Classic (non-MAGI) based programs manual

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Income overview 2: income eligibility continued

Revised Date: 
December 5, 2016

Purpose: To describe how various types and amounts of income affect an individual’s eligibility for Categorically Needy (CN) or Medically Needy (MN) health care coverage.

Subtopic: Counting

WAC 182-512-0760 SSI-related medical -- Education assistance.

Effective April 14, 2014.

  1. The agency does not count:
    1. Educational assistance in the form of grants, loans or work study, issued from Title IV of the Higher Education Amendments (Title IV – HEA) and Bureau of Indian Affairs (BIA) education assistance programs. Examples of Title IV – HEA and BIA educational assistance include, but are not limited to:
      1. College work study (federal and state);
      2. Pell grants; and
      3. BIA higher education grants.
    2. Educational assistance in the form of grants, loans or work study made available under any program administered by the department of education (DOE) to an undergraduate student. Examples of programs administered by DOE include, but are not limited to:
      1. Christa McAuliffe Fellowship Program;
      2. Jacob K. Javits Fellowship Program; and
      3. Library Career Training Program.
  2. For assistance in the form of grants, loans or work study under the Carl D. Perkins Vocational and Applied Technology Education Act, P.L. 101-391:
    1. If the person attends school half-time or more, the agency subtracts the following expenses:
      1. Tuition;
      2. Fees;
      3. Costs for purchase or rental of equipment, materials, or supplies required of all students in the same course of study;
      4. Books;
      5. Supplies;
      6. Transportation;
      7. Dependent care; and
      8. Miscellaneous personal expenses.
    2. If the person attends school less than half-time, the agency subtracts the following expenses:
      1. Tuition;
      2. Fees; and
      3. Costs for purchase or rental of equipment, materials, or supplies required of all students in the same course of study.
  3. WorkFirst work-study income is not counted.
  4. Income received from work study program that is not excluded under subsection (1) of this section is counted as earned income and is subject to earned income disregards as described in WAC 182-512-0840(2).
  5. If the person receives Veteran's Administration Educational Assistance:
    1. All applicable attendance costs are subtracted; and
    2. The remaining income is budgeted as unearned income.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-512-0770 SSI-related medical -- American Indian or Alaska Native excluded income and resources.

Effective April 16, 2015.

  1. The agency excludes the following types of income from being considered when determining eligibility for Washington apple health (WAH) categorically needy (CN) and medically needy (MN) SSI-related programs for American Indians or Alaska Natives:
    1. Distributions from Alaska Native corporations and settlement trusts;
    2. Distributions from any property held in trust, subject to federal restrictions, located within the most recent boundaries of a prior federal reservation, or otherwise under the supervision of the Secretary of the Interior;
    3. Distributions and payments from rents, leases, rights of way, royalties, usage rights, or natural resource extraction and harvest from:
      1. Rights of ownership or possession in any lands described in (b) of this subsection; or
      2. Federally protected rights regarding off-reservation hunting, fishing, gathering, or usage of natural resources.
    4. Distributions resulting from real property ownership interests related to natural resources and improvements that are:
      1. Located on or near a reservation or within the most recent boundaries of a prior federal reservation; or
      2. Resulting from the exercise of federally protected rights related to such real property ownership interests.
    5. Payments resulting from:
      1. Ownership interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance; or
      2. Rights that support subsistence or a traditional lifestyle according to applicable tribal law or custom.
    6. Student financial assistance provided under the Bureau of Indian Affairs education programs; and
    7. Any other applicable income exclusion as provided by federal law, regulation, or rule.
  2. The agency excludes the following types of resources from being considered when determining eligibility for WAH-CN and WAH-MN SSI-related programs for American Indians or Alaska Natives:
    1. Property, including real property and improvements, that is:
      1. Held in trust, subject to federal restrictions, or otherwise under the supervision of the Secretary of the Interior; and
      2. Located on a reservation, including any federally recognized Indian tribe's reservation, pueblo, or colony, including:
        1. Former reservations in Oklahoma;
        2. Alaska Native regions established by the Alaska Native Claims Settlement Act; and
        3. Indian allotments on or near a reservation as designated and approved by the Bureau of Indian Affairs of the Department of the Interior.
    2. Property located within the most recent boundaries of a prior federal reservation for any federally recognized tribe not described in (a) of this subsection;
    3. Ownership interests in rents, leases, royalties, or usage rights related to natural resources (including, but not limited to, extraction of natural resources or harvesting of timber, other plants and plant products, animals, fish and shellfish) resulting from the exercise of federally protected rights; and
    4. Ownership interests in or usage rights to items not covered in (a), (b), or (c) of this subsection that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable tribal law or custom.
  3. When determining eligibility for WAH-CN and WAH-MN SSI-related programs for American Indians or Alaska Natives, the agency counts or excludes amounts received by tribal members from exercise of gaming revenues (per capita distributions) that are retained after the month of receipt based on the type of resource in which the money is retained.  If the amounts are retained in a countable resource (for example, cash, checking account, or savings account), the agency treats the amounts as a countable resource.  If the amounts are converted to an excluded resource (for example, personal property like a refrigerator), the agency treats the amounts as excluded resources.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

  1. Payments made under the Cobell Statement Agreement for the Land Buy-Back for Tribal Nations are excluded when determining countable income. When determining countable resources, they are excluded for twelve months from the date of receipt. See the Claims Resolution Act of 2010, P.L. 111-291, Section 101 (f) for more information.

  2. Assistance based on need that is not counted as income includes payments wholly funded by a State or not of its political divisions. For this purpose, an Indian tribe is considered a political subdivision within the geographical boundary of a State. When such payments are provided under a program that uses the amount of an individual's income to determine eligibility, the payments are not counted as income. If the individual's income is used only for determining the amount of a payment, however, and not also for eligibility for the program under which the payment is made, then the payment is counted as unearned income.

  3. Some tribes, such as the Muckleshoot Indian Tribe, provide this type of cash assistance to its elder members. When eligibility for this assistance is based on the individual's income, the payments are not counted when determining eligibility for Apple Health. These payments are excluded under 20 CFR § 416.1124(c)(2) - Unearned income we do not count. 

  4. It is important to understand that the Tribal General Welfare Exclusion Act of 2014 amends the Internal Revenue Service (IRS) code. The bill language does not add any new exclusions from Indian income to the SSI program. Its primary purpose is to codify that certain payments, programs, or services provided by tribal governments for the general welfare of their people that meet the requirements under the Tribal Act are excluded from federal income tax, as are TANF and SSI benefits. For more information, go to the Social Security Administration's American Indians and Alaska Natives (AIAN) webpage. 

  5. For information about tribal payments made to members that are based on income and need, see Clarifying Information under WAC 182-512-0860 SSI-related medical - Income exclusions under federal statute or other state laws.

WAC 182-512-0780 SSI-related medical -- Employment and training programs.

Effective April 14, 2014.

  1. The agency excludes income received from the following programs:
    1. Payments issued under the Workforce Investment Act (WIA);
    2. Payments issued under the National and Community Service Trust Act of 1993. This includes payments made through the AmeriCorps program;
    3. Payments issued under Title I of the Domestic Volunteer Act of 1973, such as VISTA, AmeriCorps VISTA, University Year for Action, and Urban Crime Prevention Program; and
    4. All payments issued under Title II of the Domestic Volunteer Act of 1973. These include:
      1. Retired Senior Volunteer Program (RSVP);
      2. Foster Grandparents Program; and
      3. Senior Companion Program.
  2. The agency counts training allowances from vocational and rehabilitative programs as earned income when:
    1. The program is recognized by federal, state, or local governments; and
    2. The allowance is not a reimbursement.
  3. The agency excludes support service payments received by or made on behalf of WorkFirst recipients.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

  1. Rent payments received from roomers or boarders are considered unearned income.
  2. The interest portion of payments on sales or real estate contracts owned by an individual who is resource eligible is counted as unearned income when the combined value of all resources is at or below the resource standard. Count only the portion of the payment that goes toward interest as unearned income.
  3. Puyallup Tribe Settlement Income: Budget interest income from the annuity fund payment or the initial investments as newly acquired income.
  4. Receipt of gaming money by tribal members is considered unearned income in the month received. Gaming money set aside in trust funds by the tribe is not considered available until it may be accessed by the tribal member for whom it is set aside.

    Example: A tribe pays $2,000 per month gaming money to each tribal member. For tribal members under age 18, $1,000 per month is set-aside in a trust fund which can be used by the child on or after his or her 18th birthday. The $1,000 received each month is considered income in the month received. The $1,000 per month set-aside is not considered until the child reaches 18. The month after the child turns 18, any money remaining from the trust fund is considered an available resource and that month’s $2,000 is considered income.

  5. Home equity conversion plans: a security interest in the home is given in exchange for a lump sum, a periodic cash payment, or a line of credit. The most common home equity conversion plan is a reverse mortgage that allows the homeowner to borrow from the equity in the home with no repayment as long as they live in the home. The funds received under a home equity conversion plan are a loan, and thus do not count as income. However;
    1. Interest earned on any money received under the home conversion plan is considered unearned income, and
    2. Money retained into the following month is considered a resource as of the first of the month following the month of receipt.