Section 5321 Income
(05/01/2010, 10-02)
Countable income is all earned and unearned income, as
defined in this section, less all allowed deductions.
Income in the month of application (or review) and future
months is estimated based on income in the calendar month prior to the month of
application (or review) unless changes have occurred or are expected to occur
and this income does not accurately reflect ongoing income. If changes are
expected to occur, an estimate of income based on current information should be
used.
To determine countable monthly income, average weekly income
is multiplied by 4.3 and average bi-weekly income is multiplied by 2.15.
A. Lump Sum Receipts
Lump sum benefits that would have been counted as income if
received on time, such as social security benefits and unemployment
compensation, shall be added to all other countable income of an applicant for
or recipient of VHAP and counted only in the month of receipt.
Windfall lump sums such as insurance payments and money
received from the sale of a resource (including the sale of an excluded
resource) are not counted.
An insurance payment or similar third party payment that is
received for a specific purpose, such as the payment of medical bills or
funeral costs, and is used for the stated purpose is excluded. Payments not
used for the stated purpose are counted as income in the month received.
B. Unearned Income
Unearned income includes, but is not limited to, the
following:
Income from pension and benefit programs, such as social
security, railroad retirement, veteran's pension or compensation, unemployment
compensation, and employer or individual private pension plans or
annuities.
Interest and dividends.
Child support payments (see 4001.82 #23 for the exclusion of
the first $ 50) and alimony payments.
Income from capital investments in which the individual is
not actively engaged in managerial effort.
Time payments on mortgages or notes resulting from a casual
sale (i.e., a sale not related to self-employment) of real (stationary or
fixed) property or personal property.
Voluntary contributions from others.
Unearned income does not include the following:
Infrequent or irregular voluntary cash contributions or
gifts, such as Christmas, birthday, or graduation presents, received from
friends or relatives.
In-kind income.
Five percent of a VA monthly award that is retained by a
guardian.
C. Earned Income
Earned income includes all wages, salary, commissions or
profit from activities in which the individual is engaged as an employee or a
self-employed person, including, but not limited to, active management of
capital investments (e.g., rental property).
Earned income is defined as income prior to any deductions
for income taxes, FICA, insurance or any other deductions voluntary or
involuntary except that, in determining earned income for self-employed
individuals, business expenses are deducted first.
Earnings over a period of time, for which settlement is made
at one given time, are also included (e.g., sale of farm crops, livestock,
poultry). Monthly income is determined by dividing the settlement by the number
of months in which it was earned.
Earned income does not include in-kind income.
The following items are deducted from gross earned income in
the sequence listed:
- Business expenses (self-employment only)
- Standard employment expense deduction
- Dependent care expenses
D. Business Expenses
Business expenses, which are deducted from gross receipts to
determine adjusted gross earned income, are limited to operating costs
necessary to produce cash receipts, such as:
1. Office or shop rental; taxes on farm or
business property;
2. Hired
help;
3. Interest on business
loans;
4. Cost of materials, stock,
and inventory, livestock for resale required for the production of this income;
and
Tax returns and business records are considered appropriate
sources of accurate figures for farm and business receipts and expenses.
The income of a VHAP group owning or operating a commercial
boarding house shall be treated as any other business income. A commercial
boarding house is defined as an establishment licensed as a commercial
enterprise that offers meals and lodging for compensation. In areas without
licensing requirements, a commercial boarding house shall be defined as a
commercial establishment that offers meals and lodging with the intention of
making a profit.
No computation is required for foster homes furnishing
boarding care to children in custody of, and placed by, the Family Services
Division (FSD). Department board rates are established to cover expenses only,
with no profit available; therefore, no earned income is considered available
from this source.
For a VHAP group that is not a commercial boarding house, the
business expense of furnishing room and board, alone or as part of custodial
care, shall be allowed, provided that the amount shall not exceed the payment
the VHAP group receives from the roomer/boarder for lodging/ meals. (See the
Medicaid Procedures Manual at P-2420 D2 for the table of standard business
expense deductions for homes providing room or board on a non- commercial
basis.)
E.
Standard Employment Expense Deduction
The standard employment expense deduction is the first $
90.00 earned per month after deduction of business expenses, where
applicable.
The standard employment expense deduction is applied
separately to the gross countable earned income of each individual in the VHAP
group who is employed or self-employed.
F. Dependent Care Expenses
Dependent care expenses necessary to enable the individual to
retain his or her employment or accept employment will be deducted up to a
maximum of $ 175.00 per month for the care of each member of the VHAP group who
is an incapacitated adult or a child age two years or older, and up to a
maximum of $ 200 per month for the care of each child under two years of age
who is a member of the VHAP group.
Dependent care expenses for the care of a child are not
deducted unless the child requiring care is a member of the VHAP group or is
not a member of the VHAP group solely because he/ she is an SSI/AABD or an ANFC
recipient and is:
1. under age 13;
or
2. at least age 13 but younger
than age 21 and physically or mentally incapable of caring for himself or
herself, as verified by the written report of a physician or licensed
psychologist; or
3. at least age 13
but younger than age 21 and under court supervision.
Dependent care expenses will be allowed as paid up to the
maximum. If a recipient's dependent care expenses are below the maximum,
transportation to and from the dependent care facility may be deducted as part
of the expense up to the maximum for both dependent care and
transportation.
Payments for dependent care provided by a member of the same
VHAP group, by the child's parent (biological, adoptive, or stepparent) or
legal guardian, or the incapacitated adult's spouse do not qualify as necessary
dependent care expenses under this policy.
The provider of care must be at least 16 years of age. A
deduction for dependent care expenses for care of a child can be allowed only
when neither parent is available and able to provide the necessary care. A
deduction for dependent care expenses for care of an incapacitated adult can
only be allowed when the incapacitated adult's spouse (where applicable) is
either unavailable, or available but unable to provide the necessary care
because he/she is incapacitated. Incapacity shall be determined in accordance
with the process used to determine whether a parent applying for or receiving
ANFC is incapacitated (see WAM 2332.1). This process shall give appropriate
consideration to the treating physician's opinion. A spouse is considered
unavailable if he/she is employed during the time care is required.
If dependent care is required for reasons other than
employment (e.g., protective services child care or care for training
purposes), the client shall be referred to SRS.
Section 5322 Excluded Income
1. Any income received by a recipient of
SSI/AABD or ANFC living in the VHAP household.
2. All income to an undergraduate student
(including parents or children in the VHAP group) from student grants, loans,
or work study if:
a. such loans or grants are
made under a program administered or insured by the U.S. Secretary of
Education; or
b. the sponsor of the
grant or loan precludes its use for maintenance purposes; or
c. the work/study program is administered by
a college or university recognized by educational authorities and the
undergraduate student is enrolled half time or more than half time, as defined
in relation to the definition of full time used by the school.
Examples of excludable income sources are: federal Pell
Grants, Vermont Student Assistance Corporation grants or loans, federal
Supplemental Educational Opportunity Grants (SEOG), and federal College
Work-Study Programs (CWSP).
That portion of any Veterans Administration Educational
Assistance Program payment that is for the student and is actually used for
tuition, books, fees, child care services or other expenses necessary for
enrollment is also excluded.
3. Student financial assistance provided
under Title IV of the Higher Education Act or Bureau of Indian Affairs Student
Assistance programs.
Examples of programs in Title IV of the Higher Education Act
include:
a. Federal Pell
Grants.
b. Federal Supplemental
Educational Opportunity Grants (SEOG).
c. State Student Incentive Grants
(SSIG).
d. Federal College Work
Study (CWSP).
e. Federal Perkins
Loans. These are different from loans under the Carl D. Perkins Vocational and
Applied Technology Education Act, which are not totally disregarded (see
#4).
f. Educational loans under the
federal Family Educational Loan Program or the federal Direct Student Loans
Program (Stafford or PLUS loans).
4. Student financial assistance provided
under the Carl D. Perkins Vocational and Applied Technology Education Act when
the assistance is made available to meet attendance costs. Attendance costs
include:
a. tuition and fees normally
assessed a student carrying the same academic workload as the
applicant/recipient, as determined by the institution, including costs for
rental or purchase of any equipment, materials, or supplies required of all
students in the same course of study as the applicant/recipient; and
b. an allowance for books, supplies,
transportation, dependent care and miscellaneous personal expenses for a
student attending the institution on at least a half-time basis, as determined
by the institution.
5.
Reimbursements for expenses (such as child or dependent care, transportation,
purchase or maintenance of clothing, and meals) attributable to participation
in unpaid voluntary activities, including the value of meals provided during
the course of these activities.
6.
Payments made pursuant to a court order for support or alimony, an
administrative order for support issued by the Human Services Board, or a
contract between the Office of Child Support and noncustodial parent requiring
the payment of support. This income exclusion is limited to payments actually
made by a member of the VHAP group toward the support of a person outside the
group. The payment amount is deducted first from the VHAP group's countable
earned income, with any balance deducted from unearned income.
7. The value of food stamp benefits under the
Food Stamp Act of 1977.
8. The
value of foods donated by the U. S. Department of Agriculture (surplus
commodities).
9. Any payment
received under Title II of the Uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970.
10. Earned income of a child under the age of
19 if such child is a full-time student or a part-time student who works less
than full time. A child is a student if he or she is enrolled in a school,
college, university, or a course of vocational or technical training designed
to prepare him or her for gainful employment. Such educational institution
shall determine whether the student is enrolled full time or part time.
Full-time employment is work that involves 100 or more hours per month; less
than full-time employment is work that involves fewer than 100 hours per
month.
11. Monthly income of any
child (see definition of child at 10, above) from any program carried out under
the Job Training Partnership Act (JTPA). This applies to earned or unearned
income, except that, in the case of earned income, this disregard may not
exceed six months per calendar year.
This income cannot be disregarded for adults.
The $ 10 per day allowance given to individuals in JTPA
training is always disregarded as income for both children and adults.
12. Payments for support services
and/or reimbursement for out-of-pocket expenses made to individual volunteers
serving as foster grandparents, senior health aides, or senior companions and
to persons serving in the Service Corps of Retired Executives and Active Corps
of Executives or any other program under Titles II and III pursuant to Section
418 of P.L. 93-133.
13. Payments to
individual volunteers under Title 1 of P.L. 93-133. Section 404(g); University
Year For Action payments under P.L. 93-113, and P.L. 96-143; and Section
9 (VISTA)
payments; unless determined by the Director of ACTION to be equivalent to or
greater than the federal or state minimum wage.
14. The tax-exempt portions of payments made
pursuant to P.L. 92-203 (Alaska Native Claims Settlement Act of
1973).
15. Payments distributed per
capita to or held in trust for members of any Indian Tribe under P.L. 92-254 or
P.L. 93-134, or P.L. 94-540.
16.
Payments received for the care of foster children in the custody of, and placed
by, the Department of Social and Rehabilitation Services. The rate of payment
is established to cover expenses only, with no profit available; therefore, no
income is considered available from this source.
17. Experimental Housing Allowance Program
payments made under Annual Contributions Contracts entered into prior to
January 1, 1975, under the U.S. Housing Act of 1937, as amended.
18. Reach Up support services, either as
reimbursements or advance payments to the individual for child care,
transportation, work-related expenses, work-related supportive services,
education, or training-related supportive services.
19. Any benefits received under Title VII.
Nutrition Program for the Elderly, of the Older American Act of 1965, as
amended.
20. The value of
supplemental food assistance received under the Child Nutrition Act of 1966, as
amended, and the Special Food Service Program for children under the National
School Lunch Act, as amended ( P.L. 92-433 and P.L. 93-150 ).
21. Receipts distributed to members of
certain Indian tribes referred to in Section 5 of P.L. 94-114, which became
effective October 17, 1975.
22. Any
income received from an emergency fuel supplement or energy allowance to assist
with the cost of heating.
23. The
first $ 50 in child support payments made by a noncustodial parent on behalf of
a VHAP group member within each calendar month. When more than one noncustodial
parent makes child support payments on behalf of a single VHAP group in the
same calendar month, the maximum amount of child support to be disregarded in
determining the VHAP group's eligibility is $ 50.
24. Payments to persons of Japanese or Aleut
ancestry as restitution for injustices suffered during the Second World
War.
25. Federal Earned Income Tax
Credit (EITC), whether received with each paycheck or as a refund (lump
sum).
26. Payments made from the
Agent Orange Settlement Fund or any other fund established because of the Agent
Orange product liability litigation.
27. Payments made pursuant to the Radiation
Exposure Compensation Act (
P.L.
101-426 ).
28. Payments made under Indian Trust Funds
Acts ( P.L. 97-458 and P.L. 98-64 ) and initial purchases made with such funds
by the original recipient of the funds.
29. Interest held in a trust or in restricted
lands pursuant to section 8 of P.L. 93-134 and up to $ 2,000 annual income
received from the lease or other uses of the individually owned trust or
restricted lands.
30. Distributions
made under P.L. 100-241, which amended the Alaska Native Claims Settlement Act:
a. cash, including cash dividends on stock
received from a Native Corporation, to the extent that it does not, in the
aggregate, exceed $ 2000 per individual per calendar year; or
b. stock, including stock issued or
distributed by a Native Corporation as a dividend or distribution of stock;
or
c. a partnership interest;
or
d. land or an interest in land,
including land or an interest in land received from a Native Corporation as a
dividend or distribution on stock; or
e. an interest in a settlement
trust.
31. Payments made
pursuant to the Maine Indian Claims Settlement Act of 1980 to a member of the
Passamaquoddy Indian Tribe, the Penobscot Nation, or the Houlton Band of
Maliseet Indians.
32. Payments made
to a member of the Aroostook Band of Micmacs pursuant to the Aroostook Band of
Micmacs Settlement Act.
33.
Financial assistance paid through the Disaster Relief Act of 1974 as amended by
P.L. 100-707 in 1988 and provided as major disaster and emergency assistance.
This disaster coverage is intended to provide relief to people living or
working in an area severely struck by natural or man-made disaster. The
disaster must have been so severe as to cause the President to designate a
Federal Disaster Zone. Additional relief provided under these circumstances by
states, local governments and disaster assistance organizations is also
excluded.
34. Bona fide
loans.
Section 5323
Countable Income
Complete the following steps to determine countable
income:
I. Constitute the VHAP group
according to the definition included in the Financial Need of a VHAP Group
(4001.8) section.
II. Determine the
combined countable income for the VHAP group, as constituted in step I
above.
III. Compare the result to
the applicable income test for the VHAP group size, as constituted at step I
above.
All otherwise eligible individuals in a VHAP group who pass
the income test are income-eligible for the VHAP program.
Individuals potentially eligible for traditional Medicaid,
such as pregnant women and children, have their eligibility determined under
those rules but are considered members of the VHAP group for purposes of
determining the VHAP group size and countable income.
33
V.S.A. §§
105,
1901
