Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 475 - SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM
Chapter 3 - ELIGIBILITY
Section 475-3-003 - ELIGIBILITY COMPUTATIONS

Universal Citation: 475 NE Admin Rules and Regs ch 3 ยง 003

Current through September 17, 2024

After the household's resource eligibility and determination regarding how to treat the household's income has been established, the net monthly income is determined for households which either passed the gross income standards or who are exempt from meeting the gross income standards. This section discusses the process of finding the net monthly Supplemental Nutrition Assistance Program income by outlining deductions and applying monthly income standards.

003.01 POLICIES FOR HANDLING DEDUCTIONS. The following applies to how deductions are used when budgeting.

003.01(A) DEDUCTIONS. Deductions are taken after the household's earned and unearned income are determined.
003.01(A)(i) ITEMS NOT ALLOWED. The following expenses will not be allowed as deductions:
(1) An expense covered by an excluded reimbursement; and

(2) An expense is not deductible if:
(a) The expense is for a service provided by a household member; or

(b) The household does not make a money payment for the service.

003.01(A)(ii) EXPENSES AS BILLED. A deduction is allowed only in the month the expense is billed regardless of when the household intends to pay the bill. Amounts carried forward from past billing periods are not deductible with the exception of medical expenses. A particular expense may be deducted only once.

003.01(A)(iii) AVERAGING EXPENSES. For fluctuating expenses, the household chooses one of the following methods to determine the monthly deduction:
(1) Expenses which are billed less often than monthly may be averaged over the period the expense is intended to cover;

(2) "One time only" expenses may be averaged over the entire certification period in which they are billed; or

(3) An expense may be deducted entirely in the month in which it is billed.

003.01(A)(iv) ANTICIPATING EXPENSES. A household's expenses are computed based on expenses the household expects to be billed for during the certification period. The anticipation of expenses is based on the most recent month's bills unless the household is reasonably certain a change will occur.

003.01(A)(v) VERIFICATION OF DEDUCTIONS. If the household claims an expense it must be verified before it can be allowed as a deduction. The client's declaration of shelter and utilities is accepted as verification unless questionable. If the household claims an expense but does not provide verification, the household may be certified; however, the deduction will not be allowed.

003.01(B) EARNED INCOME DEDUCTION. A percentage of a household's gross earned income will be deducted pursuant to Title 7 CFR § 273.9(d)(2).
003.01(B)(i) EARNED INCOME DEDUCTION FOR OVERISSUANCES. Households in the Simplified Reporting category are not allowed the earned income deduction when an overissuance was caused by the household's failure to meet a reporting requirement for a new source or change in earned income timely.

003.01(C) STANDARD DEDUCTION. Each household will be allowed a monthly standard deduction pursuant to Title 7 CFR § 273.9(d)(1)(i).

003.01(D) MEDICAL EXPENSE DEDUCTION. The medical expense deduction is allowed only for the eligible individuals in households with one or more elderly or disabled members. Only the amount of the expense incurred or reasonably anticipated by the elderly or disabled household member(s) may be considered. To qualify for the deduction, the medical expenses must be:
(1) Verified as non-reimbursable; and

(2) In excess of the monthly threshold amount.

003.01(D)(i) SUPPLEMENTAL SECURITY INCOME ELIGIBILITY FOR MEDICAL EXPENSE DEDUCTION. Persons receiving Supplemental Security Income presumptive disability payments are considered eligible for the medical expense deduction. Presumptive disability payments are regular benefits for a three-month period paid to persons most likely to meet Supplemental Security Income disability criteria. These persons are considered Supplemental Security Income eligible by the Social Security Administration and receive a federal Supplemental Security Income check for the amount of entitlement.
003.01(D)(i)(1) RECEIPT OF SUPPLEMENTAL SECURITY INCOME ON BEHALF OF SOMEONE ELSE. Spouses or other persons receiving benefits as a dependent of a Supplemental Security Income or disability recipient are not eligible to receive this deduction unless they are elderly or otherwise meet the definition of a disabled person.

003.01(D)(ii) ALLOWABLE MEDICAL EXPENSES. Any non-reimbursable costs over the monthly amount for allowable items are deducted from the household's income if the cost was incurred by an eligible household member. These items are:
(a) Medical care including psychotherapy and rehabilitative costs provided by a licensed medical practitioner;

(b) Dental care provided by a licensed medical practitioner;

(c) Hospitalization or nursing home care which is paid on behalf of a person who was a household member immediately before entering the hospital or nursing home;

(d) Health and hospitalization insurance premiums which cover medical costs;

(e) Ambulance insurance premiums;

(f) Medicare premiums and any cost sharing copay or spend down expenses incurred by a Medicaid recipient;

(g) Animals providing service to disabled persons such as seeing eye dogs, their veterinary fees, food, and other maintenance costs;

(h) Prosthetic devices;

(i) Dentures;

(j) Hearing aids;

(k) Transportation to obtain medical treatment, services, or prescriptions. To be deductible, costs for this transportation must be reasonable;

(l) The cost of a medic-alert system above the basic telephone rate;

(m) The principal, but not the interest, on a loan to cover medical expenses;

(n) Corrective footwear, wheelchairs, and other items prescribed by a licensed medical practitioner;

(o) Drugs, including over-the-counter, prescribed by a licensed medical practitioner;

(p) Eyeglasses prescribed by a physician skilled in eye diseases or by an optometrist;

(q) Attendant, housekeeper, or home health aide if the care is needed because of age, infirmity, or illness. When the household supplies a majority, 51%, of an attendant's meals, the maximum allowable one-person allotment is deducted in addition to the attendant's wages;

(r) Adult day care expenses for the elderly or disabled;

(s) Telephone amplifiers, warning signals for handicapped, and costs of typewriter equipment for the deaf, etc.; and

(t) Annual enrollment fee for Medicare prescription drug card.

003.01(D)(ii)(1) MEDICAL VENDOR PAYMENTS. If a vendor payment for any allowable medical expense is excluded as income, this expense will not be allowed as a medical deduction.

003.01(D)(ii)(2) NON-ALLOWABLE MEDICAL COSTS. The following medical costs are not allowed:
(a) Premiums for life or dismemberment insurance;

(b) Premiums for income producing policies;

(c) Special diets;

(d) Interest on a loan to pay medical expenses;

(e) The basic telephone rate for a medic-alert system;

(f) Overdue or past due expenses;

(g) Medical expenses previously deducted in the Supplemental Nutrition Assistance Program budget;

(h) Prescriptions received at no cost through the prescription drug discount program; and

(i) Automobile medical liability insurance.

003.01(D)(iii) ONE TIME ONLY MEDICAL EXPENSES. A one-time only medical expense is the cost of a medical occurrence which is not ongoing or routine. The following procedures apply solely to one time only medical expenses:
(1) If a household reports a one time only medical expense at certification or recertification, the household will have the choice of having the expense:
(a) Budgeted as a lump sum; or

(b) Averaged and budgeted over the certification period;

(2) If a household reports they anticipate a medical expense during the certification period and at the time of certification they can provide adequate verification of the anticipated expense, the expense can be prorated over the entire certification period;

(3) If a household reports a one time only medical expense during the certification period, the household will have the choice of having the expense:
(a) Budgeted as a lump sum; or

(b) Averaged and budgeted over the remaining months in the certification period;

(4) If a household reports they anticipate a medical expense during the certification period but are unable to provide the verification at the time of certification, the expense will be allowed if the verification is provided during the certification period and the expense will be prorated over the balance of the certification period; or

(5) If a one-time medical expense was averaged over the certification period and the certification period is extended, the one-time medical expense will be recalculated. The medical expense will be averaged over the months in the extended certification period.

003.01(D)(iv) VERIFICATION OF MEDICAL EXPENSES. Before initial certification, the household must verify the following:
(a) The amount of medical expenses, including the amount of reimbursement if any; and

(b) The type of medical expense, whether allowable or non-allowable.

003.01(D)(iv)(1) RECERTIFICATION. At the time of recertification the household must verify medical expenses it has claimed if changes have occurred since last verified.

003.01(E) DEPENDENT CARE COST DEDUCTION. Dependent Care costs allowable pursuant to Title 7 CFR § 273.9(d)(4).
003.01(E)(i) VERIFICATION OF DEPENDENT CARE COSTS. The household must verify dependent care costs that it claims as an expense:
(a) If questionable; or

(b) If allowing the expense could potentially result in a deduction.

003.01(E)(i)(1) AFTER INITIAL VERIFICATION. Subsequent verification is not required unless the household reports a change in the provider or in the amount of the deduction or unless the information is questionable.

003.01(F) CHILD SUPPORT DEDUCTIONS. Child support paid by a household member is an allowable expense when it meets all of the following conditions:
(1) Child support is paid to or for a non-household member;

(2) The household member has a legal obligation to pay child support; and

(3) The amount of child support paid is verified.

003.01(F)(i) PAYMENT TO THIRD PARTY. If the noncustodial parent makes a payment to a third party in accordance with the court order, these payments are allowable as child support expenses.

003.01(F)(ii) ALLOWABLE CHILD SUPPORT COSTS. In computing the child support deduction, the Department considers the following as long as the expense is court-ordered and verifies any of the following as paid:
(a) Payments to the court;

(b) Payments to the custodial parent in accordance with a court order;

(c) Payments to the custodial parent's mortgage company or landlord;

(d) Payments to the custodial parent's utility company;

(e) Payments to obtain health insurance for the child(ren); or

(f) Payments for child care per court order.

003.01(F)(ii)(1) ALIMONY AND SPOUSAL SUPPORT. Alimony or spousal payments made to or for a non-household member are not an allowable child support deduction.

003.01(F)(iii) ARREARAGES. Households which have a three-month record of current child support payments and are also paying arrearages will have the arrearage amount also included as part of the child support deduction. The three-month record of payment is the current three-month period.

003.01(F)(iv) VERIFICATION OF CHILD SUPPORT COSTS. The household has the responsibility to provide verification of:
(a) The legal obligation;

(b) The obligated amount; and

(c) The amount paid.

003.01(F)(iv)(1) VERIFICATION WITH SAME DOCUMENTS. The same document cannot be used to verify the household's legal obligation to pay child support and to verify the household's actual monthly child support payments.

003.01(F)(iv)(2) VERIFICATION AT RECERTIFICATION. The amount of legally obligated child support a household member pays to a non-household member will be verified at initial certification and at each recertification.

003.01(F)(iv)(3) PAYMENTS MADE TO THE CLERK OF THE DISTRICT COURT. If the child support payments are made to the Clerk of the District Court, the Department is responsible for obtaining verification of the household's child support payments. The Department will give the household an opportunity to resolve any discrepancy between the household verification and the Clerk of the District Court records.

003.01(F)(v) BUDGETING THE CHILD SUPPORT PAYMENT. The amount of the child support deduction is determined by the amount of child support paid by the household. Child support must actually be paid before it can be allowed as a deduction.
003.01(F)(v)(1) IRREGULAR AND NEW PAYMENTS. If a household has an irregular pattern of paying child support, the Department may use the past payment history in determining the monthly amount used as a child support deduction. If a household has no record of paying child support or a payment record of less than three months, the Department will budget the child support deduction using the best information available.

003.01(G) SHELTER DEDUCTIONS. Each household is allowed to deduct shelter expenses in excess of 50% of the household's net income after allowable deductions. This is automatically calculated by the automated system. The following procedures apply:
(1) The household's excess shelter deduction cannot exceed the maximum allowable amount for households with no elderly or disabled members; or

(2) If the household contains a member who is elderly or disabled the household is entitled to an unlimited excess shelter deduction.

003.01(H) UTILITY ALLOWANCE. Actual utility costs cannot be allowed as a deduction. To qualify for a utility allowance, the household must be billed for utilities on a recurring basis apart from the rent or mortgage. If the household does not qualify for one of the allowances, the household is not eligible for any utility deduction. The household may receive one of the following:
(1) Standard Utility Allowance;

(2) Limited Utility Allowance;

(3) One Utility Allowance; or

(4) Telephone Standard Allowance.

003.01(H)(i) UTILITY ALLOWANCE DETERMINATION AFTER A MOVE. If a Simplified Reporting household reports a move the entitlement to a utility allowance will be re-determined.

003.01(H)(ii) UTILITY ALLOWANCE FOR UNOCCUPIED HOMES. If a household owns a home that is temporarily unoccupied because of employment or training away from home, illness, or abandonment due to a casualty or natural disaster, the household is entitled to only one utility allowance. If the household is paying different utility types at the two residences, the household has the choice of using the temporarily unoccupied structure or their current residence in the Supplemental Nutrition Assistance Program budget.

003.01(H)(iii) STANDARD UTILITY ALLOWANCE. To qualify for the Standard Utility Allowance, the Supplemental Nutrition Assistance Program household must have a member who:
(a) Is billed for a recurring heating or cooling expense separately and apart from its rent or mortgage; or

(b) Has received one or more Low-Income Home Energy Assistance Program payment(s) that exceed $20 annually in the current or preceding 12 months.

003.01(H)(iii)(1) COSTS INCLUDED IN THE STANDARD UTILITY ALLOWANCE. The Standard Utility Allowance includes:
(a) Costs of heating and cooking fuel, such as oil, gas (including the rental fee for the propane tank), wood when the primary heating source, or electricity;

(b) Costs of air conditioning;

(c) Costs of septic tank installation and maintenance;

(d) Fees for water;

(e) Sewage costs;

(f) Garbage and trash collection fees;

(g) Basic telephone rate; and

(h) Initial fees, other than the deposit, charged by the utility provider.

003.01(H)(iii)(2) ELIGIBILTY FOR STANDARD UTILITY ALLOWANCE. Any household which is billed for a heating or cooling expense on a recurring basis separately and apart from its rent or mortgage or has a member who has received one or more Low Income Home Energy Assistance Program payment(s) in the current or preceding 12 months that exceed $20 annually is entitled to the Standard Utility Allowance. Eligibility for Standard Utility Allowance based on receipt of the Low Income Home Energy Assistance Program is not affected by a change in household residence after the household has received the Low Income Home Energy Assistance Program payment(s).
003.01(H)(iii)(2)(a) RECURRING PAYMENTS. Recurring means the household is billed on a regular basis or the expense is incurred on a regular basis. A household that only incurs cooling costs for two weeks out of the year is not entitled to the Standard Utility Allowance. A household that incurs heating or cooling costs several months out of the year is entitled to the Standard Utility Allowance. A household which incurs recurring cooling or heating fuel costs on an irregular basis but is otherwise eligible to use the Standard Utility Allowance may continue to use the Standard Utility Allowance between billings. A household only needs to have a member who has received one or more Low Income Home Energy Assistance Program payment(s) totaling more than $20.00 within the current or preceding twelve months to be eligible for Standard Utility Allowance.

003.01(H)(iii)(2)(b) COOLING COST ENTITLEMENT. Cooling costs that entitle the household to the Standard Utility Allowance are those costs related to the operation of an air conditioning system, evaporative cooler, swamp box, or room air conditioner(s). The use of a fan does not qualify the household for the Standard Utility Allowance.

003.01(H)(iii)(2)(c) NONALLOWABLE HEATING SOURCES. Utility costs for the operation of a space heater, electric blanket, heat lamp, cooking stove, or other similar heating source when used as a supplemental heating source do not qualify a household for the Standard Utility Allowance. The cost of operating an electric blower for an oil or gas furnace does not qualify a household for the Standard Utility Allowance.

003.01(H)(iv) LIMITED UTILITY ALLOWANCE. To qualify for the Limited Utility Allowance, the household must be billed on a recurring basis separately and apart from its rent or mortgage for at least two utilities other than heating or cooling. The Limited Utility Allowance covers the basic telephone rate, water, sewer, garbage or trash collection, maintenance of wells and septic tank systems. Gas, propane, and electricity are included when only non-heating or cooling costs are incurred.

003.01(H)(v) ONE UTILITY ALLOWANCE. To qualify for the One Utility Allowance, the household must be billed for no more than one utility. The household cannot be eligible for the One Utility Allowance and be billed for heating or cooling costs, the telephone or have received a Low Income Home Energy Assistance Program payment. A household which is billed for one utility on a recurring basis separately and apart from its rent or mortgage payment is entitled to the One Utility Allowance.

003.01(H)(vi) TELEPHONE ALLOWANCE. To qualify for the Telephone Allowance, the household must be billed for the basic service fee for a telephone. The Telephone Allowance may be allowed for a cell phone if there is no house phone available and the cell phone is the household's primary phone.

003.01(H)(vii) UTILITIES SHARED WITH OTHERS. When multiple households are living in one physical residence and more than one household is being billed for or contributing to the utility costs, this agreement is considered shared utilities. This type of shared utilities is for convenience and is not a self-employment enterprise. The Standard Utility Allowance, Limited Utility Allowance, One Utility Allowance, or Telephone Allowance is not prorated for households that share utility expenses. These households are eligible for the appropriate utility allowance.

003.01(H)(viii) RENTAL HOUSING. The following applies to individuals in rental housing.
003.01(H)(viii)(1) PRIVATE HOUSING. The following households are also eligible for one of the utility deductions:
(a) Private rental housing units which are billed by the landlord on the basis of individual usage;

(b) Private rental housing units which are charged a flat fee separately from their rent; or

(c) Households receiving direct or indirect energy assistance, which is excluded from income consideration, other than Low-Income Home Energy Assistance Program, if their expenses exceed the amount of assistance.

003.01(H)(viii)(2) PUBLIC HOUSING. The following households are eligible for one of the utility deductions:
(a) Public housing units which determine the amount of usage separately for each household through a metering system; and

(b) Public housing units which have central meters and which charge the household only for excess cost.

003.01(H)(ix) VERIFICATION OF UTILITY EXPENSES. The household must report a utility expense(s) if the Standard Utility Allowance, Limited Utility Allowance, One Utility Allowance, or Telephone Allowance is to be used.
003.01(H)(ix)(1) MOVES DURING CERTIFICATION PERIOD. When a Simplified Reporting household reports a move or a change in the source of utilities during the certification period, the utility allowance must be re-determined based on the current physical address and household circumstances. When a Transitional Benefit Reporting household reports a move or change in the source of utilities during the certification period, the information is acted on at the next recertification.

003.02 INCOME ELIGIBILITY STANDARDS. Applicant households must meet the income eligibility standards of the Supplemental Nutrition Assistance Program as follows:

(1) Households containing a member who is elderly or disabled must meet the net monthly income eligibility standards. Gross and net income eligibility tables are included in a guidance document;

(2) Households which do not contain an elderly or disabled member must meet both the gross and net monthly income eligibility standards;

(3) Households which are categorically eligible are not required to meet either the gross or net monthly income standard. Eligible one or two-person households whose income exceeds the net income limits are entitled to the minimum monthly benefit, listed in a guidance document, except during an initial month if the benefit prorates to less than the minimum monthly benefit. If the initial month's benefit is prorated to $10, $11, $12, or $13, the prorated amount is issued; and

(4) Households which are Expanded Resource Program eligible must meet the Expanded Resource Program income standards.

003.02(A) GROSS MONTHLY INCOME ELIGIBILITY STANDARDS. Gross income refers to income after any allowable income exclusions have been applied. Households which do not include an elderly or disabled member and are not categorically eligible must be under the gross monthly income standard for their household size. Households which are determined to be eligible under gross monthly income standards must also pass the net monthly income standards. Households which include one or more elderly or disabled household members are exempt from the gross monthly income standard. If the household income exceeds the gross income limits, the automated system will deny or close the case when a final budget is processed.

003.02(B) NET MONTHLY INCOME ELIGIBILITY STANDARDS. Net income refers to income after all deductions have been applied. These standards are used for all households in determining benefit amounts. Eligible one or two-person households which are categorically eligible qualify for a minimum monthly benefit listed in a guidance document even if their income exceeds the net monthly income limits.

003.03 BENEFIT LEVEL. The household's monthly allotment will be equal to the maximum Supplemental Nutrition Assistance Program allotment for the household size reduced by 30% of the household's net monthly income. If 30% of the household's net income ends in cents, the value is rounded up to the nearest dollar.

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