Current through Register Vol. 48, No. 38, September 20, 2024
a) Unless otherwise
specified and for purposes of this Part, the term "resource" (as defined in
42 USC
1382 b, except subsection (a)(1) of that
section, which excludes the home as a resource) means cash or any other
personal or real property that a person owns and has the right, authority or
power to liquidate.
b) A resource
is considered available to pay for a person's own care when at the disposal of
that person; when the person has a legal interest in a liquidated sum and has
the legal ability to make the sum available for support, maintenance or medical
care; or when the person has the lawful power to make the resource available or
to cause the resource to be made available.
c) The value of nonexempt resources shall be
considered in determining eligibility for any means-tested public benefit
program administered by the Department, the Department of Human Services or the
Department on Aging if eligibility is determined, in part, on the basis of
resources as provided under this Section.
d) Determination of Resources
1) In determining initial financial
eligibility for medical assistance:
A) The
Department considers nonexempt verified resources available to a person as of
the date of decision on the application for medical assistance. The date of
verification (see Section
120.308(f)
) may be prior to the date of decision. Resources applied to a spenddown
obligation in a retroactive month (see Section
120.61(b)
) shall not be treated as available in the determination of initial financial
eligibility. Money considered as income for a month is not considered a
resource for that same month. If income for a month is added to a bank account
that month, the Department will subtract the amount of income from the bank
balance to determine the resource level. Any income remaining in the following
months is considered a resource.
B)
Effective June 16, 2014, clients and applicants who receive Supplemental
Security Income (SSI) payments or who were receiving SSI when they entered a
nursing home or the supported living program or initiated other long term
support services are considered to have their current resources
verified.
C) Effective June 16,
2014, individuals who have verified income at or below 100% FPL and report
resources at or below the appropriate resource disregard in Section
120.382 or
120.510
are considered to have their current resources verified, unless there is a
specific reason to question the value of the resource.
2) Effective July 1, 2012, an applicant for
medical assistance may be eligible for up to 3 months prior to the date of
application if the person would have been eligible for medical assistance at
the time he or she received services if he or she had applied, regardless of
whether the person is alive when the application for medical assistance is
made. In determining financial eligibility for retroactive months, the
Department will consider the amount of income, resources and exemptions
available to a person as of the first day of each of the backdated months for
which eligibility is sought.
3) In
determining a person's spenddown obligation (see Section
120.384) ,
the Department considers the amount of nonexempt resources available as of the
date of decision, in the case of initial eligibility, and the first day of the
month, in the case of retroactive eligibility, that are in excess of the
applicable resource disregard (see Section 120.382).
e) Subject to subsection (c) of this Section
and 89 Ill. Adm. Code
113.140, the entire equity
value of jointly held resources shall be considered available in determining a
person's eligibility for assistance, unless:
1) The resource is a joint income tax refund,
in which case one-half of the refund is considered owned by each person;
or
2) The person documents that he
or she does not have access to the resource. Appropriate documents may include,
but are not limited to, bank documents, signature cards, trust documents,
divorce papers, and papers from court proceedings that show the person is
legally unable to access the resource; or
3) The resource is held jointly with an
individual eligible under any means-tested public health benefit program (other
than the Supplemental Nutrition Assistance Program) administered by the
Department, the Department of Human Services, or the Department on Aging;
or
4) The person can document the
amount of his or her legal interest in the resource and that such amount is
less than the entire value of the resource, then the documented amount shall be
considered. Appropriate documentation may include, but is not limited to, bank
documents, trust documents, signature cards, divorce papers, or court orders
that show the person's legal interest is less than the entire value of the
resource; or
5) The person
documents that the resource or a portion of the resource is not owned by the
person and the person's accessibility to the resource is changed (see
subsections (e)(2) and (4) for documentation examples).
f) In determining the eligibility of a person
for long term care services whose spouse resides in the community, all
nonexempt resources owned by the institutionalized spouse, the community
spouse, or both shall be considered available to the institutionalized spouse
in determining his or her eligibility for medical assistance. From the total
amount of such resources may be deducted a Community Spouse Resource Allowance
as provided under Section
120.379.
g) Trusts established prior to August 11,
1993 shall be treated in the manner described in Section
120.346.
h) Trusts established on or after August 11,
1993 shall be treated in the manner described in Section
120.347.
i) The value of a life estate shall be
determined at the time the life estate in the property is established and at
the time the property (for example, resources) is liquidated. In determining
the value of a life estate and remainder interest based on the value of the
property at the time the life estate is established or of the amount received
when the property is liquidated, the Department shall apply the values
described in Table A. The life estate and remainder interest are based on the
age of the person at the time the life estate in the property is established
and at the time the property is liquidated and the corresponding values
described in Table A.
j) A person's
entrance fee in a continuing care retirement community or life care community
(as those entities are described in
42 USC
1396 r(c)(5)(B)) shall be considered an
available resource to the extent that:
1) the
person has the ability to use the entrance fee, or the contract provides that
the entrance fee may be used to pay for care should other resources or income
of the person be insufficient to pay for the care;
2) the person is eligible for a refund of any
remaining entrance fee when the person dies or terminates the continuing care
retirement community or life care community contract and leaves the community;
and
3) the entrance fee does not
confer an ownership interest in the continuing care retirement community or
life care community.
k)
Non-homestead real property, including homestead property that is no longer
exempt (see Section
120.381(a)(1)
) , is considered an available resource
unless:
1) the property is exempted as
income-producing to the extent permitted under Section
120.381(a)(3),
except Section
120.381(a)(3)
shall not apply to farmland property and
personal property used in the income-producing operations related to the
farmland (e.g., equipment and supplies, motor vehicles, tools, etc.) through
December 31, 2013;
2) ownership of
the property consists of a fractional interest of such a small value that a
substantial loss to the person would occur if the property were sold;
3) the property has been listed for sale, in
which case the property will not be counted as available for at least six
months as long as the person continues to make a good faith effort to sell the
property. This effort can be verified by evidence, including advertisements or
documentation of the listing of the property with licensed real estate agents
or brokers that includes a report of any offer from prospective buyers. The
Department will review cases in which the property has not been sold after six
months and will consider the following factors in determining if extensions of
the initial six months are warranted:
A) the
asking price is less than the fair market value of the property;
B) the property is marketed through a
qualified realtor who is acting in good faith;
C) there is not a substantial market for the
type of property being sold; and
D)
the person has not rejected any reasonable offer to buy the property;
or
4) the homestead
property that is no longer exempt (see Section
120.381(a)(1)
) is producing annual net income for the person in an amount that is not less
than six percent of the person's equity value in the property. In determining
net income, the Department shall recognize business expenses allowed for
federal income tax purposes.
