Current through Register Vol. 35, No. 18, September 24, 2024
A.
Living in the home with a relative: To be included in the
assistance unit, a child must be living, or considered to be living, in the
home of:
(1) a natural or an adoptive parent;
there is a presumption that a child born to a married woman is the child of the
spouse, or if the individual established parentage by some other legally
recognized process; or
(2) a
specified relative who is related within the fifth degree of relationship by
blood, marriage or adoption and assumes responsibility for the day-to-day care
and control of the child; the determination of whether an individual functions
as the specified relative shall be made by the specified relative unless other
information known to the worker clearly indicates otherwise.
B.
A child considered to be
living in the home: A child is considered to be part of the assistance
unit as evidenced by the child's customary physical presence in the home. If a
child is living with more than one household, the following applies:
(1) when the child is actually spending more
time with one household than the other, the child would be determined to be
living with the household with whom the child spends the most time;
and
(2) when the child is actually
spending equal amounts of time with each household, the child shall be
considered to be living with the household who first applies for medicaid
enrollment.
C.
Extended living in the home: An individual may be physically
absent from the home for longer or shorter periods of time and be a member of
the assistance unit and budget group.
(1)
Extended living in the home includes:
(a) when
an individual is attending college or a boarding school; or
(b) when an individual is receiving treatment
in a Title XIX medicaid facility (including institutionalized when meeting a
nursing facility (NF) level of care (LOC) and intermediate care facilities for
individuals with an intellectual disability (ICF-IID) LOC.
(2) When an individual has been a member of
the assistance unit, eligibility for another medicaid eligibility category,
such as long term care medicaid, should be evaluated. Until a determination of
eligibility for another category can be made, the individual is considered to
be living with the budget group.
D.
Temporary absence - extended living
in the home: An individual may be physically absent from the home and be
a member of the assistance unit and budget group. These other temporary
absences include:
(1) an individual not living
in the home due to an emergency who is expected to return to the household
within 60 calendar days, continues to be a member of the household;
(2) a child removed from the home of a parent
or a specified relative by a child protective services agency (tribal, bureau
of Indian affairs, or children, youth and families department), until an
adjudicatory custody hearing takes place; if the adjudicatory hearing results
in custody being granted to some other entity, the child will be removed from
the assistance unit; or
(3) a child
residing in a detention center:
(a) continues
to be a member of the household if he or she resides fewer than 60 calendar
days who is either adjudicated or not adjudicated as an inmate of a public
institution; or
(b) the individual
is not eligible for medicaid enrollment if he or she resides 60 calendar days
or more as an adjudicated inmate of a public institution pursuant to 8.200.410
NMAC.
