1. Is likely to be received in the next month, or 2. Was received on a regular and predictable basis in past months.

Transcription

1 TITLE: OVERVIEW OF INCOME REQUIREMENTS Procedure No: 5.01 Page Number: 1 of 10 PURPOSE: To define countable and exempt income for purposes of determining a client s level of financial assistance. GUIDELINES/PROCEDURES STATEMENT: Clients applying for financial assistance are required to provide proof of income for the past thirty (30) days for all household members. The definitions and income determinations in this policy are based upon County Indigent Health Care Program criteria. ELABORATIONS: I. DEFINITIONS: A. EARNED INCOME: Income related to employment. B. GROSS FAMILY INCOME: The sum of income before deductions, whether earned or unearned, for all members of the family. C. INCOME: A type of payment that is a regular and predictable gain or a benefit to a household. D. REGULAR AND PREDICTABLE INCOME: Income that is received in one month, and: 1. Is likely to be received in the next month, or 2. Was received on a regular and predictable basis in past months. E. UNEARNED INCOME: Income received without performing work. It includes benefits from government program. II. GENERAL GUIDELINES: A. Gross family income for the prior thirty (30) days is the basis for determining the client s level of financial assistance. All income, whether earned or unearned, must be included as part of the family income unless the income source is specifically designated as exempt income from all members must be included,

2 Page Number: 2 of 10 even if all family members do not apply for financial assistance. See Harris Health System Eligibility Services Departmental Guidelines and Procedures 4.01, Verifying Household Composition for detail on determining the members of a household for eligibility determination purposes. B. Clients will be referred to pursue or take advantage of all income to which they are entitled. C. Proof must be provided for all types of income received by the family within the prior thirty (30) days. See Harris Health System Eligibility Services Departmental Guidelines and Procedures 5.10, Verification of Income for the types of verifications required. D. If the gross family income proof for the last 30 days provided during the renewal process still falls on the same financial assistance classification since last expiration, it will be accepted and will be updated accordingly on the Eligibility software system. E. The Eligibility Services department reserves the right to request copies of bank statements or federal tax forms to verify income when deemed necessary. III. COUNTABLE INCOME: A. Countable income, for purposes of calculating the level of financial assistance, includes the following: 1. Alimony/ Spousal Support: Considered unearned income. 2. Cash Gifts and Contributions: Considered unearned income if they meet the definition of regular and predictable as described above;

3 Page Number: 3 of Child Support Payments: Considered unearned income; Child support arrears and medical arrears will be counted when calculating child support income. 4. Disability Insurance Benefits: Count the gross disability payment as unearned income, including Social Security Disability Insurance (SSDI) payments and disability insurance payments issued for non-medical expenses; 5. Dividends and Royalties: Considered unearned income. a. Count dividends as unearned income, exception: exempt dividends from insurance policies as income; and b. Count royalties as unearned income, minus any amount deducted for production expenses and severance taxes. 6. Government Disaster Program: Exempt federal disaster payments and comparable disaster assistance provided by states, local government, and disaster assistance organizations if the household is subject to legal penalties when the funds are not used as intended (e.g., payments by the Individual and Family Grant Program, Small Business Administration, and/or Federal Emergency Management Agency (FEMA). 7. Mineral Rights: Count payments for mineral rights as unearned income. 8. Income-Producing Property: Considered unearned income whether from rent, lease, or sale on an installment plan. Income produced from boarding situations is considered earned income.

4 Page Number: 4 of Interest: Considered unearned income. 10. Loans (Non-educational): Considered unearned income unless there is an understanding that the money will be repaid, and the client can reasonably explain how he will repay it. 11. Lump Sum Payments: a. Count as income in the month received if the client receives it or expects to receive it more often than once a year. b. Consider retroactive or restored payments to be lump-sum payments and count as a resource. Separate any portion that is ongoing income from a lump-sum amount and count it as income. c. Exempt lump sums received once a year or less, unless specifically listed as income. Count them as a resource in the month received. Effective January 1, 2013 exempt federal tax refunds permanently as income and resources for twelve (12) months after receipt. Exempt the Earned Income Credit (EIC) for a period of twelve (12) months after receipt through December 31, d. If a lump sum reimburses a household for burial, legal, or health care bills, or damaged/lost possessions, reduce the countable amount of the lump sum by the amount earmarked for these items. 12. Military Pay and Allowances: Count military pay and allowances for housing, food, base pay, and flight pay as earned income, minus pay withheld to fund education under the G.I. Bill.

5 Page Number: 5 of Pensions: Count the gross payment as unearned income. A pension is any benefit derived from former employment, such as retirement benefits or disability pensions. 14. Reimbursements: Exempt. 15. Self-Employment Income: Considered earned income, minus business expenses. Refer to Harris Health System Eligibility Services Departmental Guidelines and Procedures 5.10, Verification of Income for information on identifying the self-employed client. 16. Retirement, Survivors and Disability Insurance (RSDI) Benefits/Other Retirement Benefits: Count as unearned income the RSDI benefit amount including the deduction for Medicare premium, minus any amount that is being recouped for a prior RSDI overpayment. 17. Supplemental Security Income (SSI) Payments: Considered unearned income minus any amount that is being recouped for a prior SSI overpayment. 18. Temporary Assistance to Needy Families (TANF): Considered unearned income. 19. Trust Funds: Withdrawals or dividends are considered unearned income.

6 Page Number: 6 of Unemployment Compensation: Count as unearned income the gross benefit less any amount being recouped for an unemployment insurance benefits (UIB) overpayment. 21. Veterans Administration (VA) Benefits: Count the gross VA payment as unearned income, minus any amount being recouped for a VA overpayment. Exempt VA Special needs payments, such as annual clothing allowances or monthly payments for an attendant for a disabled veteran. 22. Wages, Salaries, and Commissions: The gross amount is considered earned income. 23. Worker s Compensation: Count the gross payment as unearned income, minus any amount being recouped for a prior worker s compensation overpayment or paid for attorney s fees. NOTE: The Texas Workforce Commission (TWC) or a court sets the amount of the attorney s fee to be paid. Do not allow a deduction from the gross benefit for court-ordered child support payments. 24. Housing allowances: Considered unearned income. Note: A minister who receives a housing allowance may exclude the allowance from gross income to the extent it is used to pay expenses in providing a home. Generally, those expenses include rent, mortgage interest, utilities, repairs, and other expenses directly relating to providing a home.

7 Page Number: 7 of Tip Income: Count the actual (not taxable) gross amount of tips as earned income. Add tip income to wages before applying conversion factors. IV. EXEMPT INCOME: Exempt Income: The following types of income are exempt and should not be included in calculating the family income. A. Child s Earned Income: Exempt if the child is under eighteen (18) (and is not an emancipated minor), is a full-time high school student (including a home schooled child), or a part-time high school student employed less than thirty (30) hours per week. B. Crime Victim s Compensation Payments: Exempt Payments are made either monthly or in a lump sum to victims of a violent crime. C. Educational Assistance: Exempt educational assistance, including educational loans, regardless of source. Education assistance also includes college work study. D. Energy Assistance: Exempt the following types of energy assistance payments: 1. Assistance from federally funded, state or locally-administered programs including Home Energy Assistance Program (HEAP), weatherization, or Energy Crisis Intervention, and one-time emergency repairs of a heating or cooling device (down payment and final payment). 2. Energy assistance received through Housing and Urban Development (HUD), United States Department of Agriculture (USDA s) Rural Housing Service (RHS), or Farmer s Administration (FmHA).

8 Page Number: 8 of Assistance from private, non-profit, or governmental agencies based on need. If an energy assistance payment is combined with other payments of assistance, exempt only the energy assistance portion from income (if applicable). E. Foster Care / Adoption Payments: Exempt these payments. F. In-Kind Income: Exempt any gain or benefit that is not money or check payable directly to the household, such as clothing, public housing, or food. G. Job Training: 1. Exempt payments made under the Workforce Investment Act (WIA) 2. Exempt portions of non-wia job training payments earmarked as reimbursements for training related expenses. Count any excess as earned income. 3. Exempt on-the-job training (OJT) payments received by a child who is under age nineteen (19) and under parental control of another household member. H. Vendor Payments: Exempt if made by a person or organization outside the household directly to the household s creditor or person providing the service. I. Unusual Types of Benefits/Payments: Exempt benefits and payments from the following program: 1. AmeriCorps; 2. Tax-exempt portions of payments made under the Alaska Native Claims Settlement Act;

9 Page Number: 9 of Funds distributed or held in trust by the Indian Claims Commission for Indian tribe members under Public Laws or ; 4. Child Nutrition Act of 1966; 5. National School Lunch Act; 6. Food Stamp Program - SNAP (Supplemental Nutrition Assistance Program); 7. Nutrition Program for the Elderly (Title III, Older American Act of 1965); 8. Uniform relocation Assistance and Real Property Acquisitions Act (Title II); 9. Women, Infants, and Children (WIC) Program; 10. Volunteers in Service to America (VISTA); 11. Foster Grandparents; 12. Learn and Serve; 13. National Senior Service Corps (Senior Corps); 14. Retired and Senior Volunteer Program (RSVP); or 15. Senior Companion Program.

10 Page Number: 10 of 10 REFERENCES/BIBLIOGRAPHY: County Indigent Health Care Program Handbook, Section 2 Harris Health System Eligibility Services Departmental Guidelines and Procedures 4.01, Verifying Household Composition Harris Health System Eligibility Services Departmental Guidelines and Procedures 5.10, Verification of Income IRS Tax Topic 417 Earning for Clergy: ttp:// OFFICE OF PRIMARY RESPONSIBILITY: Harris Health System Eligibility Services Department REVISION HISTORY: Effective Date Version # (If Applicable) Review or Revision Date (Indicate Reviewed or Revised) Reviewed or Approved by: (Directors, Committees, Managers, and Stakeholders etc.) 08/01/ Dir. Eligibility & Regis Svcs /01/2010 Adm Dir. Eligibility & Regis Svcs /01/2011 Adm Dir. Eligibility & Regis Svcs /07/2012 Adm Dir. Eligibility & Regis Svcs /07/2013 Adm Dir. Eligibility Svcs Dept /01/2013 Adm Dir. Eligibility Svcs Dept /31/2013 Adm Dir. Eligibility Svcs Dept /15/2014 Adm Dir. Eligibility Svcs Dept /10/2014 Adm Dir. Eligibility Svcs Dept /29/2015 Adm Dir. Eligibility Svcs Dept /02/2015 Adm Dir. Eligibility Svcs Dept /01/2016 Adm Dir. Eligibility Svcs Dept