TITLE 40.SOCIAL SERVICES AND ASSISTANCE

Part 1. TEXAS DEPARTMENT OF HUMAN SERVICES

Chapter 15. MEDICAID ELIGIBILITY

Subchapter E. INCOME

40 TAC §15.460

The Texas Department of Human Services (DHS) adopts a federally- mandated amendment to §15.460, concerning income exemptions, in its Medicaid Eligibility chapter.

DHS has a contract with the Social Security Administration under section 1634 of the Social Security Act that requires it to use policy for the Supplemental Security Income program in determining eligibility for Medicaid in its long term care programs.

Federal regulations (Volume 65, Number 251, pages 82905-82912) effective January 1, 2001, increased the student earned income exclusion from $400 to $1290 monthly, with an annual limit increase from $1620 to $5200. These amounts will now increase annually, with amounts set by the Social Security Administration.

Justification for this amendment is to incorporate these federally mandated changes.

The amendment is adopted under the Human Resources Code, Title 2, Chapters 22 and 32, which authorizes the department to administer public and medical assistance programs and under Texas Government Code §531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds.

The amendment implements the Human Resources Code, §§22.001- 22.030 and §§32.001-32.042. The amendment is adopted in compliance with federal requirements effective January 1, 2001.

§15.460.Income Exemptions.

(a)

The income described in this section is not counted in eligibility or payment-plan determination. The disregarding of this income is called an exemption. An exemption is not an exclusion. Exempt income is never counted in eligibility or payment-plan determination.

(b)

The Texas Department of Human Services exempts income that a client receives from any of the following sources:

(1)

cash received from the sale of a resource. This cash is a resource, not income.

(2)

value of medical services provided to a client free of charge or paid for with direct payment to the provider by someone else. Medical services, including in-kind medical items, are never income regardless of the source of the service or the source of payment for the service. Payments by a third party of an individual's medical insurance premiums are not considered a medical service, but they are not income. Items which do not qualify as a medical service may qualify as items received in conjunction with a social service and may not be income.

(3)

premium payment for supplementary medical insurance benefits (SMIB) under Title XVIII (Medicare), paid by a third party directly to the Social Security Administration.

(4)

cash or in-kind payments for social services provided by a federal, state, or local government program.

(5)

reimbursement for medically-related payments that a client has previously made or for payments that he owes because of medically- related services already received. Cash contributions from family members to the client for Medically-related payments (made or owed by the client) are not considered income exemptions.

(6)

the amount of income of a dependent who is receiving Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF). This income has already been considered in determining the dependent's need for SSI or TANF.

(7)

grant, scholarship, and fellowship funds used to pay tuition and fees at an educational institution (including vocational and technical schools). Any portion of a grant, scholarship, or fellowship used to pay any other expense, such as room, board, or books, cannot be exempt.

(8)

home produce for home consumption.

(9)

infrequent or irregular income. Infrequent or irregular income is excluded from the eligibility determination if the total per month is $20 or less in unearned income and $10 or less in earned income; and if the income is received only once per calendar quarter from a single source or cannot be reasonably anticipated. If received in a larger amount or more frequently than specified, the entire amount is included in determining eligibility.

(A)

Income need not be both infrequent and irregular to be excluded. The exclusion applies only to infrequent or irregular income in which the total income from all sources does not exceed the dollar limits. The frequency is evaluated for the quarter, but the dollar amount is evaluated for the month.

(B)

Irregular payments that do not exceed the dollar limits when combined with other irregular and infrequent incomes received in the same month are not counted as income.

(10)

payments for foster care of a child if the child

(A)

is not eligible for SSI; and

(B)

was placed in the client's home by a public or private, nonprofit child-placement or child-care agency.

(11)

one-third of the total amount of child support payments for an eligible child.

(12)

earnings of a child who is a student regularly attending school, with limits set by the Social Security Administration for the Supplemental Security Income program and published annually in the Federal Register. This exemption applies until the child is 22.

(13)

benefits received under Title III, Public Law 100-175.

(14)

value of meals and benefits provided under the Child Nutrition Act of 1966.

(15)

value of meals provided under the National School Lunch Act as amended by Public Law 90-302 of 1968.

(16)

benefits received from Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970.

(17)

salaries, value of meals, and travel allowances to participate in the Retired Senior Volunteer Program and in the Foster Grandparent Program of Title II of the Domestic Volunteer Service Act of 1973 (formerly Title VI of the Older Americans Act). Also included are payments from Title III of the same act, which include the Service Corps of Retired Executives (SCORE), the Active Corps of Executives (ACE), and the Action Cooperative Volunteer Program (ACV). Wages and salaries from Title V of the Older Americans Act, such as Green Thumb and Senior Texan Employment Program (STEP) are not exempt income.

(18)

payments by the Federal Disaster Assistance Administration authorized by the Disaster Relief Act, as amended.

(19)

value of any housing assistance payment paid on a house under the United States Housing Act of 1937, the National Housing Act, the Housing and Urban Development Act of 1965, §101, or Title V of the Housing Act of 1949, as authorized by Public Law 94-375.

(20)

home energy assistance, except food or clothing under Public Laws 97-377 and 97-424. Home energy assistance is assistance in cash or in- kind that is provided by a private, nonprofit organization or a utility company. Some examples of home energy assistance are heating, cooling, weatherization, storm windows, and blankets.

(21)

proceeds of either a commercial loan or an informal loan, for which repayment is required with or without interest. The proceeds (amount borrowed) are not counted as income in the month in which they are received but are considered to be a resource in the following month(s). To claim exemption of the proceeds of a loan, a client must prove that he acknowledges an obligation to repay and that some plan for repayment exists. If these conditions can be verified, no written contract is required.

(22)

interest earned on excluded burial funds and any appreciation in the value of an excluded burial arrangement that are left to accumulate and become a part of separately identifiable burial fund. If the burial funds increase by more than $1,500 because of contributions by client actions, the amount in excess of $1,500 is a countable resource.

(23)

value of any noncash item (other than food, clothing, or shelter) for the month of receipt, if that item would become a partially or totally excluded resource were it kept into the month after the month of receipt.

(24)

Agent Orange Settlement Fund or any other fund established in settlement of the Agent Orange product liability litigation. Public Law 101-239 excludes the payments from countable income and resources. The law covers both disability and death benefits and is retroactive as of January 1, 1989.

(25)

reparation payments received by Holocaust survivors from the Federal Republic of Germany. The payments may be made periodically or as a lump sum. DHS accepts the client's signed statement of amounts involved and dates of payment.

(26)

payments from a state-administered fund to aid victims of crime.

(27)

payments a state or local government may make as relocation assistance.

(28)

compensation received under the Radiation Exposure Compensation Act for injuries resulting from exposure to radiation from nuclear testing and uranium mining.

(29)

payments to an ICF-MR client by the MR facility, intended to enhance the client's social skills and functional abilities. The use of such payments must be included in the client's active treatment plan.

(30)

hazardous duty pay of a spouse or parent absent from the home because of active military service.

(31)

restitution payments made by the United States government under Public Law 100-383 to Japanese-Americans (or, if deceased, to their survivors) and Aleuts who were interned or relocated during World War II.

(32)

reparation payments received under Sections 500-506 of the Austrian General Social Insurance Act.

(33)

payments under the Netherlands' Act on Benefits for Victims of Persecution 1940-1945 (Dutch acronym, WUV).

(34)

payments from any source made to individuals because of their status as victims of Nazi persecution.

(35)

interest or other earnings on any designated account established for Supplemental Security Income (SSI) clients under age 18 for retroactive benefits, as required by Public Law 104-193, effective August 22, 1996.

(36)

payments made in the class settlement of the Susan Walker vs. Bayer Corporation lawsuit, as required by Public Law 105-33, effective August 5, 1997.

(37)

payments from the Department of Veterans Affairs made to or on behalf of certain Vietnam veterans' natural children regardless of their age or marital status, for any disability resulting from spina bifida suffered by such children as required by Public Law 104-204, effective October 1, 1997. Interest earned on unspent payments is not excluded.

(38)

gifts from tax-exempt organizations, such as the Make-A-Wish Foundation, to children with life-threatening conditions, as required by Public Law 105-306, effective retroactively to October 28, 1996. The exclusions apply to children under age 18. The gift must be from an organization described in Section 501(c)(3) of the Internal Revenue Code of 1986 and which is exempt from taxation under Section 501(c). The eligibility specialist documents the case record with an oral or written statement from the organization that the gift was made based on the child having a life-threatening condition. No additional medical development is necessary.

(A)

The following gifts to or for the benefit of a child described above are excluded from income:

(i)

Any in-kind gift, not converted to cash; and

(ii)

A cash gift to the extent that the cash excluded under this provision does not exceed $2,000 in any calendar year. Cash in excess of $2,000 received in a calendar year is subject to regular income counting rules.

(B)

If an in-kind gift is converted to cash, the cash counts as income in the month converted. For purposes of this exclusion, an in-kind gift is any gift other than cash, including gifts of food, clothing, or shelter.

(C)

The exclusion also applies to a deeming situation if the gift is made to a parent for the benefit of a child with a life-threatening condition.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on April 30, 2001.

TRD-200102443

Paul Leche

General Counsel, Legal Services

Texas Department of Human Services

Effective date: January 1, 2001

For further information, please call: (512) 438-3108


Part 12. TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Chapter 371. INACTIVE/RETIREE STATUS

40 TAC §371.1

The Texas Board of Occupational Therapy Examiners, adopts amendments to §371.1 Inactive Status without changes to the proposed text as published in the February 23, 2001 issue of Texas Register (26 TexReg 1686) and will not be republished.

The section was amended to restructure licensing procedure rules and update description of the requirements for licensure, reflecting changes to the procedures. They enable administrative procedures for improved administrative efficiency.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on April 30, 2001.

TRD-200102446

John P. Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: May 20, 2001

Proposal publication date: February 23, 2001

For further information, please call: (512) 305-6962


40 TAC §371.2

The Texas Board of Occupational Therapy Examiners, (TBOTE) adopts the repeal of §371.2 Retired Status without changes to the proposed text as published in the February 23, 2001 issue of Texas Register (26 TexReg 1687) and will not be republished.

This deletion removes the retired status as this status is not recognized in the Act.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the Occupational Therapy Practice Act, Title 3, Subchapter H, Chapter 456, Occupations Code, which provides the Texas Board of Occupational Therapy Examiners with the authority to adopt rules consistent with this Act to carry out its duties in administering this Act.

Title 3, Subchapter H, Chapter 454 of the Occupations Code is affected by this amended section.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on April 30, 2001.

TRD-200102445

John P. Maline

Executive Director

Texas Board of Occupational Therapy Examiners

Effective date: May 20, 2001

Proposal publication date: February 23, 2001

For further information, please call: (512) 305-6962