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***This version of the Health Care Programs Manual has been replaced and is no longer in effect. Please see the current Health Care Programs Manual for policy as of December 1, 2006.***
The terminology used to describe people with disabilities has changed over time. The Minnesota Department of Human Services ("Department") supports the use of "People First" language. Although outmoded and offensive terms might be found within documents on the Department's website, the Department does not endorse these terms.

MDHS Health Care Programs Manual (Eligibility Policy through 11/30/06)

Chapter 0911 - Income
All chapters are numbered beginning with 09. The first chapter is 0901 (Table of Contents).

   
0911

INCOME

PDF(s): Jan 98

0911.03

AVAILABILITY OF INCOME

PDF(s): Jan 05 | Oct 02

0911.03.03

APPLYING FOR OTHER BENEFITS

PDF(s): May 00

0911.05

EXCLUDED INCOME

PDF(s): Dec 02

0911.05.03

EXCLUDED INCOME -- PROGRAM PROVISIONS

PDF(s): Jan 05 | Jan 03

0911.07

DETERMINING IF INCOME IS EARNED OR UNEARNED

PDF(s) Jul 98

0911.07.03

EARNED INCOME

PDF(s): Dec 02 | Jun 02

0911.07.05

UNEARNED INCOME

PDF(s): Jul 04 | Jan 03

0911.09

SPECIFIC TYPES OF INCOME

PDF(s) Jul 98

0911.09.03

SELF-EMPLOYMENT INCOME

PDF(s) Jul 98

0911.09.03.03

SELF-EMPLOYMENT INCOME -- MINNESOTACARE

PDF(s): Jul 02

0911.09.03.05

SELF-EMPLOYMENT INCOME -- MA/GAMC

PDF(s): Jul 04 | Jul 98

0911.09.03.07

SELF-EMPLOYMENT USE OF HOME

PDF(s): Feb 99

0911.09.03.09

SELF-EMPLOYMENT TRANSPORTATION

PDF(s): Jan 06 | Jan 05 | Jan 04 | Jan 03 |

0911.09.03.11

IN-HOME DAY CARE

PDF(s) Jul 98

0911.09.03.13

RENTAL INCOME

PDF(s) May 05 | Jul 98

0911.09.03.15

FARM INCOME

PDF(s): Jul 02

0911.09.03.17

ROOMER/BOARDER INCOME

PDF(s): Apr 06 | Jan 04 | Dec 02

0911.09.05

DEPENDENT CHILD INCOME

PDF(s): Jan 99

0911.09.07

STUDENT FINANCIAL AID INCOME

PDF(s): Jan 05 | Jan 03

0911.09.09

SEASONAL INCOME

PDF(s): Jul 02

0911.09.11

CHILD SUPPORT INCOME

PDF(s): Apr 00

0911.09.11.01

CHILD SUPPORT INCOME -- MA/GAMC

PDF(s): Jul 02

0911.09.13

ASSISTANCE PAYMENTS INCOME

PDF(s): Dec 02

0911.09.15

INCOME FROM RSDI AND SSI

PDF(s) Jan 05 | Jul 98

0911.09.15.01

INCOME FROM RSDI AND SSI -- MA/GAMC

PDF(s): Jan 05 | Jul 01

0911.09.15.03

DETERMINING GROSS RSDI

PDF(s) Jul 98

0911.09.15.05

LUMP SUM RSDI AND SSI PAYMENTS

PDF(s): Jan 05 | Jul 04 | Oct 03

0911.09.17

IN-KIND INCOME

PDF(s): Jul 98

0911.09.19

INTEREST AND DIVIDENDS

PDF(s): Jan 05 | Jan 00

0911.09.21

TRIBAL LAND SETTLEMENTS AND TRUSTS

PDF(s): Jan 03

0911.09.23

LUMP SUM INCOME

PDF(s): Jul 04 | Jun 02

0911.11

COMPUTING COUNTABLE INCOME -- MINNESOTACARE

PDF(s): Jul 02

0911.11.01

COMPUTING INCOME -- MINNESOTACARE - PART 2

PDF(s): Jul 02

0911.11.03

COMPUTING COUNTABLE INCOME -- MA/GAMC

PDF(s): Jul 04 | Oct 02

0911.11.05

MA/GAMC VARYING INCOME

PDF(s): May 05 | Mar 03

***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


INCOME 0911
All of the health care programs consider income in determining eligibility. Do not count income that is unavailable. See §0911.03 (Availability of Income).

Certain types of income are excluded. See §0911.05 (Excluded Income).

Earned income may be treated differently than unearned income. See §0911.07 (Determining if Income Is Earned or Unearned).

Some types of income have special rules to determine the countable amount. See §0911.09 (Specific Types of Income).

MinnesotaCare premiums are based on countable gross annual income. See §0911.11 (Computing Countable Income--MinnesotaCare).

MA and GAMC eligibility and spenddown amount (if any) are based on gross income less allowable deductions. See §0911.11.03 (Computing Countable Income--MA/GAMC) and §0912 (Income Eligibility).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


AVAILABILITY OF INCOME 0911.03
Determine if income is available or unavailable. Count only available income to determine eligibility. Income is available when:

• Received by the client.
• Received by someone else on the client's behalf.
• Counted as available to the client, whether or not the client receives it.
• Withheld by the employer or other payor at the client's request.
Income is unavailable when the client cannot gain access to the income.

EXAMPLE:

Adult applicant is disabled and his mother, with whom he lives, receives his social security check for him as his representative payee. Count the social security check as income to him. Do not count it as income to the mother. See §0911.09.15 (Income From RSDI and SSI).

EXAMPLE:

Program rules require a 19-year-old who lives at home to be considered part of his parents' household. See §0908 (Household Composition). Count his parents' income toward his eligibility whether or not he receives any cash payments from them.

EXAMPLE:

Applicant has a court order requiring her ex-husband to pay $400 per month child support for their two children. He is paying only $300 per month and efforts to enforce the full order have been unsuccessful. Count $300 as income. The unpaid portion is unavailable.

EXAMPLE:

Enrollee asks his employer to withhold his last two paychecks of the year until the following tax year. The paychecks are available on the date they would normally be paid.


MinnesotaCare:
If applicants/enrollees claim no income from any source, count zero income. If you have conflicting information, ask if they receive any money that they may not consider income but that is counted for MinnesotaCare.

EXAMPLE:

Pete applies for MinnesotaCare and claims no income. He also reports he is making current child support payments. Contact Pete to resolve the conflicting information.


MA/GAMC:
Clients must try to gain access to unavailable income as a condition of eligibility, unless they can document that the income is permanently unavailable. Deny or terminate MA or GAMC if clients refuse to cooperate in trying to gain access to unavailable income.

METHOD A:

Do not allow a deduction from income when part of the income is being withheld to repay a debt or obligation, unless the income is being reduced to recover a prior overpayment from the same income source.

EXAMPLE:

Roger is entitled to a VA payment of $400 per month. $150 is withheld to repay a prior VA overpayment. Count $250 per month as available income.

EXAMPLE:

Penny has $50 per week withheld from her paycheck due to a court-ordered garnishment for an unpaid credit debt. Consider the $50 as available income. Do not deduct it from her gross wages.

METHOD B:

Do not allow a deduction from income when part of the income is being withheld to repay a debt or obligation, unless the income is being reduced to recover a prior overpayment AND the overpaid amount had been previously counted as unearned income for MA or GAMC eligibility.

EXAMPLE:

Larry has received MA for two years. He reports that his $300 per month VA check has been reduced by $100 to recover an overpayment incurred one year ago while he was receiving MA. Allow a deduction of $100 until the overpayment is paid.

EXAMPLE:

Mildred applies for MA for the first time. Her RSDI benefit of $500 has been reduced by $30 to repay a prior overpayment. Count the full $500 RSDI benefit as available because the overpayment occurred before Mildred received MA.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


APPLYING FOR OTHER BENEFITS 0911.03.03

MinnesotaCare:
Require clients to apply for Medicare Part A and Part B coverage if it appears they would be eligible for both programs. People who are eligible for Part A at no cost may not refuse coverage to gain or continue MinnesotaCare eligibility. Review the case facts to determine if the person refused Part A specifically for the purpose of gaining or continuing MinnesotaCare eligibility. Do not automatically assume that a person who refused the coverage in the past did so to get MinnesotaCare.

EXAMPLE:

Herman refused Part A coverage three years ago. He applies for MinnesotaCare after a neighbor tells him he might be eligible. He is no longer eligible for Part A without a large monthly premium. His refusal three years ago is not a bar to MinnesotaCare eligibility.

Do not require clients who are denied coverage under Part A at no cost to apply for or accept Part A or Part B.


MA and GAMC:
Require clients to apply for benefits from other programs for which they appear eligible if those benefits would increase their net countable income or help pay their medical expenses. They must apply for benefits within 30 days of when you told them about their potential eligibility. Deny or terminate eligibility if clients fail to apply without good cause. Do not require clients to reapply for benefits which were previously denied unless there has been a change in circumstances or eligibility requirements of the benefit program.

People may lose eligibility or have benefits reduced for certain benefits when they are incarcerated. Require people to reapply for these benefits when they are released from the control of the penal system, including conditional medical releases when the client enters a nursing facility.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


EXCLUDED INCOME 0911.05
Exclude income from the following sources in determining eligibility for all health care programs:

NOTE:

Some types of income that are otherwise excluded may be counted for long term care budgeting. See §0913.13 (Long Term Care Spenddown Calculation).

• Children’s Nutrition Act.
• Benefits from the Women, Infant, and Children (WIC) nutrition program.
• Benefits from the National School Lunch Act.
• Benefits from the Food Support Program issued in the form of coupons or Electronic Benefit Transfer (EBT) payments.
• Benefits from the State Food Programs provided to non-citizens or vouchers from the Minnesota Grown Program. See §0918.17 (Food Stamps and Related Programs).
• Loans which the applicant or enrollee has a written obligation to repay, except some student loans. See §0911.09.07 (Student Financial Aid Income).
• The principal portion of repayments on a loan owed to the applicant or enrollee. Interest payments received by the applicant or enrollee are counted.
• Reverse mortgages.
• Payments from the Low Income Home Energy Assistance Program (LIHEAP).
• Amounts an applicant or enrollee receives which are related to shared living expenses and are solely to pay a portion of another person's living expenses. For example, exclude payments a person receives from a roommate for a portion of the rent to be forwarded to the landlord. Do not apply this exclusion to payments people receive from renting or providing room and board in property they own. See §0911.09.03.17 (Roomer/Boarder Income).
• Rental payments made directly to a landlord through the Housing and Urban Development (HUD) agency, including Section 8 payments made through the Housing and Redevelopment Authority.
• Refunds or rebates from HUD for excess rents charged.
• Security deposit refunds and utility deposit refunds whether paid by the applicant or another party, including the Emergency Assistance (EA) or Emergency General Assistance (EGA) programs.
• Cash from the sale of the client's property or assets, regardless of whether the asset was excluded. This includes money withdrawn from savings accounts or other liquid assets for living expenses. This does not apply to some business capital gains. See §0911.09.03 (Self-Employment Income). It does not apply to interest or dividends regularly earned on assets and paid to the household. Count these payments as income.
EXAMPLE:

An enrollee receives $3,000 from the sale of his car. Exclude this money as income.

EXAMPLE:

A household withdraws $300 each month from a savings account and uses it to pay rent. Exclude this money as income.

EXAMPLE:

A household receives a quarterly dividend payment of $65 from stocks they own. Count this payment as income. Also see §0909 (Assets) for information on treating cash from the sale of property as assets for MA and GAMC.

• Payments to replace personal or real property made by public agencies, issued by insurance companies, awarded by a court, or issued through public appeal.
• Payments received and used for care and maintenance of a 3rd party beneficiary who is not a household member. This includes payments for the care of foster children who live in the household.
• Federal and state adoption assistance payments, except for state adoption assistance payments which continue beyond age 21. See §0911.09.13 (Assistance Payments Income).
• Tax refunds, credits, and rebates. Tax refunds include:
• Federal and state withholding refunds.
• Homeowner/Renter Property Tax Refund.
• Tax credits include:
• Earned Income Credit (EIC).
• Federal Child Care Credit.
• Minnesota Working Family Credit.
Tax rebates include amounts returned to individual taxpayers based on federal or state taxes paid, such as the 1999 sales tax rebate authorized by the Minnesota legislature.

• Payments by the vocational rehabilitation program administered by the state under Minnesota Statutes, chapter 268A, except those payments that are for current living expenses.
• Relocation Assistance for displaced persons under Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, the Housing and Redevelopment Act of 1965, or the Housing Act of 1965.
• Payments made under the Radiation Exposure Compensation Act (Public Law 101-426).
• Mandatory salary reduction amounts for military service personnel which are used to fund the G.I. Bill (Public Law 99-576).
• Payments from the Consumer Support Grant (CSG) program.
• Federal payments issued due to a presidential declaration of disaster. Federal payments include, but are not limited to, grants from the Federal Emergency Management Agency (FEMA).
• Disaster assistance provided by states, local governments, and disaster relief organizations such as Red Cross and Salvation Army.
• Payments made to people because of their status as victims of Nazi persecution. This includes reparation payments the Federal Republic of Germany makes to certain survivors of the Holocaust, and Netherlands’ Act (WUV) payments to victims of Nazi (German) persecution. Exclude all WUV payments for Method B. Count WUV payments to victims of Japanese persecution as unearned income for Method A and MinnesotaCare.
• Family Support Grant Payments.
• Benefits and payments provided to volunteers through the Domestic Volunteer Service Act., which includes:
• Title I:
• Volunteers in Service to America (VISTA). Also exclude Americorps VISTA payments.
• University Year for Action (UYA).
• Urban Crime Prevention Program.
• Title II:
• Retired Senior Volunteer Program (RSVP).
• Foster Grandparent Program.
• Older Americans Community Service Program.
• Senior Health Aides.
• Senior Companions.
• Title III:
• Service Corps of Retired Executives (SCORE).
• Active Corps of Executives (ACE).
• Count payments to people administering VISTA who are civil service employees as earned income for all programs.
• Reimbursements for expenses, other than normal living expenses. This includes reimbursements from employment and training programs such as JTPA, volunteer service programs, county social services programs, jury duty, employment, and reimbursements for medical expenses.
• Payments made under the Vietnamese Commandos Compensation Act.
• Payments made under Public Law 104-204 on behalf of children of Viet Nam veterans who are born with spina bifida.
• Blood Product Litigation settlement payments.
• Payments made to compensate crime victims for losses resulting from the crime.
• Settlements to hemophiliacs under the Ricky Ray Hemophilia Relief Act of 1998.
• Federal and non-federal matching funds deposited into Individual Development Accounts (IDAs). See §0902.19 (Glossary: In-Kind....) for a definition of IDAs.
• Certain payments made by tax-exempt organizations to or for the benefit of children with life-threatening conditions. Apply this exclusion to cash payments of up to $2,000 per calendar year and to the total value of in-kind gifts. This includes gifts to the child’s parents for the child’s benefit and indirect benefits to other family members, such as payment to accompany the child on a trip. Count the amount of total cash payments that exceed $2,000 in a calendar year. Count the value of in-kind gifts converted to cash unless the gift could be excluded as an asset under other provisions.
The Make-A-Wish Foundation is an example of an organization meeting the criteria for exclusion. If an organization’s status is unclear, ask if the organization is a section 501 (c) (3) organization under the Internal Revenue Code of 1986 and is exempt from taxation under Section 501 (a). Accept the organization’s statement that the gift was made based on a child’s life-threatening condition.

See §0911.05.03 (Excluded Income--Program Provisions) for additional types of income excluded for each program.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


EXCLUDED INCOME -- PROGRAM PROVISIONS 0911.05.03
See §0911.05 (Excluded Income) for general provisions which apply to all programs.


MinnesotaCare:
Also exclude income from the following sources:

• Earned income of full- or part-time students under age 19. See §0911.09.05 (Dependent Child Income).
• Infrequent or irregular income. Income is infrequent or irregular if it is not possible to anticipate receiving it. Count income that applicants/enrollees regularly receive at least annually.
EXAMPLE:

The Brown family receives $10,000 every December from Mrs. Brown's parents. Count this money as income.

EXAMPLE:

Sarah received a $500 gift from her uncle last year. She explains that it was a one-time gift because her uncle sold some stock. Do not count this income.

• Lump sum income. Generally, lump sums are one-time, non-recurring payments. Examples include winnings, inheritances, insurance settlements, and retroactive payments.
EXAMPLE:

Household is approved for social security survivors' benefits because of the death of the father. They receive a lump sum of $5,000 for previous months and ongoing benefits of $1,000 per month. Exclude the $5,000 retroactive payment.

EXAMPLE:

Enrollee receives a cost of living adjustment to his wages effective July 1. He receives a retroactive payment for July and August on his September 1 paycheck. Exclude the portion of the paycheck that covers the retroactive pay increase.

EXAMPLE:

Enrollee wins $4,000 at a casino. Exclude the winnings.

Some lump sums, such as winnings over a given amount, may be taxable. If an applicant or enrollee's tax forms include a lump sum, subtract the lump sum from the adjusted gross income unless the household anticipates receiving income from the same source in the next year. See §0911.11 (Computing Countable Income--MinnesotaCare).

Some other types of income may be partially excluded. See the sections on specific types of income for more information.

M. S. 256.9354 subd. 4a


MA/GAMC:
METHOD A:

Exclude irregular cash gift income totaling $30 or less per calendar quarter for each person whose income is counted. Count gifts the client receives on a regular basis or which exceed $30.

EXAMPLE:

Martha applies for MA for herself and her children. Her parents give her $25 per month to help with expenses. Count this gift because Martha receives it regularly.

EXAMPLE:

Jennifer receives MA for herself and her 2 sons. Jennifer reports on her 6-month income review that she and the children each received $25 as a birthday gift. Exclude this income because it totals less than $30 per person per quarter and is received infrequently.

METHOD B:

Infrequent or irregular income is income that is received no more than once in a calendar quarter from a single source or could not reasonably be expected.

Exclude the first $30 per calendar quarter of irregular or infrequent earned income. This exclusion applies to the combined total irregular/infrequent earned income of all people whose income is being considered.

EXAMPLE:

Betsy reports receiving $38 for babysitting a neighbor's child. She does not babysit regularly. Exclude the first $30 of this income because it is irregular and count the remaining $8.

Exclude the first $60 per calendar quarter of irregular or infrequent unearned income. Apply this exclusion to the total irregular/infrequent unearned income received in each calendar quarter. To be considered infrequent income, the same type of income may be received more than once in a calendar quarter as long as it is not from the same source. This exclusion is applied to the combined total irregular/infrequent unearned income of all people whose income is being considered.

EXAMPLE:

Herman and Sheila receive MA using a manual monthly spenddown. See §0913.11 (Manual Monthly Spenddown Calculation). They report on their monthly income report for April that they received $65 as an anniversary gift from friends. Herman received $20 for his birthday from his mother. They do not expect to receive additional gifts during the calendar quarter.

Total all the infrequent unearned income ($85) and exclude the first $60. The remaining $25 is counted as unearned income because it exceeds the first $60 in a calendar quarter.

Exclude as income gifts used by an individual to pay tuition or other education related expenses.

Except for long term care budgeting, exclude income from the Mille Lacs Band of Ojibwe Elder Supplemental Assistance Program. See §0911.09.21 (Income From Tribal Land Settlements and Trusts).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


DETERMINING IF INCOME IS EARNED OR UNEARNED 0911.07
All income is either earned or unearned. Earned income is money people receive in exchange for work or service, including some training stipends. Unearned income is money people receive without being required to perform work.

Whether income is earned or unearned affects:

• Income exclusions for dependent children. See §0911.09.05 (Dependent Child Income).
• Income deductions and disregards for MA and GAMC.
• Verification requirements.
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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


EARNED INCOME 0911.07.03
Consider the following types of income as earned income for all of the health care programs except MA-EPD:

• Wages.
• Commissions.
• Tips.
• Jury duty pay.
• Picket duty pay.
• Severance pay, if based on accrued leave time.
• Vacation pay.
• Sick pay, if based on accrued or earned time.
• Compensation from the employer’s vacation donation program, if paid and taxed in the same manner as the employee’s usual pay.
• Blood and blood plasma sales.
• Royalties and honoraria which result from the client’s work or service
• Wages paid to participants in programs carried out under the Community Service Employment Program (Title V of the Older Americans Act), which includes the Experience Works (formerly Green Thumb) program and the Senior Aides Program.
• Wages paid through the National and Community Service Act of 1990 under Title I, which includes the following programs:
- Serve-America.

- Higher Education Innovative Projects.

- Conservation and Youth Service Corps.

- National and Community Service Models.

Count benefits other than wages paid through the programs listed above as unearned income. Exclude reimbursements for expenses.

• AmeriCorps living allowances. Exclude in-kind AmeriCorps benefits. See §0911.09.17 (In-Kind Income).
See §0907.21.07.06 (MA-EPD: Employment Definition) for a definition of earned income for MA-EPD.


MinnesotaCare:
Consider all income from self-employment or an owned business as earned income. Consider distributive profits paid to children through a partnership as unearned income unless the child performs labor for the partnership. See §0911.09.03 (Self-Employment Income).

Consider housing allowances paid in cash to members of the clergy as earned income. Exclude housing provided directly without charge, such as use of a parsonage, as in-kind income.

M. S. 256L.01 subd. 4 & 5

Minnesota Rule 9506.0040 subp. 2


MA/GAMC:
Follow general provisions.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


UNEARNED INCOME 0911.07.05
Consider the following types of income as unearned income for all of the health care programs. Some programs may exclude all or part of a particular type of payment. See the specific income sections for more information.

Allow a deduction from unearned income for costs necessary to secure the payments, such as attorney’s fees, if these costs are withheld from the ongoing payment under a legal agreement.

Do not allow a deduction for repayment of any other debt. See §0911.03 (Availability of Income) for more information on money withheld to recoup overpayments. Submit a HealthQuest if you are not sure whether to allow a particular deduction.

EXAMPLE:

William receives Workers Compensation (WC). The gross biweekly payment is $720. $140 is withheld for attorney’s fees incurred when obtaining the WC benefits. William signed an agreement to allow repayment of the fees from his benefits, as a condition of the attorney accepting the case. Allow the $140 deduction. William also has $20 deducted for payment of an old credit card debt. Do not allow the $20 deduction.

• Alimony.
• Child support. See §0911.09.11 (Child Support Income) and §0911.09.11.01 (Child Support Income--MA/GAMC).
• Annuity and pension payments.
• Disability benefits. This does not include sick pay based on accrued time. See §0911.07.03 (Earned Income).
• Retirement, Survivor's, and Disability Insurance (RSDI). See §0911.09.15 (Income From RSDI and SSI) and §0911.09.15.01 (Income From RSDI and SSI--MA/GAMC).
• Supplemental Security Income (SSI). See §0911.09.15 (Income From RSDI and SSI) and §0911.09.15.01 (Income From RSDI and SSI--MA/GAMC).
• Retirement benefits from public or private sources, such as Railroad Retirement or private pension.
• Unemployment Insurance (UI, previously known as Reemployment Insurance).
• Extended income support payments through the Trade Adjustment Reform Act of 2002. These payments are available to certain workers participating in training when the job loss was related to foreign trade. Workers must exhaust regular UI benefits before becoming eligible for TAA payments.
• Workers' Compensation.
• Veteran's Benefits.
• Trust disbursements.
• Severance pay, if not based on accrued leave time.
• Tribal per capita payments from casinos. Also see §0911.05 (Excluded Income).
• Regularly received gifts. Also see §0911.05 (Excluded Income).
• Countable interest and dividends, if not earned as part of a self-employment operation. See §0911.05 (Excluded Income), §0911.09.19 (Interest and Dividends), and §0911.09.03 (Self-Employment Income).
• Countable assistance payments income. See §0911.09.13 (Assistance Payments Income).
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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SPECIFIC TYPES OF INCOME 0911.09
Some types of income have specific rules and may be treated differently by different programs. See the following sections for more information:

§0911.09.03 Self-Employment Income.

§0911.09.05 Dependent Child Income.

§0911.09.07 Student Financial Aid Income.

§0911.09.09 Seasonal Income.

§0911.09.11 Child Support Income.

§0911.09.13 Assistance Payments Income.

§0911.09.15 Income From RSDI and SSI.

§0911.09.17 In-Kind Income.

§0911.09.19 Interest and Dividends.

§0911.09.21 Tribal Land Settlements and Trusts.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SPECIFIC TYPES OF INCOME 0911.09.03
Self-employed people:

• Generally work for themselves rather than for an employer. However, some self-employed people may have an employer or work out of another's business location. Examples include real estate sales people, people who work for commission sales, manufacturer's representatives, independent contractors, and some members of the clergy.
• Are responsible for their own work schedule.
• May not be covered under an employer's liability or Workers' Compensation.
• May or may not have FICA (social security tax) deducted from the check another party issues to them.
If you are unsure whether a person who has an employer or works from another's business location is considered self-employed, refer to the type of tax forms the person files. If you need further information, check with the employer with the person's signed consent.

Examples of self-employment enterprises include:

• Farming.
• Product sales such as Avon, Tupperware, etc.
• Small businesses.
• Services such as day care.
• Skilled trades such as roofers, painters, etc.
Types of self-employment enterprises include:

• Sole proprietorship. A sole proprietorship is owned and controlled by one individual. A sole proprietor is not required to file a separate business tax return. Sole proprietors must include the profit or loss from all sole proprietorships on the federal 1040 tax forms and must file a separate Schedule C (non-farm) or Schedule F (farm) for each business operated as a sole proprietorship.
• Partnerships. A partnership is owned by two or more individuals. Although partnerships are not taxed as separate entities, they must file a return on federal Form 1065. Each partner will also receive a Schedule K-1 (Form 1065) showing his/her distributive share of certain items of income, gain, loss, deduction, or credit. Partners may receive differing shares depending on the original partnership agreement. Farm partnerships must file a Form 1065 and a Schedule F.
In some cases, certain members of the partnership, such as children, may not perform labor for the partnership. However, they do receive K-1's and are entitled to a distributive share of profit or loss. Count the distributive share of profits as unearned income.

EXAMPLE:

A family of 2 adults and 5 children are members of a religious community which operates several businesses. None of the children works in any of the businesses. Each member of the community receives a Form K-1 showing a distributive share of $4,000 for the previous tax year. Count the $4,000 as unearned income to the children and as earned self-employment income to the parents. If there are non-allowable expenses, such as depreciation, use the percentage of ownership shown on the K-1 to determine the amount of the non-allowable expense to add back to each member's share.

• Corporations. A corporation exists separately from the individuals who own interest in it and must file a separate corporate tax return. There are two types of corporations:
C-Corporations - Shareholders who also perform work for the corporation are paid as employees and receive a W-2
form reporting their wages. They receive profits in the form of dividends. The dividends must be reported on the
shareholder's individual tax return and are counted as income. Use the individual wages and dividends instead of the
self employment figures to compute income.
S-Corporations - An S-corporation is a small business corporation of 35 or fewer shareholders. S-corporations must

file a tax return on form 1120-S. An S-corporation is similar to a partnership in that each partner separately reports his

or her share of the income, deductions, loss, and credits on the personal tax forms. Unlike a C-corporation, taxable

distributions of profits are treated as capital gains rather than dividends and are reported on Schedule D.

Farm S-corporations must file a form 1120-S and are not required to file a Schedule F. However, some farm

corporations may file both forms. Be sure to check both for depreciation amounts.

C-corporations are taxed on the corporation's ordinary income, while S-corporations are taxed only at the shareholder

level.

In general, countable income for a self employed person is the gross receipts from the business minus the allowable costs of doing business. The allowable costs are listed later in this section for each program. Use the previous year's tax forms to determine net self-employment income. If the household did not file taxes, or there has been a substantial change in the self-employment income since the tax return was filed, or the household has not yet been in business long enough to file taxes, use available business records to project income. Examples of acceptable documentation when tax forms are not available or are no longer accurate include:

• Business financial statement or detailed records of gross receipts and expenses.
• Business quarterly report (may be filed for tax purposes).
• Computer print-out showing gross receipts and expenses.
• Signed statement from the business's accountant verifying projected business income or expenses.
Determine countable self-employment income by deducting allowable costs of doing business from the gross receipts.


MinnesotaCare:
Also see §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
Also see §0911.09.03.05 (Self-Employment Income--MA/GAMC).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.

SELF-EMPLOYMENT INCOME -- MINNESOTACARE 0911.09.03.03
See §0911.09.03 (Self-Employment Income) for general provisions which apply to all programs.


MinnesotaCare:
For C-corporations, follow general provisions. Count shareholder's wages reported on the W-2 and any dividends paid.

For other types of self-employment, use the tax forms if available to determine countable self-employment income. The MinnesotaCare income worksheet and the Tax Form Reference Guide both help to identify where to find required information on the tax forms.

Some deductions allowed for tax purposes are not allowed for MinnesotaCare. These are also known as non-allowable expenses. All other costs of doing business are allowable expenses.

Add the following amounts back to the net profit, if any. Also refer to the work sheet and guide to find these figures.

• Depreciation. This is a deduction for the cost of a business asset that gradually loses value through the wear and tear of use.
Some self-employed people, such as in-home day care providers, may have an amount for "non-deductible depreciation" recorded on the tax forms (generally on Schedule C). Do not add non-deductible depreciation to the person's net business income.

• Amortization. This is a deduction for other costs of starting a business that are deducted from the business income over a period of time.
EXCEPTION:

Business owners may be able to take the maximum deduction for certain property in the year they purchase the property. This is called a Section 179 expense. MinnesotaCare allows a deduction for Section 179 expenses. If the household has claimed a Section 179 expense on their tax forms, subtract the Section 179 amount from the depreciation amount before adding the depreciation back to the net profit.

• Carry forward net operating loss (NOL) for non-farm businesses. Do not add back NOL to farm income. When allowable deductions exceed gross receipts for the tax year, the business has incurred a loss that may be carried over into future years. MinnesotaCare does not allow a deduction for carry-forward NOL for non-farm businesses.
• Capital gain or loss. Capital gains or losses result from the sale or exchange of business assets held for more than 1 year. Do not allow a deduction for a capital loss unless it resulted from a sale, distribution, or exchange that occurred within the same tax year the deduction is claimed. Count capital gains as income if they result from sale or other gain on a business asset. Do not count capital gains from the sale or exchange of personal assets.
• Wage deductions. Deductions for wages paid to employees of the business are allowable. However, if the wages were paid to adult members of the MinnesotaCare household (or minor children whose wages must be counted), be sure to include that amount in the household’s total income. The household member may or may not receive a W-2 form for the wages paid.
• Do not add back any other deductions on the tax forms, including deductions from gross income on the personal tax form. Use the adjusted gross income (AGI).
For partnerships and S-corporations, each person's share of profit, deductions, and loss will vary depending on the percentage of the business they own. If a household member receives a Form K-1, use the percentage shown on the K-1 form to determine the individual's share of depreciation and any other non-allowable deductions.

EXAMPLE:

George, a MinnesotaCare applicant, is a partner in a small business with Sam. Because Sam contributed a larger share of the initial investment and both work full-time for the business, Sam owns 60% of the partnership while George owns 40%. Each receives a K-1 form showing his share of the partnership's income. The form indicates that the amount reported for George, $15,000, represents 40% of the business profit. The partnership's tax forms show a $5,000 depreciation deduction. Add $2,000 (40% of $5,000) to George's K-1 share for a net countable self-employment income of $17,000.

New business or no tax returns filed: If a business has not operated long enough to file taxes, request records for the previous 12 months or since the business began, whichever is less. Average the net monthly income by subtracting allowable expenses from gross receipts and dividing by 12 or by the number of months the business has operated, whichever is less. Do not deduct amounts for the expenses listed earlier in this section that are not allowable deductions for MinnesotaCare. If the business is a partnership or S-corporation, use the terms of the original partnership or corporate agreement to determine the applicant’s or enrollee’s share of the income and expenses. Ask the applicant or enrollee to provide tax forms for the business when they become available.

Substantial change: If the business has filed tax forms but indicates a substantial change, request business records covering the time period since the last tax return was filed. Use the MinnesotaCare Income Worksheet to determine adjustments from the income reported on the tax forms.

Generally, normal business fluctuations from year to year are not considered to be a substantial change. If the nature or scope of the business has changed, evaluate the potential effect on the business income.

EXAMPLE:

Mr. Jones is a dairy farmer. He sold half his herd at the end of the last tax year. His income for the coming year is expected to be about one-half of the previous year's income. Consider this to be a substantial change. Use current business records to determine income. Also determine whether Mr. Jones received countable capital gains from the sale of his herd.

If the applicant or enrollee asks for assistance in determining whether or not there has been a substantial change, determine whether the change is likely to affect group status or eligibility for the fixed premium for children. See §0907 (Eligibility Groups and Bases of Eligibility) and §0913(Premiums and Spenddowns).

EXAMPLE:

Ms. Anderson owns a beauty shop. Her income for the last tax year was over 150% FPG. At the time of her annual renewal, she reports that her earnings have fallen substantially. Based on her current business records, projected income is now below 150%. Her children will have Group 1 status and be eligible for the fixed premium. Consider this to be a substantial change.

If a business is no longer operating, subtract the net income from that business from the household's other countable income.

Deduct a self-employment loss from other countable household income. This includes profit from other self-employment, regular wages, and unearned income.

M.S. 256L.01 subd. 4


MA/GAMC:
See §0911.09.03.05 (Self-Employment Income--MA/GAMC).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SELF-EMPLOYMENT INCOME -- MA/GAMC 0911.09.03.05
See §0911.09.03 (Self-Employment Income) for general provisions which apply to all programs.


MinnesotaCare:
See §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
Use the previous year's tax returns to determine net self-employment income. Follow MinnesotaCare if the business did not file taxes or has had a substantial change since the last tax return was filed.

METHOD A:

The following expenses are non-allowable. Add these amounts to the net profit shown on the tax returns to determine countable self-employment income:

• Carry over net operating loss (NOL) from a previous tax year.
• Personal federal, state, and local income taxes.
• The self-employed client's share of FICA. Allow the employer's share of FICA payments made for employees who are not members of the MA or GAMC household.
• Money set aside for the self-employed person's own retirement.
• Work-related personal expenses.
• Payments on principal of loans. Allow interest payments as a self-employment expense.
• Capital expenditures. Capital expenditures are payments made to purchase or improve property with a useful life of more than one year.
• Charitable contributions.
• Depreciation.
• Wages or other benefits paid to a member of the MA or GAMC household, regardless of whether that person is applying for or receiving MA or GAMC.
• Any expenses not allowed by the IRS, unless specifically authorized by this manual.
• The costs of building an inventory. Deduct the cost of a product only after it sells.
• Personal business and entertainment expenses.
Count capital gains and losses if they are part of the self-employment operation. If they can be distinguished from other business income, count them only if the household expects similar gains or losses in the coming year.

If an applicant or enrollee operates more than one self-employment business, deduct a loss from one business from any profit of a second business.

METHOD B:

Do not deduct expenses the IRS does not allow as a self-employment expense.

Deduct a self-employment loss from other household earned income.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SELF-EMPLOYMENT USE OF HOME 0911.09.03.07

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
Determine if the self-employment business operates from the client's home. Allow as a deduction the costs for the portion of the home used exclusively for the business.

Use self-employment business and shelter costs provided by the client. If these are not available, use the client's tax records or determine a reasonable ratio to allow as a business expense. Compare the number of rooms used for business to the total number of rooms in the house, or compare the total square footage of the house to the square footage used for business.

Allowable deductions for business use of the home include:

• Rent.
• Real estate taxes and insurance.
• Interest on mortgage.
• Utilities.
• Repairs made to specific areas of the home used for business.
Allow a deduction for business use of the home for inventory storage or in-home child care even if the client does not use those areas exclusively for business if:

• For inventory storage, the client's home is the only work station. Base the business deduction on the ratio of square footage used for inventory storage to the total square footage of the home.
• For in-home child care, the client's home is licensed for child care or is exempt from licensing. Base the business deduction on the ratio of square footage used for child care to the total square footage of the home and the proportion of time the household uses the area for child care. Prorate the expense accordingly.
EXAMPLE:

Deb is a licensed child care provider. Her home has 2,000 square feet. She uses 1,000 square feet, or 50% of the total square footage, for child care 50 hours per week. The portion of the home used for child care is also used by Deb's family. The portion used for child care is used 30% of the time (50 hours is 30% of the 168 hours in a week). Allow 15% (30% multiplied by 50%) of the allowable costs listed above as a business deduction.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SELF-EMPLOYMENT TRANSPORTATION 0911.09.03.09

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
Do not allow the cost of travel between the self-employed person's home and place of business as a business expense. Personal use of transportation is not a business expense.

Prorate the expense of transportation used for self-employment and personal needs based on the percentage of use for each.

Transportation expenses include:

• Gas and oil costs.
• Parking fees.
• Car insurance.
• Car repairs.
• Interest payments on a car loan.
METHOD A:

Allow the IRS mileage rate (also known as the flat rate) for self-employment transportation. Effective January 1, 2006, the rate is 44.5 cents per mile. The rate for 2005 was 40.5 cents per mile for January through August. That rate was increased to 48.5 cents per mile for September through December 2005. Use the flat rate even if itemized self-employment transportation costs exceed the flat rate amount.

METHOD B:

Self-employed people may use the flat rate deduction or itemize actual transportation expenses. If an applicant or enrollee chooses the flat rate, use this amount even if greater than actual itemized transportation expenses.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


IN-HOME DAY CARE 0911.09.03.11

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
People who provide day care in their own homes are self-employed. Treat income from day care provided in an applicant or enrollee's home as self-employment income. Deduct allowable expenses from gross receipts to determine countable net self-employment income.

People who provide day care in someone else's home are not eligible for in-home day care deductions. Treat wages from day care provided in someone else's home as regular earned income.

Commonly allowable itemized expenses for in-home day care include:

• Food.
• Toys and books.
• Supplies.
• Transportation.
• License fees and professional dues.
• Advertising costs.
• Equipment rental and lease expenses.
• Equipment which is not a capital expenditure.
In addition, deduct expenses for the area of the home used for day care. See §0911.09.03.07 (Self-Employment Use of Home).

METHOD A:

In-home day care providers may itemize expenses or take a flat rate deduction of 60% of gross receipts. Use the method most advantageous to the household.

Do not count payments from the Minnesota Child Care Food Program in calculating gross receipts.

If using the actual expense method, do not deduct expenses reimbursed through the Minnesota Child Care Food Program.

METHOD B:

In-home day care providers must itemize expenses.

Do not count payments from the Minnesota Child Care Food Program in calculating gross receipts.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


RENTAL INCOME 0911.09.03.13

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA/GAMC:
Rental property is property the client owns and rents to others, but where the client does not live. This may include separate living quarters in the same building, such as a duplex. For information on rental income from people living with the client, see §0911.09.03.17 (Roomer/Boarder Income).

Income from rental property may be earned or unearned. Follow the specific provisions for Method A and Method B to determine whether rental income is earned or unearned.

Deduct allowable self-employment expenses from both earned and unearned rental income. However, allow earned income disregards only for earned rental income. See §0912.05.09 (Earned Income Disregards--Method A) and §0912.05.09.05 (Earned Income Disregards--Method B).

When the client lives on the rental property, determine the rental property ratio. Divide the number of rooms or square footage that the client rents out by the total number of rooms or square footage in the building. To determine the portion of an expense that is an allowable deduction, multiply the expense by the ratio.

METHOD A:

Count income from rental property as earned income when the client spends an average of at least 20 hours per week maintaining or managing the property. Otherwise count it as unearned income.

Allowable expenses for rental property include:

• Real estate tax.
• Insurance.
• Utilities.
• Interest.
• Upkeep and repairs.
In addition to the expenses listed above, allow up to $103 per year or 2% of the estimated market value on the county tax assessment form, whichever is greater, for upkeep and repairs.

METHOD B:

Count income from rental property as earned income for each month the client spends an average of at least 10 hours per week maintaining or managing the property. Otherwise count rental income as unearned income.

Allowable expenses for rental property include:
• Real estate tax
• Insurance
• Utilities
• Interest
• Advertising expenses
• Lawn maintenance
• Snow removal costs
• Property management fees paid to a 3rd party.
In addition to the expenses above, deduct expenses for upkeep and repairs made to maintain or repair existing structures or equipment. Only consider minor corrections to an existing structure as a repair. There is no limit to the amount of this deduction. Do not allow expenses for adding to or replacing existing structures or equipment to increase the value of the property.
Example: Tim owns rental property that has damage to the roof. Allow the expense to repair only the damaged area of the roof as a deduction from the rental income Tim receives for that month. If Tim decides to replace the entire roof do not allow this expense as a deduction from the rental income.
Example: Jill resides in an LTCF and has a life estate interest in a home. She is receiving rental income monthly. Jill’s AREP determines that the house is very drafty and expensive to heat in the winter due to the homes’ very old windows. The AREP has all of the windows in the house replaced and requests that this expense be deducted from the rental income. This is a capital expenditure and cannot be allowed as a deduction from Jill’s rental income.
If it is uncertain whether an expense is for repair or replacement, submit a policy interpretation question to HealthQuest.
If the rental income is part of a self-employment enterprise, annualize gross rental income and expenses. Otherwise follow the instructions below.
• Subtract the allowable deductible expenses paid in a month from the gross rental income received in the same month.
• If the allowable deductible expenses paid in a month exceed the gross rental income in the same month, subtract the excess expenses from the next month’s gross rental income. Continue to do this as necessary until the end of the tax year in which the expense is paid.
• If there is still excess expenses after applying the expenses to the future months rental income, subtract the remaining excess expenses from the gross rental income received in the month prior to the month the expenses were paid. Continue to do this as necessary to the beginning of the tax year involved.
EXAMPLE:
Alfred is living in an LTCF. He owns a life estate that is currently being rented for $600 a month. Half of his property tax of $900 is due in May. Alfred pays the $900 in May. Deduct $600 of the property tax payment from the rental income received in May. There is a balance of $300 that can be deducted from the rental income received in June.
Note: Do not carry excess expenses over to other tax years. Do not use excess expenses to offset other income.
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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


FARM INCOME 0911.09.03.15

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare). Do not add back carryover losses and net operating losses to farm income. Add back depreciation.


MA/GAMC:
Common types of farm income include:

• Proceeds from sale of crops, livestock, or products.
• Soil conservation payments (CRP payments).
• Proceeds from machine rental, including wages to the farmer/operator.
• Capital gains or losses. Consider capital gains or losses reported on Schedule F or other tax forms as part of the self-employment income. When capital gains or losses are distinguishable from other self-employment income, only count gains or losses if the household expects to have similar gains or losses in the next certification period.
Deduct from farm income all expenses associated with producing the income. Separate farm and shelter expenses using farm records and information from the mortgage lender, tax assessor, or Farmer's Home Administration. When it is not possible to separate farm and shelter expenses, determine the ratio of farm property to home property and multiply the expense by the ratio.

Estimate income by averaging farm income and expenses over a 12-month period. Use the most recent tax return as a guide. If the farm income varies greatly from year to year, average the past three years' income. However, if any year results in a loss, count the income for that year as $0.

Count farm land rental as part of the self-employment income if the household is actively farming or it meets the guidelines in §0911.09.03.13 (Rental Income) for earned income. Otherwise count net rental payments as unearned self-employment income.

EXAMPLE:

Norbert resides in a long term care facility. He is no longer actively farming. He is renting out his farm land while making reasonable efforts to sell it. Count the rental payment he receives less any allowable expenses (such as taxes or property insurance) as unearned income.

Count CRP payments as part of the self-employment income if the household is actively farming. Otherwise count them as unearned income.

If tax returns are not available or do not reflect true circumstances, use the client's farm records.

If the client has had a recent financial change which makes past income an inaccurate predictor, make a reasonable estimate. Document the method you use.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


ROOMER/BOARDER INCOME 0911.09.03.17

MinnesotaCare:
Follow §0911.09.03 (Self-Employment Income) and §0911.09.03.03 (Self-Employment Income--MinnesotaCare).


MA and GAMC:
If a client receives payments for lodging, meals, or related services from people living in the client's home, the income is roomer/boarder income. Households with roomer/boarder income are self-employed. Count the income as earned income.

• A roomer lives with the household and pays for lodging only.
• A boarder eats with the household and pays for meals only.
• A roomer and boarder lives AND eats with the household and pays for lodging AND meals.
Roomer/boarder income is different from rental property or from shared living expense income. For information on rental property income, see §0911.09.03.13 (Rental Income). For information on shared living expense income, see §0911.05 (Excluded Income).

METHOD A:

Allow a flat rate deduction for each roomer/boarder:

• Roomer: $71 per month.
• Boarder: $152 effective 10/01/2005

 
$149 effective 10/01/2004
 
$141 effective 10/01/2003

• Roomer plus boarder: $223 effective 10/01/2005

 
$220 effective 10/01/2004
 
$212 effective 10/01/2003
Subtract the flat rate deduction for each roomer/boarder from total roomer/boarder income to get gross self-employment income.

METHOD B:

Allow the following expenses for a roomer/boarder:

• Roomer: The verified expense of providing the room.
• Boarder: The verified expense of providing the food.
• Roomer and boarder: The verified expense of providing the room and board.
Deduct expenses, up to the amount of the income, to get gross self-employment income. To determine the expense of providing a room, prorate the total shelter expenses based on the ratio of the number of rooms for rent to the total rooms in the house. Do not include bathrooms. Do not include attics or basements unless they are converted to living spaces.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


DEPENDENT CHILD INCOME 0911.09.05

MinnesotaCare:
Exclude the earned income of full or part time students under age 19.


MA/GAMC:
METHOD A:

Count all non-excluded unearned income of a dependent child as income to the child.

Count all earned and unearned income of a minor caretaker who is not a dependent child as income to the minor caretaker and any dependents to whom the minor's income is deemed.

Exclude the following earned income for dependent children who are not minor caretakers:

• JTPA earned income of a full-time or part-time student employed at least 37-1/2 hours per week. This exclusion is available for 6 months out of each calendar year. Use the exclusion in the first 6 months possible.
• JTPA earned income of a dependent child who is not a student. This exclusion is available for 6 months out of each calendar year. Use the exclusion in the first 6 months possible.
• Earned income of a dependent child who is a full-time or part-time student and employed less than 37-1/2 hours per week.
• All earned and unearned income of Refugee Unaccompanied Minors.
EXAMPLE:

Jessica applies for MA for herself and her sons, Randy and Jonathan. Randy attends high school full time and works 20 hours per week. Jessica also receives RSDI payments on his behalf because his father is deceased. She receives child support for Jonathan.

Exclude Randy's earnings from his job because he is a student and is employed less than 37-1/2 hours per week. Count the RSDI as unearned income to Randy. Count Jonathan's child support, less the $50 pass-through, as unearned income to Jonathan. See §0911.09.11.01 (Child Support Income--MA/GAMC).

EXAMPLE:

Melanie, age 17, lives apart from her parents in the community. She receives MA for herself and her 6-month-old son. She attends high school part time and works 25 hours per week. Count Melanie's earned income because she is a minor caretaker who is not a dependent child.

If Melanie received MA as a dependent child on her parents' case, you would exclude her earnings in determining her own eligibility because she is a student working less than 37-1/2 hours per week. You would count the earnings when deeming her income to her son.

METHOD B:

Count all income of a dependent child unless excluded under another provision.

EXAMPLE:

Scott, age 16, is certified disabled by SMRT and receives MA through the TEFRA waiver. He attends special education classes part time and works 10 hours per week. Because he uses Method B, count his earnings less any allowable deductions in §0912 (Income Eligibility) in determining his eligibility.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


STUDENT FINANCIAL AID INCOME 0911.09.07

MinnesotaCare:
Exclude all student financial aid and state work study income for undergraduate students.

Exclude training expenses paid through the Trade Adjustment Reform Act of 2002.

For graduate students:

• Count as earned income graduate student fellowships, internships, stipends, teaching assistant income, or any other financial aid that requires the student to work in order to receive the aid. Do not allow deductions for educational expenses from earned income.
• Exclude all Title IV financial aid and income from Bureau of Indian Affairs (BIA) student assistance programs. Title IV aid includes:
• PELL or BEOG grants.
• Presidential Access Scholarships (Super PELL).
• Supplemental Education Opportunity Grants (SEOG).
• Minnesota State Scholarships and Grants.
• Stafford Loan (formerly Guaranteed Student Loan).
• PLUS loans.
• Perkins Loans (formerly NDSL).
• SLS (formerly ALAS).
• Robert C. Byrd Honor Scholarships.
• Federal work study income.
• Bureau of Indian Affairs Grant Program.
• High School Equivalency Program (HEP).
• College Assistance Migrant Program (CAMP).
• Upward Bound (Trio Grants).
• National Early Intervention. Scholarship and Partnership Program.
• Robert E. McNair Post-Baccalaureate Achievement.
• Count as unearned income any non-Title IV or BIA aid such as graduate student scholarships, stipends, or other types of grants that do not require teaching or research or any other similar work. Allow a deduction for necessary educational expenses such as:
• Tuition.
• Mandatory fees.
• Course and lab fees.
• Books.
• Transportation to and from school. Use the same transportation expense rate as allowed for self-employment transportation.
• Supplies and equipment required for course work.
• Child care costs incurred while at school and in transit.
For this purpose, necessary educational expenses do NOT include living expenses.

Consider counted graduate student financial aid when it is available to meet the client's educational expenses. Budget it over the months it is intended to cover, whether or not the client attends school. To arrive at a monthly amount to budget:

1. Subtract allowable educational expenses for a given period of time (quarter, semester, year) from a graduate student's non-excluded financial aid received to cover the same period of time.

2. Divide the result by the remaining number of months in the period.

3. Add this amount to the household's gross income.

If the client receives the aid before the school year begins, do not budget the income until the period it is intended to cover. If the financial aid was received prior to application, do not budget it for that period.

For veterans’ benefits, determine which portion is designated as educational assistance benefits and exclude it as educational benefits. Treat the remaining amount of the benefit as unearned income.


MA/GAMC:
METHOD A:

Follow MinnesotaCare.

METHOD B:

Exclude the following financial aid. DO NOT deduct allowable student expenses from the excluded aid.

• Financial aid loans, including loans from the Tribal Development Student Assistance Revolving Loan Program.
• Title IV financial aid in the month the client receives it.
• Financial aid used to fulfill an approved Plan to Achieve Self-Support (PASS) for disabled or blind people. See §0912.05.11 (Plan to Achieve Self Support).
• Training expenses paid through the Trade Adjustment Reform Act of 2002.
• Gifts used to pay tuition or education related expenses.
Count all other financial aid as income in the month received. Deduct allowable expenses.

Consider student financial aid available to the client when the client or client's representative actually receives it

In addition to the allowable expenses listed under Method A, allow the following expenses as deductions from all non-excluded sources of student aid:

• Work expenses and deductions from work study income.

• Any impairment-related expenses necessary to attend school or perform school work.
For veterans' benefits, determine which portion is designated as educational assistance benefits and exclude it as educational benefits. Treat the remaining amount of the benefit as unearned income.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


SEASONAL INCOME 0911.09.09

MinnesotaCare:
Annualize seasonal income based on the number of months the person expects to work during the year. If the person typically receives Unemployment Insurance during the time they are laid off, include the anticipated amount in the annual calculation. If the earnings vary from month to month, use an average to arrive at a monthly amount.

Base the calculation on the previous year’s tax forms if they accurately reflect the current situation. Add any non-taxable Unemployment Insurance the person expects to receive. If tax forms do not reflect the current situation, require other verification of current and anticipated earnings. If seasonal income is new or changes from year to year, base the annual income figure on the applicant/enrollee’s best estimate of expected income. See §0911.11 (Computing Countable Income--MinnesotaCare).

EXAMPLE:

John works for a roofing company and is typically laid off for 4 months each year. His previous year's tax forms reflect 8 months of earnings and 16 weeks of Unemployment Insurance. Use the figures shown on the tax forms to project his earned income for the next 12-month period.

EXAMPLE:

Bob is an applicant who just started work for a landscaping company in April. He applies for MinnesotaCare in June. He earned $400 in April, $600 in May, and expects to earn $1,000 in June. He provides an employer statement which indicates he is expected to continue at the $1,000 per month level in July and August. Earnings are anticipated to drop to $600 in September and October and the employer expects Bob to be laid off from November through March.

Average Bob’s monthly earnings by adding together actual and anticipated earnings for May (the 30 days preceding the June application) through the following April and dividing by 12 to arrive at a monthly average of $433.33. Anticipate $400 for April if Bob expects to earn the same as last April.

May
$600
June-August
$3,000 ($1,000 per month)
Sept-Oct
$1,200 ($600 per month)
Nov-Mar
None
April
$400
Total
$5,200 annually or $433.33 monthly

If Bob later reports a change in income or reports being laid off, compare the actual income received to the anticipated income to determine if there is a decrease.

Minnesota Rules 9506.0040 Subd. 2 Item B (2)


MA/GAMC:
People who are seasonally employed may be self-employed or they may work for others. Treat income from seasonal self-employment in the same way as year round self-employment. Follow the provisions in §0911.09.03 (Self-Employment Income) and §0911.09.03.05 (Self-Employment Income--MA/GAMC).

EXCEPTION:

For MA-EPD, count seasonal self-employment only in the months in which the person is engaged in work activity. See §0907.21.07.05 (MA for Employed Persons With Disabilities).

When people are seasonally employed for others, estimate income anticipated to be received during the certification period. See §0911.11.03 (Computing Countable Income--MA/GAMC). Count both earnings and any Unemployment Insurance anticipated to be received during the certification period.

EXAMPLE:

Tom applies for GAMC in January. He was laid off from his job as a roofer in November and is receiving Unemployment Insurance. Based on previous years' experience, he expects to resume work in April. He is requesting GAMC to begin in January. Estimate income for the certification period using Unemployment Insurance payments received or expected to be received in January through the date Tom expects to return to work in April. Estimate earnings for April through June. Use earnings from the same period for the previous year as a guide.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


CHILD SUPPORT INCOME 0911.09.11
Follow the instructions below to determine gross countable child support for the health care programs. For MinnesotaCare, do not allow any deductions from gross child support. For MA and GAMC, follow the instructions in §0911.09.11.01 (Child Support Income--MA/GAMC) to determine the amount to deduct.

Count the full amount of child support received for a child who is a household member as unearned income whether it is paid voluntarily or pursuant to a court order.

Count child support payments that the county child support enforcement agency collects and forwards to the household. Do not count child support payments collected on behalf of a child who receives MFIP that are retained by the child support agency.

Count payments on arrearages if the payments are regular and can reasonably be expected to continue. Do not count payments on arrearages that are collected and retained by the county child support enforcement agency as reimbursement for a period when the child received AFDC or MFIP.

If the household has just begun receiving child support, base the calculation on the amount of the court order or agreed upon voluntary amount. If the household reports varying or sporadic support payments, base the calculation on average payments received over a representative period. If the county child support unit collects support for the client, base information on those records, or obtain information from the client. Do not require the client to submit additional verification.

EXAMPLE:

Angela submits a HCAPP dated June 25. She reports receiving child support of $50-$200 per month. The worker contacts Angela for more information. She states she has been receiving voluntary child support payments for her son since January. She received $50 in January, $200 in February, $150 in March, $75 in April, $100 in May, and nothing for June. She reports that the child’s father has promised to send $100 in July. Project monthly child support income of $95 per month based on an average of the payments received in January-June ($50 + $200 + $150 + $75 + $100 + 0 = $575 divided by 6 = $95.83 truncated to $95). Advise Angela to report any changes. See §0915.07 (Change in Income).

Include court-ordered payments for dependent care expenses as part of the gross child support. Do not include payments to reimburse the custodial parent for health insurance premiums. However, consider the availability of the other health insurance in determining eligibility for MinnesotaCare. See §0910 (Other Health Coverage). Also do not include court-ordered cash payments for medical support. The custodial parent assigns these payments to DHS by signing the application. Make a medical support referral to the county child support agency. See §0906.13 (Assigning Rights to Medical Support).

EXAMPLE:

Jan receives regular monthly child support payments of $500 for her son. The county agency collects the payments and forwards them to Jan each month. The court order specifies payment of $400 per month for child support and $100 as reimbursement for Jan's day care costs. Count the entire $500 as unearned income to the household.

EXAMPLE:

Joe receives $300 per month court-ordered child support payments for his daughter through the county agency. The county also receives $100 per month on arrearages owed for a period when Joe and his daughter received AFDC. The county retains $100 as reimbursement for AFDC issued. Count $300 as unearned income to the household. Exclude the arrearage payment.

EXAMPLE:

Mary reports on her application that she has been receiving $350 per month in child support payments. $300 is for current support and $50 is for arrearages of $5,000 owed to her. Count the entire $350 as unearned income.

EXAMPLE:

Janet reports on her application that she has been receiving $600 per month in child support payments. $500 is for current support and $100 is payment on arrears. The arrearages are paid up and she expects the payment to drop to $500 next month. Anticipate $500 as ongoing child support.

EXAMPLE:

Maria receives court-ordered child support payments for her 2 children through the county agency. The court order specifies $200 per month per child as child support, $100 as reimbursement for Maria’s day care costs, and $50 cash payment for medical costs. Count $500 per month: $200 each for 2 children plus $100 for day care as child support. Exclude the $50 medical support payment. Advise Maria that the cash medical support payment will be sent to the DHS Benefit Recovery Section as reimbursement for MinnesotaCare or MA costs. Make a medical support referral to the county agency to initiate redirection of the medical support payment.


MinnesotaCare:
Follow general provisions.

Minnesota Rules 9506.0040 Subd. 2 Item L


MA/GAMC:
See §0911.09.11.01 (Child Support Income--MA/GAMC).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


CHILD SUPPORT INCOME -- MA/GAMC 0911.09.11.01
See §0911.09.11 (Child Support Income) for general provisions which apply to all programs.


MinnesotaCare:
See §0911.09.11 (Child Support Income).


MA/GAMC:
Count both current support payments and payments on arrearages as child support income to the child for whom the payments are made if the child lives in the household. Count payments on arrearages made for a child who is no longer in the household as unearned income to the custodial parent or other caregiver to whom the payments are made.

EXAMPLE:

Phyllis receives $300 per month in child support for her son Phil. $200 is current support and $100 is payment on arrearages. Consider the $300 as child support income to Phil.

Phil turns 18 and leaves the household. Current support payments stop, but Phyllis continues to receive $100 as payment on arrears. Count $100 as unearned income to Phyllis.

METHOD A:

Count the full amount of child support payments actually received.

METHOD B:

Exclude child support payments received by or on behalf of children who CAC (§0907.23.07), MR/RC (§0907.23.05), CADI (§0907.23.03), TEFRA (§0907.23.09), and TBI (§0907.23.13).

For other children who use Method B, deduct 1/3 of child support payments received in each month. If more than 1 child using Method B receives support, deduct 1/3 of each payment.

EXAMPLE:

Moira’s 2 children are disabled and receive MA through the TEFRA option. She receives child support payments of $600 per month ($300 per child) from the non-custodial parent. Exclude the child support payments.

If the children are not receiving MA through TEFRA or a home or community based waiver, count $200 of the child support (2/3 of the payment) for each child.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


ASSISTANCE PAYMENTS INCOME 0911.09.13

MinnesotaCare:
Count payments from the MFIP, GA, MSA, and Refugee Cash Assistance (RCA) programs as unearned income to the household.

Exclude foster care and relative custody assistance payments. See §0911.05 (Excluded Income).

Exclude Food Support Program payments issued in the form of coupons, through an electronic benefit system, or as the food portion of a cash grant.


MA/GAMC:
Exclude all assistance payments as income to the household, including:

• Cash program payments such as MFIP, Diversionary Assistance, GA, MSA, and RCA.
EXCEPTION:

Count cash payments, such as MSA grants for personal needs, when using long term care budgeting. See §0913.13 (Long Term Care Spenddown Calculation).

• The value of Food Support Program payments, whether received in the form of coupons, electronic transfer payments, or cash.
• Vendor payments made on behalf of the household, such as:
-Emergency payments made by EA or EGA.


-MSA or GRH payments made directly to a facility.

METHOD A:

• Exclude foster care, relative custody, and adoption assistance payments.
METHOD B:

• Exclude foster care payments.
• Exclude relative custody assistance payments as income to the relative. Count them as unearned income to the child.
• Exclude adoption assistance payments for children up to the age of 21 as income to the child and parents. In rare circumstances, state adoption assistance payments can be continued up to the age of 22. If payments continue beyond age 21, count the payment as income to the child.
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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


INCOME FROM RSDI AND SSI 0911.09.15
Although the Social Security Administration (SSA) issues both RSDI and SSI payments, the terms are not interchangeable. Both programs are funded and administered by the federal government but have different purposes and eligibility requirements.

RSDI payments are funded by payroll taxes. Payments are made to people who retire, become disabled for an extended period, or who are dependents of a wage earner who has died. The amount of the payment is based on the earnings and payroll taxes of the qualifying person. Most retired people also qualify for Medicare. Disabled people qualify for Medicare after they have been continuously disabled for at least two years. People under 65 who receive survivors' benefits do not qualify for Medicare.

EXAMPLE:

Herb retires at age 65. He and his employer made social security payments on his behalf for 40 years. His 66-year-old wife did not work outside the home. Both receive RSDI retirement benefits based on Herb's earnings and social security contributions. Both are eligible for Medicare. Herb and his wife are ineligible for MinnesotaCare because they are covered by Medicare. See §0910 (Other Health Coverage). They may qualify for MA.

EXAMPLE:

Laura became unable to work due to a disability 12 months ago. She and her employer made social security payments on her behalf for 15 years. Laura receives social security disability payments. If she is still disabled 24 months after her disability payments began, she will qualify for Medicare. Advise Laura to report Medicare benefits when she becomes eligible for them.

EXAMPLE:

Anna died after she and her employer made social security payments on her behalf for 10 years. Her surviving spouse, Ken, receives survivor's benefits for their 3 children. He is employed and does not receive benefits for himself. Neither Ken nor the children qualify for Medicare. For MinnesotaCare, count the full amount of RSDI benefits as unearned income to the household. For MA, count the full amount of RSDI benefits each child receives as unearned income for that child.

SSI payments are made to people who are:

• Over 65.
OR

• Disabled.
OR

• Blind.
AND

• Who do not qualify for RSDI payments because they have not made payments to the RSDI system.
OR

• Whose RSDI payments are less than the SSI income standard.
People must be within SSI income and asset limits to qualify for payment. Income and assets of responsible household members (spouses and parents of minor children) are counted in determining eligibility and payment amount. However, responsible household members are not included in the payment unless they are also elderly, disabled, or blind and meet SSI income and asset requirements.

SSI recipients do not automatically qualify for Medicare. However, DHS may purchase Medicare benefits for them through the Buy-In. See §0910.05.05 (Medicare Premium Payment).

Most SSI recipients qualify for MA without a spenddown.

If you are unsure what type of payment an applicant/enrollee receives, review the social security claim number. The 1st part of the claim number is the social security number (SSN) of the wage earner on whose account claims are being paid. If the person receiving benefits is a dependent of the wage earner, the claim number SSN will not be the same as the SSN of the person receiving benefits.

EXAMPLE:

Mildred receives survivor's benefits on the account of her deceased husband, Milton. The first part of the claim number is 444-33-2222. Mildred's SSN is 444-34-5555. The claim number is based on Milton's SSN, not Mildred's.

The suffix following the claim number SSN is usually a letter which may or may not be followed by a digit. The suffix indicates what type of benefits the claimant receives. The Social Security Administration publishes a reference guide which identifies claim types by suffix.


MinnesotaCare:
Count the gross amount of RSDI and SSI payments as unearned income to the household.

EXAMPLE:

Bob is disabled and did not work long enough to qualify for RSDI disability payments. He receives SSI of $470 per month based on his and his wife Agnes's assets and Agnes's earnings from part-time employment. Bob is not eligible for Medicare and receives MA. Agnes is not elderly, disabled, or blind. They apply for MinnesotaCare for Agnes. Count Agnes's earnings and Bob's SSI to determine eligibility.

Many RSDI beneficiaries have their Medicare Part B premiums deducted from the RSDI check. Count the amount before the Part B payment is deducted. See §0911.09.15.03 (Determining Gross RSDI).

EXAMPLE:

Mildred is retired and receives an RSDI check for $683. $78.20 is deducted for Medicare Part B. Mildred's countable RSDI benefit is $761, the amount to which she is entitled before deductions.

The Medicare premium amount changes annually. If someone reports that they receive RSDI, check to see if they are also covered by Medicare Part B. If so, add the current Medicare premium to the amount of the RSDI check the person actually receives. Consider the availability of Medicare in determining the person's MinnesotaCare eligibility. See §0910 (Other Health Coverage).


MA/GAMC:
See §0911.09.15.01 (Income From RSDI and SSI--MA/GAMC).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


INCOME FROM RSDI AND SSI -- MA/GAMC 0911.09.15.01
See §0911.09.15 (Income From RSDI and SSI) for general provisions that apply to all programs.


MinnesotaCare:
See §0911.09.15 (Income From RSDI and SSI).


MA:
METHOD A:

Exclude SSI. Also exclude all other income that SSA considered in determining SSI eligibility and benefit amount in determining the SSI recipient's eligibility only. If SSI excludes a particular type of income, exclude that income for MA.

EXAMPLE:

Greta applies for MA for herself and her son Robert. Robert is disabled and receives SSI. Greta is employed. Her earnings are considered in determining the amount of Robert's SSI payment. Count Greta's earnings when determining her own MA eligibility. Do not deem her earnings to Robert, regardless of which method he chooses.

EXAMPLE:

Andrew applies for MA for himself and his daughter. Andrew is disabled and receives RSDI and SSI. His daughter receives dependent RSDI benefits. Exclude Andrew's income in determining his eligibility regardless of which method he chooses. Count his RSDI payment and his daughter's RSDI payment in determining her eligibility.

If a person does not receive SSI but receives RSDI, count the gross RSDI amount as unearned income unless the client has a representative payee who does not live in the client's household. If the representative payee does not live in the same household as the beneficiary, presume the gross RSDI is available to the beneficiary unless the client can demonstrate that the payment is not available. If the client demonstrates that part of the payment is unavailable, count only that portion made available to the client in cash or spent on behalf of the client or household.

Notify SSA in writing to request a change in representative payee under either of the following circumstances:

• The representative payee is diverting the RSDI benefit for use by the representative payee or a 3rd party, not the client.
• It appears that the representative payee is not using the RSDI benefit in an appropriate way to meet the needs of the beneficiary.
If SSI benefits are suspended for reasons other than lack of disability, consider the person to be an SSI recipient for purposes of meeting a disabled basis of eligibility. See 0907.21.07 (MA/Medicare Savings Basis: Disability). However, do not exclude other income received during the month(s) of suspension even if it is normally considered in determining the SSI payment.

METHOD B:

Exclude SSI and all other income considered by SSA in determining SSI eligibility and payment amount when determining eligibility for the SSI recipient.

EXAMPLE:

Marcus receives SSI and MA. The MA worker discovers that he received a one-time VA payment in February. This payment is an excluded form of income for SSI. Exclude the payment for MA also.

EXCEPTION:

Count SSI and MSA for people who use long term care budgeting, with the specific exceptions listed in §0913.13 (Long Term Care Spenddown Calculation), items 10 and 11.

If a spouse or child of an SSI recipient (who lives with the SSI recipient) requests MA, exclude the SSI payment but count all other non-excluded income of the SSI recipient in determining the spouse and/or child's eligibility.

EXAMPLE:

Herman and Helen, a married couple, apply for MA and GAMC. Herman is disabled and receives RSDI and SSI. Helen is employed part time and her earnings are considered in determining Herman's SSI eligibility. Exclude Herman's SSI and RSDI and Helen's earnings in determining his eligibility. Exclude Herman's SSI but count his RSDI and Helen's earnings in determining her eligibility.

Some clients are still considered SSI recipients after their SSI payments stop. They have special SSI status under sections 1619 (a) and (b) of the Social Security Act. See §0907.21.07.03 (MA Basis: 1619 A and B).

If SSI benefits are suspended for reasons other than lack of disability, consider the person to be an SSI recipient for purposes of meeting a disabled basis of eligibility. See §0907.21.07 (MA/Medicare Savings Basis: Disability). However, do not exclude other income received during the month(s) of suspension even if it is normally considered in determining the SSI payment.

EXAMPLE:

Gary applies for MA in February. Gary receives SSI and is employed part time. His SSI benefits are suspended for 3 months beginning in February because of an overpayment. Count his earnings in determining his eligibility for February, March, and April. Disregard the earnings beginning the month that SSI payments resume.

For people who receive RSDI but not SSI, count the gross amount of RSDI as unearned income unless all or part of the benefit is excluded under another provision. Exclude RSDI for people who qualify as disabled adult children or disabled widows or widowers. See §0912.05.19 (Disabled Adult Children Disregard) and §0912.05.21 (Disabled Widow/Widower’s Deduction). Deduct cost of living increases (COLA) from the RSDI of clients who qualify for the Pickle disregard, the widow or widower disregard or the MA COLA disregard. See the following sections:

§0912.05.23 (Pickle Disregard)

§0912.05.17 (Widows and Widower’s Disregard)

§0912.05.15 (RSDI COLA Disregard)

Disregard RSDI benefits paid to or on behalf of children who receive MA under the Special Category for Disabled Children (§0907.21.07.07), CAC (§0907.23.07), MR/RC (§0907.23.05), CADI (§0907.23.03), TEFRA (§0907.23.09), and TBI (§0907.23.13).

For all other clients, count the gross amount of RSDI received. A Medicare premium included in the gross RSDI amount may be allowed as a deduction from excess income to meet a spenddown. For more information, see:

§0913.13 Long Term Care Spenddown Calculation.

§0913.13.03 LTC Spenddown--EW With Community Spouse.

§0913.15 Combination LTC/Medical Spenddown.

§0913.21 Allowable Medical Bills to Meet Spenddown.

Count the gross RSDI when a representative payee receives the RSDI payment regardless of the representative payee's decision to distribute the funds.

Notify the Social Security Administration in writing to request a change in representative payee under either of the following circumstances:

• The representative payee is diverting the RSDI benefit for use by the representative payee or a 3rd party, not the client.
• It appears that the representative payee is not using the RSDI benefit in an appropriate way to meet the needs of the beneficiary.
See §0911.03 (Availability of Income) for information on when to deduct an overpayment withheld from an SSI or RSDI benefit


GAMC:
Follow MA Method B.

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***This version of the manual is no longer in effect as of December 1

DETERMINING GROSS RSDI 0911.09.15.03
Gross RSDI is the total amount of RSDI a client is entitled to before the deduction (if any) of Medicare premiums. Not all documents from the Social Security Administration (SSA) report gross RSDI. The following are SSA documents and interfaces you can use to verify and determine the amount of gross RSDI. Do not require clients to provide a specific document if another is available which provides the information.

• Initial award letter (SSA-4926-SM). This lists gross RSDI, the Medicare premium, and the monthly payment (net RSDI) to the client. The gross amount is the figure described as, the total amount of your monthly benefit before deductions.
• Report of Confidential Social Security Benefit Information (SSA-2458). This is a report sent to the client, although the information may have been requested by a 3rd party. It reports the gross RSDI, monthly payment (net RSDI) to client, and Medicare premium.
• SVES interface. See Temp Manual TE02.12.13 (SVES TPQY Interface).
• Public Assistance Agency Information Request (SSA-1610-U2). This form reports both gross RSDI and the payment to client (net RSDI).
• Annual notice of cost of living increase (COLA) received by the client.
Some documents report gross RSDI as a whole dollar figure. Others report the figure in dollars and cents. Count only the whole dollar figure as gross RSDI; drop any cents.

Other SSA documents report only the payment to the client and the Medicare premium. Do not add these figures together to calculate gross RSDI. Because the client payment amount is truncated (rounded down), adding the figures together may not yield the correct amount of gross RSDI.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.

LUMP SUM RSDI AND SSI PAYMENTS 0911.09.15.05

MinnesotaCare:
People may receive a one-time payment covering several retroactive months when SSI or RSDI is approved. Do not count the retroactive payments received for a previous period.

EXAMPLE:

Roland is enrolled in MinnesotaCare. On his annual renewal due for December, he reports that he was approved for RSDI. He received a retroactive lump sum payment of $3,000 in October covering the months of May-October. He will receive $500 per month beginning in November. Do not count the $3,000 in determining his eligibility or premium amount for the new eligibility period because it is a one-time payment and will not be received during the next 12 months.


MA/GAMC:
METHOD A:

Exclude retroactive lump sum payments of SSI and all other lump sum income (including RSDI) of an SSI recipient even if the lump sum is a retroactive payment for a period for which the SSI recipient received MA. However, count any portion of an RSDI lump sum payment designated as dependent benefits as unearned income to the dependent in the month received.

Count retroactive lump sum RSDI payments for people who do not receive SSI as unearned income in the month received and an asset in the following month if retained.

METHOD B:

Exclude retroactive lump sum payments of SSI as income and assets in the month received.

Count retroactive RSDI lump sum payments as unearned income in the month received. See §0911.09.23 (Lump Sum Income) for more information on budgeting lump sums.

Exclude as an asset for 9 months any retroactive SSI or RSDI lump sum payments, received on or after 3/2/04, if retained after the month of receipt.

Exclude as an asset for 6 months any retroactive SSI or RSDI lump sum payments received before 3/2/04 if retained after the month of receipt. This includes money deposited in a separate dedicated account for the medical, health, educational and disability related needs of a child. Follow §0909.21.03 (Supplemental Needs Trusts) if the retroactive payment is issued under the Sullivan vs. Zebley decision and is used to fund a supplemental needs trust.

SSI, RSDI or Special Veterans Benefits for the Elderly may be reissued by the SSA when an individual rep payee of 15 or more beneficiaries or an organization rep payee has been found to misuse the benefits. Treat the reissuance of these benefits as follows:

• SSI – Exclude the reissuance as income and an asset in the month received. Exclude as an asset for 9 months if retained after the month of receipt.
• RSDI and Special Veterans Benefits – Count the reissuance as income in the month received unless the original payment of the income was used in determining the individual’s MA eligibility. Exclude as an asset for 9 months if retained after the month of receipt.
For Medicare Part B reimbursements for non-LTCF recipients:

• If Medicare Part B premiums paid by the client were used as an MA spenddown expense (this would occur when clients add SLMB coverage to MA retroactively), count the lump sum reimbursement as income in the month received. Do not count a lump sum Medicare Part B reimbursement when Part B was not used as a MA spenddown expense in the MA computation for the months which the reimbursement covers. See §0907.21.09.05 (Medicare Supplement Programs: SLMB) and §0910.05.05 (Medicare Premium Payment).
For Medicare Part B reimbursements for LTCF recipients:

• Count a lump sum Medicare premium reimbursement due to Buy-In eligibility in the month of receipt. This is because the gross RSDI amount is not budgeted for these clients until it is actually received. See §0913.13 (Long Term Care Spenddown Calculation) and §0910.05.05 (Medicare Premium Payment).
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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.

IN-KIND INCOME 0911.09.17
In-kind income is income a person receives in a form other than cash. It may be payment for work or service or a non-cash gift or contribution. Examples include:

• Free rent in exchange for caretaking duties. Determine if compensation to an apartment building caretaker is in-kind income or earned income. If the person receives a paycheck with an amount for rent deducted, the gross earnings are earned income, not in-kind income.
• Free room and board provided by a friend or relative.
• Clothing or household goods provided by a community organization.
• Exchange of services, such as babysitting.

MinnesotaCare:
Exclude in-kind income.


MA/GAMC:
METHOD A:

Count the value of in-kind earnings as earned income if the unit has a choice of receiving cash or in-kind income.

EXAMPLE:

Marcy is an apartment caretaker. She receives free rent in exchange for her duties. She does not receive a paycheck with rent deducted, so this is in-kind rather than earned income. However, the apartment complex Marcy works for gives caretakers the choice of receiving a paycheck or free rent. Count the value of Marcy's rent as earned income.

Clients must make a good faith effort to convert ongoing in-kind income into cash. See §0911.03 (Availability of Income).

METHOD B:

Exclude in-kind income.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.

INTEREST AND DIVIDENDS 0911.09.19

MinnesotaCare:
Count interest and dividend payments if they are paid or credited directly to the household at least annually. See §0911.05 (Excluded Income).

Count interest and dividends earned on an asset and paid to the household or credited to the household's account as unearned income. See §0911.07.05 (Unearned Income). These payments are shown on the household's tax forms.

EXAMPLE:

The Jones family has a savings account with a balance of $5,000. Interest of $60 is credited to the account each quarter. It is not paid directly to the family. The bank reports the interest annually to the Internal Revenue Service and it is included on the family's tax forms. Count the interest as income.

EXAMPLE:

John owns stock in ABC corporation. He is not an employee of the corporation. He receives a dividend check every 3 months which is reported on his tax return. Count the dividend payment as unearned income.

EXAMPLE:

Susie is a minor child. A trust fund of $50,000 was set up on her behalf as a result of an auto accident. She and her parents cannot gain access to the trust principal without court approval. However, her parents receive a monthly check representing interest earned by the trust. Count the monthly payment as unearned income.

Count dividends earned as part of a self-employment operation, such as dividends from ownership interest in a C-corporation, as part of the earned self-employment income.

EXAMPLE:

George has ownership interest in a C-corporation. He is also an officer of the corporation and receives wages. His share of corporate dividends are reported yearly and included on his tax return. Count the dividends as part of his annual income.

Minnesota Rules 9506.0040 subp. 2 Item C


MA/GAMC:
METHOD A:

Exclude as income any interest or dividends from assets, including amounts accrued on the asset, which when combined with other assets are within and counted toward the asset limit.

EXAMPLE:

Al receives MA. He has a savings account with $2,500, which is within the $3,000 asset limit. At the time of his annual recertification, he reports that $75 in interest has been credited to the account in the past year. Exclude the interest as income because the total account balance remains within the asset limit.

Count other interest or dividends as unearned income. This includes the interest portion of payments on contracts for deed and promissory notes. Count the principal portion as an asset conversion. See §0909.13.05 (Contracts for Deed).

METHOD B:

The following exclusion does not apply to people using Long Term Care (LTC) budgeting or the spousal allocation calculations. For LTC budgeting continue to count interest/dividend income.

Exclude as income, interest or dividends received from counted or excluded assets.

EXCEPTION:

Count as unearned income interest or dividends earned on:

• Unspent tax refunds related to an Earned Income Tax Credit (EITC) or Child Tax Credit (CTC)
• Unspent federal relocation assistance payments
• Payments to replace lost, damaged or destroyed assets which are no longer excluded as assets. See §0909.11.01 (Additional Excluded Assets for Method A/B)
• Gifts to children with life-threatening conditions under Section 1613(a)(13) of the Social Security Act.
• Payments to replace lost, damaged, or destroyed assets if the payment is no longer an excluded asset. See §0909.11.01 (Excluded Assets – Program Provisions)
• Victims' compensation payments
• Financial aid which is neither Title IV nor received under the Bureau of Indian Affairs (BIA) program. Such aid includes grant, scholarship, fellowship, or gifts used or intended to be used to pay the cost of tuition, fees, or other necessary education expenses at any educational institution, including vocational and technical education
• A life insurance policy which pays interest on dividends accumulations
• Proceeds from the sale of a home which are excluded as an asset. See §0909.11.01 (Excluded Assets – Program Provisions)
If interest or dividend is not excluded due to the provisions above, review to determine if the income meets the exclusions for infrequent income. See §0911.05 (Excluded Income). Interest or dividends that are within and counted toward the asset limit should be excluded (See §0909.29.03 (Excess Assets--Enrollees).

Contracts for deeds - this interest exclusion includes the interest portion of payments on contracts for deed and promissory notes. Count the principal portion as an asset conversion. See §0909.13.05 (Contracts for Deed).

Burial funds – exclude interest that accrues on an excluded burial fund. See §0909.17 (Burial Funds/Life Insurance: Fund Types) and §0909.17.03 (Determining the Burial Fund Exclusion). This exclusion applies to LTC as well.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


TRIBAL LAND SETTLEMENTS AND TRUSTS 0911.09.21
Exclude most income from American Indian tribal land settlements and some income from interest in tribal trust and other restricted Indian lands.

Exclude the first $2,000 a person receives each year from his or her interest in Indian trust land or other restricted Indian lands.

Also exclude American Indian tribal land settlements as income if the Public Law awarding the settlement directs its exclusion. The following settlements are excluded as income from all programs:

• Any funds distributed per capita under Public Laws 98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations.
• Payments to members of the White Earth Band from the White Earth Reservation Land Settlement Act of 1985 (Public Laws 99-264, 100-153, and 100-212).
Count per capita payments made to members of the Grand Portage and Fond Du Lac Bands of Chippewa Indians as unearned lump sum payments and as a resource thereafter.

Exclude per capita payments made to members of the Bois Forte Band of Chippewa.

Count tribal payments that are not derived from land settlements, such as per capita earnings from casino profits, as unearned income in the month received.

EXCEPTION:

Exclude payments from the Mille Lacs Band of Ojibwe Elder Supplemental Assistance Program for people who do not use long term care budgets. Count them for people residing in long term care and using long term care budgets and people receiving EW. These payments are made to tribal members age 65 and over who meet the program’s income and asset limits.

Contact the Health Care Programs Policy Center for information on payments from settlements not listed. Include the Public Law number if known.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


LUMP SUM INCOME 0911.09.23
See §0902.21 (Glossary: Insurance...) for a definition of lump sums.


MinnesotaCare:
Exclude lump sum income. See §0911.05.03 (Excluded Income--Program Provisions).

Minnesota Rule 9505.0065 subp. 3b


MA/GAMC:
See §0911.09.15.05 (Lump Sum RSDI and SSI Payments) for instructions on treatment of lump sum retroactive payments from the Social Security Administration, including Medicare Part B reimbursements.

Treat other lump sums as income in the month received and an asset if retained beyond the month of receipt. Do not change eligibility or spenddown amounts for previous or current months, or for future months for which you cannot give 10-day notice, based on receipt of an unanticipated lump sum. Lump sums may affect eligibility after the month of receipt for people who have an asset limit if the lump sum creates excess assets. Lump sums may also result in termination of eligibility before the end of the 6-month budget period for people who were open with 6-month spenddowns before receipt of the lump sum.

EXAMPLE:

Maria, Lawrence, and their 2 children are eligible for MA without a spenddown for the current certification period of January-June. On May 5, they report they received a $20,000 insurance settlement on April 25. Recompute eligibility for the current certification period. If the lump sum creates a 6-month spenddown which they cannot meet, determine eligibility on a monthly basis for the remainder of the certification period. If anticipated monthly income remains below the appropriate standard for each household member, (100% FPG for Maria and Lawrence; 150% FPG for the children) income eligibility continues. If ongoing income is over the appropriate standard in one or more of the remaining months, use a manual monthly spenddown for those months. Review assets for Maria and Lawrence. Terminate their coverage if they do not properly reduce the excess. See §0909.29.03 (Excess Assets – Enrollees).

If the case was open with a 6-month spenddown for January-June and the lump sum resulted in an increased spenddown, determine if the household has bills to meet the higher amount (such as unused old unpaid bills). If not, terminate MA effective June 1, the first month for which you can give a 10-day notice.

EXAMPLE:

Brett is eligible for MA with a monthly automated spenddown for the current certification period of July-December. On September 10, he reports he won $5,000 at a casino in August. It is not possible to increase his August spenddown retroactively. He must reduce assets to within the $3,000 limit to retain eligibility for October. See §0909.29.03 (Excess Assets--Enrollees).

EXAMPLE:

Marcus is eligible for MA without a spenddown for the certification period of January-June. He is approved for RSDI in February and receives a lump sum retroactive payment of $12,000. He is unable to meet a 6-month spenddown with the lump sum included. His ongoing RSDI amount exceeds the standard, but he has regular medical bills sufficient to meet a monthly spenddown for March-June. Since he previously had no spenddown, he can choose an automated monthly spenddown for the remainder of the budget period.

Count non-excluded lump sums when calculating the spenddown for the month of receipt for people who are eligible using a manual monthly or an LTC spenddown. Adjust the LTC spenddown if a lump sum is reported after the month of receipt.

NOTE:

If the lump sum creates a combination LTC/medical spenddown, adjust the LTC spenddown only. Do not establish a medical spenddown retroactively.

Allow the following deductions from the lump sum:

• Costs associated with getting the lump sum, such as attorney’s fees.
• Any portion of the lump sum earmarked for and used to pay medical expenses not covered by insurance or any Minnesota health care program.
• Any portion of the lump sum recovered by Benefit Recovery.
• Any portion of the lump sum earmarked for and used to pay funeral and burial costs.
Anticipate recurring income received less often than monthly when determining initial and continuing eligibility.

EXAMPLE:

Elmer receives RSDI monthly. He also receives a rental payment every June and December. His budget period is January-June. Count the RSDI and the rental payment in the 6-month certification period. If Elmer has a spenddown, help him choose the most beneficial method.

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


COMPUTING COUNTABLE INCOME -- MINNESOTACARE 0911.11

MinnesotaCare:
Follow the steps below to determine the household's countable annual income and convert income to a monthly amount to establish the premium. Use the MinnesotaCare Income Worksheet. Also see §0904.13 (Verification) for more information on acceptable verification of earned income.

1. Determine if anyone in the household has self-employment income. Request the most recent year’s tax forms for self-employed households. Use tax forms to compute net self-employment income unless the household reports a significant change or has not been in business long enough to file taxes. See §0911.09.03.03 (Self-Employment Income--MinnesotaCare) for complete information on determining self-employment income.

2. Determine if anyone in the household has seasonal income. Request verification of income for the most recent 30 days in which the person was seasonally employed, or request the previous year’s tax forms and W-2s or other documentation of the seasonal employment. See §0911.09.09 (Seasonal Income) for complete information on determining seasonal income.

3. Determine if anyone has regular wage income. Accept pay stubs, employer statements, the previous year’s tax forms or other documentation of earnings.

If the household submits a tax return as verification of any type of income, compare the information on the tax forms to the information reported on the application. If the tax forms do not accurately reflect the household’s current situation, contact the household to resolve the discrepancy. Request verification of the current income if it is from a different employer than shown on the tax forms or the amount on the tax forms is not reflective of current earnings.

Examples of circumstances that may or may not result in a significant difference between tax forms and the household’s current situation include but are not limited to:

• A wage earner has changed jobs.
• A wage earner has increased or decreased hours of employment.
• A self-employment enterprise has changed in size, nature, or scope.
• A wage earner who was previously employed seasonally has begun year-round employment.
• A source of unearned income has started or stopped.
These instructions are CONTINUED on §0911.11.01 (Computing Income--MinnesotaCare - Part 2).

M.S. 256L.01 subd. 4, 5

Minnesota Rule 9506.0040 subp. 2


MA/GAMC:
See §0911.11.03 (Computing Countable Income--MA/GAMC) and §0911.11.05 (MA/GAMC Varying Income).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


COMPUTING INCOME -- MINNESOTACARE - PART 2 0911.11.01

MinnesotaCare:
These instructions are continued from §0911.11 (Computing Countable Income--MinnesotaCare).

4. If you are using tax forms for households with non-self-employment income, base the determination of countable annual income on the amount reported on the tax forms and W-2's. Use gross wages before any deductions for all household members whose earned income must be counted. See §0908 (Household Composition), and §0911.09.05 (Dependent Child Income). Enter the Adjusted Gross Income (AGI) from the tax forms on the MinnesotaCare Income Worksheet. Refer to the worksheet to determine where to find the AGI.

If the amount(s) on the tax forms does not agree with the amount(s) on the W-2 forms, document the reason for the discrepancy. Use the Adjustments to Income section of the worksheet.

5. Determine if there is countable income not included on the tax forms. Some types of non-taxable unearned income may not be reflected. Use the information on the application to determine the amount of unearned income to count. If the income is ongoing, multiply the expected amount by the factor below to arrive at an annual figure:

Weekly income--multiply by 52
Biweekly income--multiply by 26
Semi-monthly income (received twice per month)--multiply by 24
Monthly income--multiply by 12
Enter the information in the Unearned Income section of the worksheet.

For households with non-self-employment income who submit current wage verification:

6. Use the information on the application and wage verification to determine the amount of current countable income.

Follow the guidelines below for non-self-employment income. Also see the sections of this chapter covering specific types of income.

1. Determine how often each source of countable income is received.

2. If the amount of the income varies, determine an average amount. If there has been an ongoing change in the amount, use the most current information to project annual income. Base the determination on the last 30 days of earnings. You may use a longer period if the client submits more than 30 days of wage verification, but do not require more than 30 days.

EXAMPLE:

Mr. and Mrs. B are both employed. Mr. B earns a salary of $1,500 per month. Mrs. B earns $5.50 per hour. Her hours vary. She is paid weekly. She enclosed the 7 paychecks she has received so far with the application. She expects to continue working similar hours at the same pay. Total the gross wages from the 7 checks she submitted and divide by 7 to arrive at an average weekly amount.

EXAMPLE:

Mr. A reports on his application that he has been receiving Unemployment Insurance (UI) of $150 per week. He just started a job working 30 hours per week at $6 per hour. He will be paid biweekly. He is not a seasonal employee.

Do not include the UI payment in computing Mr. A’s annual income. This source of income will end now that he is employed. Based on the information he provided, base his annual income on expected biweekly earnings of $360.

For people receiving UI who do not yet have a new job, annualize the UI amount to determine eligibility and premium amount, regardless of when the UI is scheduled to end. Advise the client to report any changes such as beginning employment. Adjust the premium if the change results in a decrease.

EXAMPLE:

Ron applies for MinnesotaCare in July. He is receiving UI of $150 per week. He has 16 weeks remaining on his claim. He has no other income and has not yet found a job. Base eligibility and premium amount on projected annual income of $7800 ($150 x 52). Advise Ron to report any changes.

In November, Ron reports he began employment with projected annual earnings of $10,000. Because this would result in an increased premium, do not adjust the premium until the next renewal.

3. Multiply each source of projected income by the following factor to determine an annual amount:

Weekly income--multiply by 52
Biweekly income--multiply by 26
Semi-monthly income (received twice per month)--multiply by 24
Monthly income--multiply by 12
Adjust the projected annual income for any known changes in the following 12 months. Reduce projected annual income for people who plan a leave of absence from employment. Increase projected annual income for people who expect to begin or return to employment.

EXAMPLE:

Loren applies for MinnesotaCare in March. He is employed full time but expects to take a leave of absence from May 1 until August 1, during which he will receive no pay. He expects to resume his employment on August 1. Calculate annual income based on the number of months he intends to work in the next 12 months.

If Loren did not have a tentative return date, you would use zero income beginning with the month in which his leave of absence begins.

EXAMPLE:

Jen applies for MinnesotaCare in April, while she is on maternity leave from her job. She currently has no income. She expects to return to work in the 3rd week of June and receive her first weekly $400 paycheck a the end of that week. Calculate Jen’s annual income using zero for the 4 weeks of May and the first 2 weeks of June. Project income from wages for the remaining 46 weeks.

Record the projected totals in the Application Wages and Unearned Income sections of the worksheet as appropriate.

For self-employment income, follow the instructions in §0911.09.03 (Self-Employment Income). Use the information on the worksheet and the reference guide to determine where to find the information on the tax forms. Complete the Self-Employment section of the worksheet.

In some cases the tax forms may provide current information for some of the household’s income while other sources have changed. Begin with the AGI on the tax forms. Use the Adjustments to Income section of the worksheet to record differences. Record new or changed wages, unearned income, or self-employment income in the appropriate sections.

All households:

Include dollars and cents to compute the total annual income. Truncate the result. Enter the total on MMIS. The system will automatically compute a monthly amount and premium.

M.S. 256L.01 subd. 4, 5

Minnesota Rule 9506.0040 subp. 2


MA/GAMC:
See §0911.11.03 (Computing Countable Income--MA/GAMC) and §0911.11.05 (MA/GAMC Varying Income).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


COMPUTING COUNTABLE INCOME -- MA/GAMC 0911.11.03

MinnesotaCare:
See §0911.11 (Computing Countable Income--MinnesotaCare) and §0911.11.01 (Computing Income--MinnesotaCare - Part 2).


MA/GAMC:
Base eligibility on:

• Actual income received in the month(s) for which you are determining eligibility. Use this method for retroactive months and manual monthly spenddowns. See §0904.07.09 (Eligibility Begin Date) and §0913.11 (Manual Monthly Spenddown Calculation).
OR

• Income anticipated to be received in the month(s) for which you are determining eligibility. Use this method whenever you determine eligibility for a future month(s).
OR

• A combination of actual and anticipated income. Use this method for people requesting retroactive and continuing coverage.
EXAMPLE:

Abigail applies for MA in April. She is requesting retroactive coverage beginning in January. Her 6-month certification period is January-June. The worker processes the application on May 2. Determine eligibility for the certification period using actual income received in January, February, March, and April, and anticipated income for May and June.

When people who are approved for a type of cash assistance that includes automatic health care coverage request retroactive MA, use actual income for the retroactive months. The household will be automatically eligible for the cash months. See

§0913.19 (Shortened Spenddown).

Use actual dollars and cents to calculate income. Truncate the final monthly figure.

When unvarying income is received monthly, such as RSDI or SSI, use the actual countable monthly benefit amount to anticipate income unless you know the amount will change during the certification period. When unvarying income is received more often than monthly, such as Unemployment Insurance:

• Multiply income received twice monthly by 2.
• Multiply income received every 2 weeks (biweekly) by 2.16, and income received every week (weekly) by 4.3.
OR

• Determine the number of receipt dates expected during the remainder of the certification period. Multiply the biweekly or weekly amount by the number of receipt dates to anticipate the total for the certification period. Divide by the number of months in the period to determine a monthly amount (if necessary).
Use the method that most accurately reflects income expected during the certification period. In most cases, the results will be similar.

EXAMPLE:

Dave applies for GAMC in May. He is not requesting retroactive coverage. He receives Unemployment Insurance of $125 per week every other Friday. He received a check on May 8 and expects his next check May 22. Based on this schedule, he anticipates receiving biweekly checks on the following dates for the remainder of the certification period: June 5 and June 19; July 3, July 17, and July 31; August 14 and August 28; September 11 and September 25; and October 9 and October 23. Anticipate income by either:

• Multiplying the biweekly payment of $250 by 2.16 to arrive at a monthly average of $540 and anticipated income of $3,240 for the certification period.
OR

• Multiplying the total number of checks expected for the certification period of May-October (13) by the check amount ($250) to anticipate income of $3,250 for the certification period.
EXAMPLE:

Andrea applies for MA on April 5. She is requesting MA retroactive to January. She receives $80 every Friday from her parents to help with living expenses. She received 5 checks in January, 4 each in February and March, and 1 so far in April. Anticipate weekly income by either:

• Multiplying the weekly payment by 4.3 to arrive at a monthly average of $344 for April, May, and June. Determine income for the 6-month certification period by adding $344 for April, May, and June to the actual amounts received in January, February, and March. $400 (January) + $320 (February) + $320 (March) + $344 + $344 + $344 results in anticipated income of $2,072 for the certification period.
OR

• Determining the actual amounts expected to be received in April, May, and June and adding this total to the actual amounts received in January, February, and March. If there are 4 Fridays in April, 5 in May, and 4 in June, the anticipated amount is $1,040 (13 x $80). Adding $1,040 + $400 + $320 + $320 results in anticipated income of $2,080 for the certification period.
Also see §0911.11.05 (MA/GAMC Varying Income).

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***This version of the manual is no longer in effect as of December 1, 2006.*** Current Manual.


MA/GAMC VARYING INCOME 0911.11.05

MinnesotaCare:
No provisions.


MA/GAMC:
Also see §0911.11.03 (Computing Countable Income--MA/GAMC). For MA-EPD, see §0913.01.03 (MA-EPD Premiums). MA-EPD rules for computing varying income differ slightly from regular MA in order to maintain consistent premiums.

When income from a single source varies but is expected to be received throughout the certification period, determine an average weekly or biweekly amount based on the available information. Compare the income information on the application, income review or renewal to the income verification. Follow up with the client if the verification does not reflect the reported information to determine the reason for the discrepancy. Examples of situations that may result in a discrepancy between reported ongoing income and verified income from the preceding 30 days include but are not limited to:

• Receipt of non-recurring overtime.
• Temporary or ongoing change in pay rate or hours worked.
• Job change.
• Short term absence from employment without pay.
Do not require verification of income beyond the 30 days preceding application, income review or renewal unless an applicant requests retroactive coverage. If the client submits additional verifications, determine if verified income older than 30 days provides a more accurate reflection of expected income in the certification period.

EXAMPLE:

Bert applies for MA on July 10. He is not requesting retroactive coverage. He reports on the HCAPP that he works 10-20 hours per week and earns $6.50 per hour. He is paid weekly. He supplies the following pay stubs:

June 4 - $72
June 11 - $113.75
June 18 - $98.15
June 25 - $82
All pay stubs reflect between 10 and 20 hours weekly at $6.50 per hour.

To anticipate income for the July-December certification period, determine average weekly income by averaging the checks submitted. This results in average weekly income of $91.48. Project income for the July-December certification period by either:

• Multiplying the weekly average of $91.48 by 4.3 to arrive at a monthly average of $393.64. Subtract applicable deductions and disregards. Multiply the average monthly amount (truncated) by 6 for projected income for the certification period.
OR

• Multiplying the average weekly amount by the number of weekly checks anticipated during the certification period. The result will depend on whether there are 26 anticipated pay dates ($91.48 x 26 = $2,378.48, or $2378 truncated) or 27 anticipated pay dates (27 x $91.48 = $2,469.96, or $2,469 truncated) in the certification period.
EXAMPLE:

George applies for MA for himself and his family on October 9. He reports on the HCAPP that he works 40 hours per week at $8.00 per hour. He submits the following pay stubs:

September 3

$360

September 10

$450

September 17

$430

September 24

$260

October 1

$320

The worker contacts George to clarify the discrepancy between his regular reported wage and his recent check stubs. He explains that the company had a short-term project in late August and early September that resulted in overtime. In mid-September he took time off without pay because of a family emergency. He is now working his regularly scheduled 40 hours per week and does not expect any changes or further overtime. Anticipate income beginning in October based on a weekly wage of $320.

EXAMPLE:

Gerald and Suzanne receive MA for themselves and their two children. Both are employed. On their 6-month income review they report that Suzanne started a new job during the previous month. She has received two weekly paychecks so far. They submit her pay stubs from the past 30 days, which include her final checks from the previous job. Use the paychecks from the new job to anticipate Suzanne’s income for the next certification period. Average Gerald’s income based on the 30 days of wages he submitted.

When income is received less often than monthly, count the full amount in the month it is received. Do not prorate the payment to convert it to a monthly amount.

EXAMPLE:

Rodney applies for MA in February. He is not requesting retroactive coverage. He lives in the community. He receives quarterly payments of $450 on a contract for deed. He receives the payments on January 1, April 1, July 1, and October 1 of each year. Anticipate $900 for the certification period of February-July (April and July payments). If Rodney has other income which results in a spenddown and chooses a manual monthly spenddown, count the payments only in the months in which they are received (April and July). See §0913.11 (Manual Monthly Spenddown Calculation).

If Rodney becomes subject to a long term care spenddown, count the payments in the month in which they are received. See §0913.13 (Long Term Care Spenddown Calculation).

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