A. Chapter Contents

This chapter contains the following topics:

Topic

701.00    General Information about Resources

702.00    Resource Groups

703.00    Resource Availability

703.01 Unavailable Resources

703.02 Available Resources

703.03 Excluded Resources

703.04 Countable Resources

703.05 Commingled Funds

703.06 Constructively Received

703.07 Payments to Nursing Facility

703.08 Deeming of Resources-ALTCS Acute Care

703.09 Sponsor Deeming

703.10 Good Faith Effort to Sell

704.00       Determining the Value of Countable Resources

705.00    Ownership of Resources

705.01 Sole and Separate Ownership

705.02 Joint Ownership

705.03 Change in Ownership

705.04 Equitable Ownership

705.05 Ownership Involving an Agent

706.00    Types of Resources

706.01 Agent Orange Payments

706.02 Alaska Native Claims Settlement Act Payments and Stock

706.03 Aleutian and Pribilof Islands Payments

706.04 Animals

706.05 Annuities

706.06 Austrian Reparation Payments

706.07 Bonds

706.08 Burial Funds

706.09 Burial Plots

706.10 Cash

706.11 Child Nutrition Payments (CNP)

706.12 Crime Victim Payments

706.13 Disaster Assistance

706.14 Domestic Volunteer Service Payments

706.15 Earned Income Tax Credits (EITC)

706.16 Educational Assistance

706.17 Federally Donated Foods

706.18 Financial Accounts

706.19 Food Stamp Coupons

706.20 German Reparation Payments

706.21 Grazing Rights

706.22 HCBS Refunds

706.23 Hemophiliacs Infected with HIV

706.24 Home Energy Assistance

706.25 Home Property

706.26 Household Goods and Personal Effects

706.27 Housing (Dwelling) Assistance

706.28 Indian Judgment Payments

706.29 Indian Per Capita Judgment Payments

706.30 Indian Tribe Land

706.31 Indian Tribe Receipts

706.32 Individual Indian Money Accounts (IIM)

706.33 Inheritances and Death Benefits

706.34 Interest, Dividends and Royalties

706.35 Japanese Reparation Payments

706.36 Life Insurance

706.37 Mineral, Oil, Timber Rights

706.38 Mutual Fund Shares

706.39 Netherlands WUV Payments

706.40 Nursing Facility Refunds

706.41 Promissory Notes, Loans and Property Agreements

706.42 Property Essential to Self-Support

706.43 Radiation Exposure Payments

706.44 Real Property- General

706.45 Relocation Assistance Payments

706.46 Relocation Assistance and Real Property Acquisition

706.47 Replacement or Repair Funds

706.48 Retirement Funds: Pensions and Annuities

706.49 Reverse Mortgage Payments

706.50 School Lunch Assistance

706.51 SSI Funds in a Designated Account

706.52 Stocks

706.53 Time Deposits

706.54 Title II or Title XVI Retroactive Payments

706.55 Trust Funds

706.56 Undergraduate Student Loans

706.57 Uniform Transfers to Minors Act (UTMA) Accounts

706.58 U.S. Savings Bonds

706.59 Value of Entrance Fee in Continuing Care Retirement Communities (CCRCs)

706.60 Vehicles

706.61 529 Education Savings Accounts (ESA)

707.00    Resource Budgeting

                  707.01    Anticipating Resource Changes

708.00    Community Spouse Resource Budgeting

708.01 Community Spouse Initial Rules

708.02 Community Spouse Resource Transfers

708.03 Community Spouse Post-Initial Rules

709.00 Community Spouse Resource Assessments

710.00 Establishing the First Continuous Period of Institutionalization (FCPI)

710.01 FCPI Based on Medical Institutionalization

710.02 FCPI Based on Receipt of Paid Formal HCBS

710.03 FCPI Based on Intent to Receive HCBS

711.00 Community Spouse Resource Deduction

Appendix 7A Life Estate Interest Tables

Appendix 7B Life Expectancy Tables

B. Introduction

This chapter provides information about how to determine resource eligibility for ALTCS.

A. Policy

To be eligible for ALTCS, the customer' s countable resources must be less than or equal to the appropriate resource limit (MS 707.00.E). Only available resources are counted in determining resource eligibility. 

The resources of responsible relatives may be considered to be available to the customer in determining eligibility. The Resource Group (MS 702.00) specifies whose resources are counted for resource budgeting. 

Resource eligibility is determined on a month-by-month basis. 

EXCEPTIONS: Resource requirements do not apply or are limited when the following circumstances exist:

If the customer...

Then...

Is eligible for ALTCS services under:

• AHCCCS Freedom to Work; or

• AF related categories

The requirements in this chapter do not apply in the customer' s eligibility determination.

Receives SSI Cash; Title IV-E Foster Care, or Title IV-E Adoption Subsidy

The resource requirements in this chapter do not apply except under the following circumstances:

• The customer can be determined ineligible for long term care services (MS 302.02) under the transfer policies in Chapter 900; and

• The customer can be determined ineligible for ALTCS, SSI-MAO, QMB, SLMB, QI-1, or QDWI due to exceeding income or resource limits due to a trust established by the customer, customer's spouse, legal representative, or court, as described in Chapter 800.

B. Definition of Resources

Resources are items of real or personal property, including cash, which may be used to meet the customers need for food or shelter.

C. Treatment

Resource determinations are based on the resources available to the customer during a calendar month (MS 703.00). A resource may either be available, unavailable or excluded during a specific month. 

Resources are evaluated at equity value unless an exception is noted for a specific type of resource. Resource types are described in MS 706.00. 

Constructively received resources (MS 703.06) are considered available resources. 

Generally, the proceeds from the sale of a resource are not income, but rather the conversion of one type of resource to another. The converted resource must be evaluated to determine its effect on eligibility. 

The policies shown in MS 703.08 and 707.00 do not apply if the customer is an institutionalized individual who is legally married to a spouse residing in the community. Refer to MS 708.00 for policies and procedures to follow for Community Spouse cases.

D. Resource Transfers

For ALTCS only, transfers made without receiving fair consideration may result in a period of ineligibility for long term care services. The penalty does not apply to the receipt of ALTCS Acute Care.  Chapter 900.00 contains detailed information about transfers and how they affect ALTCS eligibility.

E. General Verification and Documentation

Verify and document resources to the point that there is no doubt as to the type, value (when countable), and ownership. 

• Investigate all resources identified on the application form, in the case file or during the interview.

• Verify each resource to establish its ownership, type and value. When a type of resource requires specific verification, the verification requirements are explained in the subsection of MS 706.00 that describes the resource type.

• Follow the policy in this chapter to determine whether the resource is countable or excludable

• When a resource exclusion is time limited or conditional, set an appropriate alert.

• Document all currently owned or transferred resources in ACE.

Term

Definition

Verification

Verification consists of contacts and reports from institutional entities or other knowledgeable sources that establishes ownership, value and the type of the resource. These entities may include financial institutions such as banks or insurance companies, government agencies, courts, legal firms, etc.

Documentation

Documentation means written reports and records of the verification received.  Verification must originate with the institution or third party knowledgeable about the resources in question. Written documentation of a resource must be in the case file. Although a written report from the institution or third party responsible for administering, overseeing or dispensing the resource is preferred, verbal or other non-written verification may be documented in ACE.

F. Budgeting

Resource budgeting is described in:

• MS 707.00 for SSI-MAO, Medicare Cost Sharing, and ALTCS non-community spouse cases; and

• MS 708.00 for ALTCS community spouse cases.

A. Definition

Resource groups are the individual(s) whose resources are counted in determining the customer' s resource eligibility.

B. Overview

For each individual included in the resource group:

• Include the individual(s) in the household for ACE resource budgeting; and

• Verify each individual' s resources and enter the amount(s) in ACE.

C. Resource Group Members

Use the following chart to determine who is included in the Resource Group:

If the customer is

And

And

Then the Resource Group is

Unmarried child <18

Lives with parents (home)

Resources<$2,000

Customer

Resources < $2000 & refuses HCBS services

(see MS 702.00.D)

Customer

Ineligible parents

Resources>$2,000

N/A

(S.O.B.R.A.)

Does not live with parents

Resources < $2,000

Customer

Resources > $2,000

N/A

(S.O.B.R.A.)

Adult or married child <18

Has a community spouse

During the Initial Period

Customer

Spouse

During Post-Initial Period

Customer

Lives with a spouse

(not legally married)

Living at home or together in an alternative residential setting

Customer

Living together in an alternative residential setting in which ALTCS services cannot be provided

(see MS 702.00.D)

Customer

Spouse

Customer refuses HCBS

(see MS 702.00.D)

Customer

Spouse

Single, or

Legal spouse in medical institution, or

Does not live with spouse (not legally married)

Customer

Pregnant

Lives with spouse

Resources > $2,000

N/A

Does not live with spouse

Resources > $2,000

(S.O.B.R.A.)

Resources > $2,000, but not living in an appropriate living arrangement or refused HCBS services

D. Deeming Resources from Parent or Spouse

Deeming of parental resources occurs when a child lives at home, is otherwise eligible but the parents refuse HCBS services.

For a married couple, spousal deeming occurs when:

• The customer and spouse live together at home and the customer refuses HCBS services, or
• The customer and spouse live together in an alternative residential facility in which ALTCS services cannot be provided.

When any of these situations occur and the customer is otherwise eligible for ALTCS Acute Care benefits, submit a Policy Clarification request with verification of the customer and family members' resources to the Program Support Administration at Mail Drop 2600.

See MS 707.00 for additional information.

Each item of real or personal property must be evaluated individually to determine whether or not it is actually available to meet the needs of the customer. The following subsections describe the conditions under which a resource is considered available to the customer and his or her responsible relatives and conditions under which a resource is unavailable.

Resources are considered to be unavailable to the customer under one or more of the conditions described below.

A.

Resources for which the customer, or responsible relative, does not have an ownership interest during the budget month.

NOTE: This does not include property in which the customer has an ownership interest but the resource is legally held by an agent acting on the customer' s behalf (MS 705.05). 

EXAMPLE: When ownership of a resource is being disputed or is undecided, such as during divorce proceedings or while the resources are in probate, the resource is considered to be unavailable.

B.

Resources for which the customer, or responsible relative, does have an ownership interest during the budget month but does not have either the legal right, authority, or power to liquidate them; or the legal right to access (spend or convert) the resources for his support and maintenance.

EXAMPLE: When land on an Indian reservation may not be sold (there is no legal right to liquidate), the resource is considered to be unavailable.

C.

When there is a legal bar to the sale of property (e.g., if a non-responsible relative co-owner legally blocks sale of jointly owned property), the resource is considered to be unavailable.

D.

MS 706.00 includes other resource-specific reasons for which a resource may be considered unavailable.

E.

An item can never be considered to be income and a resource within the same budget month and must be deducted from the considered value of a resource when including the income causes ineligibility. An item determined to meet the criteria of income according to the policies in Chapter 600 is not a resource until the following budget month.

Resources that do not meet any of the criteria described in MS 703.01 are considered to be available. Treatment of available resources is described in MS 703.03 through MS 703.09.

Certain types of resources are excluded from the eligibility determination. These excludable types are divided into two categories.