in determining eligibility and the amount of client obligation for persons in HCBS. One disregard is allowed for the combined income of the individual. Disregarded income is not considered available to meet medical expenses.

The following are the amounts to be disregarded:

1. From earned income, certain work expense deductions. This disregard does not apply to ineligible members of the assistance plan. The amount of the disregard cannot exceed the amount of earned income. The standard amounts may be deducted if allowable expenses are reported. If expenses exceed this amount, actual expenses may be used but must be verified and averaged. Expenses cannot be subject to reimbursement from any source (including Medicaid or the employer).

a. Blind Work Expense (BWE) - For the blind, the first $300 of earned income is disregarded for persons reporting allowable work expense(s). If verified expenses exceed this amount, actual average expenses shall be allowed. Allowable expenses for the blind are expenses reasonably attributable to earnings of the income. The following are allowable expenses:

· Guide dog expenses including the (cost of obtaining and maintaining the animal such as food, licenses and vet bills);

· Transportation to and from work (For purposes of determining actual expenses for private transportation, the current state reimbursement rate for privately owned vehicles shall be used. This includes the increased rate for specially equipped or modified vehicles to accommodate a disability. Because this standard mileage rate includes expenses for gas, oil, insurance, etc. in the determination, these items are not separately allowable. The cost of modifying a vehicle are allowable (e.g., installing a ramp) but the cost of the actual vehicle is not. Actual costs of public

· transportation (e.g., cab fare, bus tokens) shall be allowed.);

· Federal, state and local income taxes, Social Security tax;

· Attendant care services;

· Visual aids and translation services;

· Drugs (except for lifestyle or cosmetic medications) and other medical expenses or equipment NOT covered by Medicaid, or Medicare or other insurance, including co-payments;

· Costs of training to use special equipment.

b. Impairment Related Work Expense (IRWE) - For others, the first $100 of earned income is disregarded for persons reporting allowable work expense(s). If verified expenses exceed this amount, actual average expenses shall be allowed. Allowable expenses are those directly related to enabling a person to work which are incurred because of a physical or mental impairment. The following are allowable expenses:

Specialized Transportation to and from work; Examples include structurally modified vehicles to accommodate the individuals disability (both the operating costs and the cost to modify), the costs of a driver or taxi cab if the individual requires assistance and cannot manage to get off or on public transportation or public transportation has not been modified for the person’s disability (e.g., wheelchair accessible). Transportation is not allowable for persons who can drive an unmodified car or utilize public transportation without assistance.

Drugs (except for lifestyle or cosmetic medications) and other medical expenses or equipment NOT covered by Medicaid, or Medicare or other insurance, including co-payments;

Service Animal expenses including the costs of obtaining and maintaining the animal such as food, licenses and vet bills as described in P-1: Medical Necessity;

Non-medical equipment and services, such as tools and one-handed typewriters, related to the impairment.

Attendant care performed in the work setting or helping prepare for work;

2. The first $20 per month of any income (this disregard is to be applied first to unearned income, if any, with any remainder of the disregard applied to earned income, if any); and

3. The first $65 per month of gross (or adjusted gross) earned income and

4. One-half of the remainder of earned income.

8260 Income Standards - A standard has been established which is the amount of monthly income protected from medical expenses to allow applicants/recipients to meet their maintenance needs. This standard is $727/month. This standard is applicable the month HCBS is effective (8200.3).

Each individual shall be considered a separate household of one for budgeting purposes except as provided in 8243. Adults may allocate a portion of their income for the support of dependents. (See 8243 (3) or the spousal impoverishment income provisions of 8244.2.)

An HCBS recipient who enters a medical institution for a temporary stay shall continue

to be budgeted for HCBS for the month of entrance and the two following month. After

that time period, HCBS services would be fully terminated and the long term care

rules outlined in 8100 would be applicable. See also 8272.

For an individual who fails the 300% special income test described in 7430(4), a

standard of $727/month shall be applicable if the client obligation does not exceed

the monthly cost of care for the HCBS services. If the client obligation exceeds

the cost of care, the independent living standard (7430(2)), budgeting methodology

(4300) and base period (7330) shall be applicable. See 8270.2.

Each individual shall be considered a separate household of one for budgeting purposes

except as provided in 8243. Adults may allocate a portion of their income for the

support of dependents. (See 8243 (3) or the spousal impoverishment income provisions

of 8244.2.)