10.1 DEFINITIONS... 1
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1 10.1 DEFINITIONS INTRODUCTION CHART OF INCOME SOURCES A. ACE... 9 B. ADOPTION ASSISTANCE... 9 C. ADULT FAMILY CARE PROVIDER INCOME... 9 D. ADVANCE PAY... 9 E. AGENT ORANGE PAYMENT PROGRAM... 9 F. AGRICULTURAL STABILIZATION AND CONSERVATION PROGRAMS... 9 G. ALASKAN NATIVE CLAIMS SETTLEMENT ACT PAYMENTS. 9 H. ALLOTMENTS DIVERTED FROM: Military Job Corps... 9 I. AMERICORPS J. ANNUITY PAYMENTS K. BASIC ALLOWANCE FOR HOUSING L. CASH CONTRIBUTIONS FROM: Individuals Charitable Organizations M. CHILD SUPPORT Current Arrearages N. CHORE SERVICE PROVIDER INCOME O. COMMISSIONS P. COMMUNITY DEVELOPMENT BLOCK GRANTS AND LOANS. 13 Q. DAY CARE AND OTHER CARE PROVIDER INCOME R. DEATH INSURANCE BENEFITS S. DEPOSITS INTO A BANK ACCOUNT T. DISABILITY BENEFITS FROM EMPLOYER U. DISASTER ASSISTANCE V. DIVIDENDS W. DOMESTIC VOLUNTEER ACT OF X. DRS FUNDS Y. EITC Z. EDUCATIONAL INCOME AA. EMERGENCY ASSISTANCE FROM DHHR BB. EMERGENCY CHILD CARE PROVIDER INCOME CC. EMPLOYMENT DD. ENERGY ASSISTANCE PAYMENTS OTHER THAN LIEAP. 22 EE. FACTOR XIII OR IX BLOOD PRODUCTS LITIGATION. 22 FF. FHA; FmHA GG. FOOD STAMPS HH. FOSTER CARE PAYMENTS II. FOSTER GRANDPARENTS PROGRAM JJ. GUARDIANSHIP PAYMENTS KK. GSYP /01 i
2 LL HEMOPHILIA/AIDS SETTLEMENTS AND FUNDS Factor XIII or IX Blood Products Litigation Ricky Ray Funds Walker v. Bayer Settlements MM. HUD NN. INCOME PROTECTION INSURANCE PROCEEDS OO. INCOME TAX REFUNDS PP. INDEPENDENT LIVING SUBSIDY QQ. INDIAN SETTLEMENT INCOME RR. IN-KIND PAYMENTS SS. INSURANCE PROCEEDS TT. INTEREST INCOME UU. JOB CORPS VV. LIEAP WW LOANS XX. MEDICAL INSURANCE REIMBURSEMENTS YY. NAZI PERSECUTION VICTIMS PAYMENTS ZZ. OLDER AMERICANS ACT AAA. PENSIONS BBB. PERSONAL CARE PROVIDER INCOME CCC. PERSONAL INJURY AWARDS DDD. RAILROAD RETIREMENT EEE. RENTER'S INSURANCE PROCEEDS FFF. REIMBURSEMENTS GGG. RELOCATION PAYMENTS HHH. RENT AND/OR UTILITY SUPPLEMENTS III. RENTAL INCOME JJJ. REPLACEMENT OF PROPERTY BENEFITS KKK. RETIREMENT BENEFITS LLL. RICKY RAY FUNDS MMM. RSDI NNN. ROOMER/BOARDER PROVIDER INCOME OOO. ROYALTIES PPP. RSVP QQQ. SALE OF PROPERTY RRR. SCORE SSS. SICK BENEFITS FROM EMPLOYER TTT. SOCIAL SECURITY PAYMENTS UUU. SPOUSAL SUPPORT OR ALIMONY VVV. SSI WWW. STRIKE BENEFITS XXX. TANF PAYMENTS YYY. THIRD-PARTY PAYMENTS ZZZ. TITLE XIX MEDICAID WAIVER PAYMENTS AAAA. TRUST ACCOUNT DISBURSEMENTS BBBB. UCI CCCC. UNIFORM GIFTS TO MINORS ACT... 36a DDDD. UNSTATED INCOME... 36a EEEE. UNIVERSITY YEAR OF ACTION... 36a /01 ii
3 FFFF. URBAN CRIME PREVENTION PROGRAM a GGGG. U.S. ACTION AGENCY a HHHH. U.S. SAVINGS BONDS a IIII. VACATION PAY a JJJJ. VETERAN'S COMPENSATION OR PENSION... 36a KKKK. VICTIM COMPENSATION PAYMENTS a LLLL. VISTA AND AMERICORPS VISTA a MMMM. WALKER v. BAYER SETTLEMENTS... 36a NNNN. WIA... 36a OOOO. WIC... 36a PPPP. WINNINGS a QQQQ. WORKERS COMPENSATION... 36b RRRR. WV LOCAL HOUSING AUTHORITIES b SSSS. WV WORKS c TTTT. YOUTHBUILD PROGRAM c 10.4 FOOD STAMP PROGRAM A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS... 40k 1. Earned Income Disregard... 40l 2. Standard Deduction... 40l 3. Dependent Care Deduction... 40l 4. Child Support Deduction Homeless Shelter Standard Deduction Medical Expenses a. Allowable Expenses b. Consideration of Medical Bills c. Medical Deduction for Residents of Group Living Facilities d. Categorically Eligible, Retroactive SSI Approvals Shelter/Utility Deduction a. Shelter Costs b. Actual Utility Costs c. Standard Utility Allowance (SUA) d. Categorically Eligible, Retroactive SSI Approvals C. DETERMINING ELIGIBILITY AND BENEFIT LEVEL Determining Eligibility Determining Countable Income Determining the Amount of the Benefit D. SPECIAL SITUATIONS Categorical Eligibility Expedited Service Destitute AG s Income from Self-Employment a. Determining Gross Income b. Determining Gross Profit Migrant Farm Laborers With Seasonal 6. Employment Annual Contract Employment /01 iii
4 7. Educational Income Deeming a. Deeming From Disqualified Individuals. 72 b. Failure To Comply With Public Assistance Requirements Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS... 82a 14. Unstated Income... 82a 15. Spenddown... 82a 16. Unavailable Income... 82a 17. Income Received For A Non-Income Group Member... 82a 10.5 RESERVED FOR FUTURE USE GENERAL INCOME INFORMATION FOR MEDICAID COVERAGE GROUPS A. UNCOMPENSATED TRANSFERS OF INCOME B. BUDGETING METHOD C. CATEGORICAL ELIGIBILITY, EXPEDITED SERVICES, DESTITUTE AG S AND MIGRANT FARM WORKERS AFDC MEDICAID (Categorically Needy, Mandatory) A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS m 1. Earned Income m 2. Unearned Income p C. DETERMINING ELIGIBILITY AND BENEFIT LEVEL.. 116p 1. Determining Eligibility - 185% of Need Test 116q 2. Determining Need - 100% of Need Test.. 116q 3. Determining Countable Income r D. SPECIAL SITUATIONS r 1. Categorical Eligibility r 2. Expedited Service r 3. Destitute AG s s 4. Self-Employment Income s a. Determining Gross Income s b. Determining Gross Profit t 5. Migrant Farm Laborers With Seasonal Employment v 6. Annual Contract Employment v 7. Educational Income w 8. Deeming y Strikers cc Irregular Income cc Lump Sum Payments cc Withheld Income jj 13. Funds Diverted To A Pass kk 14. Unstated Income kk 15. Spenddown kk /01 iv
5 16. Unavailable Income kk 17. Income Received For A Non-Income Group Member kk 10.8 RESERVED FOR FUTURE USE TRANSITIONAL MEDICAID (TM) (Categorically Needy, Mandatory) A. SELF-EMPLOYMENT B. ANNUAL CONTRACT EMPLOYMENT a C. EDUCATIONAL INCOME a D. DEEMING a E. STRIKERS a F. IRREGULAR INCOME a G. LUMP SUM PAYMENTS a H. WITHHELD INCOME a I. FUNDS DIVERTED TO A PASS a J. UNSTATED INCOME a K. SPENDDOWN a L. UNAVAILABLE INCOME a M. INCOME RECEIVED FOR A NON-INCOME GROUP MEMBER MEDICAID FOR QUALIFIED CHILDREN, REGARDLESS OF BIRTHDATE (Categorically Needy, Mandatory - Born On Or After 10/1/83; Optional - Born Prior to 10/1/83) A. INCOME DISREGARDS AND DEDUCTIONS Earned Income Unearned Income From Remaining Income B. DETERMINING ELIGIBILITY a 1. General Rules a 2. Specific Steps a C. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown /01 v
6 12. Unavailable Income Income Received for a Non-Income Group Member MEDICAID FOR POVERTY-LEVEL PREGNANT WOMEN (Categorically Needy, Mandatory) A. INCOME DISREGARDS AND DEDUCTIONS Earned Income Unearned Income B. DETERMINING ELIGIBILITY C. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown Unavailable Income Member MEDICAID FOR POVERTY-LEVEL CHILDREN UNDER AGE 1, AGES 1-5 AND AGES 6-18 IF BORN ON OR AFTER 10/1/83 (Categorically Needy, Mandatory) A. INCOME DISREGARDS AND DEDUCTIONS Earned Income Unearned Income B. DETERMINING ELIGIBILITY C. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income a 7. Lump Sum Payments a 8. Withheld Income a 9. Funds Diverted To A PASS a 10. Unstated Income a 11. Spenddown a 12. Unavailable Income a Member a /01 vi
7 10.13 MEDICAID FOR CONTINUOUSLY ELIGIBLE NEWBORNS (Categorically and Medically Needy, Mandatory) MEDICAID FOR SSI RECIPIENTS (Categorically Needy, Mandatory) MEDICAID FOR DEEMED SSI RECIPIENTS (Categorically Needy, Mandatory) A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS C. DETERMINING ELIGIBILITY Method Method D. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown Unavailable Income Member MEDICAID FOR QUALIFIED MEDICARE BENEFICIARY (QMB), SPECIFIED LOW-INCOME MEDICARE BENEFICIARY (SLIMB) AND QUALIFIED INDIVIDUALS (QI-1) (Categorically Needy, Mandatory) A. INCOME DISREGARDS AND DEDUCTIONS B. DETERMINING ELIGIBILITY C. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown Unavailable Income Member /03 vii
8 10.17 MEDICAID FOR QUALIFIED DISABLED WORKING INDIVIDUALS (QDWI) (Categorically Needy, Mandatory) A. INCOME DISREGARDS AND DEDUCTIONS B. DETERMINING ELIGIBILITY C. SPECIAL SITUATIONS MEDICAID FOR ILLEGAL ALIENS (Categorically Needy, Mandatory) MEDICAID FOR CHILDREN WITH DISABILITIES, COMMUNITY SERVICE PROGRAM (CDCS) (Categorically Needy, Optional) A. INCOME DISREGARDS AND DEDUCTIONS B. DETERMINING ELIGIBILITY C. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown Unavailable Income Member MEDICAID FOR AIDS PATIENTS (Categorically Needy, Optional) A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS C. DETERMINING ELIGIBILITY D. SPECIAL SITUATIONS AFDC-RELATED MEDICAID (Medically Needy, Mandatory for Children and Optional For Parents) A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS Earned Income Unearned Income /01 viii
9 C. DETERMINING ELIGIBILITY D. SPECIAL SITUATIONS a 1. Self-Employment a 2. Annual Contract Employment a 3. Educational Income a 4. Deeming a 5. Strikers Irregular Income Lump Sum Payments Withheld Income Funds Diverted To A PASS Unstated Income Spenddown a. Procedures b. Whose Medical Expenses May Be Used c. Allowable Spenddown Expenses Unavailable Income Member SSI-RELATED MEDICAID (Medically Needy, Mandatory) A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS Earned Income Unearned Income C. DETERMINING ELIGIBILITY D. SPECIAL SITUATIONS Self-Employment Annual Contract Employment Educational Income Deeming Strikers Irregular Income Lump Sum Payments Withheld Income a. From Earned Income b. From Unearned Income Funds Diverted To A PASS Unstated Income Spenddown a. Procedures b. Whose Medical Expenses May Be Used c. Allowable Spenddown Expenses a 12. Unavailable Income d Member d /01 ix
10 10.23 RESERVED FOR FUTURE USE WV WORKS A. BUDGETING METHOD B. INCOME DISREGARDS AND DEDUCTIONS Earned Income a. Earned Income Disregard b. Dependent Care Deduction Unearned Income C. DETERMINING ELIGIBILITY AND BENEFIT LEVEL Determining Eligibility - 100% of Need Test Benefit Reductions and Incentives a. Non-AG Members or Non- Disqualified Individuals Living With the AG - Benefit Reduction b. AG Includes Legally Married Parent(s) - Marriage Incentive 208 c. Child Support Incentive a 3. Determining Countable Income c D. SPECIAL SITUATIONS d 1. Categorical Eligibility d 2. Expedited Service d 3. Destitute AG,s d 4. Self-Employment Income d a. Determining Gross Income d b. Determining Gross Profit f 5. Migrant Farm Laborers With Seasonal Employment h 6. Annual Contract Employment h 7. Educational Income h 8. Deeming i a. Ongoing Income i b. Lump Sum Payment i 9. Strikers i 10. Irregular Income j 11. Lump Sum Payments j 12. Withheld Income p 13. Funds Diverted To A Pass q 14. Unstated Income q 15. Spenddown r 16. Unavailable Income r 17. Income Received For A Non-Income Group Member r /01 x
11 APPENDIX A APPENDIX B APPENDIX C APPENDIX D APPENDIX E APPENDIX F APPENDIX G INCOME LIMITS... A-1 STANDARD DEDUCTIONS PRIOR TO 10/02 AND LIMITS FOR THE FOOD STAMP PROGRAM... B-1 BASIS OF COUPON ISSUANCE... C-1 PRORATION TABLE - FOOD STAMPS AND WV WORKS... D-1 PAC ELIGIBILITY - METHOD 1 AND METHOD 2... E-1 WEST VIRGINIA WORKS REDUCTION SCHEDULES... F-1 STANDARD DEDUCTION - FOOD STAMPS... G /02 xi
10.1 DEFINITIONS INTRODUCTION CHART OF INCOME SOURCES...10 B. ADOPTION ASSISTANCE...11 C. ADULT FAMILY CARE PROVIDER INCOME...
10.1 DEFINITIONS...1 10.2 INTRODUCTION...8 10.3 CHART OF INCOME SOURCES...10 A. ACE...11 B. ADOPTION ASSISTANCE...11 C. ADULT FAMILY CARE PROVIDER INCOME...11 D. ADVANCE PAY...11 E. AGENT ORANGE PAYMENT
10.1 DEFINITIONS INTRODUCTION CHART OF INCOME SOURCES...10 B. ADOPTION ASSISTANCE...11 C. ADULT FAMILY CARE PROVIDER INCOME...
10.1 DEFINITIONS...1 10.2 INTRODUCTION...8 10.3 CHART OF INCOME SOURCES...10 A. ACE...11 B. ADOPTION ASSISTANCE...11 C. ADULT FAMILY CARE PROVIDER INCOME...11 D. ADVANCE PAY...11 E. AGENT ORANGE PAYMENT
10.1 DEFINITIONS INTRODUCTION CHART OF INCOME SOURCES A. ACE B. ADOPTION ASSISTANCE... 11
10.1 DEFINITIONS... 1 10.2 INTRODUCTION... 8 10.3 CHART OF INCOME SOURCES... 10 A. ACE... 11 B. ADOPTION ASSISTANCE... 11 C. ADULT FAMILY CARE PROVIDER INCOME... 11 D. ADVANCE PAY... 11 E. AGRICULTURAL
RETIREMENT BENEFITS... 34a. RETIREMENT, SURVIVORS, DISABILITY INSURANCE (RSDI)... 34a. RICKY RAY FUNDS... 34a
TTT. UUU. VVV. RETIREMENT BENEFITS... 34a RETIREMENT, SURVIVORS, DISABILITY INSURANCE (RSDI)... 34a RICKY RAY FUNDS... 34a WWW. ROOMER/BOARDER PROVIDER INCOME... 35 XXX. ROYALTIES... 35 YYY. RURAL HOUSING
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