New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 281 - MEDICAID ELIGIBILITY - INSTITUTIONAL CARE (CATEGORIES 081, 083 AND 084) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.281.500.18 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The applicable income standard used in the determination of
				  a MAP category of institutional care eligibility for an applicant or recipient
				  who has not been institutionalized for a period of 30 consecutive days is the
				  SSI federal benefit rate (FBR) for a non-institutionalized individual.
				  Participation in the medicaid home and community based waiver program is
				  considered institutionalization and counts toward the calculation of the 30-day
				  period. All income, whether in cash or in-kind, shall be considered in the
				  eligibility determination, unless such income is specifically excluded or
				  disregarded.
A.
Institutionalization period of 30 consecutive days:
After the
				applicant or recipient has been institutionalized for 30 consecutive days, the
				application can be approved as of the first day of the 30-day period. Once an
				applicant or recipient has been institutionalized for 30 consecutive days, the
				higher income maximum as specified in 8.200.520 NMAC is used.
B.
Institutionalization period less
				than 30 consecutive days:
If the applicant or recipient leaves the
				facility before 30 consecutive days, the lower income standard (SSI FBR) is
				used to establish eligibility.
C.
Transfer or death:
If an applicant or recipient transfers to
				another institution or dies prior to completing 30 consecutive days of
				institutionalization, the higher income maximum is used. See 8.200.520 NMAC.
(1)
Income exclusions:
Income
				exclusions are applied before income disregards. Exclusions are applied in
				determining eligibility whether the income belongs to the applicant or
				recipient or to an individual from whom income is deemed.
(2)
Infrequent or irregular
				income:
Exclude the first $30 per calendar quarter of earned income; and
				the first $60 per calendar quarter of unearned income. The following
				definitions apply:
(a) "Irregular income" is
				income received on an unscheduled or unpredictable basis.
(b) "Infrequent income" is income received
				only once during a calendar quarter from a single source and includes:
(i) proceeds of life insurance
				policies;
(ii) prizes and
				awards;
(iii) gifts;
(iv) support and alimony;
(v) inheritances;
(vi) interest and royalties; and
(vii) one-time lump sum payments, such as
				social security.
(c)
				"Frequency" is evaluated for the calendar quarter (i.e. January - March, April
				- June, July - September, October - December) but the dollar amount is
				considered in the month received.
(3)
Foster care:
Foster care
				payments are totally excluded if:
(a) the
				foster child is not eligible for SSI; and
(b) the child was placed in the applicant's
				or recipient's home by a public or private nonprofit child placement or child
				care agency.
(4)
Domestic volunteer services exclusions:
Payments to volunteers
				under domestic volunteer services (ACTION) programs are excluded from
				consideration as income in the eligibility determination process. These
				programs include the following:
(a) volunteers
				in service to America (VISTA);
(b)
				university year for action (UYA);
(c) special demonstration and volunteer
				programs;
(d) retired senior
				volunteer program (RSVP);
(e)
				foster grandparent program; and
(f)
				senior companion program.
(5)
Census bureau employment:
Wages paid by the census bureau for temporary employment related to the census
				bureau are excluded from consideration as income in the eligibility
				determination process.