Family and Children's Medicaid MA-3305 MAF, MIC, HSF BUDGETING

III. FINANCIAL RESPONSIBILITY

Count the income of individuals who are financially responsible for the applicant(s).

A. Spouse for Spouse

1. Except as stated in 2. count a spouse’s income as available to the spouse who is applying for or receiving Medicaid when:

a. They live together, or

b. One is temporarily absent for 12 months or less, including temporary absence in long-term care.

2. Do not count the income of a spouse who receives SSI, Work First or CAP, and do not include them in the budget unit or needs unit.

B. Parent for Child

1. Except as stated below, count the income of the parent(s) including a putative father, regardless of the parent(s)’ age, as available to an individual under age 21 who:

a. Lives in the home of his parent(s) or is temporarily absent (see C., below.), and

b. Lives outside of the home and is a student, unless evidence is presented to establish that the student is not financially dependent upon his parent(s) and has assumed total responsibility for his own support and care. (See C. below)

2. Exceptions to parental financial responsibility

a. Do not count the income of a parent who receives SSI, Work First or CAP.

b. Do not count the income of the putative father of an unborn child in any program category/coverage group.

c. Do not count parent’s income to an individual under age 21 who:

(1) Is or has been legally married.

(2) Lives outside the parent(s)’ home in excess of 12 months or intends to be outside of the home on a permanent basis.

(3) Is budgeted under long-term care policy because he will be out of the home in a Medicaid certified medical institution in excess of 12 months. Refer to MA-3325, Long Term Care Budgeting, for instructions for verifying type of treatment and length of stay.

REVISED 10/01/07 – CHANGE NO. 16-07

(III.B.)

(4) Has served in or is currently in the military.

(5) Has been legally emancipated.

(6) Is applying for FPW benefits. Parental financial responsibility does not apply in FPW.

d. Is in custody of the county department of social services, or for whom the county agency has court-ordered placement responsibility, regardless of where the child is placed (i.e. temporary placement in the home while custody is retained by the dss). Financial responsibility on the part of the parents ceases beginning with the month in which the county assumes custody.

e. Is eligible for Title IV-E adoption/foster care assistance, receives State Foster Home Funds or is evaluated as an adoptive child with special needs. Do not count the assets or income of the IAS child from age 18 through the month he turns age 21.

(1) HSF and IAS coverage for county custody and Title IV-E begins the month the county actually takes responsibility or the child is released by the parent(s) for adoption.

(2) Evaluate retroactive coverage under the aid program/category appropriate to the child’s situation during the retroactive months. Do not count the assets or income in the retroactive months of the IAS child from age 18 through the month he turns age 21. Retroactive months cannot be prior to October 1, 2007, for EFCP.

NOTE: Follow instructions in MA-3365, Child Support, for referring a foster child to Child Support Enforcement.

f. Is a newborn child who does not go home from the hospital with the parent(s) and they are never his caretaker and/or do not intend to provide a home for him. (This includes any retroactive or ongoing period of eligibility).

REISSUED 10/01/07 – CHANGE NO. 16-07

(III.)

3. Joint Custody

a. When a child's parents live apart but have joint custody, determine which parent is the primary caretaker. This is the parent with whom the child spends the majority of his time, the parent who is primarily responsible for the child's day-to-day care (school, day care, medical care). Consider this parent the primary caretaker for budgeting purposes. Count the income of the primary caretaker as available to the child.

b. If the child spends equal time with both parents and you are unable to establish a primary caretaker, consider both parents financially responsible for the child. Count both parents' income as available to the child. Their other children who are not in the assistance unit can be in the needs unit if they meet the requirements in IV.F.

In this situation neither parent can be included in the a.u. If one of the parents wishes to be included in the assistance unit, he or she must be the primary caretaker.

c. If the child spends equal time with both parents, but one parent pays child support for the child, consider the parent receiving the child support to be the primary caretaker. Count the income of the primary caretaker parent as available to the child.

C. Verifying Parental Financial Responsibility for Individual Under Age 21

1. Individual Under 21 Living Outside of Parent(s)’ Home On a Permanent Basis (Not a Student)

a. Accept the individual’s statement that he intends to live outside of his parent’s home, unless questionable.

b. If the individual’s statement is questionable:

(1) Obtain verification from a third party source to determine the absence is permanent or temporary.

(2) If the individual lives in the home of an adult, obtain a statement verifying the situation as instructed in d.(1).

c. Temporary absence is 12 months or less, including absence in a Medicaid certified medical institution, and begins with the month the person leaves the home.

(1) If the individual is temporarily absent, count the parent(s)’ income.

REISSUED 10/01/07 – CHANGE NO. 16-07

(III.C.1.d.(b))

(2) Do not include the parent in the budget unit if the individual is determined to be permanently absent from the parent(s)’ home.

(3) If a child returns to the parent(s)’ home, begin counting the parent(s)’ income at the beginning of the following month.

d. Verification sources include but are not limited to one of the following:

(1) A written statement, from the individual’s parent(s) or the adult with whom he lives. The statement must include where and with whom the individual lives, the reason the individual lives outside of the parent(s)’ home, how long he has lived or is expected to live continuously outside the parent(s)’ home, and if the parents are providing support for the child.

(a) If the individual states that he lives independently of any adult (i.e. - on the streets) and it is not possible to obtain a statement from a parent or caretaker, obtain a written statement from the individual under age 21 or from a knowledgeable person.

(b) The written statement must include the total period of time he has lived or expects to live continuously outside of his parent(s)’ home.

(2) Court document ordering the county agency to take custody or placement responsibility for an individual under age 21.

(3) Evidence available to the county department of social services such as food stamp records, service records, etc.

(4) Other records establishing that parental financial responsibility does not exist (i.e. school records showing the child lives outside the home or records showing the child lives in a private child caring facility).

2. Student Under 21

a. If a student lives outside his parent(s)’ home, count the parent(s)’ income unless the following conditions are met:

(1) The student submits convincing evidence that shows he lives independently of his parent(s) for his total financial support (tuition and living expenses), and

(2) The student does not regularly return to his parent(s)’ home to live (excluding brief visits during school breaks).

REISSUED 10/01/07 – CHANGE NO. 16-07

(IV.A.)

b. The evidence the student can provide may include but is not limited to any one of the following.

(1) Copies of the parent(s)’ income tax forms. If the parent(s) claim the student as a dependent, count the parent(s)’ income in determining the child’s eligibility.

Note: Tax returns may be unreliable as parents may claim the child for tax purposes but actually provide no support.

(2) Statements from the parent(s) or adult caretaker containing the information outlined in C.1.d.(1).

(3) Bank records for deposits and expenditures which verify where the student obtains money for living expenses. If the bank records show the student pays his own way, do not count parent(s)’ income.