Current through Register Vol. 35, No. 18, September 24, 2024
A.
General: To be eligible for
inclusion in a GA benefit group, a person must be individually eligible
according to requirements set forth in 8.106.410 NMAC, 8.106.420 NMAC and
8.106.430 NMAC and not otherwise disqualified from participation. The person or
persons meeting individual eligibility requirements and for whom an application
has been or must be made constitute the benefit group.
B.
Disability: The benefit
group for the GA-disabled adult program consists of the disabled adult and may
include the needs of other adults living in the home. An adult who shares
custody of his or her biological child may apply for GA-disabled adults in his
or her own right, provided that the adult who is applying has less than half
time custody of the child.
(1)
Spouse: The spouse, residing in the home with the disabled adult must be
included in the benefit group to determine need, but not payment. The spouse
may be included in payment if the spouse is determined disabled.
(2)
Essential person: An
individual, regardless of relation, is considered essential to the well being
of a disabled GA applicant and may be included in the GA benefit group to
determine need and payment. An essential person is capable of providing the
physical care needed by the GA disabled recipient to the extent that placement
into institutional care would otherwise be required without this
care.
(3)
Pregnant
individual: An emancipated unmarried pregnant woman, age 17 or younger,
or a pregnant adult, who has not reached her third trimester and has been
determined to be disabled, may be considered a benefit group member in the GA
disabled adult program. The father of the unborn child that resides in the
home, must be included in the benefit group to determine need, but not
payment.
(4)
SSI: An
individual receiving SSI, or who would be receiving SSI except for recovery by
the social security administration of an overpayment, is not eligible to be
included in a GA benefit group.
C.
State supplement for adult
residential care: To be eligible for inclusion in an ARSCH supplemental
payment benefit group, an individual must be eligible for SSI. The benefit
group consists of the SSI recipient. Two SSI recipients who would constitute a
family if living at home, but who reside in an adult residential shelter care
facility, are considered to be two separate benefit groups.
D.Unrelated child: The benefit group for the
GA-dependent child program consists of a dependent child who lives in a family
setting with a non-related adult caretaker, and all of that dependent child's
full, half, step- or adopted siblings living in the home. An adult caretaker
may be an individual who is not a specified relative within the fifth degree of
relationship and who is not eligible for NMW in his or her own right.
(1)
Caretaker: The unrelated
caretaker shall be included in the benefit group upon request. The spouse of
the unrelated caretaker, if living in the home, shall be included in the
benefit group when the unrelated caretaker is included in the benefit
group.
(2)
Need and
payment: The unrelated caretaker and spouse shall be included in the
benefit group to determine need and payment only if they request
inclusion.
(3)
Fifth degree
of relationship: The following relatives are within the fifth degree of
relationship to the dependent child:
(a)
father (biological or adoptive);
(b) mother (biological or
adoptive);
(c) grandfather, great
grandfather, great-great grandfather, great-great-great grandfather;
(d) grandmother, great-grandmother,
great-great-grandmother, great-great-great grandmother;
(e) spouse of child's parent
(stepparent);
(f) spouse of child's
grandparent, great grandparent, great-great grandparent, great-great-great
grandparent (step-grandparent);
(g)
brother, half-brother, brother-in-law, stepbrother;
(h) sister, half-sister, sister-in-law,
stepsister;
(i) uncle of the whole
or half-blood, uncle-in-law, great uncle, great-great uncle;
(j) aunt of the whole or half blood,
aunt-in-law, great aunt, great-great aunt;
(k) first cousin and spouse of first
cousin;
(l) son or daughter of
first cousin (first cousin once removed);
(m) son or daughter of great aunt or great
uncle (first cousin once removed) and spouse;
(n) nephew/niece and spouses.
(4) A second cousin is a child of
a first cousin once removed or child of a child of a great aunt or uncle and is
not within the fifth degree of relationship.
(5)
Effect of divorce or death on
relationship: A relationship based upon marriage, such as the "in-law",
or "step-" relationships, continues to exist following the dissolution of the
marriage by divorce or death.
(6)
Unrelated child adult only benefit group: An adult only benefit
group may consist of the non-related adult caretaker when all of the dependent
children are receiving SSI.
