Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 148 - OFFICE OF CHILD AND FAMILY SERVICES › Chapter 5 - PURCHASE OF SERVICE POLICY MANUAL › Section 148-5-V - INCOME ELIGIBILITY DETERMINATION, VERIFICATION AND DOCUMENTATION

Current through 2024-29, July 17, 2024
A.
INTRODUCTION
PURPOSE:
The Department of Health and Human Services is committed to
				  utilizing its resources to make social services available to those in the
				  greatest economic need. To assure that services are provided to address
				  economic need for the general population and for specific target populations,
				  income eligibility guidelines have been established by the Department. For
				  selected service areas, individuals must meet income guidelines to be eligible
				  for services. This policy is applicable to all agreements, contracts, and
				  grants containing client income eligibility guidelines. To implement the
				  guidelines, the Department has established definitions of
family
and
gross family income
and standards
				  for verification, documentation and treatment of gross family income.
STANDARDS
1.00 DEFINITION OF TERMS
2.00 INCOME GUIDELINE STANDARDS
3.00 DEFINITION OF FAMILY
4.00 INCOME INCLUDED IN FAMILY GROSS INCOME
5.00 ADJUSTMENTS TO FAMILY GROSS INCOME
6.00 INCOME EXCLUDED FROM FAMILY GROSS INCOME
7.00 VERIFICATION, DOCUMENTATION AND TREATMENT OF GROSS
				  FAMILY INCOME
B.
DEFINITION OF
				TERMS
1.00 DEFINITION OF TERMS
1.01
Adult
means an individual 18 years of
				  age or older, or court emancipated minor.
1.02
Applicant
means the individual applying
				  for services.
1.03
Department
means the Department of
				  Health and Human Services.
1.04
Department Approved
means approval of
				  the assigned agreement administrator or their supervisor.
1.05
Family
- See definition contained in
				  Section
				  V, Sub-Section D.
1.06
Federally Recognized Tribe
means the
				  Penobscot Tribe, Passamaquoddy Tribe, Aroostook Band of Micmacs, Houlton Band
				  of Maliseets and other Native American Tribe, band, nation or other organized
				  group or community that is recognized as eligible for the special programs and
				  services provided by the United States to Indians because of their status as
				  Indians.
1.07
Maine
Resident
means
				  an applicant who has established Maine as a permanent home, the place where
				  s/he intends to return after any period of absence. Maine residency, once
				  established, continues until a new, fixed and permanent home is acquired. No
				  change of Maine residency results from moving to a new location if the intent
				  is to remain only for a limited time, even if it is for a relatively long
				  duration. Documentation of Maine residency includes a Maine home address where
				  the applicant lives and one or more of the following items: current Maine
				  individual income tax return indicating Maine resident status, valid Maine
				  driver's license, current Maine motor vehicle registration, current Maine
				  hunting/fishing license, proof of undergraduate student instate tuition
				  payment, and other reasonable verification.
Exception: Homeless individuals are exempt from documenting a
				  home address.
1.08
Provider
means the community agency or
				  individual who has entered into a contractual agreement with the Department of
				  Health and Human Services, , to provide services.
1.09
Service Area
means a type of service
				  purchased by the Department, e.g., child care, homemaker, transportation
				  services.
1.10
Student
means an individual enrolled
				  and attending an elementary or secondary educational institution, a program
				  that provides for completion of a secondary diploma or GED, a school for the
				  handicapped, a vocational education program, or post-secondary undergraduate
				  institution.If the student is the applicant, they must be a Maine resident and
				  attending an educational program in Maine. (See definition of
Maine
				  Resident
)
1.11
Significant Income Change
means a
				  change in the source or amount of income which is greater than $25.00 per month
				  and expected to continue into the future for more than one month.
1.12
Special Needs Child
means a child who
				  is identified with one or more of the following conditions: (1) Children with a
				  specific diagnosis/disability which, without intervention, may impede or impair
				  the attainment of development milestones; (2) Children who evidence a
				  developmental delay in one or more of the following skill areas: cognitive,
				  fine motor, gross motor, receptive and/or expressive language,
				  social/emotional, or self-care; (3) Children considered to be at-risk for
				  health or developmental problems as a result of established biological risk
				  factors, and/or as a result of identified environmental risk factors. At-risk
				  children must be referred by a third party such as public health agencies,
				  physicians, schools, welfare offices, government agencies, federally recognized
				  Tribes, community social service agencies, and early intervention specialists.
				  Note: If the Department or Tribal referred child is served as a "special needs"
				  child, the family must meet the applicable income eligibility requirements for
				  this target group.
C.
INCOME
				GUIDELINE STANDARDS
2.00 INCOME GUIDELINE STANDARDS
Financial eligibility for clients served with Department
				  funds shall be determined in accordance with the following standards:
2.01 Income eligibility guidelines shall be based upon gross
				  family income, adjusted to family size.
2.02 Income eligibility guidelines shall be annually updated
				  by the Department.
2.03 The basis for establishing gross family income shall be
				  selected by the Department.
2.04 The Department shall identify the service areas (types
				  of services) that have income eligibility guidelines as a condition of
				  eligibility.
2.05 The Department shall identify the target group
				  populations within service areas that are eligible for services based upon
				  income eligibility.
2.06 The Department shall identify the target group
				  populations within service areas that are eligible without regard to
				  income.
2.07 The Department shall adhere to all statutes, rules and
				  regulations for establishing income eligibility applicable to Federal and State
				  funding sources.
2.08 The Provider shall comply with all income eligibility
				  standards contained in this Section and within the applicable service area
				  policies, Section
				  V of this Manual.
D.
DEFINITION OF
				"FAMILY"
3.00 DEFINITION OF 'FAMILY'
In order to determine gross family income, the Provider shall
				  comply with the following standards for defining the
family
unit:
3.01 A
family
is a group of related and/or
				  non-related individuals, who are living together as one economic unit. An
				  economic unit shares housing, and significant income and expenses of its
				  members. Generally, individuals residing in the same dwelling are one economic
				  unit. However, if more than one economic unit reside together in the same
				  dwelling, there is typically a written or verbal agreement made between the two
				  parties concerning the sharing of housing expenses such as rent, heat and
				  utilities. The two parties to the agreement are otherwise economically
				  independent from one another.
3.02 An individual living alone shall be a family of
				  one.
3.03 Married couples residing together shall be considered to
				  be family members.
3.04 Couples residing together who are not married to each
				  other, but hold themselves out to the community as husband and wife or life
				  partners by representing themselves as such to relatives, friends, neighbors or
				  trades people; shall be considered to be family members.
3.05 When there are children who reside together with both of
				  their biological or adoptive parents and the parents are not married to each
				  other, both parents of the child(ren) shall be included as family
				  members.
3.06 Family membership includes individuals who reside with
				  the applicant and are claimed as dependents on the applicant's income tax
				  returns. An exception is made for parenting teens (see Standard 3.09), foster
				  children (see Standard 3.12), students (see Standard 3.15), and children living
				  with a court-appointed, legal guardian (see Standard 3.13).
3.07 Family membership may include adults, age 18 and over,
				  who reside with the applicant but are neither married to the applicant nor hold
				  themselves out to be a husband, wife or life partner of the applicant, may or
				  may not be otherwise related to the applicant, but are dependent upon the
				  applicant for all or most their economic needs. Once an individual is claimed
				  as a family member, any income received by that individual while residing with
				  the applicant shall be counted as family income.
3.08 Adults, age 18 and over, who share a dwelling with the
				  applicant but are neither married to the applicant nor hold themselves out to
				  be a husband, wife or life partner of the applicant, may or may not be
				  otherwise related to the applicant, but contribute their agreed upon share of
				  housing expenses such as rent, heat and utilities; shall not be counted as
				  family members. These individuals are likely to have their own checking
				  accounts and file their own income tax returns. Generally, they share a
				  residence out of economic necessity, but are economically independent of the
				  applicant.
3.09 Parenting teens (under 20 years of age), who attend
				  elementary school, high school or a GED program and live with their children
				  and their parents, step-parents, relatives or non-relatives, are considered a
				  separate family unit consisting of the teen parent(s) and their
				  child(ren).
Exception: The school attendance requirement does not apply
				  to child protective referrals from the Department or federally recognized
				  Tribe.
3.10 Biological children, step-children, adopted children and
				  all other children under 18 years of age residing with the applicant, who is
				  maintaining a home for them and assuming parental responsibility, shall be
				  considered to be family members.
Exception: Foster children, parenting teens, and children
				  living with their legal guardian may be considered as separate family units as
				  provided in Standards 3.09, 3.12 and 3.13.
3.11 In cases where joint custody has been awarded and the
				  child physically changes residence between custodial parents, the child is a
				  member of each custodial parent's family for the period of time that the child
				  resides with each parent. Example: The custodial mother applies for child care
				  for a child who resides with her every other week. The child will be included
				  as a member of the mother's family every other week. If the mother is eligible,
				  the child will receive child care every other week. If the custodial father
				  also needs child care, then he may apply for the weeks that the child resides
				  with him.
3.12 For Department and Tribal child custody (foster
				  children) referrals, the foster child shall be considered a family of one. The
				  foster care payment shall not be included as family income. If there is no
				  referral for service from the Department or Tribal caseworker, then the foster
				  child(ren) shall be included as a member of the foster family, but the foster
				  care payment is not included as income.
3.13 Children living with a court-appointed, legal guardian
				  may be considered a family of one. Only the income received in behalf of the
				  child shall be included as family income (e.g., TANF, SSI, Social
				  Security).
3.14 When the biological or adoptive parent of a foster child
				  applies for services, their children in foster care shall not be included as
				  family members.
3.15 Children of the applicant or other family member, who
				  are temporarily away at school (e.g., attending a boarding school, technical
				  school or college) are considered to be family members.
3.16 Service applicants may be residents of a shelter for
				  battered women and their children; a homeless shelter; a semi-independent group
				  living arrangement; an assisted housing program for people with a mental health
				  diagnosis, mental retardation, or people with AIDS. Family membership shall not
				  include other residents of the facility who were not admitted as members of the
				  applicant's family.
3.17 Family members living apart on a temporary basis are
				  considered family members.
Temporary
means the absent family
				  member's permanent home is with the applicant's family, where they intend to
				  return after any period of absence.
3.18 Residents of a substance abuse treatment program which
				  is time-limited (usually 28 days or less), where the participant is expected to
				  be returning home to live with their family, shall be included as family
				  members.
3.19 Family members living apart for an extended period of
				  time due to employment or educational purposes shall be considered members of
				  the family.
3.20 Individuals who are long-term residents of institutions
				  such as hospitals, skilled nursing facilities, intermediate care facilities and
				  prisons, shall not be counted as family members.
Long Term
means that the individual is not expected to return home within two
				  months.
3.21 Roomers, boarders and live-in attendants shall not be
				  included as family members.
3.22 The applicant must be a resident of the State of Maine.
				  See definition of
Maine Resident
.
3.23 Each individual in the family for whom assistance is
				  being requested must be a U.S. citizen, an alien lawfully admitted for
				  permanent residence or otherwise permanently residing in the U.S. under the
				  color of law.
Note: Aliens legally admitted on a temporary basis such as
				  visitors, travelers, crewmen on shore leave, foreign students, and members of
				  the foreign press, radio, etc. are not eligible for services, even if they have
				  authorization to work.
Note: The Jay Treaty of 1794 recognizes the aboriginal right
				  of Native Americans to pass the border of the U.S. and Canada. When a Native
				  American with Canadian citizenship moves to Maine, they are recognized as
				  lawfully admitted for permanent residence.
Note: U.S. born children of illegal immigrants shall not be
				  denied services based upon the citizenship status of their parent(s). Their
				  parent(s), however, are not eligible to receive services.
Exception: This standard does not apply to blended or
				  wrap-around child care for children enrolled in the Head Start Program, and
				  child care provided in a public or private educational setting for
				  out-of-school time (before and after school, school holidays, and summer
				  vacation).
3.24 A family member cannot belong to more than one family at
				  the same time.
E.
INCOME
				INCLUDED IN FAMILY GROSS INCOME
4.00 INCOME INCLUDED IN FAMILY GROSS INCOME
In order to determine gross family income, the Provider shall
				  comply with the following standards for defining what sources of income shall
				  be
included
in gross family income:
4.01 "Gross family income" is the sum of all money, earned
				  and unearned, already received or reasonably anticipated to be received by all
family
members during the service eligibility period. Gross
				  family income is calculated before such deductions as income taxes, employee's
				  social security taxes, employee pension contributions, employee deferred
				  compensation plans (IRA accounts, 401K plans, etc.), insurance premiums
				  (including Medicare), bonds, union dues and other employee payroll deductions
				  and benefit deductions. Gross income does not include the employer's fringe
				  benefit contribution/obligation. Gross family income is received or available
				  or earned on a recurring basis. Negative income from business losses or
				  investment/gambling losses shall not be deducted from other sources of
				  earned/unearned income in calculating gross family income. Except for a farm
				  enterprise, a net business, investment, or gambling loss shall have zero value
				  in computing gross family income.
4.02 Gross family income shall include
Earned Income
from all sources, except for excluded income as set forth in Standard
				  6.01 Earned income includes:
a. Wages,
				salaries, commissions or fees, tips, piece-rate payment and cash bonuses before
				any payroll deductions;
b. Gross
				income from self-employment, excluding mostIRS deductible business expenses
				(see Standard 7.10(d)(3). Types of self-employment include but are not limited
				to:
1 Independent contractors, franchise
				holders, owners/operators, farmers, people who produce and sell a product, and
				service-type businesses;
2 Seasonal
				self-employment such as fishing, clamming, worm digging, logging, harvesting,
				etc.;
3 Income from boarders (not
				included as family members)
4
				Income from roomers (not included as family members);
5 Income from ownership of rental
				property.
c. That
				portion of training allowances or training stipends which exceeds expenses, and
				represents a gain or benefit to the family;
d. On-the-job training JTPA (Job Training
				Partnership Act) earnings of family members.
Exception: Earnings of dependents less than 19 years of age,
				  and all earnings under the JTPA-Summer Youth Employment and Training Program
				  and comparable summer youth employment programs under Americorps are exempt
				  (See Standard 6.01b.)
4.03 Gross family income shall include
Unearned
				  Income
from all sources, except for excluded income as set forth in
				  Standard 6.01. Unearned income includes:
a. Pension and retirement benefits such as
				government employee pensions, military retirement/pensions, railroad
				retirement, private pensions, annuities, IRA accounts, 401K plans and so
				forth;
b. Social Security benefits
				including pensions, survivor's benefits, and permanent disability insurance
				payments;
c. Assistance program
				payments such as SSI (Supplemental Security Income), TANF (Temporary Assistance
				for Needy Families), PaS (Parents as Scholars), Refugee Cash Assistance, and
				other means tested assistance. TANF payments which are diverted to a third
				party shall be counted as income. Assistance payments from programs which
				require the performance of work without compensation other than the assistance
				payment shall be considered unearned income;
d. Veteran's benefits including money paid
				periodically by the Veterans Administration to disabled members of the Armed
				Forces or survivors of deceased veterans; Aid and Attendance portion of
				veteran's benefits, subsistence allowances paid to veterans for education and
				on-the-job training, as well as so-called refunds of GI insurance
				premiums;
e. Military family
				allotments or other regular support from an absent family member or someone not
				living in the household;
f.
				Unemployment insurance and worker's compensation;
g. Strike benefits from union
				funds;
h. Regular cash income
				received from earned interest, dividends, royalties, estates and
				trusts;
i. Interest income received
				from all loans and notes such as personal loans, secured loans (includes real
				estate mortgages), installment contracts and interest-only loans. Loans of this
				nature usually require periodic payments of constant amounts over the life of
				the loan. The amount of the loan principal (return of capital) is considered an
				asset and shall not be included in gross income. The recognized gain on sale
				amount of the loan repayment shall be included in gross income. This
				determination shall be made in accordance with IRS regulations;
j. Child support and alimony payments made
				directly to the family, including the pass through and gap supplements received
				by TANF clients. Money deducted or diverted from court-ordered support or
				alimony to pay household expenses is also counted as income;
k. Income from ownership of rental property,
				excluding most IRS deductible business expenses. The business expenses
				disallowed are the same costs that are not allowed for self-employed
				individuals as set forth in Standard 7.10(d)(3).
l. Income from capital gains as defined and
				calculated in accordance with IRS regulations. Capital gains is the profit from
				the sale of real and personal property such as the sale of a residence, land,
				income producing property, investment property, capital equipment, stocks and
				bonds. Generally, profits resulting from disposal of business inventory of real
				and personal property are included as income from self-employment as opposed to
				being separately classified as capital gains;
m. Regular general assistance cash payments
				from municipalities that are not made directly to vendors such as a
				landlord;
n. Regular money
				contributions from persons determined not to be family members;
o. The portion of all educational grants,
				scholarships and other awards available to pay for living expenses . All fees
				assessed by the educational institution are not counted as income. If a student
				is not enrolled in a recognized institution of post-secondary education, a
				school for the handicapped, a vocational educational program or a program that
				provides for completion of a secondary school diploma or equivalent, the full
				amount of educational assistance is counted as income. Income from student
				loans shall be counted only if there are no repayment terms as a condition of
				the loan. This standard does not apply to educational assistance which is
				totally excluded under Federal statute as set forth in Standards 6.01(k) and
				6.01(l);
p. Regular income received
				from lottery and sweepstakes winnings. Lump sum lottery and sweepstakes
				winnings are counted within the eligibility period they are received.
q. Net income from gambling;
r. Money that is legally due the family which
				is diverted to a third party to pay household expenses, such as: diversion of
				all or part of a TANF grant to a landlord; and that portion of an unemployment
				insurance benefit check intercepted by the State (SELU) commonly referred to as
				garnished wages. See Standard 5.01 applicable to adjustments for court ordered
				child support payments. General Assistance vendor payments are
				excluded;
s. Income that is legally
				due a family member but is received and used for that family member by a
				non-family member;
t. Income from
				sponsors of aliens lawfully admitted for permanent residence in the U.S. A
				sponsor is a person or organization signing an affidavit or document on behalf
				of the alien as a condition of entry;
u. All other income from government programs
				not specifically excluded by law.