Current through all regulations passed and filed through September 16, 2024
(A) This rule sets forth how in-kind support
and maintenance is valued for purposes of determining eligibility
for medical assistance.
(B) Definitions.
(1) "Actual value" is the dollar amount that
an individual paid for an item or service, or for his/her share of an item or
service.
(2) "Current market value"
is the dollar amount for which an item would sell on the local open
market.
(3) "Household" is a
personal place of residence in which individuals share common living quarters
and function as a single economic unit.
(4)
"Household of
another income standard" is equal to two-thirds of the income standard for an
individual or couple as applicable.
(5) "In-kind support
and maintenance" is unearned income in the form of food or shelter, or
something that can be used to get food or shelter, that a person is given or
receives because someone else pays for it.
(6) "Living in
household of another" means that the individual does
not live in his/her own household as defined in paragraph (B)(7) of this
rule.
(7) "Living in own
household" means that:
(a) The individual has
ownership interest or life estate in the home; or,
(b) The individual is liable for payment of
any part of a rental charge; or,
(c) The individual pays a pro-rated share of
living expenses; or,
(d) The
individual lives in a non-institutional care situation.
(8)
"Non-institutional care situation" means that:
(a) The individual has been placed by a
public or private agency under a specific program of protective placement;
and,
(b) The placement is in a
private household that is licensed or otherwise approved by the state to
provide protective care; and,
(c)
The placing agency retains responsibility for continuing supervision of the
need for placement and of the services provided; and,
(d) The individual, the placing agency, or
some other party pays for the services provided, or has a written agreement to
pay for the services provided.
(9) "Presumed maximum
value" is one-third the value of the individual
income standard, as set forth in rule 5160:1-3-03.5
of the Administrative Code, plus twenty dollars.
(10) "Public
assistance household" is a household in which all individuals receive some type
of public income-maintenance payments, including but not limited to Ohio works
first (OWF), supplemental security income (SSI), disaster relief and emergency
assistance, or state or local government assistance programs based on
need.
(11)
"Shelter" means living quarters for an individual in the
individual's permanent living arrangement.
(12) "Shelter
costs" means rent, mortgage payments, real property taxes,
heating fuel, gas, electricity, water, sewerage, and garbage collection
services.
(C) In-kind
support and maintenance received by an individual is excluded if:
(1) It is identified as excluded in
accordance with rule 5160:1-3- 03.2 of the Administrative Code;
or,
(2) It is received from another
member of a public assistance household; or,
(3) The individual receives SSI and the
social security administration does not reduce the individual's SSI benefit
because of in-kind support and maintenance.
(D) In-kind support and maintenance received
by an individual is valued by applying the household of another
income standard when:
(1) The individual is a recipient of SSI
benefits and receives the one-third reduction in the SSI benefit; or,
(2) The individual lives for an entire month
in another person's household, and receives both food and shelter for the
entire month from someone living in that household.
(E)
In-kind support and maintenance received by an individual is valued by treating
the in-kind support and maintenance as countable unearned income, using the
presumed maximum value if the individual:
(1)
Receives in-kind
support and maintenance but lives in his own household, or
(2)
Does not live for
the entire month in another person's household, or
(3)
Does not receive
all his food and shelter from another person in that household for the entire
month, or
(4)
Receives in-kind support and maintenance from someone
outside the household.
(F) In-kind support and maintenance received
by an individual is valued by treating the in-kind support and maintenance as
countable unearned income, using the current market value or actual value,
whichever is less, when the individual demonstrates that:
(1) The current market value of any in-kind
support and maintenance received, minus any payment the individual makes for
them, is less than the presumed maximum value; or,
(2) The actual amount someone else pays for
the individual's in-kind support and maintenance is less than the presumed
maximum value.
(G) The
administrative agency shall, for purposes of determining
eligibility
for medical assistance, determine the value of
in-kind support and maintenance received by an individual in accordance with
this rule.
