Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 469 - ASSISTANCE TO THE AGED, BLIND, OR DISABLED PROGRAM
Chapter 3 - DETERMINATION OF BENEFITS
Section 469-3-004 - BUDGET COMPUTATION

Universal Citation: 469 NE Admin Rules and Regs ch 3 ยง 004

Current through September 17, 2024

When an application for assistance is approved during the initial 30 day period, the first month's payment begins with date of application, if all eligibility factors are met. If eligibility is determined during the additional 30 day period, the payment is prorated from the date the department receives sufficient information to verify eligibility.

004.01 BUDGETING PROCESS FOR INDIVIDUALS NOT RECEIVING STATE SUPPLEMENTAL INCOME, INCLUDING INDIVIDUALS DETERMINED ELIGIBLE FOR 1619(B) STATUS BY SOCIAL SECURITY ADMINISTRATION. The budget process for determining eligibility for and amount of assistance payment is completed through the Department of Health and Human Services-designated electronic system.

004.01(A) ASSISTANCE TO THE AGED, BLIND, OR DISABLED PAYMENT BUDGETING PROCESS FOR RECIPIENTS RECEIVING SUPPLEMENTAL SECURITY INCOME. The budget for recipients who are receiving State Supplemental Income is completed through the Department of Health and Human Services-designated electronic system. To determine need:
(i) Only the following available net income is computed. This income is not allowed the $20 general income disregard:
(1) Income of non-spouse essential persons;

(2) Veteran's Aid and Attendant benefits; and

(3) Income allocated from another assistance unit;

(4) Income of an ineligible spouse not used by the Social Security Administration in the calculation of the recipient's Supplemental Security Income payment. Social Security disregards the deemed income if it is less than the difference between the federal benefit rate for an individual and a couple. Social Security calculates the Supplemental Security Income payment based on the federal benefit rate for an individual.

004.01(B) DEDUCTIONS FOR MEDICAL INSURANCE. Assistance to the Aged, Blind, or Disabled Payment Program does not allow for deductions for medical insurance premiums, such as private policies, Medicare, or Medicare supplements in the budget. The State Disability Medical Program budget can reflect medical insurance deductions.

004.02 PERSONS INCLUDED IN THE BUDGET. The assistance budget is computed to determine the need of a recipient for assistance. Consideration is given to the fact that the presence of other related persons living in the home may be essential to the individual's needs and well-being and affect the individual's need. The individual requirements of these essential persons may be included in the budget of the recipient. essential persons in the home may include the spouse, minor or adult children, grandchildren, parents, sisters, or brothers. The decision of whether another related individual is essential to the recipient rests with the recipient. If it has been determined that the related individual is not eligible for medical assistance under another program, and it has been determined that the individual must be in the presence of our recipient full time, then the individual can be an essential person. An individual, who meets the above criteria and who is considered a spouse by Social Security, even though the individual is not married to the recipient, is considered an essential person in the Aged, Blind or Disabled budget. The essential person's income and resources are included in the recipient's Aged, Blind or Disabled budget, and their combined income and resources are not exceed standards.

(1) A spouse or specified relative can be an essential person; unless:
(i) They are not living together;

(ii) The spouse or specified relative is an ineligible alien;

(iii) The spouse or specified relative is a fleeing felon;

(iv) The spouse or specified relative is eligible for assistance in his or her own right, such as receives medical assistance from another program;

(v) The spouse or specified relative is sanctioned;

(vi) The spouse is receiving Veteran's benefits and the recipient is current pay Supplemental Security Income; or

(vii) The spouse or specified relative failed to comply or apply for potential benefits. Medical health insurance premium and paid medical expenses may be paid for essential persons under Aged, Blind, or Disabled Special Requirements.

(2) The needs of an ineligible spouse are not included as an essential person in the recipient's budget. If the ineligible spouse is receiving Veterans benefits based on need that Social Security is disregarding in determining the recipient's Supplemental Security Income, the individual cannot be an essential person.

(3) The needs of an essential person may be included in the budget to determine eligibility for payment. When an essential person has been included in the recipient's budget, their combined income and resources cannot exceed standards.

(4) If there is no budgetary need, close the case and determine SDP medical eligibility with a Share of Cost using the appropriate income level. The appropriate maintenance level for the State Disability Medical Program is determined by considering the recipient and the essential person only if the essential person is the spouse or minor child.

(5) If the ineligible parent of a minor Assistance to the Aged, Blind, or Disabled or State Disability Program recipient does not have income which has been considered for deeming purposes, the individual's needs may be included in the minor's budget if it has been determined that the parent's continued full-time presence in the home is necessary for the child's well-being. If the parent has income which is being considered for deeming, the individual's needs have already been recognized in this process. If a parent's needs have been removed from an Aid to Dependent Child unit for noncooperation, such as Employment First employability or child support, that individual's needs may not be included in the Blind, Disabled, or State Disability Program child's budget.

004.02(A) POTENTIAL ASSISTANCE FOR ESSENTIAL PERSONS. Essential persons are required to apply for any financial assistance for which they appear to be eligible.

004.02(B) DETERMINING TOTAL REQUIREMENTS. In determining the amount of the individual requirements in the following subparts, living independently includes rent, allowances for the cost of home ownership, and the cost of a room when the recipient is living in a boarding home and paying room only. Alternate living arrangements include board and room, licensed boarding homes, assisted living, certified adult family homes, licensed group homes for children or child caring agencies, and centers for the developmentally disabled. Care facilities include nursing homes and public institutions for the treatment of mental diseases or developmental disabilities.
004.02(B)(i) LIVING ALONE. The following items show in the budget of an Aged, Blind, or Disabled or State Disability Program recipient:
004.02(B)(i)(1) LIVING INDEPENDENTLY. The budget of an Aged, Blind, or Disabled or State Disability Program recipient who is living alone in an independent living situation shows:
(a) The standard of need for one;

(b) The actual shelter expense up to the single shelter amount; and

(c) Special requirements, if applicable.

004.02(B)(i)(2) LIVING IN AN ALTERNATE LIVING ARRANGEMENT. The budget of an Aged, Blind, or Disabled or State Disabled Program recipient who is living alone in an alternate living arrangement shows:
(a) The standard of need for the alternate living situation; and

(b) Special requirements, if applicable.

004.02(B)(ii) LIVING WITH ESSENTIAL PERSON. The following living arrangements are considered when the recipient is living with the essential person:
004.02(B)(ii)(1) LIVING INDEPENDENTLY. The budget of an Aged, Blind, or Disabled or State Disability Program recipient who is living with an essential person in an independent living situation shows:
(a) The standard of need for the recipient plus essential person's;

(b) Actual shelter expense paid up to the multiple shelter amount; and

(c) Special requirements, if applicable for the recipient and the essential person.

004.02(B)(ii)(2) LIVING IN A BOARD AND ROOM ARRANGEMENT. The budget of an Assistance to the Aged, Blind, or Disabled or State Disability Program recipient who is living with an essential person in a board and room arrangement shows:
(a) Board and room as paid plus an allowance for personal needs up to the maximum for the recipient and essential person; and

(b) Special requirements, if applicable, for the recipient and essential person.

004.02(B)(iii) LIVING WITH RECIPIENTS WITH RELATIVE RESPONSIBILITY. When the Assistance to the Aged, Blind, or Disabled or State Disability Program recipient is living with an eligible individual for whom there is relative responsibility, payment is computed according to the guidelines in the following subparts.

004.02(B)(iv) SPOUSE ON AGED, BLIND, OR DISABILITY OR STATE DISABILITY PROGRAM. The needs of the eligible to Assistance to the Aged, Blind, or Disabled or State Disability Program couple who are living together, either independently or in an unlicensed board and room, are shown on the same budget form and the payment is divided equally.
004.02(B)(iv)(1) LIVING INDEPENDENTLY. When the couple is in an independent living situation, the budget must show:
(a) The standard of need for two;

(b) Actual shelter expense paid up to the multiple shelter amount; and

(c) Special requirements for each, if applicable.

004.02(B)(iv)(2) LIVING IN A BOARD AND ROOM ARRANGEMENT. When the couple is in an unlicensed board and room arrangement, the budget must show:
(a) The actual amount of the board and room up to the maximum for the Assistance to the Aged, Blind, Disabled or State Disability Program recipient and the Assistance to the Aged, Blind, or Disabled or State Disability Program spouse; and

(b) Special requirements for an Aged, Blind, or Disabled or State Disability recipient or an Aged, Blind, or Disabled or State Disability spouse.

004.02(B)(iv)(3) SPOUSE ON AID TO DEPENDENT CHILDREN OR REFUGEE RESETTLEMENT PROGRAM. If an Assistance to the Aged, Blind, or Disabled or State Disability Program recipient lives with a spouse who is receiving Aid to Dependent Children or Refugee Resettlement Program assistance, the budgets must be computed separately. Neither the needs nor the income of the Aid to Dependent Children or Refugee Resettlement Program recipient may be considered in the Assistance to the Aged, Blind, or Disabled, or State Disability Program budget.
004.02(B)(iv)(3)(a) LIVING INDEPENDENTLY. When the couple is in an independent living situation, the budget for the Assistance to the Aged, Blind, or Disabled or State Disability Program recipient will show:
(1) The prorated share of the standard of need based on the total number in the case;

(2) The prorated share of the shelter allowance up to the multiple shelter amount based on the total number in the case; and

(3) Special requirements, if applicable.

004.02(B)(iv)(2)(a)(i) LIVING IN AN ALTERNATE LIVING ARRANGEMENT. When the Assistance to the Aged, Blind, or Disabled or State Disability Program recipient is in an alternate living arrangement, the budget for the Assistance to the Aged, Blind, or Disabled or State Disability Program individual will show:
(1) The standard of need for the appropriate alternate living arrangement; and

(2) Special requirements, if applicable.

004.02(B)(iv)(4) LIVING WITH AN ELIGIBLE MINOR CHILD OR PARENT. If a recipient lives with an eligible minor child or parent, such as an Aged, Blind, or Disabled, State Disability parent or an Aid to Dependent Children, Assistance to the Aged, Blind, or Disabled, or State Disability Program child, the budgets are computed separately.
004.02(B)(iv)(4)(a) LIVING INDEPENDENTLY. When the individual and the eligible child are in an independent living situation, the budget for each must show:
(1) The prorated share of the standard of need based on the total number in the case;

(2) The prorated share of the actual shelter paid up to the multiple shelter amount based on the total number in the case; and

(3) Special requirements, if applicable.

004.02(B)(iv)(4)(b) LIVING IN AN ALTERNATE LIVING ARRANGEMENT. When the Assistance to the Aged, Blind, or Disabled or State Disability Program recipient is in an alternate living arrangement, the budget for each Aged, Blind, or Disabled or State Disability recipient must show:
(1) The standard of need for the appropriate alternate living arrangement; and

(2) Special requirements, if applicable.

004.02(B)(v) LIVING WITH PERSONS WITH NO RELATIVE RESPONSIBILITY. Only the needs of the recipient are considered in the budget when the recipient is living with other individuals for whom there is no relative responsibility.
004.02(B)(v)(1) LIVING WITH SELF-SUPPORTING INDIVIDUALS WITH NO RELATIVE RESPONSIBILITY. If a recipient is sharing a household with a selfsupporting individual for whom the recipient has no relative responsibility, the budget is computed:
(a) On a board and room basis, if the recipient is required to pay board and room;

(b) On an expense-sharing plan when in an independent living arrangement using:
(i) The standard of need for one;

(ii) Shelter costs, not to exceed the maximum, determined by:
(1) The prorated share of total shelter costs based on the number of persons in the case not to exceed the maximum single shelter amount; or

(2) The actual amount of shelter paid up to the single shelter amount if the recipient can verify that they pay an amount other than the prorated share; and

(iii) Special requirements, if applicable.

004.02(B)(v)(2) LIVING WITH OTHER RECIPIENTS WITH NO RELATIVE RESPONSIBILITY. The budget of an Assistance to the Aged, Blind, or Disabled or State Disability Program recipient living in the same household with other recipients for whom the Assistance to the Aged, Blind or Disabled or State Disability Program recipient has no relative responsibility is computed according to an independent living arrangement.
004.02(B)(v)(2)(a) INDEPENDENT LIVING ARRANGEMENT. When the Assistance to the Aged, Blind, or Disabled or State Disability Program recipient is in an independent living arrangement, the budget will show:
(i) The standard of need for one;

(ii) The prorated share of total shelter costs based on the number of persons in the case not to exceed the single shelter amount; and

(iii) Special requirements if applicable.

004.02(B)(v)(2)(b) LIVING IN A BOARD AND ROOM ARRANGEMENT. When the Assistance to the Aged, Blind or Disabled or State Disability Program recipient is in a board and room or boarding home arrangement, the budget will show:
(i) Board and room as paid plus personal requirements up to the maximum; and

(ii) Special requirements, if applicable.

004.02(B)(vi) RECIPIENT LIVING IN A CARE FACILITY. The budget of a recipient living in a care facility shows:
(1) The standard of need for the correct living arrangement; and

(2) An amount up to $10 when the recipient has a guardian or conservator who requests a fee.

004.02(B)(vii) ASSISTANCE TO THE AGED, BLIND, DISABLED, OR STATE DISABILITY PROGRAM CHILD LIVING WITH SELF-SUPPORTING PARENTS. If a Blind or Disabled, or State Disability minor child lives with a self-supporting parent, the child's budget will show:
(1) The prorated share of the standard of need based on the total number in the case;

(2) The prorated share of the actual shelter paid up to the multiple shelter amount; and

(3) Special requirements, if applicable.

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