LAW
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Ohio Laws and Rules
Federal statute and court decisions exclude or exempt certain types of payments or benefits in whole or in part from consideration as income. The exclusions and exemptions vary widely in their effect upon the retention or inclusion of an otherwise eligible person in the assistance group. In some instances, the payments received have no effect on the individual’s eligibility, and the individual remains part of the assistance group.
(A) The monthly earned income of each child receiving covered families and children medicaid, if the child is a full-time student, or a full-time student in a program carried out under the Job Training and Partnership Act (JTPA), is exempt from the one hundred eighty-five per cent and one hundred per cent income tests for a period of time not to exceed six months per calendar year. The six months need not be consecutive but must fall within the twelve-month calendar year. The income of students will be considered as the first disregard of earned income at all times.
(B) Court-ordered child support payments made by a member of the assistance group for a child outside the assistance group are exempt from consideration as income. The actual verified amount paid, up to the amount ordered, is exempt.
(C) Income of a stepparent.
(D) A relocation assistance benefit, paid by a public agency to a public assistance recipient who has been relocated as a result of a program of area redevelopment, urban renewal, freeway construction, or any other public development involving demolition or condemnation of existing housing, is exempt income for covered families and children medicaid provided:
(1) The benefit payment is a nonrecurring lump sum; or
(2) If more than one payment is made, such payments are made for a limited time in a manner which does not result in duplication of an allowance in the OWF standard.
(3) Examples are highway relocation assistance paid under sections 163.53 to 163.55 of the Revised Code and any additional relocation payment under Public Law 91-646 (Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970).
(E) A bona fide loan obtained by a covered families and children medicaid assistance group member from any source is exempt from consideration as countable income or resources. A bona fide loan shall not be considered as income available to the assistance group because the loan is a debt that the assistance group has an obligation to repay. The receipt of a bona fide loan (regardless of the source from which and the reason for which the bona fide loan was secured) by an assistance group shall not adversely affect the assistance group’s eligibility or level of benefits because the loan does not result in a gain to the assistance group that should be considered as countable income.
(1) Only bona fide loans are exempt from consideration as income. In determining whether a bona fide loan exists, any of the situations described in paragraphs (E)(2) to (E)(4) of this rule shall suffice as evidence of a bona fide loan.
(2) A bona fide loan may be established by a written agreement to repay the money within a specified time frame.
(3) A bona fide loan may be established by the existence of evidence to verify that the loan was obtained from an individual or establishment engaged in the business of making loans.
(4) A bona fide loan may be established by the fact that the loan is obtained from an individual or establishment not normally engaged in the business of making loans, if one of the situations described in paragraphs (E)(2) to (E)(4) of this rule exists. The loan may be defined as a bona fide loan if:
(a) The borrower’s acknowledgement of the obligation to repay the loan exists (with or without interest); or
(b) The borrower has expressed intent to repay the loan either by pledging real or personal property, or anticipated income; or
(c) A written statement exists detailing the borrower’s plans to repay the loan when future anticipated income is received (e.g., a timetable and plan for repayment).
(F) Educational grants and scholarships for college expenses.
(1) Educational grants and scholarships from any source for undergraduate and graduate college expenses are exempt from consideration as income or resources.
(2) Educational grants and scholarships are treated in the same manner whether the assistance group member who is the student is an adult or a child.
(3) Educational grants and scholarships are totally exempt as income or resources whether the funds are paid directly to the school or paid to the student.
(4) Educational grants and scholarships that are paid for, or to, a student strictly for educational expenses, or grants and scholarships that include educational and living expenses are exempt regardless of the source from which or the terms under which they are granted, as long as the funds are granted as financial assistance to a student attending an undergraduate or graduate educational institution.
(G) Contributions for shared living expenses.
(1) Cash payments (contributions) received by a covered families and children medicaid assistance group from an individual who is not an assistance group member, but who resides in the same household and shares responsibility for the household expenses through an informal arrangement, shall not be considered unearned income available to the covered families and children medicaid assistance group. The cash contribution given to the covered families and children medicaid assistance group by the individual who is not an assistance group member is not available income to the assistance group because the payment represents the individual’s (who is not an assistance group member) share of the household expenses.
(2) However, if the individual who shares the residence with the assistance group voluntarily gives a cash contribution to the assistance group for its unrestricted use, the cash contribution shall be treated as unearned income to the covered families and children medicaid assistance group.
(H) “Casual or inconsequential income” is income in cash or in kind which is unpredictable as to amount and time of receipt, of short duration, and by itself, of negligible importance in meeting continuing needs under the appropriate aid standard. Casual income remains such as long as it is not recurring and does not exceed thirty dollars per recipient in any quarter, beginning with January, April, July, or October.
(I) “Income in kind” is any benefit received other than in cash.
(J) Income paid by public or private agencies, or community groups, which is either designated by law to be disregarded or given for a special purpose, shall not be deducted. The following are designated by law to be disregarded:
(1) Rural housing loans made by farmers home administration to help individuals and families acquire and/or make needed improvements to a home or other property.
(2) The value of surplus commodities donated by the department of agriculture.
(3) Many federal statutes provide for the exclusion from income and resources of certain payments made to members of Indian tribes and groups. Due to the number of statutes that affect covered families and children medicaid eligibility, ODHS will exclude from income and resources for covered families and children medicaid purposes any payments that are also excluded under the supplemental security income (SSI) program.
(4) Tax-exempt portions of payments received by Alaskan natives as a result of the Alaska Native Claims Settlement Act, Public Law 92-203.
(5) Payments made for supporting services or reimbursement of out-of-pocket expenses to volunteers participating in any program created as a result of Titles II and III, section 418 of Public Law 93-113. These programs include foster grandparents program, senior companions, senior health aides, service corps of retired executives (SCORE), and active corps of executives (ACE).
(6) Benefits received under Title VII, nutrition program for the elderly, of the Older Americans Act of 1965, Public Law 92-258.
(7) The value of supplemental food assistance received under the Child Nutrition Act of 1966, as amended, and the special food service program for children under the National School Lunch Act, as amended, Public Law 92-433 and Public Law 93-150.
(8) Other payments made by a public or private agency for the purpose of supplementing standards, so long as there is no duplication of payment. This includes payments made by an agency providing vocational rehabilitation and payments made to individuals through participation in a JTPA program including all income received from the summer youth employment training program (SYETP). However, any payments made in the form of wages are not exempt under this rule. Payments made in the form of wages, as in the JTPA on-the-job training (OJT) program, cannot be disregarded.
(9) Payments to assistance groups participating in the volunteers in service to America (VISTA) program regardless of the amount of the payments. This disregard does not apply when the director of action determines that the value of all such payments, adjusted to reflect the number of hours such volunteers are serving, is equivalent to or greater than the minimum wage then in effect under the Fair Labor Standards Act of 1938, or the minimum wage under the laws of the states where the volunteers are serving, whichever is greater. (reference: section 404(g) of Public Law 93-113, as amended by section 9 of Public Law 96-143.)
(10) Need-based payments made to a youth under age twenty-two to enable him to participate in training under the JTPA program, Public Law 97-300.
(11) HUD (metropolitan housing authority) payments covering rent/utility bills which exceed the rent payment limitations stipulated by the Brooke amendment.
(12) Retroactive payments paid as a result of a state hearing.
(13) Retroactive payments paid as a result of a reconsideration of SSI benefits.
(14) Foster care payments, made by a state, a political subdivision, or a tax-exempt child placement agency, for a qualified foster-care child boarded in the home.
(15) Experimental housing allowance program payments made under annual contributions contracts entered into prior to January 1, 1975, under section 23 of the U.S. Housing Act of 1937, as amended. This program is designed to aid low-income families to secure adequate housing.
(16) HUD community development block grant funds received by an assistance group. Funds for this program are paid from Title I of the Housing and Community Development Act of 1974 (Public Law 93-383 and Public Law 95-128). The primary purpose of this program is to prevent the deterioration of property occupied and owned by persons with low and moderate income. rehabilitation projects made possible by this program do not include routine repairs and maintenance, but consist of major repairs or improvements such as complete renovation of the exterior or interior of a house. Funds from this program cannot be used for support and maintenance.
(17) Cash or in-kind assistance provided for supportive services that are necessary to enable program participation to a youth under age twenty-two eligible for training under the job training partnership act but who cannot pay for required supportive services. Supportive services may be required for transportation, temporary shelter, meals, health care, etc. (Public Law 97-300).
(18) Compensation provided in lieu of wages to any youth under age twenty-two participating in tryout employment under JTPA at a private-for-profit work site or at a public and private nonprofit work site when private-for-profit work sites are not available. Individuals in tryout employment may not participate more than twenty hours per week during the school year or two hundred fifty hours per assignment (Public Law 97-300).
(19) Home energy assistance (HEA) or support and maintenance assistance (SMA) paid to clients in cash or in kind per Public Law 97-377, Public Law 97-424, or Public Law 98-21.
(a) “Home energy assistance” means any assistance related to home energy.
(b) “Support and maintenance assistance” means in-kind (non-cash) assistance from a private nonprofit organization recognized by ODHS; to meet food, clothing, or shelter needs; or cash or in-kind assistance from a rate-of-return entity providing home energy, a supplier of home heating oil or gas, or a municipal utility providing home energy.
The assistance is only in-kind and is provided by a private nonprofit organization; or it is cash or in-kind assistance furnished by a supplier of home heating oil or gas, an entity providing home energy whose revenues are primarily derived on a rate-of-return basis regulated by a state or federal governmental body, or a municipal utility providing home energy; and the assistance is provided on the basis of need for such support.
(20) Payments received by individuals of Japanese ancestry under section 105 of Public Law 100-383, and payments received by Aleuts under section 206 of Public Law 100-383.
(21) Payments received under the provisions of the Agent Orange Compensation Exclusion Act (Public Law 101-201) received on or after January 1, 1989.
(22) Payments received under the provisions of the Radiation Exposure Compensation Act (Public Law 101-426) received on or after October 15, 1990.
(23) Payments received under the provisions of the child care and development block grant (section 5082 of Public Law 101-508).
(24) Escrow accounts established and credited as the direct result of the assistance group’s involvement in the family self-sufficiency program on or after May 13, 1992. These escrow accounts are only considered available when the assistance group is no longer receiving any federal, state, or other public assistance for housing.
(25) Basic health insurance, child care or child care allowances, auxiliary aid and services for disabled individuals and the national service educational award provided for individuals participating in a national service program established under the National and Community Service Trust Act of 1993 (Public Law 103-82). Payments received as a living allowance shall be considered earned income.
(K) Effective January 1, 1991, any earned income tax credit (EITC) received, whether added to the individual’s wages or as part of an income tax refund, is exempt from consideration as income in the determination of eligibility or level of benefits.
(L) SSI Income.
(M) Income tax refunds received by a member of the assistance group or by an individual whose income is considered in determining eligibility are exempt.
(N) As a result of the settlement contained in H.B. 2015, none of the payments made from any fund established pursuant to a class settlement in the case of Susan Walker v. Bayer Corporation, et al., 96-C-5024 (N.D. Ill) shall be considered income or resources in determining eligibility and/or patient liability.
Interest received as a result of payments from this settlement is not excluded for income and resource purposes.
(O) P.L. 101-610, Nnational and Community Service Act (NCSA) of 1990, section 177(d), November 16, 1990, provides that section 142(b) of the JTPA applies to projects conducted under Title I of the NCSA as if such projects were conducted under the JTPA. Title I includes three acts: (a) Serve-America: the Community Service Schools and Service-Learning Act of 1990, (b) the American Conservation and Youth Service Corps Act of 1990, and (c) the National and Community Service Act. There are about forty-seven different NCSA programs and they vary by state. Most of the payments are made as a weekly stipend or for educational assistance. The higher education service-learning program and the americorps umbrella program come under this title. The National Civilian Community Corps (NCCC) is a federally managed Americorps program. The summer for safety program is an Americorps program under which participants earn a stipend and a one thousand-dollar postservice educational award. The National and Community Service Trust Act of 1993, P.L. 103-82, September 23, 1993, amended the National and Community Services Act of 1990 but it did not change the exclusion.
(P) Compensation received for services by an individual appointed to a temporary position within the bureau of census established for purposes relating to the 2000 decennial census of the United States as specified in section 3 of the Decennial Census Improvement Act of 1999 shall not cause a reduction in benefits provided through any program such as medicaid which is financed in whole or in part by federal funds. This income exemption applies only with respect to compensation for services performed during the calendar year 2000 and does not apply if the individual performing the service involved is appointed (or first appointed to any other temporary census position) prior to January 1, 2000.
(Q) Child support payment distributions made by ODJFS pursuant to division (C) of Section 1 of Am. S.B. 170 of the 124th General Assembly and rules 5101:1-29-31.1 and 5101:1-29-31.2 of the Administrative Code shall be excluded from consideration as income or resources in the financial eligibility determination for CFC medicaid.
HISTORY: Eff 11-1-76; 12-31-77; 12-1-79; 5-29-80; 9-7-81; 3-1-84; 6-1-84; 7-1-84 (Temp); 9-1-84; 9-10-84; 10-1-84 (Emer.); 12-27-84; 1-1-85 (Emer.); 4-1-85; 1-1-86 (Emer.); 1-2-86; 2-23-86; 8-1-86 (Emer.); 10-3-86; 10-1-87; 7-1-89; 9-23-89; 10-1-89 (Emer.); 11-1-89 (Emer.); 12-16-89; 1-29-90; 6-1-90; 7-12-91 (Emer.); 9-22-91; 10-1-91 (Emer.); 12-20-91; 4-1-92; 10-1-92 (Emer.); 12-21-92; 3-1-95; 10-30-95; 10-31-97 (Emer.); 1-26-98; 2-1-99; 5-1-00 (Emer.); 8-6-00; 1-1-03; 1-1-03
Rule promulgated under: RC 111.15
Rule authorized by: RC 5111.011, 5111.01
Rule amplifies: RC 5111.01, 5111.011
R.C. 119.032 review dates: 04/05/2002 and 01/01/2008