4310 Assistance Planning

Assistance planning relates to the consideration of certain individuals living together as a family group. A family group is defined as the client and all individuals living together in which there is a legal and/or a caretaker relationship. The assistance plan shall consist of those persons in the family group for whom assistance is requested and any excluded legally responsible person.

For MediKan, the mandatory filing unit shall consist of either a single adult or a married couple residing in the same household. There is no eligibility for MediKan coverage if there are minor children in the household.

4311 Treatment of Assistance Plan

The assistance plan for all medical programs consists of those persons in the family group for whom assistance is requested and any excluded legally responsible person for those individuals.

The client may include or exclude any family group members for assistance purposes.

Except as noted below, eligibility shall generally be determined within a single assistance plan for those members who qualify under the same category of assistance. For example, if more than one member requests and is eligible for Medically Needy, a combined determination is required. This policy would also be applicable to members of a family who qualify for the same medical program but under different individual subtypes (i.e., OA, AB, or AD for Medically Needy). Once again, a combined determination of these individuals would be required.

Separate assistance plans shall be established in the following instances, which are not applicable to family medical programs:

Each SSI recipient (including 1619b recipients) shall have a separate plan as well as any child whose needs are met through foster care or adoption support payment.
Family group members who qualify under different medical programs (e.g., Medically Needy, Medicaid poverty level, etc.) shall have separate plans.
Each client in a long term care arrangement (including HCBS and PACE) shall have a separate plan.
Emancipated minors, minors determined to be able to act in their own behalf, and 18 year old children shall have separate assistance plans apart from their parents.
Any child (and his or her siblings) in the family who is not living with a legally responsible person (such as grandchildren, nieces, and nephews, etc.) shall have a separate assistance plan.

4312 Additional Assistance Planning Provisions

The following additional principles are applicable for assistance planning purposes:

1. Marriage establishes legal responsibility between the couple. Any marriage (including same sex) validly established in Kansas or another jurisdiction either through a civil licensed contract or by common-law (see 2 below) shall be recognized. Once established, the marriage (both civil and common-law) may only be dissolved through a formal divorce court proceeding.
A common-law marriage establishes legal responsibility between the couple. To be considered common-law married, the couple must meet all of the following conditions:
1. has the legal capacity to marry:
  1. be at least 18 years old.
  2. are legally competent.
  3. are not already married to someone else.
2. considers themselves to be presently married.
3. holds themselves out to the public as married.
Any individual who does not have the legal responsibility to support a person in need is not required to do so. When such individual in the household, including an SSI recipient, voluntarily and regularly contributes cash to the applicant/ recipient toward household expenses (including his maintenance needs), the net amount of income realized by the household shall be considered. To determine the net amount of income to be counted, the difference in the PIL including the individual and the PIL excluding the individual shall be deducted from the gross amount of the contribution.
The total income and resources of both spouses shall be considered in determining eligibility of either or both for assistance if they are living together (including physical separation while maintaining a common life). This provision is not applicable for situations where one or both spouses enter an institutional or HCBS arrangement. See 5200 (9), 6100 (5), and PM2021-02-01, re: Spouse’s Resources Disregarded in Long Term Care Determination.