5101:1-40-205 Covered families and children medicaid: disregards of earned income.

(A) For each individual whose needs are included in the eligibility determination and for each individual whose needs are not included due to the application of a sanction for the individual’s failure to fulfill an eligibility requirement, there are certain disregards allowed in order to determine the countable income.

(1) The disregards are deducted from the gross earnings of each employed individual included in the assistance group and for each employed individual whose needs are not included due to the application of a sanction for the individual’s failure to fulfill an eligibility requirement, in the order listed in paragraphs (B) to (D) of this rule.

(2) For self-employed individuals, these disregards are also deducted from gross earnings as defined in paragraph (B) of rule 5101:1-40-204 of the Administrative Code. These disregards are not allowed when comparing the gross income to the one hundred eighty-five per cent standard.

(3) These disregards are not all applicable when computing the countable income of the grandparents in the minor caretaker budgeting process, and in the determination of countable income to be allocated when there is a parent who is ineligible due to citizenship status.

(B) The monthly earned income of each dependent child who is a full-time student, a full-time student from a JTPA program, or a part-time student who is not a full-time employee is totally disregarded when determining the countable income of the covered families and children medicaid assistance group. There is no time limit on this total disregard for participants in a JTPA program or national service program established under the Nationaland Community Service Trust Act of 1993, (i.e., Americorps, youth corps).

The cost of care for a dependent child or incapacitated adult is an allowable deduction after the two hundred fifty dollars and one-half of the remainder of earned income disregard as described in paragraph (F)(3) of this rule or the thirty dollars and/or one-third disregards as determined in paragraph (E) of this rule. An amount equal to the actual cost but not to exceed one hundred seventy-five dollars per child or two hundred dollars if the child is under age two, for the care of each dependent child or incapacitated adult living in the home and receiving covered families and children medicaid or LIF if the employed caretaker is employed full time.

(1) If the caretaker is employed part time, an amount equal to the actual cost, but not to exceed one hundred twenty dollars per child may be deducted. “Full-time employment” is defined as thirty-five hours or more per week. “Part-time employment” is defined as less than thirty-five hours per week.

(2) The cost of care for a dependent child or incapacitated adult may be disregarded even though the provider is a household member or relative. The disregard does not apply if the dependent care provider is an assistance group member, a parent of the child receiving dependent care, or a legal guardian of the child receiving dependent care.

(3) Documentation of the incapacitated adult’s need must be contained in the assistance group record to support the allowance of the disregard. There is no disregard allowed for the cost of care for an incapacitated adult living in the home who is not also a member of the assistance group.

(4) The caretaker shall have the following options with respect to child care costs:

(a) The caretaker may elect to have the actual monthly child care costs (up to the applicable maximums of one hundred seventy-five dollars per child, or two hundred dollars if the child is under age two, for full time or one hundred twenty dollars for part-time) disregarded in the covered families and children medicaid/LIF medicaid budget calculation. This includes any mandatory family fee that may be charged when there is a social service vendor payment for child care.

(b) The caretaker may elect to have the monthly child care costs met through social service vendor payment. This option is contingent upon the availability of a vendor payment provider and sufficient title XX funds. Dependent care costs that are being met through vendor payment shall not be allowed as an earned income disregard.

(D) Ninety dollars standard work allowance

For those assistance groups that are not eligible to receive the two hundred fifty dollars and one-half of the remainder of earned income disregard as described in paragraph (F) of this rule, the first ninety dollars of monthly earned income of each employed individual whose needs are included in the assistance group and of each employed individual whose needs are not included due to the application of a sanction for the individual’s failure to fulfill an eligibility requirement.

(E) Additional disregards for covered families and children medicaid covered groups other than low-income families (LIF) medicaid and OWF medicaid.

(1) Thirty dollars and one-third of the remaining income for individuals found other wise eligible or who have received OWF in one of the prior four months. An assistance group which did not receive an OWF cash payment due to the minimum payment requirement is considered to be receiving OWF.

(2) The thirty dollars and one-third of the remaining income shall be applied to earnings for a period of four consecutive months. After the four month period, the thirty dollars disregard continues to be applied for a maximum of eight additional months to the assistance group member’s earned income. The one-third disregard is limited to four months.

(3) The four consecutive month period begins with the first month in which both the thirty dollars disregard and the one-third disregard are allowed in the computation of eligibility for covered families and children medicaid.

(4) Any month in which the one-third disregard is allowed in an overpayment calculation is part of the four consecutive month period.

(5) The four consecutive month period is considered to be uninterrupted when a penalty is applied for a month in which the assistance group member or sanctioned individual would have been eligible for the one-third disregard.

(6) In some instances there may be a break in the four consecutive month period because the assistance group member lost the earnings or lost covered families and children medicaid eligibility due to an eligibility factor. If the assistance group becomes eligible again for covered families and children medicaid and is eligible for the thirty dollars and the one-third disregards, the four consecutive month period begins again.

(7) After the individual has received the thirty dollars disregard for the eight additional months, the individual does not become eligible again for the application of the thirty dollars disregard until he is once again eligible to receive the one-third disregard.

(a) The eight month period begins with the month following the fourth consecutive month in which the thirty dollars and one-third disregards were applied and ends with the eighth consecutive month regardless of whether the thirty dollars disregard is actually applied to the assistance group member’s earned income.

(b) When an assistance group member becomes ineligible for covered families and children medicaid before the thirty dollars and one-third disregards have been applied for four consecutive months, but before eight additional months of the thirty dollars disregard have been available, the assistance group member or sanctioned individual is eligible for the remaining months of the thirty dollars disregard if he becomes eligible for covered families and children medicaid during that time. The thirty dollars disregard is available to assistance group members who lost eligibility because of the thirty dollars and one-third disregards and become applicants during this eight-month period, even if such applicants were not recipients during one of the four prior months.

(8) The one-third disregard may only be applied for a period of four consecutive months. After the four month period, the one-third disregard is no longer deducted from the assistance group member’s or sanctioned individual’s earned income. The assistance group member does not become eligible for the use of the one-third disregard in the determination of eligibility for covered families and children medicaid until twelve months have expired.

(F) Additional disregards for low-income families (LIF) medicaid and OWF medicaid

(1) Disregards as described in paragraphs (B) to (C)(4) of this rule.

(2) The first two hundred fifty dollars and one-half of the remainder of monthly earned income of each employed individual in the assistance group.

(3) An assistance group which did not receive an OWF cash payment due to the minimum payment requirement is considered to be receiving OWF.

(4) The use of the thirty dollars and one-third disregards as described in paragraph (E) of this rule does not preclude the use of the two hundred fifty dollars and one-half of the remainder of earned income disregard when determining LIF medicaid or OWF medicaid eligibility.

(5) Eligibility for LIF medicaid can be determined for an assistance group who would be eligible for OWF but declines cash assistance.

(G) The remaining income after the deductions set forth in paragraphs (A) to (F) of this rule is countable earned income.

(H) Earned income disregard penalties

The two hundred fifty dollars and one-half of the remainder of earned income disregard, the ninety dollars standard work allowance, the dependent care costs, and the thirty-dollars and one-third disregards are not deducted from the earned income of the assistance group or individual for the month in which any of the following situations exist. Any month in which the one-third disregard is not applied due to one of the following situations is considered as one of the four consecutive months periods.

(1) The individual terminated his/her employment or reduced his/her earned income without good cause within the preceding month. The penalty is applied to the earned income of the individual in the month following the month of termination of employment or reduction in earnings.

(2) The individual refused without good cause within the preceding month to accept a bona fide offer of employment. The penalty is applied to the earned income of the individual in the month following the month of the refusal to accept an offer of employment.

(3) The individual voluntarily requests assistance to be terminated for the purpose of avoiding the receiving of the one-third disregard for four consecutive months.

(4) The individual failed without good cause to make a timely report of earnings. This penalty is applied if an individual does not report a change in a timely manner.

HISTORY: Eff 11-1-76; 5-14-77; 4-5-79; 10-1-81; 12-1-82; 3-1-84; 10-1-84 (Emer.); 12-27-84; 1-1-85 (Emer.); 4-1-85; 1-2-86; 4-1-86; 4-1-88 (Emer.); 6-30-88; 1-1-89 (Emer.); 4-1-89; 7-1-89 (Emer.); 9-23-89; 10-1-89 (Emer.); 12-16-89; 4-23-90; 7-12-91 (Emer.); 9-12-91; 9-1-94; 10-1-97 (Emer.); 1-26-98; 7-1-00

Rule promulgated under: RC 111.15.

Rule authorized by: RC 5111.01, 5111.011

Rule amplifies: RC 5111.01, 5111.011

REPLACES: FORMER 5101:1-40-205

RC 119.032 REVIEW DATES: 7/1/2005