.5 Return Check Procedures
.51 Counties which receive a returned check from a provider or recipient shall follow the applicable procedures in the user's manual.
.6 Refunds/Recoupment
.61 Counties which receive refunds or recoupments shall:
.611 Deposit the money received in a county account; and
.612 Send a monthly check to the payrolling contractor for the amount of refund/recoupment received during the previous month in accordance with applicable procedures in the User's Manual.
.7 Recipient Responsibility
.71 It is the responsibility of the recipient to report to social services staff accurately and completely all information necessary to complete the SOC 311.
.72 The recipient, within his/her physical, emotional, educational or other limitations, shall:
.721 Designate the authorized hours per provider within the total of the recipient's authorized hours.
.722 Designate each provider(s) portion of the share of cost.
.723 Sign and date the prescribed time sheet to:
(a) Verify payment of the share of cost to the appropriate provider(s).
(b) Verify that services authorized where rendered by the appropriate provider.
.724 Inform social services staff of any changes affecting the payrolling process.
.73 Payments for authorized services rendered shall be sent to the recipient's appropriate provider.The recipient shall not receive payment for services except as provided in .731 through .734 below.
.731 Severely impaired recipients as defined under Section 30-753, shall have the option of choosing to directly receive their payment at the beginning of each authorized month. Such payment shall be the net amount exclusive of the appropriate withholdings.
.732 In direct payment cases, where a recipient is incapable of handling his/her financial and legal affairs and has a legal guardian or conservator, direct payment shall be made to the recipient's legal guardian or conservator at such person's request.
.733 Payment may be made to a recipient's guardian, conservator, substitute payee, or person designated by the recipient.
.734 When payment is made as a result of a state hearing decision.
.735 If the recipient is severely impaired he/she shall be notified in writing of the right to hire and pay his/her own provider, and to receive his/her monthly cash payment in advance.
.736 When direct payment is made to a recipient, guardian, conservator, or substitute payee, the provider shall be hired, supervised, and paid by such payee.In such cases, the recipient or the person authorized to act in the recipient's behalf shall insure that the services provider is capable of and is providing the services authorized.
.737 It shall be the responsibility of the severely impaired recipient, legal guardian or conservator who receives payment in advance to submit their provider's time sheets at the end of each authorized service month to the appropriate county social services office.
.8 Provider Benefits
.81 The department has elected to provide the worker's compensation coverage required by Welfare and Institutions Code Section 12302.2 through a single statewide insurance policy. Additional insurance coverage will not be reimbursed as an IHSS program cost.
.82 The department has elected to handle the payment of the unemployment insurance tax, unemployment disability insurance tax, and social security tax required by Welfare and Institutions Code Section 12302.2 through the payrolling system.
.83 The department has elected to require the payrolling contractor to deduct the employee's share of the following taxes from the payment to the provider or the recipient:
.831 Social security.
.832 State disability insurance.
.84 The department has elected to deduct and transmit the state and federal income tax withholdings due on the provider's earnings for those providers who voluntarily request this service.
.9 Excessive Compensation
(See Section 30-769.91 (Handbook) for examples of excessive compensation)
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.91 Excess compensation to an individual provider but is not necessarily limited to the following circumstances:
.911 The provider was paid for more hours than authorized or more hours than worked.
.912 The provider was paid at a higher hourly rate than appropriate.
.913 The share of cost withheld from provider's payment was less than the recipient affirms was paid to the provider.
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.92 All excess provider compensation is recoverable. The county shall demand repayment from the provider. The county shall be permitted to seek recovery of excess compensation by civil suit.
.93 Provider Fraud or Forgery
If the county suspects that excess provider payment occurred because of fraudulent devices of the provider, forgery, or collusion between the provider and the recipient, the county shall investigate the suspected fraud, forgery, or collusion. If the facts warrant prosecution and the county does not have an investigative unit, the county shall refer the matter directly to the county district attorney's office for investigation and possible prosecution.
NOTE: Authority cited: Sections 10553 and 10554, Welfare and Institutions Code; and Chapter 939, Statutes of 1992. Reference: Section 14132.95, Welfare and Institutions Code.
30-770 ELIGIBILITY STANDARDS 30-770
.1 Persons applying for IHSS under Sections 30-755.112, .113 and .114 shall meet the SSI/SSP eligibility standards except as modified by Section 30-755.1.
.2 Detailed eligibility standards shall be those located in 20 CFR Part 416, except as modified by IHSS regulations beginning with Section 30-750.
.3 Definitions.
.31 For the purposes of eligibility for IHSS, a child means an individual who is neither married nor the head of a household, and who is under the age of 18, or under the age of 22 and a student regularly attending a school, college, or university, or a course of vocational or technical training designed to prepare him/her for gainful employment.
.311 For the purposes of deeming for IHSS, a child means an individual who is neither married nor the head of a household, and who is under the age of 18.
.312 Regularly attending school means being enrolled in eight semester or quarterly hours weekly in a college or university, or 12 hours weekly in a secondary school. In a course of vocational or technical training, 15 clock hours weekly are required; without shop practice, at least 12 hours weekly are required.
.313 Eligible spouse means an aged, blind, or disabled individual who is the husband or wife of another aged, blind, or disabled individual who has not been living apart from such other aged, blind, or disabled individual for more than six months.
.4 Residency
.41 Residency in State Required
To be eligible for IHSS, an individual shall be a U.S. citizen, or an eligible alien pursuant to Welfare and Institutions Code Section 11104.The individual shall also be a California resident, physically residing in the state except for temporary absence as noted below in Sections 30-770.42 through .45, with the intention to continue residing here.
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Welfare and Institutions Code Section 11104 states:
"Aliens shall be eligible for aid only to the extent permitted by federal law.
"An alien shall only be eligible for aid if the alien has been lawfully admitted for permanent residence, or is otherwise permanently residing in the United States under color of law.No aid shall be paid unless evidence as to eligible alien status is presented."
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.42 Physical Absence from the State
Physical absence from the state indicates a possible change of state residence. The county shall make inquiry of a recipient who has been continuously absent from the state for 30 days or longer in order to ascertain the recipient's intent to maintain California residency.If the inquiry establishes that the recipient is no longer a California resident, authorization for IHSS shall be discontinued.
.421 The county inquiry to the recipient will require the recipient to submit a written statement that:
(a) Declares his/her anticipated date of return to the state, or his/her intent not to return to the state;
(b) Declares his/her reason for continued absence from the state; and
(c) Provides needed information on his/her location and status of household arrangements.
.422 The county will include in the inquiry to the recipient a statement that his/her failure to respond to the inquiry by a specified date will result in his/her ineligibility and the discontinuation of IHSS.
.43 Evidence of Residence Intention
.431 The written statement of the recipient is acceptable to establish his/her intention and action on establishing residence unless the statement is inconsistent with the conduct of the person or with other information known to the county.
.432 If the recipient does not respond by the specified date to the inquiry of residence, it shall be presumed that he/she does not intend to maintain California residency, and authorization for IHSS shall be discontinued when the absence exceeds 60 days in accordance with regulations (Sections 30-759.7 and 10-116).
.433 If the recipient responds to the inquiry and advises the county that he/she does not intend to return to California, authorization for IHSS shall be discontinued in accordance with regulations.
.44 Absence from State for More than 60 Days
.441 If the recipient responds to the inquiry and advises the county that he/she intends to maintain his/her California residence, but he/she remains or has remained out of state for 60 days or longer, his/her continued absence is prima facie evidence of the recipient's intent to have changed his/her place of residence to a place outside of California, unless he/she is prevented by illness or other good cause from returning to the state at the end of 60 days. Such absence in itself is sufficient evidence to support a determination that the recipient has established residence outside of California. Therefore, his/her intent to return must be supported by one or a combination of the following:
(a) Family members with whom the recipient lived, currently live in California;
(b) The recipient has continued maintenance of his/her California housing arrangements (owned, leased, or rented);
(c) The recipient has employment or business interest in California;
(d) Any other act or combination of acts by the recipient which establishes his/her intent to reside in California.
.442 Even if the recipient's intent to reside in California is supported by .441 above, the following evidence shall be utilized to determine the recipient's intent to reside in California:
(a) The recipient has purchased or leased a place of residence out of state since leaving California;
(b) The recipient has been employed out-of-state since leaving California;
(c) The recipient has obtained an out-of-state motor vehicle driver's license after leaving California;
(d) The recipient has taken any other action which indicates his/her intent to establish residence outside of California.
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.443 Welfare and Institutions Code Section 1110 states that if a recipient is prevented by illness or other good cause from returning to California at the end of 60 days, and has not by act or intent established residence elsewhere, he shall not be deemed to have lost his residence in this state. The following is added by Welfare and Institutions Code Section 11100.1(a):
For purposes of the In-Home Supportive Services Program ..."good cause," as defined in Section 11100, shall include, but is not limited to, the following:
(1) Outpatient medical treatment necessary to maintain the recipient's health where the medical treatment is not available in California.
(2) Short-term schooling or training necessary for the recipient to obtain self-sufficiency where training which would achieve that objective is not available or accessible in California.
(3) Court-issued subpoena or summons.
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(a) For outpatient medical treatment out of state, good cause for continuing to receive benefits while absent from the state for more than 60 days shall also include the situation where the medical treatment is not accessible in California.
(b) Accessible in these regulations means attainable for the recipient in California, given the dysfunctioning and needs of the recipient.
(c) Other good cause reasons for continuing to receive IHSS benefits while absent from the state for over 60 days shall be consistent with the good cause reasons contained in Welfare and Institutions Code Section 11100.1.
(1) The situation shall be of an urgent or emergency nature:
(2) The service required shall be necessary to maintain the physical or psychological health of the recipient:
(3) The services required or like services shall be either not available or not accessible in California.
.444 A recipient absent from California for more than 60 days and who is not prevented from returning to this state because of illness or other good cause shall have his/her authorization for IHSS discontinued in accordance with regulations.
.45 Absence from the State Exceeding Six Months
.451 Authorization for IHSS shall be suspended for any recipient who leaves the state and who remains absent from the state for a period which exceeds six months, notwithstanding the fact that the recipient has continued to receive IHSS benefits beyond 60 days because he/she was prevented from returning to the state due to illness or other good cause, as specified in Sections 30-770.43 and .44.Suspension of benefits will be in accordance with notice of Action regulations contained in Sections 30-759.7 and 10-116.
.452 In-Home Supportive Services shall not be resumed until the recipient, upon returning to the state, requests a reassessment of need from the county, and the reassessment has been completed in accordance with regulations (Section 30-763).
.46 Outside the United States While Absent from the State
.461 In-Home Supportive Services shall be discontinued for any recipient who is outside the United States for all of any month, or for 30 days in a row, as such an individual is no longer eligible to receive SSI/SSP. Discontinuation of benefits will be in accordance with notice of action regulations.
(a) Upon the individual's return to the United States, and upon his/her reestablishment as an SSI/SSP recipient, an SSI/SSP eligible recipient, or an individual who would be eligible for SSI/SSP except for excess income, he/she may again apply for IHSS benefits. The county shall redetermine IHSS eligibility and perform a needs assessment based on current circumstances.
(b) "United States" includes the 50 states, the District of Columbia, and the Northern Mariana Islands.
.47 Continuation of IHSS While Absent from the State
.471 When the county has determined that the recipient is entitled to the continuation of IHSS benefits while absent from the state (the recipient is absent from the state for 60 or more days and is prevented from returning due to illness or other good cause, as determined in Sections 30-770.42, .43, and .44), the following apply:
(a) The recipient shall continue to receive the same number of hours of IHSS that were authorized prior to his/her temporary absence. This level of authorization will continue until a reassessment is required.
(b) The recipient's out-of-state individual provider (IP) shall be reimbursed at the county's lowest current IP base rate.
(c) The recipient must continue to mail time sheets to the county as required by regulations.
.5 State Program Noncitizen Status
.51 A noncitizen victims of human trafficking, domestic violence, or other serious crimes as defined under the Trafficking and Crime Victims Assistance Program (TCVAP), MPP Chapter 70-100, shall be eligible for IHSS if all other eligibility criteria are met.
.511 A victim of human trafficking must meet the same eligibility criteria as those used for the TCVAP found in MPP Sections 70-102 and 70-103.1.For examples of documentation requirements, please see Sections 70-103.2 through .4.
.512 A victim of domestic violence or other serious crimes must meet the same eligibility criteria as those used for the TCVAP found in MPP Section 70-104.1.For examples of the definition of a noncitizen victim of serious crime, please see Handbook Section 70-104.11.For examples of documentation requirements, please see Section 70-104.12.
NOTE: Authority cited: Sections 10553 and 10554, Welfare and Institutions Code; and Senate Bill 1569 (Chapter 672, Statutes of 2006). Reference: Sections 13283 and 18945, Welfare and Institutions Code.
30-771 LINKAGE 30-771
.1 Aged - An aged individual shall be considered to be one who is 65 years of age or older.
.2 Blindness - An individual shall be considered to be blind for purposes of IHSS if:
.21 He/she has central visual acuity of 20/200 or less in the better eye with use of a correcting lens. An eye which is accompanied by a limitation in the fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less.
.22 He/she is blind as defined under the state plan approved under Title X as in effect for October 1972 and received aid under such plan on the basis of blindness for December 1973, provided that he/she is continuously so defined.
.3 Disability - An individual shall be considered to be disabled for the purposes of IHSS if one of the following applies:
.31 He/she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which has lasted or can be expected to last for a continuous period of not less than 12 months.
.32 In the case of a child under the age of 18, if he/she suffers from any medically determinable physical or mental impairment of comparable severity.
.33 He/she is permanently and totally disabled as defined under a state plan approved under Title XIV as in effect for October 1972 and received aid under such plan on the basis of disability for at least one month prior to July 1973 and for December 1973, provided that he/she is continuously disabled as so defined.
.4 Additional criteria regarding aged, blindness and disabled eligibility shall be applied as outlined in 20 CFR 416, Subpart 1.
30-773 RESOURCES 30-773
.1 All resources, both liquid and non-liquid, shall be evaluated based upon their equity value with the exception of automobiles, which shall be evaluated as specified in .6(c) below.
.2 Each aged, blind, or disabled individual whose eligibility for aid commenced on or after January 1, 1974 may have countable resources not in excess of $1,500 in value and be eligible.
.3 An individual who is living with either an eligible or ineligible spouse may have countable resources not in excess of $2,250 in value and remain eligible.
.31 The $2,250 limitation includes the resources of such spouse.
.4 The resources of a recipient child who is living with his/her parent, parents, or parent and spouse of parent, shall be deemed to include that portion of the countable resources of his/her parent(s) and spouse of parent which exceeds $1,500 in value in the case of one parent, or $2,250 in value in the case of two parents or parents or parent and spouse.
.41 For the purposes of this section, a recipient child is an unmarried person under the age of 18.
.5 Individuals receiving AB, ATD, or OAS in December 1973, including individuals who applied for aid in December 1973 and met all the conditions of eligibility for payment in that month, shall continue to be subject to the property limitations in effect in December 1973 unless the recipient would be advantaged by the regulations regarding resource limitations currently in effect.
.6 In determining the countable resources of an individual, and spouse if any, the following items shall be excluded:
(a) The home.
(b) Household goods and personal effects to the extent that the combined equity value does not exceed $2,000.Where the equity value exceeds $2,000, the excess shall be counted toward the resources limitation.
(c) Automobiles, as defined in 20 CFR 416, Subpart L.
(1) One automobile shall be totally excluded regardless of its value if, for the individual or a member of the individual's household, one of the following applies:
(A) It is necessary for employment.
(B) It is necessary for transportation to a site for medical treatment of a specific ongoing medical problem.
(C) It is modified for operation by or transportation of a handicapped person.
(2) If no automobile is excluded under (1) above, one automobile shall be excluded from counting as a resource to the extent its current market value does not exceed $4,500.
(A) If the market value exceeds $4,500, the excess shall be counted against the resources limitation.
(3) When the recipient or spouse has more than one automobile, such additional automobile(s) shall be treated as non-liquid resources and shall be counted to the extent of their equity value unless they are the property of a trade or business, or are nonbusiness properties which are essential to the means of self-support, as provided in (d) and (e) below.
(d) Property of a trade or business which is essential to the means of self-support, as provided in federal guidelines.
(e) Nonbusiness property which is essential to the means of self-support, as provided in federal guidelines.
(f) Resources of a blind or disabled individual which are necessary to fulfill a plan for achieving self-support as described in Section 30-775.436.
(g) Life insurance if the face value does not exceed $1,500.If the face value exceeds $1,500, the entire cash surrender value of the insurance shall be counted toward the resources limitation. Term insurance and burial insurance shall be totally excluded.
(h) Any other resources deemed excludable by the Secretary of Health and Human Services under the provisions of Title XVI of the Social Security Act.
(i) Restricted allotted land owned by an enrolled member of an Indian tribe.
(j) Per capita payments distributed pursuant to any judgment of the Indian Claims Commission or the Court of Claims in favor of any Indian tribe as specified in Public Law 93-134.
(k) Shares of stock and money payments made to Alaskan Natives under the Alaskan Native Claims Settlement Act provided that the payments or stock remain separately identifiable and are not commingled with nonexempt resources. Any property obtained from stock investments under the Act shall not be exempt.
(l) Tax rebates, credits or similar temporary tax relief measures which state or federal laws specifically exclude from consideration as a personal property resource. The specific rebates and credits listed in Section 30-775.42(a) shall also be exempt as property provided that the monies retained are not commingled and are separately identifiable as a proportionate share of the recipient's property.
(m) Otherwise countable resources shall be exempt up to the amount of benefits paid on behalf of the applicant/recipient for long-term care services under a State certified long-term care insurance policy or certificate, certified by the State to provide such exemption.
(1) Any income generated by such exempt property is countable as income in the month received.See Section 30-775.
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(A) An example of income generated by such exempt property would be rental income generated by an exempt resource.
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(2) The burden shall be rebuttably presumed to have been met if the applicant/recipient presents a "SERVICE SUMMARY" signed by a representative of the insurance company verifying that the applicant/recipient is a holder of an insurance policy or certificate certified by the State to provide the exemption, and specifying the total amount of qualifying benefits paid out under the policy to date.
(3) The amount of the qualifying benefits stated to have been paid in the "SERVICE SUMMARY" referred to in Section 30-773.6(m)(2) shall be the amount of the exemption to which the applicant/recipient is entitled.
(4) If the statement by the insurance company is found to be erroneous, the county shall promptly notify the California Department of Health Services.
(5) If the statement by the insurance company is such that the county cannot determine whether the applicant/recipient is covered by a qualifying policy or the amount of the benefits paid out on behalf of the beneficiary, the county shall deny the exemption. When an exemption is denied, the county shall refer the recipient to the California Department of Health Services for assistance and shall notify the California Department of Health Services of the reasons for this determination.
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(6) This is a sample of a SERVICE SUMMARY as referred to in Section 30-773.6(m)(2). The service summary is a form required by the California Department of Health Services.(See Title 22, Sections 58032 and 58080.)
(Company letterhead with company seal)
Name of InsuredDate of Birth
Social Security Number
Address of Insured
Policy NumberIssue Date
Insurance Company
SERVICE SUMMARY:The Total Amount of Benefits Paid for$91,000
Long-Term Care Services Countable toward
the Medi-Cal Property Exemption
To the Insured:This summary provides you with the total amount of insurance payments that count towards the Medi-Cal Property Exemption to be applied in determining eligibility for the State of California's Medicaid (Medi-Cal) Program.Please examine this summary and carefully compare your current asset total with the amount.If the amount of your Medi-Cal Property exemption is close to the amount of the assets you currently have, you may be eligible for the Medi-Cal Program.It is your responsibility to make application to the county (usually the Department of Social Services) for such eligibility.At the time of your application, a determination will be made whether and when you are eligible.(Please note:You may have assets, in addition to the Property Exemption listed above, that are exempted from the determination of Medi-Cal eligibility.)
To the County:This summary verifies that the amount indicated with the label "SERVICE SUMMARY" was paid by (company name) for long-term care services as defined in California Code of Regulations, Title 22, Section 58023 on behalf of the person whose name appears as the "Name of Insured" above.This amount is exempt from the determination of Medi-Cal eligibility pursuant to California Code of Regulations, Title 22, Section 50453.7.If such person is found eligible for Medi-Cal by applying the Medi-Cal Property Exemption amount reported in this summary and after receiving Medi-Cal services is found to be ineligible solely by reason of errors in this summary, the Department of Health Services may recover from (company name) the amount of service payments as provided in California Code of Regulations, Title 22, Section 58082(e).
(Name and Title)(date)
(Company Name)
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.7 Disposition of Resources.
.71 Although an individual's resources, including those of his/her spouse, exceed the limits imposed in .2 through .4 above, he/she shall be eligible for IHSS during the period of disposition of such excess resources provided that he/she meets other eligibility criteria, including those specified in this section.
.711 In no event shall total countable resources exceed $3,000 in value for an individual, or $4,500 in value for an individual and spouse.Total countable liquid resources shall not exceed $714 for an individual or $1,071 for an individual and spouse.
.72 The applicant or recipient shall agree in writing to dispose of the excess resources within the time limit specified in .74 below and to repay any overpayments with the proceeds of the disposition.
.73 During the period that the excess property is held and is under disposition, in accordance with the individual's agreement to dispose of the property, any IHSS payments made shall be considered to be overpayments.
.731 The net proceeds from the disposition of the excess property shall be considered to be available for liquidation of overpayments occurring during the disposition period in accordance with Section 30-768.3.
.74 The disposition of the excess property shall be accomplished within a six-month period in the case of real property and within three months in the case of personal property.
.741 The time period shall begin on the date the agreement is signed by the individual.
(a) In the case of a disabled individual, the time period shall begin on the date of the disability determination.
.742 The time limits may be extended another three months where it is found that the individual had "good cause" for failing to dispose of the property within the original time period.
(a) "Good cause" shall exist if, despite reasonable and diligent effort on his/her part, he/she was prevented by circumstances beyond his/her control from disposing of the property.
NOTE: Authority cited: Section 22009(b), Welfare and Institutions Code. Reference: Section 22004, Welfare and Institutions Code.
30-775 INCOME 30-775
.1 Income means the money or other gain periodically received by an individual for labor or service, or from property, investment, operations, etc. Income may be in the form of cash, including checks and money orders; in-kind items; real property; or personal services.
.11 When the item of receipt is not in the form of cash, the cash equivalent shall be determined.
.12 An individual's or individual and eligible spouse's income shall include all of his/her or their income in cash or in-kind, both earned and unearned.
.13 An individual's income shall also include those amounts of income of his/her eligible spouse, or, if the individual is a child as defined in Section 30-770.3, of his/her parent and parent's spouse residing in the same household.
.14 If income after applying the allowable disregards or exclusions exceeds the appropriate SSI/SSP benefit level, the excess shall be applied to the cost of IHSS.
.2 Earned Income
.21 Earned income means:
.211 Gross wages.
.212 Net earnings from self-employment.
(a) Net earnings shall be determined by deducting from gross earnings from self-employment all ordinary and necessary business expenses. Principal payments on encumbrances and personal income taxes shall not be considered expenses. Schedules attached to Form 1040 of the IRS for various types of self-employment may be used to verify allowable expenses.
.213 Those amounts of countable earned income deemed to be available to the individual from the income of his/her ineligible spouse, or parent(s) in the case of a recipient child.
(a) When a parent and recipient child live in a household with the parent's spouse, who is not the parent of the child, the income of the parent's spouse shall also be deemed to the child.
(b) Deeming procedures shall conform to those specified in 20 CFR 416.1185, as set forth on the form(s) developed and approved by the department.
.3 Unearned Income.
.31 Unearned income means all other available income.
.32 In evaluating the amount of unearned income which is available to the individual, consideration shall be given to any necessary costs involved in obtaining or securing the income.
.33 Unearned income includes, but is not limited to, the following:
.331 Support and maintenance furnished in cash or in-kind.
(a) A person who meets the criteria in Section 46-325.51 shall have the household of another SSI/SSP benefit level used to compute share of cost in lieu of counting the support and maintenance as unearned income.
(1) A person subject to the above procedure may still be eligible for IHSS if living in his/her own home as defined in Section 30-753.
.332 Any payments received as an annuity, pension, retirement, disability, OASDI, unemployment, veteran's or workmen's compensation benefit.
.333 Prizes and awards.
.334 Gifts, support and alimony payments, and inheritances.
.335 Rents, dividends, interests, and royalties.
.336 The proceeds of any life insurance policy to the extent that they exceed the amount expended by the beneficiary for purposes of the insured individual's last illness and burial expenses or $1,500, whichever is less.
.337 Those amounts of countable unearned income deemed to be available to the individual from the income of his/her ineligible spouse or parent(s) in the case of a recipient child.
(a) When a parent and recipient child live in a household with the parent's spouse, who is not the parent of the child, the income of the parent's spouse shall also be deemed to the child.
(b) Deeming procedures shall conform to those specified in 20 CFR 416.1185, as set forth on the form(s) developed and approved by the department.
.4 Payments Excluded or Disregarded in Considering Income.
.41 In determining the eligibility for and amount of IHSS, certain payments received or portions thereof shall not be counted as income to the individual and eligible spouse. These exclusions shall also apply in deeming from an ineligible spouse or, in the case of a recipient child, the ineligible parent(s).
.42 The following items shall be excluded from consideration as income:
(a) Refunds, credits and rebates of taxes.
(1) Refunds of taxes paid on real property or purchased food received from any public agency, or renter's credit payments, or special tax credit payments for renters 62 years and older.
(2) mTax rebates, credits or similar temporary tax relief measures which state or federal law specifically exclude from consideration as income.
(b) Assistance based on need.
(1) Payments which are composed entirely of state or local government funds, when made under a program using income level as a criteria for determining the amount of such payment.
(A) When federal or nonpublic monies are included in the assistance payment, such payments shall be countable, including AFDC payments to federally eligible persons, which are countable on a dollar-for-dollar basis related to the recipient's pro rata share.
(c) Grants, scholarships, and fellowships.
(1) Any portion of any grant, scholarship, or fellowship received, used or to be used in paying tuition and fees at any educational institution, including technical or vocational.
(d) Home produce.
(1) The value of agricultural products which are not raised in connection with a trade or business and are utilized for consumption by the household.
(A) If the produce is sold, the net earnings shall be countable as earned income.
(e) Foster care payments.
(1) Payments for the foster care of a child who is not an eligible individual but who resides in the same home as such individual and was placed there by a public or nonprofit agency.
(f) Support payment from an absent parent.
(1) One-third of any payment received from an absent parent for an eligible individual who is a child as defined in Section 30-770.3.
(A) The remainder shall be countable as unearned income.
(g) Readers and educational scholarships for the blind.
(1) Funds, not available to meet basic needs, awarded for readers and educational scholarships by a high school, institution of higher learning, or a vocational or technical training institution to a recipient due to his/her blindness while he/she is regularly attending any public school or any institution of higher learning in this state.
(h) Vendor payments.
(1) Payments made from any source to a vendor in order to meet the needs of the recipient for medical or social services, as determined by the county welfare department. When the vendor is the recipient's spouse, the provisions of .213 above shall apply.
(i) CETA incentive payments.
(1) Up to $30 per week of the incentive allowances made to trainees under Title I of the Comprehensive Employment and Training Act (CETA).
(A) This exemption shall apply to any CETA trainee whose needs or income are taken into account in determining the amount of public assistance payments to himself/herself or others.
(B) This exemption shall not apply to wages or other training allowances under the Act.
(j) Payments to Indians.
(1) Per capita payments distributed pursuant to any judgment of the Indian Claims Commission or the Court of Claims in favor of any Indian tribe as specified in Public Law 93-134.
(A) This exemption shall apply to anyone whose income is taken into account to determine the eligibility or grant of a recipient.
(k) Payments made to Alaskan Natives.
(1) Shares of stock and money payments made to Alaskan Natives under the Alaskan Native Claims Settlement Act.
(A) Income resulting directly from stock investments under the Act shall not be exempt.
(l) Supportive services payments.
(1) Payments for supportive services or reimbursement of out-of-pocket expenses made to persons serving in the Service Corps of Retired Executives (SCORE) and the Active Corps of Executives (ACE) pursuant to Section 418 of Public Law 93-113.
(A) This exemption shall apply to all persons whose income is taken into account in determining the amount of the IHSS payment.
(m) Domestic Volunteer payments.
(1) Payments made under the Domestic Volunteer Services Act of 1973 to welfare recipients who are VISTA volunteers.
(n) Supplemental food assistance.
(1) The value of supplemental food assistance received under the Child Nutrition Act (WIC) and the National School Lunch Act, as specified in Public Laws 92-433 and 93-150.
(o) Energy assistance allowances.
(1) Payments or allowances made under any federal, state or local laws for the purpose of energy assistance, e.g., Low Income Energy Assistance Program (EAP), Energy Crisis Assistance Program (ECAP), and Crisis Intervention Programs (CIP) payments.
(A) Such payments or allowances shall be clearly identified as energy assistance by the legislative body authorizing the program or providing the funds.
.43 The following disregards shall be applied in the order listed below:
.431 Infrequent or irregular income.
(a) Unearned income.
(1) Unearned income which does not exceed $60 per quarter and is received not more than once per quarter or cannot be reasonably anticipated.
(b) Earned income.
(1) Earned income which does not exceed $30 per quarter and is received not more than once per quarter or cannot be reasonably anticipated.
.432 Student exemption.
(a) Up to $1,200 per calendar quarter of the earned income of the recipient who is a child and a student, but in no instance more than $1,620 per calendar year.
.433 The first $20 per month.
(a) The first $20 of earned or unearned income per month not disregarded above. If the eligible individual or individual and eligible spouse has:
(1) Only earned income, the disregard shall be applied to that income.
(2) Only unearned income, the disregard shall be applied to that income.
(3) Both types of income, the disregard shall first be applied toward the unearned income, and any amount of the disregard remaining shall be applied to the earned income.
.434 Earned income.
(a) The first $65 per month of earned income not disregarded above plus one-half of the remainder.
.435 Work expenses of the blind.
(a) Earned income not disregarded above of a blind individual in the amount of ordinary and necessary expenses related to work activity, and only to the extent that they are paid or to be paid. Broad categories of expenses shall include but not be limited to the following:
(1) Transportation to and from work.
(2) Job performance.
(3) Qualification for promotion.
.436 Income necessary to achieve self-support.
(a) Earned or unearned income not disregarded above and received by an individual who is blind or disabled as defined in Sections 30-771.2 and .3 to the extent that such income is needed to implement a plan of self-support.
(1) Such plan shall be in writing and shall be approved by the United States Social Security Administration (SSA) unless a state-approved plan is still in effect when the blind or disabled individual becomes eligible for IHSS.
(2) The plan shall contain the following elements:
(A) Specific savings and/or disbursement goals for a designated occupational objective.
(B) Identification and segregation of such money and other resources as are being accumulated and conserved toward this goal.
.437 Income exclusions for certain blind individuals.
(a) For an individual who is blind as determined under the state plan approved until Title X as in effect in October 1972, and who received assistance under such plan in December 1973, an amount equal to the greater of the following:
(1) The maximum amount of any earned or unearned income which could have been disregarded under the state plan as in effect in October 1972; or
(2) The amount which would be required to be disregarded under .4 above without application of this subsection.
30-776 PROVIDER ENROLLMENT 30-776
.1 An applicant provider shall complete the enrollment requirements specified in Sections 30-776.41, 30‑776.42, 30-776.43, and 30-776.44 before he/she can be enrolled as a provider and receive payment for providing services for a recipient(s).
.2 An applicant provider shall be allowed a maximum of 90 calendar days to complete all of the enrollment requirements specified in Sections 30-776.41, 30-776.42, 30-776.43, and 30-776.44.
.21 The county shall deem ineligible a prospective provider who does not complete all of the enrollment requirements within 90 calendar days of initiating the enrollment process.
.211 Initiating the enrollment process shall be defined as either:
(a) Completing any one of the enrollment requirements specified in Sections 30‑776.41, 30-776.42, 30-776.43, and 30-776.44, or
(b) Being designated by a recipient (in writing) as the individual from whom the recipient elects to receive his/her authorized services.
.22 Prior to determining an individual who has failed to complete the enrollment requirements within 90 calendar days ineligible to be a provider, the county shall send a notice to the prospective provider informing him/her that he/she will be determined ineligible to be a provider unless he/she completes the remaining provider enrollment requirements.
.221 The notice shall include the following:
(a) The specific provider enrollment requirements that the individual has failed to complete.
(b) The date by which the individual must complete the requirements or be determined ineligible.
.222 The notice shall be sent at least 15 calendar days before the 90-day time period for completing the enrollment requirements ends.
.23 The county may extend the period for which an individual may be allowed to complete the enrollment requirements by an additional 45 calendar days for "good cause," which includes, but is not limited to:
(a) A delay that is directly attributable to a county error;
(b) A delay in the county's receipt of the results of the individual's criminal background check from the Department of Justice;
(c) An unforeseen illness, hospitalization, or other medical issue prevents the individual from completing the enrollment requirements.