Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 28 - Division of County Operations › Rule 016.28.22-009 - Adding Unborn Child to Pregnant Woman Need Standard

Current through Register Vol. 49, No. 6, June, 2024
Medical Services Policy Manual, Section O
O-422 Deprivation Due to Unemployment of the Principal
				Wage Earner
MS Manual 01/01/23
Deprivation due to unemployment must be based on the parent who
				has been the principal wage earner (PWE) for the past two (2) years.
The PWE is the parent who earned the greater amount of income
				during the twenty-four (24) month period which immediately precedes the month
				in which application for assistance is made. The earnings of each parent are
				considered in determining the principal wage earner regardless of when their
				relationship began. Only one (1) parent can be the PWE.
Unemployed means:
1.
			 The principal wage earner is not employed or is employed less than one hundred
			 (100) hours a month; or
2. If one
			 hundred (100) hours or more were worked in a particular month because the work
			 was intermittent and the excess was temporary, the PWE must have been under the
			 one hundred (100) hour standard for the two (2) prior months and is expected to
			 be under the standard for the following month.
The PWE must meet each of the following criteria at initial
				application, or during the month of application, in order for Health Care
				coverage to begin in the month of application (see note below):
1. Must have been unemployed for at least
			 thirty (30) consecutive days or is employed less than one hundred (100) hours a
			 month;
2. Must have had six (6)
			 quarters of work within any thirteen (13) calendar quarter period ending within
			 one (1) year prior to application or received unemployment compensation within
			 one (1) year prior to application. For the six (6) quarters of work, education
			 may be substituted for up to four (4) of the six (6) quarters;
3. Must not, without good cause, have refused
			 a bona fide offer of employment or training for employment within the last
			 thirty (30) days; and
4. Must not
			 have refused to apply for or accept unemployment compensation if qualified.
Note:
If an applicant does not meet
				the above criteria at application, or during the month of application,
				eligibility cannot begin until the first day of the month in which the criteria
				are met.
Example:
An individual loses his job
				on May 15 and applies for UP-MN on May 16. He worked one hundred ten (110)
				hours in May before losing his job. He will not have been unemployed for 30
				consecutive days by the end of May; therefore, his family will not be eligible
				for Health Care during May. He will have been unemployed for thirty (30) days
				on June 14, however. Assuming all other eligibility criteria are met, Health
				Care benefits could begin June 1.
O-430 Medically Needy Pregnant Women
				Categories
Pregnant Women (Re. MS B-230) may be considered for Medically
				Needy-EC or SD, if they do not meet the need requirements for PW No-Grant. If a
				pregnant woman's income, resources, or both exceed the limits for PW No-Grant,
				the PW's income and resources will be compared to the Medically Needy MNIL and
				MNRL to determine eligibility in PW-EC or SD.
If a pregnant woman has income above the MNIL but below two
				hundred percent (200%) of Poverty Level, then SOBRA PW eligibility will be
				determined prior to determining eligibility for Spend Down.
Note:
The unborn child will always be
				counted in the need standard for the pregnant woman.
O-451 Medically Needy - Foster Care
Foster Children (Re. MS B-400) who do not meet the income, or
				resource need requirements, or both, of State FC (U-18 criteria - Re. MS 0-143)
				or of Title IV-E-FC may be considered for Medically Needy FC - EC or SD by
				comparing income and resources to the Medically Needy MNIL and MNRL. The
				Division of Children and Family Services (DCFS) will determine IV-E and Health
				Care eligibility for Foster Children.
Each child will be evaluated as a one-person household unit
				against the appropriate criteria. Consideration of parental income and
				resources will cease effective the month a child enters Foster Care by the
				Court awarding custody to the Agency. A child taken into foster care on the
				basis of an emergency order only may be determined Health Care eligible. If
				custody is later established by a judicial determination, the DCFS Worker will
				be required to include a copy of the order in the foster care Health Care
				record.
If a Foster Child reenters his parent's home, the child's
				Health Care eligibility redetermination will include parental income and
				resources, even if the reentry is a trial placement and the Agency retains
				custody.