A. This regulation contains the rules for:
(1) Considering available earned and unearned income of assistance unit members; and
(2) Determining income eligibility of assistance unit members requesting Primary Adult Care Program coverage.
B. Regulation .03B(2)(a) of this chapter contains the income standard for the Primary Adult Care Program.
C. For the Department to determine countable gross income in accordance with the requirements of this regulation:
(1) Regulation .02B of this chapter lists examples of the types of countable earned and unearned income; and
(2) Regulation .02C of this chapter lists the types of excludable income.
D. The applicant, recipient, or representative shall:
(1) Provide an explanation, with appropriate verification, to reconcile any inconsistency identified by the Department between household expenditures and reported income; and
(a) The source, type, gross amount, and frequency for receipt of all income received by each assistance unit member or expected to be received during the period under consideration;
(b) Verification of income and expenditures, when required by the Department; and
(c) Any changes in income within 10 business days of the change.
E. Income Eligibility Determination.
(1) The Department shall:
(a) Establish a period under consideration in accordance with Regulation .04 of this chapter;
(b) Consider all of the assistance unit's income in accordance with this regulation; and
(c) Determine whether each source of income received by assistance unit members is countable or excludable.
(2) Gross income shall be determined based on the assistance unit's total earned and unearned income before any type of deduction or withholding.
(3) Income for the period under consideration may be projected based on retrospective income.
(4) Income may not be anticipated beyond the period under consideration.
(5) For a deceased individual's income, the income to be considered shall be what was received up to and including the month of death.
(6) When an assistance unit member:
(a) Has regular income, the amount to be considered shall be what is received or reasonably is expected to be received during the period under consideration;
(b) Works less than 12 months in a year but receives an annual salary, is self-employed, or has irregular or seasonal earnings, the amount to be considered for the period under consideration shall be one-half of the expected annual income based on the prior year's gross income; or
(c) Receives lump-sum benefits or other amounts of income on a one-time-only basis, the amount to be considered for average monthly countable gross income shall be 1/6 of the total amount received.
(7) All earned and unearned income that is not designated as excludable income pursuant to Regulation .02C of this chapter shall be considered and calculated to establish monthly countable gross income.
(8) Monthly countable gross income shall be reduced by subtracting the appropriate income disregards specified in §F of this regulation, to determine monthly countable net income. However, the amount of disregards that is subtracted may not exceed the amount of income to which the disregard is applied.
(9) Income eligibility shall exist when the assistance unit's monthly countable net income for the period under consideration is within the income standard specified at Regulation .03B(2)(a) of this chapter for the household size.
F. Disregards. To determine the assistance unit's monthly countable net income, the following disregards shall be deducted in the following order from the assistance unit's monthly countable gross income:
(1) Disregard of one-half of gross income amount for the following types of income:
(a) Self-employment income, unless an applicant or recipient can document a cost to produce in excess of the disregard of one-half of gross income; and
(b) Rental property income and other income from income-producing property;
(2) General income disregard of $20 per month per assistance unit, which is deducted from the assistance unit's countable unearned income, with any remaining amount of the $20 disregard deducted from countable earned income; and
(3) Disregard from the assistance unit's monthly countable earned income, as follows:
(a) $90 per month for each assistance unit member with earnings, if the applicant or recipient is not aged, blind, or disabled; or
(b) If the applicant or recipient is aged, blind, or disabled:
(i) Earned income disregard for the assistance unit of $65 per month;
(ii) Disregard of the amount of an assistance unit member's earned income that is used to meet any impairment-related work expenses, if the member is either disabled and younger than 65 years old, or aged and disabled and received Supplemental Security Income as a disabled individual for the month before the individual reached 65 years old;
(iii) Earned income disregard of one-half of the assistance unit's remaining countable earned income;
(iv) Disregard of an assistance unit member's earned income that is used to meet any expenses reasonably attributable to the earning of income of an individual who is either blind and younger than 65 years old, or aged and blind and received Supplemental Security Income as a blind individual for the month before the individual reached 65 years old; and
(v) Disregard of an assistance unit member's income that is received and used to fulfill a Plan for Achieving Self-Support approved by the Social Security Administration, if the individual is either younger than 65 years old and blind or disabled, or aged and either blind or disabled and received Supplemental Security Income as a blind or disabled individual for the month before the individual reached 65 years old.