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400-1 AN OVERVIEW OF THE ADULT PUBLIC ASSISTANCE PROGRAM
Alaska's Adult Public Assistance ( APA ) program was established in Alaska law "to furnish financial assistance as far as practicable to needy aged, blind, and disabled persons, and to help them attain self-support or self-care".
A set of changes to the state statutes enacted in 1982 combined the three formerly distinct Old Age Assistance ( OAA ), Aid to the Blind ( ABL ), and Aid to the Permanently and Totally Disabled ( APD ) programs into today's APA program. The primary purpose of the 1982 statutory changes was to integrate state program policy with that of the federal Supplemental Security Income ( SSI ) program which was established effective January, 1974 by Title XVI of the Social Security Act. The SSI program is a national, federally funded program which, like APA , provides financial assistance to the needy aged, blind, and disabled. The SSI program is administered by the federal Social Security Administration ( SSA ).
The intent of the 1982 APA legislation was to establish APA as a state-funded and administered program to supplement the benefits provided by SSI . The SSI and APA programs use basically the same eligibility criteria. Although the two programs differ in administrative procedures and in certain eligibility criteria, the essential difference between SSI and APA is APA 's higher standard of need.
The language of the APA statutes commits the State to a policy of cooperation and coordination with the federal government and its agencies in the administration of APA for the residents of Alaska. Most of the other States operate similar, state-funded programs that supplement the benefits of the SSI program. States may opt for federal administration of their supplemental benefits; in these States the Social Security Administration ( SSA ) determines eligibility and disburses payments for the state supplement as part of the SSI administrative process. States also may opt to have SSA determine Medicaid eligibility for SSI recipients.
Alaska has chosen to administer its own state supplement and to make its own Medicaid eligibility decisions. Even though Alaska administers its own programs, regular and frequent exchanges of information between the State's administering agencies and the SSA are essential to the operation of the APA program. In the interest of efficiency, the State regularly accepts the decisions of the Social Security Administration regarding eligibility and countable income levels for individual cases and applies the decisions to APA cases; to do otherwise would involve an unnecessary duplication of effort.
Before the establishment of the SSI program, the OAA , ABL , and APD programs were administered by the State but were jointly funded by state and federal monies. The APA program is now funded entirely by the State. However, the State's Medicaid Plan includes Medicaid benefits for most recipients of APA .
Note: Effective October 1, 2026, SSI and APA recipients must also meet Medicaid qualified alien requirements for Medicaid. Refer to ADLTC MS 522 and MAGI MS 808 for Medicaid policy on U.S. citizenship and eligible alien status.
The APA program is administered through the local offices of the Division of Public Assistance ( DPA ) of the Alaska Department of Health (DOH). DPA , with its staff of case workers, is the agency that determines eligibility and provides APA financial assistance.
Another agency of DOH , the Division of Health Care Services ( DHCS ) is responsible for administration of the Medicaid program; however, DPA makes the eligibility decision and authorizes Medicaid benefits to eligible APA recipients. This shared administrative responsibility requires a great degree of coordination and cooperation between the two divisions.
The Division of Public Assistance also cooperates with the Division of Vocational Rehabilitation ( DVR ) of the Alaska Department of Labor and Workforce Development in the administration of the APA program. DVR evaluates the disability of certain APA applicants and accepts referrals for vocational rehabilitation services.
To fulfill its responsibility to furnish financial assistance to Alaska's needy aged, blind, and disabled, DPA provides information about the APA program and furnishes applications to all individuals who wish to apply. Case workers make decisions on all applications submitted, based on state and federal eligibility criteria. APA benefits are provided in the form of a monthly check that supplements the individual's or couple's monthly income up to the applicable monthly maximum amount provided for under Alaska state law.
This manual is provided as a tool for the case workers who administer the APA program. It provides an explanation of the federal and state policies which apply to the determination of eligibility for the APA program and to the provision of benefits to eligible individuals and couples.
400-2 PRUDENT PERSON JUDGMENT
This manual is a broadly written guide to the policy and procedures that apply to the administration of the APA program. It is impossible to anticipate every issue that a case worker will encounter in his or her casework. It is expected that the case worker will, from time to time, encounter circumstances where the manual does not provide enough detail to make a decision on an individual's eligibility.
Case workers are expected to operate independently and to apply their prudent judgment to the decisions they make in the course of their work. If a case worker is unable to reach a decision on a particular point of eligibility, he or she is expected to consult with his or her supervisor or with the supervisor's designee. In all circumstances, it is important that the decision made, and the reasons for that decision, be documented in the case file in enough detail to allow another worker or a reviewer to understand what was done and why it was done.
Because of the unique relationship between the APA program and the Supplemental Security Income ( SSI ) program, the APA case worker will sometimes need to know the SSI policy on a particular point of eligibility. The SSI policy manuals are written in much greater detail than this manual. Case workers are, however, discouraged from contacting SSA personnel for policy clarification; the APA Policy Specialist is, in all circumstances, to be used as the contact for clarification of APA policy. Questions from field staff are encouraged and will be dealt with as quickly as possible.
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400-3 CONFIDENTIALITY AND DISCLOSURE OF INFORMATION
Applicants for, and recipients of, Adult Public Assistance, in order for their eligibility to be determined, must make known to the Division and its case workers many intimate facts about their personal lives. Additionally, APA applicants and recipients are often under extreme financial and personal stresses which could make them particularly vulnerable to exploitation if their situation were known. They are, therefore, in particular need of the protection of privacy and confidentiality.
It is against the law to use or disclose information obtained from Adult Public Assistance households to any person other than the applicant or recipient, with the following exceptions:
Persons directly involved in the administration of the APA program;
Persons directly involved in the enforcement of the provisions of the APA program;
Persons directly involved in other state-or federally-funded public assistance programs. Such programs include General Relief Assistance ( GRA ), Alaska Temporary Assistance Program ( ATAP ), Supplemental Nutrition Assistance Program ( SNAP ), Energy Assistance, Medicaid, Supplemental Security Income ( SSI ), or Bureau of Indian Affairs General Assistance ( BIA-GA ).
Note: For APA purposes, such programs do not include Unemployment Insurance Benefits ( UIB ).
Further guidance regarding confidentiality and disclosure requirements may be found in section 100-3 of the Administrative Procedure Manual.
400-4 VERIFICATION
400-4 A. REQUIREMENT TO PROVIDE NECESSARY VERIFICATION
An individual must satisfy many eligibility requirements to be determined eligible to receive APA benefits. The client must provide proof that he or she meets each factor of eligibility. The proof offered by the individual may consist of written documents or, if appropriate, the names of collateral contacts who have knowledge of the client's circumstances. The case worker must evaluate the evidence offered and apply prudent judgment in deciding if the evidence shows that the eligibility factor is met. Guidelines for verification of each factor of eligibility are presented in the manual sections that specifically address each factor.
400-4 B. INFORMING THE CLIENT OF REQUIREMENT TO PROVIDE NECESSARY VERIFICATION
If a particular factor of eligibility must be verified so that a decision can be made on a client's eligibility for assistance, the case worker shall provide the client with a written notice that states what evidence is needed and gives a reasonable amount of time (at least 15 days) to submit the necessary proof. Whenever possible, the case worker should follow-up a written notice to a blind applicant or recipient with a telephone call.
If the client fails, without good cause, to respond to the notice within the amount of time allowed, eligibility for assistance does not exist. If the client responds to the notice and indicates that he or she is either unable to provide the necessary evidence or unable to understand what is being asked for, the client must be provided with help in understanding the requirement and getting the necessary proof.
400-4 C. FAILURE TO PROVIDE NECESSARY VERIFICATION
Eligibility does not exist if an applicant or recipient fails to provide necessary verification or refuses to allow the agency to verify information relevant to his or her eligibility for benefits.
If the client provides the verification before the effective date of the case closure, the caseworker must accept the verification and process the reported change.
400-4 D. RESPONSIBILITY TO PROVIDE NECESSARY VERIFICATION
The client is always responsible for providing whatever verification is necessary to establish his or her own eligibility for benefits. If, however, the case worker can obtain the needed evidence more easily or more quickly than the client, he or she should do so. For example, if a case worker can get information from SSA through the State Data Exchange ( SDX ), Beneficiary and Earnings Data Exchange ( BENDEX ), or State Verification Exchange System ( SVES ), there is no need for the client to provide proof of the same information.
Case workers must also keep in mind that many APA clients are limited in their capacity to understand program eligibility requirements or to take the steps necessary to get required verification, and offer help with the process if necessary. In many circumstances, it is best to encourage the client to contact a social service or advocacy agency or to appoint an authorized representative for help in getting the needed verification.
400-4 E. WHEN VERIFICATION IS NOT NECESSARY
It is not necessary to get documents or other evidence to verify that a client is ineligible for assistance if the client provides credible information which shows that he or she does not meet one or more factors of eligibility. If, for example, an individual alleges in an interview or on an application that he or she receives monthly income in excess of the applicable maximum, assistance may be denied based on the client's statement.
400-5 DOCUMENTATION
The case record must show that all relevant eligibility criteria have been considered, and that necessary verification has been obtained. The recording of this information in the case record is known as documentation. The case worker must document every eligibility decision well enough so that a reviewer examining the case record can understand what action was taken on the case and why it was taken. The requirement for documentation applies not only to recording how eligibility was verified, but also to recording how the case worker applied prudent judgment to determine eligibility.
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400 GENERAL INFORMATION
This chapter provides a general overview of the Adult Public Assistance ( APA ) program. It also sets forth certain procedural requirements that case workers must follow when they determine an individual's eligibility for APA . The APA program is authorized under Alaska Statutes 47.25.430 - 47.25.615 and the Alaska Administrative Code (state regulations) at 7 AAC 40.005 - 40.900.
410-1 ELIGIBILITY IN ONE HOUSEHOLD
An individual may only be determined eligible as a member of one household at a time in any given month.
410-2 THE APPLICATION FORM
410-2 A. WHAT IS AN ACCEPTABLE APPLICATION FORM?
An application form approved by the division must be submitted in one of the approved ways outlined in APA MS 410 . The Eligibility Review Form (GEN 72) is the recertification application form that is used to determine continued eligibility.
If received in the month following case closure for any reason, the GEN 72 form can be used as an initial application form.
If received after the month following the end of the review/recertification period, a GEN 50C application form is required. The GEN 72 form will be accepted to protect the benefit start date, however, it cannot be used as the initial application form.
A Native Family Assistance Program ( NFAP ) application form is an acceptable application and recertification form.
The MED 4 specialized application form is also available and its use is encouraged when appropriate. The MED 4 is used to apply for nursing home, home and community-based services, disabled children living at home ( TEFRA ) coverage, children applying for or receiving SSI , and APA .
410-2 B. WHEN IS AN APPLICATION REQUIRED?
Upon the individual's first application for a program, even if the individual is already a recipient of another DPA assistance program.
Upon application from a denied, withdrawn, or closed status, unless the denial or closure was the result of an administrative error.
Any time the caseworker believes the individual’s circumstances have changed sufficiently to justify conducting a special redetermination of eligibility, including when an office conducts a special review project for all or part of its caseload.
410-2 C. WHEN IS AN APPLICATION NOT REQUIRED?
To reopen a closed case as a result of an individual's timely request for a fair hearing, or to open or reopen a case as the result of a fair hearing decision.
To reopen a case that had been closed incorrectly.
To resume benefits after benefits have been suspended.
To redetermine eligibility after the application is denied for failing to provide verification and the household provides the verification within 30 days from the application filing date.
To redetermine eligibility after the application is denied for failing to participate in an interview and the household contacts the office to reschedule the interview within 30 days from the application filing date.
When there is a change in "payee", "in care of" addressee, or mailing address.
When an aged, blind, or disabled Medicaid recipient who has been living in a Medicaid institution and is ineligible for APA benefits leaves the institution to live in the community, APA benefits may be started without a new application. A caseworker may require a special review if he or she considers it necessary.
When a household is ineligible for the first month, but eligible for the second month or months following the initial months. See manual section 410-5A .
410-2 D. WHAT IS AN IDENTIFIABLE APPLICATION?
An identifiable application is an acceptable application form containing the applicant’s name, address, and signature (or witnessed mark) of the individual seeking assistance or of the individual's authorized representative. Each DPA office must accept and date the identifiable application when it is presented.
See MS 410 for application signature requirements.
An individual who contacts a DPA office and who shows interest in the program or a desire to apply shall be advised of his or her right to submit an identifiable application on the date of the contact in order to establish the benefit start date. The individual may file an identifiable application on an acceptable application form, as described at manual section 410-2A.
410-2 E. WHO CAN SIGN THE APPLICATION FORM?
The applicant
The applicant's authorized representative
An individual who has legal authority to act on the applicant’s behalf (i.e., Office of Public Advocacy, legal guardian)
An individual with appropriate power of attorney
A responsible person, if the individual filing the application is incapable of applying and of appointing an authorized representative in writing.
The signer must certify, under penalty of perjury, the truth of the information contained in the application.
The proper individual to sign an APA application is the applying adult. If both members of a married couple wish to apply, they may do so on a single application form if both spouses sign the form. If the applying adult is incompetent or incapacitated, or wishes to appoint an authorized representative, a responsible individual acting on the individual's behalf may apply for him or her.
See MS 410 for application signature requirements.
Note: If both members of a married couple wish to apply, both spouses must sign the application.
410-2 F. WHO CAN BE AN AUTHORIZED REPRESENTATIVE?
A responsible adult, 18 years or older, may be designated by the applicant in writing as authorized representative. If the applicant is illiterate, his/her mark must be witnessed by two individuals who must each sign their names and date the document. No special form is required.
Authorized representatives may sign the application and act on behalf of a household. A household member should prepare or review the application, if possible, even though the authorized representative will be filing the application and/or participating in the interview.
410-2 G. COMPLETING THE APPLICATION FORM
In addition to making an identifiable application and having it signed by an eligible individual, the applicant must answer all of the questions on the application form.
If the individual requests help in completing the application form, the caseworker will offer assistance.
If the application form is not completed, the caseworker will allow the household an opportunity to complete the form. In this case, written notification will be sent to the household listing the items that need to be completed. See manual section 410-5C , Pending the Application.
410-3 THE INTERVIEW
410-3 A. WHEN IS AN INTERVIEW REQUIRED?
An interview is required at the time of initial application and once every 12 months thereafter.
An interview does not need to be completed if a household submits their recertification after the end of the certification period but within the following month and they are not due for their annual interview.
Note: Individuals who only receive APA /MED benefits, that also receive any amount of SSI, are not required to complete an annual APA interview. If they stop receiving SSI or are receiving benefits (as the PI or SP) from a program that requires an annual interview, such as SNAP , they are required to complete an APA annual interview. See APA MS 480-1B . The annual APA interview is required even if the SNAP interview is waived.
410-3 B. WHO MUST PARTICIPATE IN THE INTERVIEW?
The applicant, their authorized representative, or an individual with the legal authority to act on the applicant's behalf such as a legal guardian or power of attorney.
If legally married, only one spouse needs to participate in the interview.
410-3 C. WHO CAN CONDUCT THE INTERVIEW?
• DPA Caseworker:
Most individuals will be interviewed by a DPA caseworker in the DPA office or by telephone.
• DPA -contracted Fee Agent:
In communities where there is no DPA office, the fee agent conducts the interview for individuals who want to apply for public assistance. The fee agent will complete a Fee Agent Interview Report form (FA #1) and submit it with each application.
Note : Regardless of who conducts the interview, if additional information or verification is needed to process the application, the caseworker will contact the applicant to get this information.
410-3 D. HOW TO CONDUCT AN INTERVIEW
Interviews can be conducted face-to-face, by phone or, in rare circumstances when a face-to-face or phone interview is not possible, by correspondence.
The caseworker may require a face-to-face interview if they determine it is appropriate to the situation unless attending in person is a hardship to the household. A face-to-face interview must be provided when requested by the household.
410-3 E. SCHEDULING INTERVIEWS
Interviews must be scheduled for applicants who cannot be interviewed on the day they submit an application. This means the DPA office must give the applicant a date and time for the interview appointment. The office must document the applicant was informed of their interview date and time by:
Writing a case note indicating the applicant was informed and agreed to their interview date and time over the phone. The case note must include the date and time the applicant was given for the interview; or
Writing a case note indicating the applicant was informed of their interview date and time in writing via the “What do I need to bring to my interview?” sheet in the GEN 50C . The case note must include the date and time the appointment was given for the interview; or
Sending an EIS notice informing the applicant of their interview date and time.
The interview must be scheduled timely to ensure eligible households have an opportunity to participate within 30 days after the application is filed.
Applicants may have anyone they choose with them at the interview. During the interview, applicants must be informed of their rights and responsibilities and basic program procedures.
When the applicant fails to participate in a scheduled interview and does not reschedule, the application is denied. If the household contacts the office within 30 days of the application filing date, the office must schedule an interview. If the household is determined eligible, the original application is used and benefits start based on the date the application was filed.
Note: If an application is registered on EIS Eligibility Information System as an Adult Public Assistance request for service (RP), EIS Eligibility Information System will automatically deny the application. The denial action is done on or after the 30th day from the date the application was filed, depending on when the weekly denial job is run. The household is notified via the system-generated notice X022, No APA Interview.
410-3 F. CHANGES REPORTED DURING THE INTERVIEW
Applicant households must report all changes affecting their eligibility or benefits during the interview. Changes reported after the interview, but before a case decision is made, will be considered in the initial eligibility determination.
When an applicant reports that a spouse has moved into the home before a case decision is made, the spouse must be included in the household beginning with the month the spouse moved in. When an applicant reports that a spouse has moved out of the home, that spouse is still considered to be part of the household for the month during which the spouse moved out.
Example: Hope applies for APA on May 27. At the interview on June 5, she reports that her spouse moved in on May 30. The spouse is considered part of Hope’s household for May. If her spouse had moved in on June 3, he would be included in Hope’s household beginning June 1.
Example: Brie applies for APA on April 1. Her application lists herself and her spouse as household members. On April 10, she reports that her spouse left the home that day due to incarceration. Her spouse is considered to be a household member for April. He is not considered to be a household member for May, the month after he moved out.
410-4 VERIFICATION
See manual section 400-4 for policy on verification.
Information from Data Systems and EIS Interfaces
Several data systems and computer interfaces are available through the Internet and on-line EIS access. Some interfaces must be checked at each application and recertification as part of the verification process. Others only need to be checked if questionable or if certain conditions apply
a. Interfaces That Must Be Checked
Interface Information Verified When To Check Instant Eligibility Verification System (IEVS) Provides information that may indicate questionable eligibility At each application, review, and when adding a spouse. Department of Labor (DOL) Unemployment SAM Unemployment Insurance Benefits Unreported employment At each application and review. SDX #9 on INME for EIS Social Security Information At each application and review. ( SOLQ ) #14 on INME for EIS SSA and SSI payments At each application and review. BENDEX #15 on INME SSA payments Medicare At each application and review. Department of Labor (DOL) Quarterly Wage In IEVS Employment history through quarterly wage match. At each application and review. CSED ACSESS Child Support collections Child support disbursements Legal obligation to pay child support At each application and review. SVES #13 on INME for EIS Social Security Information, including quarters of work Death Match Prisoner Match At each application and redetermination. *Death match alerts that are generated during the certification period must be processed within 10 days.
b. Interfaces That Are Checked If Questionable or Under Certain Conditions
Interface Information Verified When To Check SAVE In IEVS Qualified alien status of household members who are not U.S. citizens This verification is only required for each alien at initial application and whenever an alien is added to a household.
Note: T he SOLQ interface may be used only to determine eligibility for the Alaska Temporary Assistance, SNAP , Medicaid, and Adult Public Assistance programs.
In some situations, the information will be from the source and can be used as verification. In other situations, the caseworker must follow-up on the information.
Note: When we receive an electronic data match from Social Security Administration (Prisoner or Death match), or a prisoner match received by IEVS, that an individual may be ineligible for benefits, we must send the household a notice that gives them an opportunity to dispute the information before we take action to reduce or end their ongoing benefits. See Admin MS 108-5 for current EIS notices.
Example: The caseworker checks the interfaces and data systems for the two members of an applicant household. The Department of Labor system shows one is currently receiving unemployment benefits of $120 weekly. This information is used as income verification since the information is directly from the source of the income. The caseworker also finds that the other applicant had earnings listed for the prior quarter. The caseworker contacts the household to determine if the person is still working and, if so, requests verification of wages. If the person is not working, the caseworker asks why the job ended to find out if there was a recent job quit.
410-5 ACTIONS TAKEN ON THE APPLICATION
Every applicant must be provided with adequate written notice of the action taken on the application. Adequate notice means that the individual is informed of the action taken, the reasons for the action, and the manual sections from the appropriate program policy manual that supports the action.
410-5 A. APPROVING THE APPLICATION
An approval notice must be sent to the household following a determination of eligibility. Except when the application is delayed as described below, approved households must receive benefits no later than 30 days after the application filing date. To meet this requirement, the caseworker must authorize the benefits by the 28th calendar day following the application filing date. See manual section 410-5F for policy on when an application is delayed.
• Eligible First Month/Ineligible Second Month:
A household may be eligible for the month of application and ineligible in the subsequent month. In this case, the household should be approved only for the month of application. However, if the anticipated change is expected to last only for the second month, the case should be suspended for the second month according to the temporary ineligibility policy at manual section 480-5A .
• Ineligible First Month/Eligible Second Month:
A household may be ineligible for the month of application but eligible in the subsequent month. Even though denied for the month of application, the household does not have to reapply. The same application is used for the first month denial and the determination of eligibility for the subsequent month.
• Months Following the Initial Months:
If DPA does not make a decision on an application during the first two initial months (the month that eligibility may begin and the following month), the application is valid through the month that the decision is actually made. The original application is enough to establish continued eligibility. A case worker does, however, have the authority to ask for a special review application if he or she believes that circumstances warrant it.
If an applicant is found eligible for at least one month during this period, and then becomes ineligible for a following month(s), the case worker can either suspend or terminate the APA case, depending on the circumstances. (Refer to section 480-6 for the policy on APA suspension or termination.)
410-5 B. BENEFIT START DATE
The benefit start date determines the date from which benefits begin. See manual section MS 410-7 for policy on determining the benefit start date.
410-5 C. PENDING THE APPLICATION
When the office needs the applicant to submit a complete application form, or provide information needed to determine eligibility, the application is pended, and a notice is sent. The notice clearly informs the applicant what is needed to complete the application. Applicants will be given at least 15 days, but no more than 30 days, from the date of this notice to provide the verification. The same verification pend time frames will be consistently applied to all applicants within each office.
Applicants failing to provide all necessary verification at the interview will be sent a pend notice no later than 30 days after the application filing date requesting the required verification.
Applicants contacting the agency within the pend period expressing difficulty in obtaining required verification will be offered assistance. The caseworker should extend the pend period if additional time is needed to obtain the information. A new pend notice should be sent.
If the applicant does not complete the application process, the application is denied at the end of the period provided in the notice.
410-5 D. DENYING THE APPLICATION
A denial notice must be sent to the applicant explaining the reason for the denial. This notice should be sent as soon as possible following the determination of ineligibility, but no later than 30 days following the application filing date.
Applicants denied for failing to provide needed verification by the end of the pend period will be sent a notice of denial at the end of the pend period. If the applicant provides the verification after the pend period but within 30 days of the application filing date, the caseworker must accept the verification and make an eligibility determination without requiring a new application. If the household is found eligible, the caseworker will use the original benefit start date.
Note: When the deadline for processing an application or providing verification does not fall on a workday, it will be extended to the next workday. See manual section 410-3E for policy on denying applicants for failing to participate in an interview.
410-5 E. WITHDRAWING AN APPLICATION
The applicant may voluntarily withdraw the application at any time before the eligibility determination is made.
The signed and dated request to withdraw must be submitted in writing. A telephonically recorded signature over the VCC is acceptable. The applicant must be given at least 15 days to provide the requested information. If the information is not provided within the pend period, the case will be denied due to failure to provide requested information.
Document in the case note the reason for the withdrawn application. If the applicant does not provide this information, document the reason as "unknown." Deny the application and send the APA denied - other reasons notice (P213), selecting withdrawal as the reason.
If the applicant verbally requests to withdraw their APA application or their written request does not contain both a signature and a date, the caseworker must send the applicant a notice requesting the required documentation. The applicant must be given at minimum 15 days to respond to the notice. Deny the application if the applicant fails to provide the requested documentation within the pend period. The denial notice must inform the applicant of their right to submit a new application at any time to reapply for APA .
410-5 F. WHEN THE APPLICATION IS DELAYED
If a household's eligibility has not been determined or benefits have not been authorized for an eligible household by the 30th day following the application filing date, the application is delayed. The caseworker will determine the cause for the delay and take appropriate action:
1. Agency-caused delays
Include cases where the application was not approved, denied or pended within the allowable time limits.
If an eligibility determination cannot be made by the 30th day from the application filing date because of action required by the agency, the case is left in a pending status. The household must be sent a pend notice by the 30th day.
In some circumstances, the caseworker cannot determine eligibility for APA because the decision must be based upon another agency's action. In these situations, the case worker may postpone the decision on the APA application. Written notice must be sent to the applicant within 30 days of the filing date, explaining that the application is being held pending the other agency's action. This provision applies to findings of disability by the Disability Determination Service ( DDS ) of the Division of Vocational Rehabilitation.
Individuals who have applied for SSI may be eligible for Interim Assistance while waiting for a final eligibility decision on their SSI application.
2. Household-caused delays
Include situations where the office cannot take further action on the application without an action from the household.
If the household fails to submit a complete application form or reschedule an interview by the 30th day from the application filing date the application is denied.
3. Delays caused by inability to provide a completed AB 3 or AD 2 .
DPA will postpone an eligibility decision for up to an additional 30 days if an applicant who must have an AD 2 or AB 3 examination is unable to do so within 30 days after the date that his or her application was filed for reasons beyond the individual's control.
This additional 30 days will also be granted to an applicant who has undergone an AD 2 or AB 3 examination, if the examiner has not furnished a completed AD 2 or AB 3 form to DPA .
410-6 REFERRALS TO OTHER AGENCIES
An important part of the APA application process is the identification of and referral to other benefits to which the applicant may be entitled; this requirement is explained in detail in Manual Section 420 .
There may be other publicly or privately operated programs available to APA clients who are residents of a particular community that are important sources of social and health services. Although such programs do not provide the financial assistance offered by the APA program, and APA clients cannot be required to participate in them, they often provide services which are specifically designed to meet the special needs of the aged, the blind, and the disabled. It is important for case workers to be aware of what programs are available in the communities they serve so that they may refer clients with special needs to the appropriate agencies.
Social service programs, whether operated by state or local agencies, provide a range of services without which many APA clients would simply be unable to live outside of an institution. The aged and the disabled are often highly vulnerable to financial, physical, and psychological exploitation.
Case workers should be alert for clients who may have limited ability to care for themselves, or who may be involved in abusive situations, and should, with the client's permission, make any needed referrals for social services. Similarly, some clients have special health care needs which can be met by home and community health care programs. These clients should be referred to apply for such services.
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410-7 INITIAL MONTH BENEFITS
The benefit start date for APA and Medicaid benefits may vary as follows:
410-7 A. INITIAL MONTH’S APA PAYMENT
1. Applicant meets all eligibility requirements on date of application
For applicants who meet all APA eligibility requirements (including receipt of SSI benefits) on the date of application, the benefit start date will begin the date the APA application is received in a DPA office.
2. Applicant is not eligible for SSI payment or needs a disability determination at time of application
For applicants who are not receiving SSI or those who need a disability determination, the APA benefit start date will be the first day of the month after Social Security Administration awards SSI or SSDI benefits, or the first day of the month after the Disability Determination Service ( DDS ) notifies DPA that the applicant is disabled, whichever is earlier.
If the applicant does not provide a copy of the Social Security award letter, eligibility staff can verify the award date with Social Security Administration. This can be done by contacting Social Security Administration directly or by utilizing the electronic interfaces.
Note: If there is conflicting or questionable information on the interfaces, eligibility staff must request a copy of the award letter from the applicant or verify the award information with Social Security Administration.
Example: On January 5, an individual applies for APA . The application is pended for 30 days for the individual to be in pay status with SSI benefits. On January 31 the SSA issues a notice to the individual that they are eligible for SSI beginning February 1. Because the SSA notified the individual of SSI eligibility in January, the benefit start date for APA is February 1.
410-7 B. INITIAL MONTH’S APA PAYMENT FOR INTERIM ASSISTANCE RECIPIENTS
Interim Assistance recipients who are approved for SSI are eligible for APA benefits beginning with the 1st day of the month after the month SSA decides the individual is eligible for SSI . (Refer to section 426-7A .)
410-7 C. ELIGIBILITY FOR MEDICAID
If otherwise eligible, APA applicants may qualify for Medicaid coverage back to the month that an APA application is received. There are some APA policies that do not apply to Medicaid. For example, development of income requirements do not apply to Medicaid. To qualify for Aged, or disability related Medicaid, an individual must still meet all other factors of eligibility including blindness, disability or age. When an APA applicant doesn't meet all factors of eligibility for Aged, or disability related Medicaid, the caseworker must always determine if an individual is eligible for another category of Medicaid such as MAGI Expansion Medicaid. See MAGI Medicaid Manual Section 816 .
Example: An applicant applies for APA and related Medicaid on September 30, 2025. The individual is 35 years of age, has no income, no disability determination, and is not in pay with SSI . The individual's APA application must be pended for the individual to apply for and be in pay with Supplemental Security Income (SSI). The caseworker determines that the individual is eligible for Medicaid in the MAGI Expansion category the month the application is received.
Note: Effective October 1, 2026, individuals must meet Medicaid qualified alien requirements for Medicaid. Refer to ADLTC MS 522 and MAGI MS 808 for policy on U.S. citizenship and eligible alien status.
410-7 D. RETROACTIVE MEDICAID COVERAGE
An APA applicant may be eligible for Medicaid benefits for one or more of the three months before the month that the APA application was filed. Eligibility for Medicaid under this provision is explained in MAGI Medicaid manual section 827 .
410-8 NOTICE OF FINDING ON APPLICATION
410-8 A. ADEQUATE NOTICE REQUIREMENT
Every APA applicant must be provided with adequate written notice of the action taken on his or her application. Adequate notice means that the individual is informed of the action taken on his or her case, the reasons for the action, and the manual section(s) which support the action. An adequate notice must be mailed or given to the individual no later than the work day following the date the action was taken.
410-8 B. APPROVAL NOTICES
An individual who has been found eligible for assistance is adequately notified if the notice states that the individual has been found eligible, informs the individual of the amount of assistance he or she will receive and when it will begin, and informs the individual of the right to a fair hearing to contest the action taken.
410-8 C. DENIAL NOTICES
An individual who has been found ineligible for assistance is adequately notified if the notice states the specific reason(s) for the denial, cites the manual section(s) which support the denial, and informs the applicant of his or her right to a fair hearing to contest the denial.
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410 APPLICATION PROCESS
In order for the Division of Public Assistance ( DPA ) to determine a household’s eligibility, the household must:
Submit an application that meets the identifiable application requirements in one of the following ways:
1. by mail; 2. in person;
3. online;
4. by fax;
5. by phone; or
6. by e-mail.
Participate in an interview with a DPA caseworker or DPA -contracted fee agent; and
Provide documentation and verification, including required forms, needed to determine program eligibility.
All households may file an application the same day they contact DPA to establish a protected filing date. DPA will help all households with the application and renewal process.
Fee agents help households who live in communities that do not have a local DPA office apply for public assistance. The fee agent can help the household apply online or use DPA applications and other forms provided by DPA . Households are not required to go to a fee agent and may apply directly through DPA .
The receipt of an identifiable application by DPA establishes the application filing date. An identifiable application must contain the applicant's name, address, and signature. The caseworker has 30 days following the application filing date to process the application. When the applicant asks to apply for another program prior to the eligibility decision, use the original filing date and benefit start date for all programs.
When an APA applicant ask apply for another program prior to a timely APA eligibility decision, use the original filing date and benefit start date for all programs. If the request occurs more than 30 days after an APA application was received, a new application is required for another program.
Note: Online applications include an electronic signature. Paper applications can be signed by e-signature, digital signature, or a handwritten signature created on an electronic device (finger/stylus to screen) starting October 1, 2024. Telephonic signatures must be recorded by a caseworker through the VCC .
When households apply for multiple programs, DPA must make an APA determination based on the information in the application. DPA must not delay the APA determination if more information is needed for other programs.
420-1 REQUIREMENT TO APPLY FOR AND PURSUE OTHER BENEFITS
420-1 A. REQUIREMENT DEFINED
To be eligible for Adult Public Assistance, an APA applicant or recipient must apply for and diligently pursue any other benefits to which the Division believes he or she may be eligible. Under this requirement, a benefit must meet all of following criteria:
Require an application or similar action; and
Have conditions for eligibility; and
Provide periodic or one-time payments; and
Be a source of income that reduces APA payments.
In addition to applying for the benefit, the applicant or recipient must take all appropriate steps to pursue eligibility for other benefits. This means that he or she must:
Apply for the benefit; and
Provide the source of the benefit with the information necessary to determine eligibility; and
Agree to receive the other benefit; and
Take all necessary steps to receive, and to continue receiving, the benefit.
420-1 B. SSI APPLICANTS OR RECIPIENTS ARE PRESUMED TO BE APPLYING FOR OTHER BENEFITS
An APA client who is applying for or receiving SSI benefits is presumed to be pursuing any other benefits to which he or she is entitled. SSI has a development of income policy which is equivalent to the APA policy. If the case worker becomes aware of an available benefit which is not being used by an SSI / APA client, he or she should inform the servicing SSA office and let the SSI claims representative resolve the matter. Whenever SSI assistance is denied or terminated for failure to apply for and pursue other benefits, the client loses APA eligibility as well.
420-1 C. NON- SSI APPLICANTS OR RECIPIENTS MUST BE ADVISED OF THE REQUIREMENT TO APPLY FOR AND PURSUE OTHER PROGRAM BENEFITS WITHIN 30 DAYS
Whenever a case worker believes that a non- SSI APA applicant or recipient may be eligible for benefits he or she is not already receiving, the individual must be given written notice of the requirement to apply for and pursue the other benefit within 30 days. The 30-day notice period shall not be used as a reason for delaying an eligibility decision on an APA application. If the individual fails, without good cause (such as illness), to apply for and pursue the other benefit within 30 days of the date the notice is mailed, the case worker shall either deny the APA application or close the APA case.
Changes in circumstances may cause a non- SSI APA recipient to become eligible for a benefit to which he or she was not previously entitled. When this occurs, the case worker must provide the client with written notice of the requirement to apply for and pursue the other benefit within 30 days of the date the notice is mailed. The client may continue to receive APA benefits while he or she is applying for the other benefit. If the recipient does not apply for and pursue the other benefit within 30 days of the date that the notice is mailed, the APA case must be closed, and the client provided with timely notice of benefit termination for failure to apply for other program benefits.
Example 1: A disabled APA applicant applies for assistance on April 7, and is interviewed on April 15. During the interview, the case worker discovers that the applicant may be eligible for Workers' Compensation payments for which he has not yet applied. The applicant is otherwise eligible for assistance. The applicant is informed, in writing, that he must provide proof that he has applied for Workers' Compensation payments by May 15. On May 7, the APA application is approved. The individual then fails to provide proof that he has applied for Workers' Compensation payments by May 15, the end of the 30-day notice period. The case worker closes the APA case effective May 31, providing timely notice of termination for failure to apply for other program benefits.
Example 2: A similar situation to the example above, except that the applicant is not otherwise eligible for assistance because the application must be held for a disability determination by either SSA or the DDS . When the individual fails to provide proof that he has applied for the other benefit by May 15, the APA application is denied.
420-1 D. VERIFICATION OF APPLICATION FOR AND PURSUIT OF OTHER BENEFITS
Application for and pursuit of other benefits must be verified. Verification may be obtained by various means, depending upon the type of benefit involved. The client's own documents (for example, award letters, referral letters, benefit-related correspondence, check stubs) are the preferred verifying documents. If the client claims that he or she is applying for the other benefit, but is unable to provide documentary evidence, the case worker must try to get the necessary verification. EIS interface information is one possible verification source; direct contact with the other agency is another acceptable method of verification.
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420-2 CONCURRENT PARTICIPATION IN THE SSI PROGRAM
420-2 A. RELATIONSHIP BETWEEN THE SSI AND APA PROGRAMS
The Supplemental Security Income ( SSI ) program is a national, federally-funded and administered, public assistance program for the needy aged, blind, and disabled. Alaska's APA program is intended to supplement the benefits provided by the SSI program.
Because of the APA program's higher income eligibility limits and differing policy concerning citizenship requirements, many clients are eligible for APA but not for SSI ; there is no requirement that APA applicants or recipients whose countable income exceeds the applicable SSI standard pursue application for SSI benefits. Participation in the SSI program is, however, a condition of eligibility for any APA applicant who receives countable needs-based income from such sources as Temporary Assistance or BIA-GA that causes them to exceed the income limit for the SSI program. If SSI decides that these individuals are eligible, SSI payments can begin once the needs-based income ends.
With few exceptions, the SSI and APA programs use the same eligibility criteria. Because of this relationship between the two programs, the decision of the Social Security Administration on a claimant's eligibility for SSI benefits may be the basis of a case worker's decision on the individual's eligibility for APA benefits. The only essential difference between SSI and APA eligibility criteria are APA 's more liberal income policies, and APA requirements that recipients be residents of Alaska and at least 18 years old. Thus, the requirement to participate in the SSI program goes beyond simple pursuit of a source of income; an APA client whose income is within SSI limits must not only apply for SSI , but also must be found eligible for SSI benefits, or the client will be ineligible for APA benefits.
Exception: The APA and SSI programs may apply a disqualification period if an individual (or spouse) transfers a resource for less than its value. If the APA disqualification period ends before the SSI disqualification period, the individual may qualify for APA benefits after the end of the APA disqualification period. To qualify for assistance, the individual must still meet all other APA eligibility requirements except for receipt of SSI benefits. See manual section 433-1 for the policy on transfer of resources.
420-2 B. TIME LIMIT FOR PURSUIT OF SSI BENEFITS
1. APA applicants
Unless the individual has already established a current SSI claim and is receiving the maximum amount of SSI for their living situation, an otherwise eligible applicant whose countable income is within SSI limits must file a claim for SSI and be in pay status within 30 days of the date of interview. The applicant must be provided with written notice of the requirement to file for SSI and be given a reasonable amount of time to do so. Clients shall be informed that SSI claims may be filed in person or by telephone, and that SSI will allow a responsible individual to apply on behalf of another. If the applicant fails, without good cause, to comply with this requirement, APA assistance must be denied.
Example: Morris receives SSI and also had a part time job at a grocery store. The job at the grocery store ended. Morris must be given 30 days to report the job end to SSI and provide verifcation of the increase of SSI before APA can begin.
2. APA recipients
Whenever the countable income of an APA recipient who is not receiving SSI is expected to decrease to less than the applicable SSI standard, the case worker shall provide the client with a notice, in writing, that he or she must apply for and provide verification of an SSI application or reported change within 30 days. SSI application, or proof of reported change in circumstances, is required of any APA recipient whose income or living situation changes enough to indicate potential SSI eligibility or an increase in SSI benefits.
If the mandatory verification is received by the due date, APA benefits continue until the Social Security Administration makes a decision. If they do not provide this verification before the due date, the APA case should be closed with 10 days notice of adverse action. Medicaid may continue if Medicaid eligibility requirements are still met. See ADLTC 530 .
Refer clients to the SSI program even if it appears that they will be eligible for a period as short as one calendar month. Clients whose monthly income fluctuates above and below SSI limits must maintain an open SSI claim; SSI rules allow an individual's claim to remain open in nonpay status for up to 11 consecutive months without reapplication. Individuals in nonpay status with SSI Supplemental Security Income are considered to have an open SSI claim because they still meet the SSI disability requirements; such individuals continue to remain eligible for APA if they meet all other factors of eligibility. Individuals in SSI nonpay status must report to the SSA any change in their circumstances which might result in eligibility for SSI payments.
Example: Jim begins seasonal employment in May. His countable earnings make him ineligible for SSI payments and he goes into non-pay status with SSI . Jim’s APA case remains open because his income is still below the need standard. In September, the tourist season is winding down and his income goes below the SSI limit. Jim is referred to SSI and given 30 days to reopen his claim.
420-2 C. BENEFITS TO APA APPLICANTS PENDING AN SSI DECISION
APA applicants who are applying for both SSI a nd APA are not eligible for regular APA benefits while SSI is determining their eligibility. They may, however, be eligible for Interim Assistance payments until SSI makes a final decision on their eligibility. See manual section 426-2 .
420-2 D. BENEFITS TO APA RECIPIENTS PENDING AN SSI DECISION
APA recipients are required to pursue SSI benefits when they appear eligible. If an APA recipient is still deemed disabled and meets all other factors of eligibility, the recipient should be given 30 days to provide verification that they are pursuing SSI . If this mandatory verification is received by the due date, APA benefits continue until the Social Security Administration makes a decision . If they do not provide this verification by the due date, the APA case should be closed with 10-day notice of adverse action. Medicaid may continue if Medicaid eligibility requirements are still met. See ADLTC 530 .
If SSI finds the client eligible, adjust the APA case to reflect receipt of SSI benefits. If SSI finds the client ineligible for any reason except excess income, close the APA case and redetermine Medicaid eligibility.
If SSI denies the application solely because of excess income, the client may continue to be eligible for APA benefits if the client's income is within the APA limits and the client continues to meet all other factors of eligibility.
420-2 E. VERIFICATION OF PURSUIT OF SSI BENEFITS
An individual's application for and pursuit of SSI benefits may be verified in several different ways. Whenever possible, the case worker should use the client's own documents as the verification source. Examples of verification sources include:
Copies of any notice from SSA to the client which indicate the client is currently pursuing a claim;
Referral letter from SSA to DPA which indicates the client has filed an SSI claim;
SSI award letter;
Current SSI benefit check;
SDX interface match or paper printout which indicates a current SSI claim;
Response to a State Verification Exchange System ( SVES ) inquiry from SSA which indicates a current SSI claim.
If no acceptable documentary evidence is available to verify application for or pursuit of SSI benefits, a case worker may request information by fax machine or telephone the servicing SSA office and get verbal verification. Telephone contacts should be used only when no alternative verification source is reasonably available.
SSI will accept a written or oral request for benefits and establish the date of the request as a filing date for SSI benefits, but an SSI application is not considered to be received until a signed SSI application form is actually received by SSA . An individual who has not submitted a signed application to SSI has not complied with the APA requirement to apply for SSI benefits.
420-3 OTHER COMMONLY AVAILABLE BENEFITS FOR WHICH AN APA APPLICANT OR RECIPIENT MUST APPLY
An APA applicant or recipient who appears to be eligible for a benefit from another program must apply for that program. The individual must file for benefits payable at the earliest month and in the highest amount available based on the earliest month.
420-3 A. PRIVATE SECTOR PENSIONS AND ANNUITIES
Private sector pensions and annuities may be available to an individual if the individual or a deceased spouse worked for a private employer, or was a member of a union, with a pension or annuity plan. An applicant or recipient who has a work history (or has a deceased spouse with a work history) which indicates potential eligibility for a pension or annuity must apply for and pursue the benefit.
In most cases, clients will already be receiving any pensions or annuities to which they are entitled. Case workers must, however, explore the possibility of potentially available benefits and make referrals if appropriate.
420-3 B. PUBLIC SECTOR PENSIONS AND ANNUITIES
The federal government operates pension plans for federal civilian employees and for members of the uniformed services. Most state and local governmental employees are also covered by pension plans. Foreign governments may also provide pensions for retired employees.
With some exceptions, state and local government and federal civilian employees must work a minimum of five years before vesting rights in the pension plan are established, and withdrawal of employee contributions to the pension plan will cause a loss of all vesting rights. Military retirement benefits generally require a minimum of 20 years' service. (See section 420-3E for VA pensions.)
Any APA client who is not already receiving a pension, annuity, or retirement payment for which he or she appears eligible must be referred for application, unless the client provides convincing evidence that he or she is not eligible for the benefit in question.
420-3 C. SOCIAL SECURITY ADMINISTRATION ( SSA ) INSURANCE
The Social Security Administration makes payments under the retirement, survivors, and disability insurance ( RSDI ) program to retired workers and their family members, survivors of deceased workers, and disabled workers and their families under Title II of the Social Security Act. In the interest of brevity, this manual refers to Social Security Insurance Benefits as " SSA " benefits.
To be found eligible for benefits for themselves, their survivors, or their dependents, individuals must have worked a minimum number of calendar quarters in "covered" employment. Covered employment is any employment that involves payment of Social Security taxes. The number of quarters needed to qualify for benefits varies between 6 and 40 depending on the applicant’s age and situation.
Although SSA payments are not needs-based, certain limits are imposed on the amount an individual under age 70 may earn while receiving benefits. After the earnings maximum is exceeded, benefits are reduced by $1 for each $2 earned over the annual exempt amount for individuals under age 65. When an individual reaches the age of 65, benefits are reduced by $1 for each $3 earned over the annual exempt amount. Benefits are not reduced by earnings for individuals who reach age 70.
The amount of a worker's SSA benefit is based on a calculation which takes into account the worker's average covered earnings and the amount of time he or she worked or could have been expected to work. For persons who reach 62, become disabled, or die after 1978, the actual earnings are indexed - updated to reflect increases in average wage levels in the economy. Auxiliary and survivor benefits are based on a percentage of the worker's benefit.
SSA benefits are potentially available to individuals in the following categories:
Retirement benefits are payable at age 62 to a retired insured person and to the spouse of a retired worker when the spouse reaches age 62. These benefits are permanently reduced if claimed before full retirement age (between age 65 and 67, depending on the individual’s date of birth).
Unreduced benefits are payable to the spouse of a retired worker at any age if the spouse has in his or her care a child under the age of 16, or disabled, who is entitled to benefits on the earnings record of the worker.
Child's benefits are paid to the retired worker's unmarried child under age 18, or from age 18 to 19 if the child is a full-time student in elementary or secondary school. They are also paid regardless of age if the child has been disabled since before reaching the age of 22.
Survivor benefits are payable to a widow or widower at age 60, or, if disabled, at age 50, and to a widow or widower at any age if she or he cares for a child who is either under age 16 or is disabled and entitled to benefits on the earnings record of the worker.
Survivor benefits are payable to unmarried children under age 18, or from 18 to 19 if in elementary or secondary school. They are also available at any age if the child has been disabled since before reaching the age of 22.
Survivor benefits are payable to a dependent parent at age 62. A parent is considered to be dependent if he or she received at least one-half of his or her support from the deceased worker.
A lump sum benefit of $255 is payable on the death of an insured worker to the spouse living with the worker at the time of death or eligible to receive benefits at that time. If there is no qualified spouse, the death benefit is payable to a child or children of the worker who are eligible for monthly survivor benefits.
Disability benefits are payable to a disabled worker who has not reached full retirement age after a waiting period of five full months. These benefits end if the worker recovers or returns to substantial work despite the impairment.
Benefits for the family members of a disabled worker are payable under the same conditions as for family members of retired workers.
Under certain circumstances, benefits may also be paid to the divorced spouse of a retired, deceased or disabled worker and to the remarried widow or widower of a deceased worker.
Case workers are not expected to understand the complexities of eligibility for SSA benefits. Clients are often unaware of their own eligibility for these benefits. In order to assure that all potential benefits are pursued, all APA applicants or recipients who are receiving neither SSA nor SSI benefits must be referred to a Social Security Administration office to apply for any benefits to which they may be entitled, unless documentation in the case file verifies that SSA benefits have been previously applied for and denied, and there is no reason to believe that the client has become eligible since the last denial.
Verification. Proof that a claim for SSA benefits has been filed is best obtained by viewing a referral letter from the Social Security office or correspondence from Social Security to the client. If such evidence is not available, the BENDEX interface is a possible alternative source, but the amount of time required for updated information to appear on the BENDEX generally means it is not usable for this purpose. State Verification Exchange System ( SVES ) responses will verify a current claim. If direct contact with the servicing SSA office is necessary, the manner in which this contact is routinely made must be coordinated by the managers of the DPA and SSA offices involved. In general, telephone contacts between case workers and Social Security claims representatives should be used only when the information needed cannot effectively obtained in some other way, or is so complex that personal contact is necessary.
420-3 D. UNEMPLOYMENT INSURANCE BENEFITS ( UIB )
Unemployment benefits may be available from the State of Alaska or another State where a client has recent employment history. Unemployment benefits may also be available in some cases from an individual's union or former employer.
Eligibility factors for unemployment benefits generally include a recent history of "covered" employment, and availability for work. Many APA applicants have recently-acquired impairments which may render them unavailable for work. Others, particularly the blind and the aged, may be able-bodied.
Any APA applicant or recipient who appears to have potential eligibility for unemployment benefits should be referred for application, unless evidence in the case file clearly documents a physical or psychological condition which, in the judgment of the case worker, makes the individual unavailable for work.
420-3 E. DEPARTMENT OF VETERANS AFFAIRS ( VA ) PENSION AND COMPENSATION BENEFITS
The VA administers numerous programs. Only VA pensions and VA compensation payments are prior resources to the APA program. Veterans have two major cash benefit programs:
1. VA compensation for service-connected disability or death
This program pays monthly cash benefits to veterans who are disabled as a result of an injury or disease incurred or aggravated by active military duty, whether in wartime or peacetime. The amount of monthly compensation depends on the degree of disability, which is rated by the percentage of normal function loss. Benefit rates above the 100% disability payment level are paid for certain specific severe disabilities. Veterans who have at least a 30% service-connected disability are entitled to an additional allowance for their dependents. VA compensation payments may also be made to dependent parents and to the widow(er) of a veteran who dies as a result of a service-connected illness or injury.
With one exception, VA compensation payments are not needs-based and are not reduced by a recipient's other income. Benefits for dependent parent(s) of a deceased veteran are based on need. A parent is considered to be dependent if he or she received at least one-half of his or her support from the deceased veteran.
2. VA pension payments
VA pension payments are made on the basis of a combination of wartime service and an age of 65 or over, a nonservice-connected disability, or death. With very rare exceptions, VA pension payments are based on need. The VA may take a veteran's dependent's needs into account in determining a pension, augmenting the amount of the basic pension.
420-3 F. WORKERS' COMPENSATION PAYMENTS AND OTHER DISABILITY BENEFITS
If an applicant or recipient indicates that he or she has been injured on the job or has what seems to be a work-related impairment, he or she must be referred for Workers' Compensation payments. Workers' Compensation payments may also be available to the survivor of an injured employee who died as a result of a work-related condition.
420-4 BENEFITS FOR WHICH AN APA APPLICANT OR RECIPIENT IS NOT REQUIRED TO APPLY
420-4 A. TEMPORARY ASSISTANCE BENEFITS
APA applicants or recipients cannot, under APA rules, be required to pursue Temporary Assistance benefits. Instead, clients who have potential eligibility for either Temporary Assistance or APA benefits must have their options explained to them so that they can make an informed choice between the two programs. Notwithstanding any other provision of the APA program, an applicant or recipient need not apply for SSI if doing so would result in termination of eligibility for Temporary Assistance benefits within the family unit.
Note: Except for Temporary Assistance to APA conversions situations, no individual may receive APA benefits for any month during which he or she was included as an assistance unit member in a Temporary Assistance case. (See APA MS 452-10 for more information about Temporary Assistance to APA conversions.)
420-4 B. BUREAU OF INDIAN AFFAIRS GENERAL ASSISTANCE ( BIA-GA )
BIA-GA is a needs-based assistance program available to American Indians and Alaska Natives to meet essential needs for food, shelter, and clothing. BIA-GA payments are considered as countable income by both the SSI and the APA program. Application for BIA-GA is not required for either APA or SSI .
420-4 C. OTHER NEEDS-BASED ASSISTANCE PROGRAMS
The only needs-based payments for which APA clients must apply are SSI and VA needs-based benefits. There is no requirement to apply for any other federal, state, local, or private program which makes payments based on need. Payments received from benefit programs in this category may or may not be excluded from income depending on the source of the payment.
420-4 D. VA IMPROVED PENSIONS
Certain individuals who were entitled to VA pensions as of December 31, 1978 can elect to receive an Improved Pension payment which is greater than a normal VA pension payment. VA Improved Pension benefits are not a prior resource to the APA program. APA clients who are eligible for either a normal or improved VA Pension are free to choose between the two payment levels.
420-4 E. AUGMENTED PORTIONS OF VA , RAILROAD RETIREMENT, AND BLACK LUNG PAYMENTS
VA , Railroad Retirement, and Black Lung benefits may be augmented (increased) because the beneficiary has dependents. When a benefit is augmented for dependents, the dependent has no vested right to the augmented portion. APA clients who are eligible for augmentation payments because they are dependents are not required to apply for augmentation.
420-4 F. BENEFITS OF INELIGIBLE SPOUSE OR ALIEN'S SPONSOR
An ineligible spouse or an alien's sponsor is not required to apply for any other program benefits. If the ineligible spouse or sponsor elects to receive benefits from another program, the amount of the benefit is subject to normal APA income availability policies.
420-4 G. BENEFITS WHICH DO NOT AFFECT AMOUNT OF ASSISTANCE
APA clients are not required to apply for any other benefits which will not affect the amount of their APA .
Note: Applicants and recipients for APA are not required to pursue child support income. Child support income is a benefit for the child not the APA recipient. If the applicant or recipient keeps child support for a child no longer in the home and uses the money it is counted as income to the APA client. Refer to APA MS 441-2L f or more information on how to budget child support income for APA .
In some cases, an APA client may be eligible for a benefit that will not affect the amount of their APA , but will affect the amount of their SSI . Like the APA requirement to apply for and pursue other benefits, Social Security also requires SSI applicants and recipients to apply for and pursue any other benefit which will reduce the amount of their SSI . Whenever SSI assistance is denied or terminated for failure to apply for and pursue other benefits, the client loses APA eligibility as well.
420 DEVELOPMENT OF INCOME
To be eligible for Adult Public Assistance, an applicant or recipient must apply for and diligently pursue any other benefits for which the Division believes he or she may be eligible. This chapter explains the development of income requirements of the APA program.
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421-1 UNITED STATES CITIZENS AND UNITED STATES NATIONALS
U.S. citizens and U.S. Nationals include:
Individuals born in one of the 50 states, the District of Columbia, Puerto Rico, Guam, Virgin Islands, and the Northern Mariana Islands;
Naturalized citizens; and
U.S. Nationals born in American Samoa or Swain's Island. An individual who was not born in American Samoa or Swain’s Island, but one of his or her parents were born in American Samoa or Swain’s Island, may be a U.S. National
U.S. citizenship is verified only when questionable.
421-2 QUALIFIED ALIENS
A qualified alien is defined as someone who, at the time of application is:
A lawful permanent resident; An asylee; A refugee; An alien who is a Cuban and Haitian entrant as defined in 501(e) of the Refugee Education Assistance Act of 1980; An alien granted parole for at least one year by the U.S. Citizenship and Immigration Services ( USCIS ); An alien who has had deportation withheld under 243(h) of the Immigration and Nationality Act ( INA ) as in effect prior to April 1, 1997; or 241(b)(3) of the INA , as amended; An alien granted conditional entry under immigration law in effect before April 1, 1980; A battered spouse or child of a battered spouse of a U.S. citizen or permanent legal resident, and aliens protected under 1508 of the Violence against Women Act of 2000; Victims of trafficking under the Trafficking Victims Protection Act of 2000 (including certain family members of victims of a severe form of trafficking); Non-citizen Native Americans as defined in 4(e) of the Indian Self-Determination and Education Assistance Act, 25 USC 450b(e) and 289 Native Americans; Special immigrants from Iraq and Afghanistan admitted under section 101(a)(27) of the INA .
421-3 NATIVE AMERICANS BORN OUTSIDE THE UNITED STATES
Noncitizen members of federally recognized Indian tribes and certain American Indians born in Canada are exempt from all noncitizen provisions.
An American Indian born in Canada or a member of a federally recognized tribe may freely enter and reside in the U.S. and are considered to be lawful permanent residence and as such are qualified aliens . To be eligible, the individual must have been born outside the U.S. and meet one of the following criteria in addition to all other eligibility criteria:
An American Indian born in Canada who is at least 50% American Indian blood to whom the provision of section 289 of the Immigration and Nationality Act (8 USC . 1359) apply. This does not include a spouse or child of such an Indian nor a non-citizen whose membership in an Indian tribe or family is created by adoption, unless such a person is at least 50 % Indian blood; or
A member of a federally recognized tribe as defined in section 4(e) of the Indian Self-Determination and Education Assistance Act. Indian tribe means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act.
421-4 FIVE YEAR WAITING PERIOD
Qualified aliens who entered the U.S. on or after August 22, 1996 cannot receive APA benefits until they have been in the U.S. for five years or until they become U.S. citizens. (See APA MS 421-4 E for more information once individual's have met the five-year waiting period.)
When the five-year waiting period begins depends upon the date the alien physically entered the U.S. Aliens who arrived before August 22, 1996 may not be subject to the five-year waiting period. Apply the five-year waiting period as follows:
421-4 A. QUALIFIED ALIEN ARRIVING ON OR AFTER 8/22/96
An alien who physically arrived and was lawfully admitted to the United States on or after August 22, 1996, must be evaluated for qualified alien status. If the alien was admitted as a qualified alien, and is subject to the five-year waiting period, the period starts from the date the alien physically arrived in the U.S.
421-4 B. NON-QUALIFIED ALIEN ARRIVING ON OR AFTER 8/22/96
A non-qualified alien who physically arrived in the United States on or after August 22, 1996, must obtain qualified alien status before the five-year waiting period begins. The five year waiting period begins on the date the non-qualified alien obtains qualified alien status, not the date they physically arrived in the U.S.
421-4 C. ALIEN ARRIVING BEFORE 8/22/96
An alien who physically arrived in the United States before August 22, 1996, but obtained qualified alien status on or after that date is not subject to the five-year waiting period as long as he or she remained continuously present in the U.S. Any single absence from the United States of more than 30 days, or a total aggregate of absences of more than 90 days, is considered to interrupt continuous presence. However, once an immigrant obtains qualified alien status, he or she does not have to remain continuously present in the United States in order to avoid application of the five-year waiting period. This rule also applies to aliens who entered the country without proper documentation and those who overstayed their visa.
For most legal entrants, the U.S. Citizenship and Immigration Services ( USCIS ) maintains a record of arrivals to and departures from the country. Verification of continuous presence may be obtained for most legal entrants by filing Form G-845 and Form G-845-Supplement with the USCIS .
The USCIS does not maintain an arrival and departure record for some entrants, such as Canadian and Mexican border crossers, and illegal entrants. In this situation, the alien must submit proof of his or her claimed date of entry and documentation showing proof of continuous presence, such as a letter from an employer or series of pay stubs or utility bills in the immigrant’s name.
421-4 D. ALIENS EXEMPT FROM THE FIVE-YEAR WAITING PERIOD
The following qualified aliens are exempt from the five-year waiting period:
Refugees admitted under Section 207 of the Immigration and Naturalization Act ( INA );
Asylees admitted under Section 208 of the INA ;
Aliens whose deportation is being withheld under sections 241(b)(3) or 243(h) of the INA ;
A Cuban/Haitian entrant as defined in section 501(e) of the Refugee Education Assistance Act of 1980;
Aliens admitted to the U.S. . as an Amerasian immigrant;
Qualified aliens who are honorably discharged U.S. military veterans, active-duty military, and their spouses (including a surviving spouse who has not remarried), and unmarried dependent children (including dependent stepchildren);
Note: Hmong and other Highland Lao tribal people who fought on behalf of the Armed Forces of the United States during the Vietnam conflict and who have been lawfully admitted to the U.S. as permanent residents are considered veterans exempt from the five-year waiting period under this paragraph.
Victims of trafficking under section 107(b)(1) of the Trafficking Victims protection Act of 2000, including certain family members of victims of a severe form of trafficking.
Legal permanent residents who first entered the country under an exempt category (i.e. as a refugee, asylee, Cuban or Haitian entrant, trafficking victim, or alien whose deportation was being withheld) and who later converted to legal permanent resident status.
Members of a federally recognized Indian tribe, as defined in 25 USC 450b(e).
American Indians born in Canada under section 289 of the Immigration and Nationality Act.
Special immigrants from Iraq and Afghanistan admitted under section 101(a)(27) of the INA .
421-4 E. INDIVIDUALS WHO ARE AT THE END OF THE FIVE-YEAR WAITING PERIOD
An individual who applies for assistance is not eligible until they have met all eligibility requirements, including the five-year waiting period.
Example: Maria submitted an application for benefits on May 21, 2011. She entered the country on June 2, 2006. She is not eligible for benefits until she has met the five-year waiting period. Maria meets the five-year waiting period as of June 2, 2011. She is eligible for benefits effective June 2, 2011. Maria’s May 21, 2011 application is denied first month and a new benefit start date of June 2 is used.
421-5 NON-QUALIFIED ALIENS
Non-qualified aliens include aliens who are permanently residing in the U.S. under color of law, non-immigrants, and illegal aliens. An alien who is not a qualified alien is not eligible for APA benefits.
421-5 A. LEGAL, NON-QUALIFIED ALIENS
Aliens in this category are legal permanent residents of the U.S. even though they did not go through the process of applying for and being admitted for permanent residence. This group includes aliens residing in the U.S. with the knowledge and permission of the USCIS whose departure the USCIS does not contemplate enforcing.
An alien who is not qualified alien is not eligible for APA benefits.
Note: An individual with Temporary Protected Status (TPS) is a legal, non-qualified alien.
421-5 B. NON-IMMIGRANTS
Some aliens may be lawfully admitted but only for a temporary or specified time (visitors, tourists, students, diplomats, crewmen on shore leave, temporary workers, members of the foreign press, etc.) These aliens are not eligible for APA because of the temporary nature of their admission status.
Non-immigrant aliens can be identified by the following USCIS documentation:
Form I-94, Arrival-Departure Record;
Form I-821, Application for Temporary Protected Status
Form I-185, Canadian Border Crossing Card;
Form I-186, Mexican Border Crossing Card;
Form SW-434, Mexican Border Visitor’s Permit; and
Form I-95A, Crewman’s Landing Permit,
Form I-766 category C33 or Deferred Action for Childhood Arrivals ( DACA ).
Note: Aliens born in the Marshall Islands, Western Samoa, the Federated States of Micronesia and Palau are the most common types of non-immigrants. These people can travel freely between the islands and the U.S., but are considered non-qualified aliens and are not eligible to receive benefits. For these people to receive benefits, they must take action to become a qualified alien.
421-5 C. ILLEGAL ALIENS
An illegal alien is any alien who either was never legally admitted to the U.S., or was admitted for a limited period of time and did not leave when that time expired.
421-6 DOCUMENTATION OF U.S. CITIZENSHIP AND ELIGIBLE ALIEN STATUS
U.S. citizenship is verified only when questionable. Every household must declare that all household members have U.S. citizenship or satisfactory immigration status. The adult household member or authorized representative fulfills this condition of eligibility by signing the application ( GEN 50C ) or recertification application ( GEN 72 ).
421-6 A. VERIFICATION oF U.S. cITIZENSHIP iS nOT rEQUIRED fOR:
A current Supplemental Security Income ( SSI ) recipient;
A current Medicare recipient;
An individual receiving Social Security Disability Insurance ( SSDI ) benefits;
Children in state foster care or Title IV-E adoption assistance; or
A newborn that is eligible for and receives Medicaid in their birth month. This includes a newborn whose mother is a non-qualified alien and is determined eligible under Emergency Treatment for Aliens. These newborns are considered to have provided satisfactory documentation of citizenship and identity, and no further documentation will be necessary in the future.
Note: Before Medicaid coverage can begin, Medicaid rules require that most applicants and recipients verify their citizenship status (Refer to ADLTC MS 520 C .) In some circumstances non-citizens may receive SSDI , SSI , or Medicare. Therefore, receipt of these programs does not exempt the individual from verifying their alien status. Effective October 1, 2026, individuals must meet Medicaid qualified alien requirements for Medicaid. Refer to ADLTC MS 522 and MAGI MS 808 for Medicaid policy on U.S. citizenship and eligible alien status.
421-6 B. ACCEPTABLE DOCUMENTATION
Sources of verification include birth certificates, certificates of citizenship or naturalization provided by the U.S. Citizenship & Immigration Services ( USCIS ), U.S. passports, and official identification cards showing U.S. citizenship. U.S. National status may be verified with a U.S. passport stamped ” U.S. National.”
421-6 C. PROOF oF QUALIFIED ALIEN STATUS
An alien must provide proof of his or her qualified alien status. The following documents are acceptable for determining alien status and whether the alien is subject to the five year waiting period.
Certain USCIS documents can be viewed online at http://www.uscis.gov/forms/all-forms
IMMIGRATION STATUS VERIFICATION DOCUMENT ( USCIS FORMS) Legal Permanent Resident I-551 (referred to as green card ), or I-94 annotated with a temporary I-551 stamp (for recent arrivals or aliens who have applied for a replacement I-551) Refugee I-94 stamped showing admission under section 207 of the INA and date of entry to the US, or I-688B annotated 274a.12(a)(3), or I-766 annotated A3, or, I-571 (Refugees usually adjust to LPR status after 12 months in the US, However, they are still considered refugee for eligibility purposes when they have a I-551 with a code of RE-6, RE-7, RE-8, or RE-9) Special Immigrants I-94 or passport stamped with an "S" category Asylee I-94 stamped showing grant of asylum under section 208 and date of entry, or A grant letter from the Asylum Office of the USCIS ; or I-688B annotated 274a.12(a)(5), or I-766 annotated A5, or Court order of an immigration judge showing asylum granted under section 208. Parolee I-94 annotated with stamp showing grant of parole under 212(d)(5) and a date showing granting of parole for at least 1 year. Deportation Withheld Order of an immigration judge showing deportation withheld under section 243(h) and date of grant; or I-688B annotated 274a.12(a)(10), or I-766 annotated A10 Conditional Entrant I-94 with stamp showing admission under 203(a)(7), refugee-conditional entry, or I-688B annotated 274a.12(a)(3) I-766 annotated A3 Battered Spouse or Child of U.S. Citizen or Permanent Legal Resident Approved or pending I-130 or I-360 petition showing a prima facie case that he or she is protected under the Violence Against Women Act, and Verification that the individual responsible for the battery or cruelty is no longer living in the household of the victim. Cuban Or Haitian Entrant I-94 with stamp showing parole as Cuban/Haitian Entrant under section 212(d)(5) of the INA Form I-551 with code CU6, CU7, or CH6 Foreign passport containing an unexpired temporary I-551 stamp with the code CU6 or CU7 U.S. Military Veteran, Active Duty Military (includes spouse and unmarried dependent children under 21) Green Form DD-2 marked ACTIVE, or A current order showing the individual is on full-time duty in the US Army, Navy, Air Force, Marine Corps, or Coast Guard (Reserves are not considered active duty). DD-214 indicating honorable discharge, or Discharge papers indicating honorable discharge Victims Of Trafficking (includes certain eligible immediate family members holding a derivative T-Visa) Letter of certification from the Office of Refugee Resettlement ( ORR ). The caseworker must verify the validity of this letter and notify ORR of the benefits for which the individual has applied by calling the toll-free trafficking verification line at 1-866-401-5510. Form I-797a indicating Class T-1 Visa. Form I-797a indicating T-2 (spouse), T-3 (child), T-4 (parent) or T-5 (unmarried sibling under age18 years on the date such alien’s T visa application was filed), known as a Derivative Visa. Note: T status is valid for 3 years from date of approval and is not renewable. However, the individual may adjust to lawful permanent resident status within the 90-day period immediately preceding the expiration of T status. American Indian Born In Canada Birth or baptismal certificate issued on a reservation; Tribal records; Letter from the Canadian Department of Indian Affairs, or School records
Note: If an applicant presents a receipt indicating that he or she has applied to USCIS for a replacement document for one of the documents identified above, contact the USCIS to verify status by filing a G-845 with the local USCIS district office and attach a copy of the receipt.
421-6 D. SYSTEMATIC ALIEN VERIFICATION FOR ENTITLEMENTS ( SAVE ) PROGRAM
The Systematic Alien Verification for Entitlements ( SAVE ) is a program run by the U.S. Citizenship and Immigration Services which provides immigration status of aliens. SAVE is part of IEVS .
The documents provided by each alien as verification of immigration status must be authenticated by using the SAVE program. SAVE will identify whether or not the alien has been lawfully admitted into the U.S. However, it may not provide enough information to determine whether or not the individual is a "qualified alien." The date of entry indicated may not accurately reflect the date an immigrant physically arrived in the U.S.
If the alien does not want the caseworker to contact USCIS , the household can withdraw its application or participate without that member.
Written consent is not required to:
Contact USCIS to verify the validity of documentation provided by the alien.
Use the SAVE inquiry process.
See Administrative Procedures Manual Section 105-14 for instructions on how to use the SAVE program.
421-7 SSI ALIEN STATUS REQUIREMENTS
Alien status requirements for the SSI program may be more restrictive than those of the APA program. Because of this, there will be situations where an alien will meet the alien status requirements of the APA program, but not SSI . If it appears an individual will not be eligible for SSI because of their alien status, do not refer that person to apply for SSI . The individual may qualify for APA if all other APA eligibility requirements except for SSI eligibility are met.
Aliens who appear eligible for SSI must be referred to apply for SSI . Any alien who meets SSI alien status requirements will also be considered to have met the alien status requirements for APA .
The following categories of qualified aliens may be eligible for SSI :
421-7 A. QUALIFIED ALIENS ELIGIBLE FOR SSI WITHOUT RESTRICTIONS
These aliens are not subject to either the seven-year time limit or the five-year waiting period described in B. and C. below.
An alien lawfully residing in the U.S. and receiving SSI benefits on August 22, 1996;
An alien lawfully residing in the U.S. on August 22, 1996 who is blind or disabled;
An alien lawfully residing in the U.S. before August 22, 1996 who can be credited with 40 quarters of coverage under the Social Security Insurance system;
U.S. military veterans or active-duty military, their spouses, and dependent children;
A battered spouse or child of a U.S. Citizen or permanent legal resident who is a military veteran or active-duty military; or
An American Indian born in Canada or a non-citizen member of a Federally recognized Indian tribes.
421-7 B. QUALIFIED ALIENS LIMITED TO SEVEN YEARS OF SSI ELIGIBILITY
SSI eligibility for these aliens is limited to a maximum of seven years.
An alien admitted as a refugee under section 207 of the Immigration and Nationality Act ( INA ) for seven years from their date of admission or the date refugee status was granted;
An alien granted asylum under section 208 of the INA for seven years from their date of admission;
An alien whose deportation has been withheld under section 243(h) of the INA as in effect prior to April 1, 1997, or whose removal has been withheld under section 241(b)(3) of the INA , for seven years after the date deportation or removal is withheld;
A Cuban or Haitian entrant for seven years after their date of admission;
An alien who is an Amerasian immigrant for seven years after their date of admission.
421-7 C. QUALIFIED ALIENS WHO MUST SERVE A FIVE-YEAR WAITING PERIOD
These aliens must serve a five-year waiting period before they can qualify for SSI .
An alien lawfully admitted for permanent residence in the U.S. after August 22, 1996 if the individual can be credited with 40 quarters of coverage under the Social Security Insurance system.
421 U.S. CITIZENSHIP AND ELIGIBLE ALIEN STATUS
To receive APA , a person must be:
A United States citizen or U.S. National;
A qualified alien, as described in section 421-2 . Qualified aliens may be subject to limited eligibility as explained in section 421-4;
A Native American born in Canada or Mexico who has treaty rights to cross the U.S./Canada and U.S./Mexico borders, as described in section 421-3 .
Refer to MS 460-2B for policy related to sponsored aliens.
422-1 APA REQUIREMENTS
A Social Security number is not an eligibility requirement for the APA program, unless needed to meet the APA development of income requirement.
For example, a widow must apply for Social Security survivor benefits. To receive survivor benefits, she must either have a Social Security number or apply for one. If she refuses to provide or apply for a Social Security number as part of the application process for the survivor benefits, she is not eligible for APA benefits because she did not take all steps necessary to receive the survivor benefits.
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422-2 MEDICAID REQUIREMENTS
A Social Security number is an eligibility requirement for Medicaid. To be eligible for Medicaid, an individual must either provide a Social Security number or show that he or she has applied for one.
If an individual does not provide a Social Security number or show that he or she has applied for one, eligibility for Medicaid does not exist. However, the individual may be eligible to receive cash-only benefits from the APA program.
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423-1 DEFINITION OF ALASKA RESIDENCY
An Alaska resident is a person who:
Lives in Alaska voluntarily; and
Is not in Alaska for a temporary purpose such as a vacation or a business trip; and
Intends to make Alaska his or her home and has no intention of shortly leaving the State to take up residence somewhere else.
Some individuals, such as migrant workers, may enter the State because of a job commitment or to seek employment. These persons are considered to be Alaska residents if they live in Alaska at the time of application and are not receiving public assistance or other benefits based on state residency from another state.
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423-2 ABSENCE FROM THE STATE
423-2 A. TEMPORARY ABSENCE
Individuals who leave Alaska are not eligible to receive APA during their absence, unless the absence is temporary. A temporary absence is an absence that lasts less than 30 days. Except for the exceptions listed below, persons who leave Alaska for a vacation, business trip, or other absence of 30 days or longer are not eligible for assistance.
The case worker must either close or suspend the individual's APA case, depending on the length of the absence. (Refer to section 480-5 for APA suspension and termination policy.) The individual is not eligible for assistance again until the month he or she returns to Alaska.
423-2 B. EXCEPTIONS FOR CERTAIN ALLOWABLE ABSENCES
An absence of 30 days or longer does not terminate APA eligibility if the absence is for
1. Medical treatment
Persons remain eligible for APA if they leave the State to get prescribed medical treatment that is not available in Alaska, do not establish residency outside the State, and intend to return to Alaska once they complete their medical treatment. APA recipients shall not be eligible for assistance if they leave Alaska for 30 days or longer to get non-emergency medical treatment that is available in Alaska.
The case worker must advise recipients planning to leave Alaska for medical treatment that the Division of Health Care Services must authorize all out-of-state medical services, unless they are of an emergency nature. The Division of Health Care Services will not pay for out-of-state, non-emergency medical treatment that is not authorized in advance of departure.
2. Absence Due to Illness
An individual may remain eligible for APA if he or she leaves the state or is prevented from returning to the State within 30 days of leaving the state because of the individual’s own illness, or the illness of the individual’s parent, spouse, sibling, or child. To remain eligible, the individual must not establish residency outside the State. In addition, the individual must notify the Division of the reason for the extended absence, provide a supporting statement from a physician, and declare in writing their intent to return to Alaska once the reason for the extended absence ends.
3. Postsecondary education
Persons remain residents of Alaska and are eligible for APA while they are attending postsecondary education outside the State if they do not establish residency outside the State and intend to return to Alaska once their course of study is completed. It does not matter whether a similar course of study is available in Alaska.
Postsecondary education is enrollment in any course of study recognized as such by the Alaska Department of Education, Postsecondary Education Commission.
Individuals leaving Alaska to attend post-secondary education must notify the Division of their intent to leave Alaska and must declare in writing their intent to return to Alaska once they complete their education. Individuals who do not notify the Division of their intended absence before leaving the State are not eligible for assistance. Continued enrollment and intent to return must be verified at least once each calendar year.
4. Vocational, professional, or other special education
Individuals may leave Alaska to attend education of this type if comparable education is not readily available in Alaska and the education will last more than 90 days. These individuals must notify the Division of their intent to leave Alaska and must declare in writing their intent to return to Alaska once they complete their education. Individuals who do not notify the Division of their intended absence before leaving the State are not eligible for assistance.
423-2 C. ALLOWABLE ABSENCE ENDS
An individual will no longer be eligible for assistance under the exceptions listed above if the individual fails to return to the Alaska within 30 days after the reason for the extended absence ends. When this happens, ineligibility begins the month following the calendar month the individual fails to return to Alaska on time.
Example: Ms. Jones, an unmarried APA recipient, remains eligible for APA while attending college in another state.On May 25, she completes her course of study and receives her degree, but fails to return to Alaska within 30 days. She is ineligible for APA beginning with the month of August.
423-3 APPLICANTS RECEIVING ASSISTANCE FROM OTHER STATES
423-3 A. OTHER STATE'S SSI SUPPLEMENT
The case worker must question applicants who have recently arrived in Alaska from other states about whether they received assistance from their previous state of residence. If the applicant was receiving a state supplement or Medicaid benefits from another state, the applicant must provide proof that assistance from the other state has ended. Eligibility for Adult Public Assistance cannot begin until the other state's benefits end.
1. SSA Administers the Other State’s SSI Supplement
In some states, SSA determines eligibility and disburses payments for the state supplement as part of the SSI administrative process. States may also choose to have SSA determine Medicaid eligibility for SSI recipients. The APA program must honor SSI residency determinations when determining Alaska residency for individuals receiving a state supplement or Medicaid benefits from these states. If the SSI program lists another state as the applicant's state of residence for a particular benefit month, and SSI paid a state supplement or determined Medicaid eligibility for that month, the other state is considered as the state of residence for that month. To change the state of residence to Alaska, the applicant must notify SSI that he or she is now a resident of Alaska. Alaska residency will exist beginning with the month that SSI determines that Alaska became the applicant's new state of residence.
2. The Other State Administers Its Own SSI State Supplement
In other states (like Alaska), the state administers its own state supplement and makes its own Medicaid determinations. Persons receiving a state supplement from a state of this type are not eligible to receive APA benefits in Alaska for the same month. However, if an applicant can prove that he or she will not receive the other state's supplement for a particular month, or that he or she has returned the other state's supplement for that month, then eligibility for APA for that month may exist.
Note: If an APA applicant is receiving SSI has an address with the Social Security Administration (SSA) that is not in the State of Alaska, the application must be pended for the applicant to change their address with the SSA unless it can be confirmed with the SSA that the out of state address is only due to a protective payee and that the client actually lives in Alaska. If the applicant is not an SSI recipient, the application can be authorized and the applicant must to be told to change their address with SSA .
423-3 B. OTHER STATE'S MEDICAID BENEFITS
Persons who receive Medicaid benefits from another state are not eligible to receive Medicaid benefits from Alaska for the same month. (Refer to MAGI Medicaid manual section 809-F for additional details.)
423-4 VERIFICATION OF RESIDENCY
423-4 A. APPLICANTS
The case worker must verify Alaska residency for all APA applicants. Items that can be used to prove Alaska residency include: rent receipts, utility bills, current Alaska driver's license, telephone book, city directory, and statements from other individuals who are aware of the client's situation. If other sources of verification are not reasonably available, and the individual is homeless or newly arrived in Alaska, the case worker may accept the client's statement of his or her intent to reside in Alaska.
Note:
Available interfaces can be used to verify Alaska residency in the following circumstances, unless questionable:
SOLQ - if the individual is currently receiving Supplemental Security Income ( SSI ) and the residential address is in Alaska
DOL /SAM - if the individual has current wages and the residential address is in Alaska
INME 9/ PFD - if the individual is eligible for the most recent PFD year
423-4 B. RECIPIENTS
The case worker may require APA recipients to provide proof of Alaska residency if there is reason to doubt their continued residency in the State.
423 ALASKA RESIDENCY
To be eligible for Adult Public Assistance, a person must be a resident of Alaska. This chapter explains the state residency requirements of the APA program.
Note: If during the application proceses DPA finds that an individual has open public assistance benefits of any kind in another state or they are an SSI recipient with an out of state address, the individual is claiming to be a resident of that other state. Until DPA verifies that the individual has reported their move to Alaska to the other state or SSI , the caseworker must find their Alaska residency questionable. Once residency is no longer questionable, we can start benefits in Alaska as outlined in the program policy manuals.
424-1 QUALIFYING AGE
Blind or disabled individuals must be at least 18 years old to be eligible for APA benefits. APA considers an individual to have reached age 18 on the day before his or her 18th birthday.
Individuals who are not blind or disabled must be at least 65 years old to be eligible for APA benefits. APA considers an individual to have reached age 65 on the day before his or her 65th birthday.
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424-2 VERIFICATION OF AGE
424-2 A. BLIND OR DISABLED INDIVIDUALS
The case worker does not need to verify the age of a blind or disabled individual unless there is reason to question the individual's own declaration of age.
424-2 B. AGED INDIVIDUALS
The case worker must verify the age of all individuals who claim to be at least 65 years old.
424-2 C. AGE VERIFICATION PROCEDURES
Section 105-13 A of the Administrative Procedures Manual explains DPA age verification procedures in general. An additional acceptable source of age verification for the APA program is the Social Security Administration.
The case worker may accept oral or written confirmation of a client's date of birth from an office of the Social Security Administration if SSA indicates that the client's case file contains documentary proof of age.
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424 AGE
A person must meet certain age requirements to be eligible for Adult Public Assistance. This chapter explains the age requirements of the APA program.
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425-1 DEFINITION OF BLINDNESS/DISABILITY
For APA purposes, a blind or disabled individual must meet the following definitions of blindness or disability:
1. Blindness
A person is blind if his or her vision, with the use of a correcting lens, is 20/200 or less in the better eye. A person who has tunnel vision of 20 degrees or less in the better eye is also considered blind.
Note: If a person meets the APA blindness criteria, SGA is not a factor in determining their eligibility for APA . The APA program only considers SGA for disability determinations (not blindness).
2. Disability
A person is disabled if he or she is unable to engage in any substantial gainful activity ( SGA ) because of a medically determinable physical or mental impairment other than drug or alcohol addiction. This impairment must have lasted, or be expected to last, for a continuous period of at least 12 months, or be expected to end in death.
"Substantial gainful activity ( SGA )" means that the individual’s own average monthly earned income is at least the amount shown in Addendum 1. This amount changes every year. When making an SGA determination, impairment related work expenses ( IRWE ) and the amount of subsidized earning provided by an employer must be subtracted from the individual’s earned income. No other deductions are allowed.
"Subsidized earnings" means the amount of earned income an individual receives that exceeds the value of the work performed. If a case worker believes that an individual may be receiving subsidized earnings, the amount of the subsidized earning must be verified by the employer.
Refer to manual section 442-2G for policy on impairment related work expenses. Refer to section 425-2D for more information about SGA determinations.
3. Grandfathered individuals
Persons who received Aid to the Permanently Disabled or Aid to the Blind in December, 1973, and who have received benefits continuously since then, are blind or disabled if they still meet the definition of blindness or disability that was in effect in December, 1973.
425-2 WHO DETERMINES DISABILITY/BLINDNESS
425-2 A. TEMPORARY DISABILITY OR BLINDNESS DECISIONS
A proper medical provider can provide a temporary decision on an individual's blindness or disability.
A proper medical provider for a disability decision is a licensed physician, psychiatrist, advanced practice registered nurse, or physician assistant within their licensed scope of practice.
A proper medical provider for a blindness decision is a licensed physician, advanced practice registered nurse, or physician assistant within their licensed scope of practice.
A temporary blindness or disability decision does not allow the authorization of full APA and Medicaid benefits. Instead, it serves as an indication that the individual is blind or disabled for the purposes of qualifying for Interim Assistance ( IA ) benefits until a final blindness or disability decision is made.
The medical provider must provide a temporary blindness or disability decision to the Division on the state form AB 3 , "Report of Eye Examination" for blindness, or on an AD 2 form for disability. The Division will not accept temporary blindness or disability decisions unless they are provided on one of these forms.
425-2 B. PRESUMPTIVE DISABILITY DECISIONS
The SSI program may make presumptive disability payments to SSI applicants before they make a final blindness or disability decision. To be eligible for presumptive disability payments, the individuals must have claimed impairments that are so severe that there is little doubt that Social Security Administration will finally decide they are blind or disabled.
SSI presumptive disability payments are made for no more than six calendar months. Recipients of such payments are considered SSI recipients in all respects. The APA program considers these persons to be blind or disabled during the same period that the person is eligible for SSI payments. The case worker shall authorize full APA and Medicaid benefits during an SSI presumptive disability period if the individual meets all other factors of APA eligibility.
The case worker must check the status of the SSI case before the end of the six-month period. If the SSI presumptive disability payments will not continue, and eligibility for regular SSI payments has not yet been determined, the case worker must close the APA and Medicaid case. The case worker must open an Interim Assistance case if the individual is eligible for such assistance. Regular APA and Medicaid benefits are not available again until SSI determines eligibility for regular SSI benefits. If the individual is finally determined eligible for regular SSI benefits, APA and Medicaid benefits are authorized retroactive to the month that SSI benefits were resumed.
425-2 C. SSA BLINDNESS OR DISABILITY DECISIONS
The Social Security Administration makes the disability decision for most APA applicants and recipients. A finding of blindness or disability allows the authorization of APA and Medicaid benefits if the individual meets all other factors of eligibility for the APA and Medicaid program.
Note: Effective October 1, 2026, individuals must meet Medicaid qualified alien requirements for Medicaid. Refer to ADLTC MS 522 and MAGI MS 808 for policy on U.S. citizenship and eligible alien status.
A finding of no blindness or disability results in denial of APA and Medicaid benefits, and if applicable, in termination of Interim Assistance benefits. The case worker may pend an individual's application for APA and Medicaid benefits only until SSA 's initial blindness or disability finding.
Applicants may appeal the SSA decision.
If the appeal results in a finding of blindness or disability, reevaluate eligibility for regular APA and Medicaid benefits back to the month of APA application. To determine the benefit start dates for APA and Medicaid, refer to manual section 410-7 .
If the appeal results in a finding of no blindness or disability, eligibility for APA and Medicaid does not exist.
If, after a finding of no blindness or disability, an Interim Assistance recipient enters or reenters the SSI appeal process the individual may continue to receive Interim Assistance benefits until a final disability decision is made. If the appeal process results in a final finding of blindness or disability, eligibility for regular APA and Medicaid benefits will be reevaluated. To determine the benefit start dates for APA and Medicaid, refer to manual section 410-7 .
Note: If an initial applicant has already been denied by SSI and they haven't appealed the decision, there is no APA or IA eligibility and the application must be denied. The application is not pended for the applicant to appeal the SSI decision.
425-2 D. STATE-ONLY BLINDNESS OR DISABILITY DECISIONS
Social Security will not decide an individual's blindness or disability if the individual is ineligible for SSI or SSA benefits because of other reasons not related to the individual's blindness or disability such as more stringent citizenship requirements for Title XVI benefits. In such situations, the State must make the blindness or disability decision; the Disability Determination Service (DDS) of the Division of Vocational Rehabilitation, Alaska Department of Labor and Workforce Development, is the agency that makes blindness or disability decisions for the State.
A finding of blindness or disability allows the authorization of APA and Medicaid benefits if the individual meets all other factors of eligibility for the APA program. A finding of no blindness or disability results in a denial of APA and Medicaid benefits. An individual may appeal a state-only DDS decision through the state's fair hearing process.
Substantial Gainful Activity . The DDS is only responsible for making state-only disability determinations based on medical evidence; it does not determine disability based on whether or not an individual is engaging in substantial gainful activity ( SGA ). If an individual (who is subject to a state-only disability determination) appears to be engaging in SGA , the case worker will need to make an SGA determination based on the criteria described in MS 425-1(2) . If the case worker determines that the individual is engaged in substantial gainful activity, APA eligibility must be denied or terminated.
If an applicant or recipient is still within the diary date of the Social Security disability determination, DDS should not be contacted for a disability decision. The disability decision made by Social Security will be honored and APA will continue until the end of the diary date.
Note: SGA determinations by DPA case workers are only necessary for state-only disability determinations. The Social Security Administration is responsible for all other SGA decisions.
Note: A disability decision made by the Social Security Administration ( SSA ) always trumps a decision made by DDS . Once SSA determines that an individual does not meet the disability requirements, it supersedes any state only disability determination that found the individual disabled. If we have an open APA /ME case based on a determination of disability made by DDS and SSA then determines that there is no disability, we would close down the APA /ME case based on the SSA denial.
425-3 PROCEDURES FOR INITIAL BLINDNESS OR DISABILITY DECISIONS
425-3 A. BLIND OR DISABLED APPLICANTS WHO HAVE BEEN FOUND ELIGIBLE FOR SSA , AND DO NOT APPEAR ELIGIBLE FOR SSI
SSA disability requirements are the same as the disability requirements for the SSI and APA programs. Persons who have been determined eligible to receive SSA disability benefits also meet the blind or disabled criteria for APA . SSA usually requires a five-month waiting period from the date that they determine the disability began before they begin to pay disability benefits. Persons who are eligible for SSA disability include individuals who are serving their five-month waiting period. Persons who are eligible for SSA disability who do not appear income eligible for SSI are not required to apply for SSI .
The case worker must verify that eligibility for SSA disability exists. APA benefits are then authorized if the individual meets all other factors of eligibility for the APA program.
425-3 B. BLIND OR DISABLED APPLICANTS WHO APPEAR ELIGIBLE FOR SSI
Individuals in this category include persons who appear eligible for SSI benefits as well as persons who may be eligible for both SSA Disability benefits and for SSI benefits.
Applicants in this category are not eligible for APA or Medicaid benefits while awaiting an SSI eligibility decision, but may be eligible for Interim Assistance. To receive Interim Assistance benefits, these applicants must meet the eligibility requirements described in manual section 426-2 .
425-3 C. BLIND OR DISABLED APPLICANTS WHO DO NOT APPEAR ELIGIBLE FOR SSI AND HAVE NOT BEEN DETERMINED ELIGIBLE FOR SSA DISABILITY
Applicants in this category include persons who do not appear eligible for SSI and who have applied for and are waiting for an SSA disability determination. It also includes individuals who do not appear eligible for SSI and have previously been determined ineligible for SSA disability for a reason other than lack of blindness or disability.
These applicants are not eligible for Interim Assistance because they are not financially eligible for SSI . (See section 426-2B .) They must meet all APA eligibility requirements except for a finding of blindness or disability, and for Medicaid they must meet all other factors of eligibility, see ADLTC MS 530 . The blindness or disability is determined by the DDS . The APA /Medicaid application must be pended for a DDS determination.
As a condition of eligibility, each applicant in this category must provide all of the following completed forms:
APA 4 , "Disability and Vocational Report" and
MED 2 , "Medical Release of Information".
Once the applicant provides the required forms, follow the procedures listed below:
Document the receipt of the APA 4 and MED 2 in the case file and complete the agency portion of the APA 4 .
Immediately mail all forms, along with a completed form GEN 141 , Referral for Disability Determination, and any other related medical/social/work history materials, to:
Disability Determination Services
Attn: DPA Adjudicator
619 East Ship Creek, Suite 305
Anchorage, AK 99501
The district office will maintain a log of all disability determination requests it sends to the DDS .
The DDS , under an agreement with the Division of Public Assistance, will issue a decision: blind/disabled, not blind/disabled, or failed to cooperate.
The DDS will send its decision back to the district office. The district office will log the DDS decision and forward it to the case worker.
The case worker will promptly:
Approve the application and authorize full APA and Medicaid benefits if the DDS has decided the individual is blind or disabled, and the individual meets all other eligibility factors of the APA and Medicaid program. To determine the benefit start dates for APA and Medicaid, refer to manual section 410-7 ; or
Deny the application if the DDS has decided the individual is not blind or disabled; or
Deny the application if the individual has failed to cooperate with the DDS in the process of determining blindness or disability; or
Deny the application if the individual is not eligible for APA for any other reason.
425-4 REVIEW OF BLINDNESS OR DISABILITY DECISIONS
425-4 A. SSA AND SSI DETERMINATIONS
The Social Security Administration periodically reviews blindness or disability decisions that allow the payment of SSA disability or SSI benefits. Review of SSA or SSI blindness or disability decisions is not necessary for APA purposes. If DPA receives information indicating that SSA or SSI disability payments have been terminated because Social Security has found that blindness or disability no longer exists, APA benefits shall be terminated.
425-4 B. DDS DETERMINATIONS
State-only decisions are subject to periodic review by the state. The DDS is the agency responsible for conducting these blindness and disability reviews. The frequency of state-only blindness or disability reviews is set by the DDS .
The DDS does not retain any of the material that they used to initially determine an individual's blindness or disability. Instead, they send the material to the DPA District Office that serves the individual. The District Office must keep all such material with the individual's case file and resubmit it along with newly completed APA 4 and MED 2 forms to the DDS at the time of the individual's periodic review. Because of this, any material that the DDS sends to the DPA District Office must never be archived. The DDS must be informed in the transmittal document that these materials are being submitted for a continuing disability review, since the DDS uses different criteria for disability review determinations than for initial disability determinations.
425-4 C. CHANGE IN SSA OR SSI STATUS
An APA recipient may sometimes become ineligible for Social Security Disability or SSI benefits. If an APA recipient is no longer eligible for SSI or SSA disability for a reason other than a finding that blindness or disability no longer exists, continued eligibility for APA may exist. If the individual is otherwise eligible, the case worker must continue APA benefits and refer the client's case to the DDS for a new blindness or disability decision. This is necessary because SSA will no longer review the individual's disability determination, and there will be no eligibility for SSI or SSA disability to form a basis for APA disability.
SSI recipients who become ineligible for an SSI payment because of excess income are put into SSI nonpay status. Do not confuse nonpay status with the actual closure of an individual's SSI case. It is not necessary to refer these individuals to the DDS unless the individual's SSI claim is actually closed.
425-5 OTHER BLINDNESS/DISABILITY PROVISIONS
425-5 A. PRESCRIBED TREATMENT REQUIREMENT
Blind or disabled individuals who can receive treatment to eliminate their impairments are not eligible for assistance if they fail, without good cause, to follow a prescribed treatment plan. The Social Security Administration or the DDS are the agencies that determine if a blind or disabled individual has not pursued treatment which will eliminate his or her impairment. If the case worker is informed by the Social Security Administration or the DDS that the client has failed, without good cause, to pursue treatment as required, the APA case must be closed.
425-5 B. REFERRAL FOR VOCATIONAL REHABILITATION OR DRUG OR ALCOHOL TREATMENT
State regulations require the State to refer certain persons for vocational rehabilitation services or to drug or alcohol treatment if it might correct their impairment. In Alaska, SSI does not currently refer any persons for vocational rehabilitation services or to drug or alcohol treatment. The State may not be more restrictive than SSI . Therefore, the case worker may make a referral to treatment, but not require the client to pursue it. If SSI begins mandatory referrals in the future, the State will adopt a similar policy.
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425 BLINDNESS/DISABILITY
If a person is not at least age 65, he or she must be blind or disabled to be eligible for Adult Public Assistance. This chapter explains the blindness and disability requirements of the APA program.
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426-1 OVERVIEW OF INTERIM ASSISTANCE
Interim Assistance was established as a special subcategory of APA in order to provide for the basic needs of APA applicants who must concurrently apply for the SSI program. These applicants are not eligible for full APA and Medicaid benefits until they become eligible for SSI . Because the SSI program operates without mandatory processing timeframes, SSI applicants frequently must wait many weeks for a decision on their eligibility. In addition, many SSI applicants are initially denied SSI benefits and pursue a lengthy administrative appeal process before being found eligible. Interim Assistance provides a source of monthly income during the period of time while SSI eligibility is being determined.
Although IA payments are made from APA funds, IA benefits are different from regular APA benefits because receipt of IA does not convey automatic eligibility for Medicaid benefits. IA payments are made to individuals whose applications for APA and Medicaid are being held, pending a final decision on their eligibility for SSI benefits. The decision on the SSI application then forms the basis of the decision on the APA and Medicaid application.
Another aspect of Interim Assistance which differs from Alaska's other public assistance programs is that there is no specific IA application requirement. A client does not apply for IA benefits; instead, the client applies for APA and the case worker determines whether or not to place the applicant into the Interim Assistance program. Eligibility to receive Interim Assistance benefits is based on a number of factors which are explained in this chapter.
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426-2 ELIGIBILITY REQUIREMENTS FOR INTERIM ASSISTANCE
To be eligible for Interim Assistance, an individual must:
Meet all APA eligibility criteria except for receipt of SSI ;
Apply for SSI ;
Appear likely to meet Social Security disability requirements and be determined disabled by the Division, or be age 65 or older; and
Agree to repay Interim Assistance from retroactive SSI benefits by completing an Interim Assistance Reimbursement ( IAR ) authorization form.
Note: The IA benefit start date is the month when all of the eligibility requirements are met and an IAR is signed.
These eligibility requirements are explained below.
426-2 A. APPLICANTS MUST BE ELIGIBLE FOR APA EXCEPT FOR A FINAL ELIGIBILITY DECISION BY SSI
With the exception of a final eligibility decision by SSI , all other APA eligibility requirements apply to the determination of eligibility for IA . This means that the caseworker must make a full eligibility determination before Interim Assistance can be approved. For blind or disabled applicants who are not eligible for Social Security disability benefits, a temporary disability or blindness decision must be made in accordance with the procedures described in this chapter.
426-2 B. CONCURRENT SSI APPLICATION
Interim Assistance is available only to APA applicants who are required to apply for SSI benefits; IA payments will not be made to APA applicants who have countable income or resources in excess of SSI program limits and are therefore not required to apply for SSI benefits.
To receive Interim Assistance, proof must be obtained that the applicant has submitted a signed SSI application to the Social Security office.
Because of the similarity between SSI and APA eligibility criteria, the identification of potentially SSI -eligible applicants is relatively simple. If the client appears to be APA eligible, and to have countable income within the applicable SSI limit, the client may be eligible for SSI and must file for SSI if he or she does not already have an active claim. If an applicant has income which changes from month to month and which is in some months within SSI limits, he or she must apply for the SSI program and may receive IA payments until Social Security makes a final decision on the SSI application.
When an APA applicant is identified as potentially SSI -eligible, the applicant has 30 days from the APA application filing date to contact SSA and file an SSI claim. The contact establishes a "protected filing" date for SSI benefits, and consists of an oral or written request for benefits. This request for SSI benefits may be made in person, by mail, or by telephone.
The SSI application process requires that an SSI applicant must have an interview with an SSA Field Office Claims Representative before a signed application for SSI benefits can be accepted. Once the interview is completed, an applicant must submit a signed application to a SSA office within 60 days of the date of the SSI interview, unless SSA determines there is good cause for a delay.
If, without good cause, an APA applicant does not submit a signed SSI application to a Social Security office within SSA's 60-day time limit, the APA application will be denied. If the individual wishes to reapply once the application has been denied, he or she must complete a new APA application.
426-2 C. INTERIM BLINDNESS OR DISABILITY DETERMINATION
The APA program uses the same definitions of disability and blindness as SSI . The Division will obtain and use medical and other information to determine whether an applicant is likely to meet the SSI disability/blindness criteria, and is eligible for Interim Assistance.
If an individual becomes ineligible for IA for any reason other than a final SSI decision, a new AB 3 , AD 2 , APA 4 or disability assessment by the Division’s Medical Reviewer is not required as long as the SSI application has remained active during the individual’s period of ineligibility. IA benefits may be authorized again once the reason for the ineligibility ends. If the applicant received a final SSI decision during the period of ineligibility, the individual must reapply for assistance and meet the criteria listed In APA MS 426-2 before IA benefits are again approved.
Note: If an individual is pursuing IA and has an application status of H80 with SSI , their APA application should be pended until we get a decision from either SSI or the IA medical reviewer, which is done with the P304. If IA is denied, then the P301 would be sent to give the client 30 days to be in pay status.
These determinations are made as follows:
1. APA applicants who are eligible to receive Social Security disability insurance benefits
Persons who receive SSA disability payments, and persons who have been determined eligible to receive SSA disability benefits but are serving their five-month waiting period, meet the blindness/disability criteria for IA . These individuals are not required to have a medical exam or an assessment by the Division’s Medical Reviewer, as described below.
2. Blind APA applicants required to submit an AB 3 form
An individual who is blind must be examined by a licensed physician, advanced practice registered nurse, or physician assistant within their licensed scope of practice as specified in Manual Section 425-2A . The results of this examination must be provided on a Review Report on Aid to the Blind ( AB 3) form. If a medical provider refuses to complete the AB 3 form, the caseworker should advise the applicant to go to a different provider for completion of the form.
The AB 3 form must be checked "Yes" or "No." A "Yes" is evidence of blindness for Interim Assistance. A "No" shows ineligibility for Interim Assistance. When determining blindness for Interim Assistance, only the AB 3 form needs to be completed. The caseworker will accept the judgment of the medical provider as noted on the AB 3 . It is not reviewed by any other authority.
If Interim Assistance is not approved, the APA application must be pended for an eligibility decision from the SSI program so that eligibility for regular APA and Medicaid can be determined.
3. Disabled APA applicants required submit an AD 2 form
An individual who has a disability other than blindness must be examined by a licensed physician, psychiatrist, advanced practice registered nurse, or physician assistant within their licensed scope of practice as specified in Manual Section 425-2A . The results of this examination must be provided on a Preliminary Examination for Interim Assistance AD 2 form. If a medical provider refuses to complete the AD 2 form, the caseworker should advise the applicant to go to a different provider for completion of the form.
In some cases, the Medical Reviewer may need to ask a medical provider for information. To assist in this process the caseworker should obtain a completed Authorization for Release of Protected Health Information ( GEN 150 IA ) form. See section 4 below for instructions on how to complete this form.
The Medical Reviewer will assess the individual’s disability using the examination results reported on the AD 2 form and any supporting documents or information, and decide whether the applicant meets SSI disability criteria.
When making a disability assessment, the Medical Reviewer will consider whether the:
Applicant’s condition meets the SSI presumptive disability criteria or another impairment category used by Social Security to determine a person’s disability status;
Medical information provided by the applicant or received by the Department documents the applicant’s impairment;
Impairment affects the individual’s activities of daily living;
Applicant can work, including sedentary work;
Impairment has lasted, or is expected to last, for a continuous period of at least 12 months.
Once the assessment is completed, the Medical Reviewer will document the disability decision on the AD 2 form and advise the caseworker of the approval or denial by fax or e-mail.
• IA Disability Approved
If approved, the caseworker will open an Interim Assistance case if the individual meets all other factors of eligibility for IA . The APA application is pended for an eligibility decision from the SSI program so that eligibility for regular APA and Medicaid can be determined.
• IA Disability Denied
If denied, the caseworker will pend the APA application, giving the individual 30 days to be in pay status with SSI .
4. Authorization for Release of Protected Health Information ( GEN 150 IA )
The GEN 150 IA form must be properly completed before it is sent to the Medical Reviewer. If information is being requested from more than one medical provider, a separate form must be completed for each provider.
The information requested on the front page of the form must be filled in before the applicant signs the form. The form is not valid if the applicant signs the form before it is filled out. The form should be completed as follows:
Name: The applicant's printed name.
SSN: The applicant's Social Security Number.
Case # or Client ID: The applicant's EIS case number or Client ID.
Date of Birth: The applicant's date of birth.
Other Names Under Which Records Might Be Filed: If applicable, enter any other names under which medical records might be filed.
Organization Releasing Information: Provide the name of the medical provider from whom we may request information. The provider must be clearly identified with a complete name. For example, "Providence" is not enough information because there are numerous providers with that name, such as Providence Mat-Su, Providence Behavioral Health, Providence Family Practice, etc.
Spell out acronyms on the release form. If the provider does not accept an acronym, then we must get a new release form - creating a delay for both the caseworker and the applicant.
If the applicant comes from another state, ask the applicant for identifying information for any out-of state providers, such as a valid phone number, fax number, or mailing address. The release form is useless if the Medical Reviewer is unable to contact the provider.
Organization Receiving Information: This section is pre-filled with: "Division of Public Assistance".
Description of Information To Be Released: This section is pre-filled with: ”All medical records supporting disability or incapacity due to mental illness, physical illness, and/or substance abuse.”
Signature: The applicant or their personal representative must sign the form.
Date: The date the form is signed.
Revocation Date(s): If the applicant enters a revocation date on either the front or back of the form, please review that date. An applicant may sometimes enter a revocation date that is the same as the signature date. When this happens, a new release form will be needed because the applicant has essentially revoked the current form.
5. Disability and Vocational Report ( APA 4 )
The APA 4 asks the client to give information about their disability, their medical provider's name and contact information, and information about past work and education. The information provided on the form will help the Medical Reviewer determine IA eligibility.
The APA 4 must be completed to the extent possible before it is sent to the Medical Reviewer. Sending incomplete documentation to the Medical Reviewer may result in a delay in the disability decision. For additional guidance on how to complete the APA 4 see Administration Manual section 115-9D(2).
426-2 D. AGED APPLICANTS
Processing times for SSI applications based on age are usually much faster than for individuals applying based on disability or blindness. In most cases, the SSI decision for old age cases will be made within the 30-day APA application processing timeframe, and eligible cases can be opened in regular APA coverage. If, however, no SSI decision is reached within the APA application processing timeframe, aged applicants may receive Interim Assistance pending the SSI eligibility decision. An interim blindness or disability determination is not required for aged applicants.
426-2 E. IAR AUTHORIZATION REQUIREMENT
APA applicants must sign an Interim Assistance Reimbursement ( IAR ) authorization form to receive Interim Assistance benefits. The IAR authorization is not, however, an eligibility requirement for regular APA benefits. The signed IAR authorization is necessary only if the applicant wishes to receive IA benefits while waiting for a decision on his or her SSI application. APA applicants who appear eligible for Interim Assistance must be given the choice of either signing or not signing the IAR authorization form.
The IAR authorization may be provided to the APA applicant during the interview process, or if this is not possible, the caseworker may send EIS notice, P021, IAR Authorization Needed, and mail the IAR authorization form separately to the client at the same time.
When a signed IAR authorization is received, the caseworker must:
Complete and sign the "State Representative Signature" and "Date Received by State" fields at the bottom of the form and send the original copy to the appropriate SSA office within 30 calendar days of the date the signed authorization was received by DPA . (The date the authorization was received by DPA is entered on the form as the date received.) If these fields are not completed, the SSA office will return the form to DPA .
Enter the date the authorization was received by DPA into EIS on the APAS screen. (The Claims Unit will use this date when calculating an IA recipient's reimbursement obligation.)
If otherwise eligible, Interim Assistance under this provision begins the month a signed IAR authorization is received in a DPA office. APA applicants who do not sign an IAR authorization are not eligible for Interim Assistance.
426-2 F. CONTACTING THE MEDICAL REVIEWER
Once all the necessary forms are complete, the caseworker must immediately notify the Medical Reviewer by sending an email to hss.dpa.interim.assist@alaska.gov . The email must include the client's name and client ID. The Medical Reviewer will find the documents in ILINX with this information.
NOTE : If an IA applicant is terminal, staff should indicate this on the IA packet being sent to the Medical Reviewer.
426-3 INTERIM ASSISTANCE REIMBURSEMENT ( IAR )
426-3 A. IAR AGREEMENT WITH SSA
Alaska has an Interim Assistance Reimbursement ( IAR ) agreement with SSA . This agreement allows SSA to reimburse the state from an individual’s initial SSI payment for some or all of the IA benefits DPA pays an individual while he or she waits for a final SSI eligibility decision. For IAR purposes, an initial SSI payment is the successful SSI applicant's first SSI check which includes both any retroactive SSI entitlement and the first current month's SSI payment. APA applicants must agree to allow DPA to recover the cost of their IA benefits as a condition of receiving IA .
426-3 B. IAR AUTHORIZATIONS
In order for SSA to reimburse DPA from an individual's initial SSI payment, the individual must sign an IAR authorization
1. Protective filing.
The date a signed IAR authorization is received by DPA may act as a protective filing date for SSI , but only if the individual submits a signed SSI application to SSA within 60 days of that date. Case workers must inform applicants of this provision and advise them to begin the SSI application process as soon as possible in order to preserve their protective filing date for SSI benefits.
2. Life of the IAR authorization.
An IAR authorization is effective for at least 12 months. The 12- month period begins the date SSA receives the authorization form from DPA and ends 12 months later unless the individual files for SSI within that time. If the individual does apply for SSI within the 12-month period, the IAR authorization remains in effect until one of the following events occurs:
SSA makes a final SSI eligiblity determination (including a determination on appeal), or
SSA releases the initial SSI payment on an individual's SSI claim, or
The Division and the individual agree to terminate the authorization.
3. Notification of a signed IAR authorization.
Upon receiving a signed IAR authorization, the case worker must distribute copies of the signed authorization within 30 calendar days. Because the signed authorization may act as a protective filing date for SSI , a copy must be sent to SSA even if, for some reason, the APA application is denied. Copies are distributed as follows:
Original to: SSA District Office.
Copy to: Client.
Copy to: Casefile.
Note: Because of the protective filing provisions for SSI , case workers should obtain a new signed IAR authorization whenever an APA applicant who appears eligible for Interim Assistance applies or reapplies for APA .
426-3 C. INTERIM ASSISTANCE REIMBURSEMENT PROCESS
SSA will notify the Claims Unit of any SSI application approval for which IAR is involved, including those made on SSI applications going through the SSI appeal process. For each approval, SSA will identify all months for which the state may claim reimbursement. Within 10 working days from the date the claims unit receives this information, it must request reimbursement from SSA through a secure Internet-based process. SSA will then compute the amount of reimbursement due the state, notify the state of the reimbursement amount, provide details of their computation, and transmit the reimbursement payment to an account designated by the state.
The initial SSI payment is used to repay IA benefits beginning with the day of the month in which the client is first determined eligible for an SSI payment, or with the first day of the month that DPA receives a signed IAR authorization, whichever is later, and ending with the month the initial SSI payment is made.
The Division may use the SSI funds to repay IA benefits only for months during which the client was eligible for both an SSI payment and an IA payment. The amount of the repayment obligation for any month is the amount of the IA payment or the amount of the SSI payment for that month, whichever is less.
After the IAR payment is received from SSA , the Claims Unit will:
Send EIS notice P900, Interim Assistance Repayment Agreement Fulfilled
Note: This notice informs the client they have fulfilled their agreement to repay IA benefits.
By e-mail, notify the office responsible for the individual's Interim Assistance case of the individual's SSI eligibility. At the same time, the Claims Unit will forward information from SSA regarding the individual's eligibility and monthly grant amounts for retroactive SSI benefits.
Maintain records of all transactions relating to Interim Assistance and the allocation of the individual's initial SSI payment.
SSA will also notify the Claims Unit of any initial SSI denial for all SSI applicants for whom they have an IAR authorization on file. By e-mail, the Claims Unit will notify the office responsible for the IA case of the initial SSI denial and forward copies of any paperwork received from SSA regarding the initial SSI denial. SSI will not notify the Claims Unit of any denial resulting from the SSI appeal process.
426-4 INTERIM ASSISTANCE SUSPENSION OR TERMINATION
An individual is not eligible for IA for any month in which his or her countable income, after rounding, exceeds the applicable APA need standard.
When an IA recipient becomes ineligible for IA because of excess income, the caseworker must close the IA case with adverse action.
If the IA case is closed because of excess income, the APA /Medicaid application is denied, and the client will have to reapply.
426-5 PROCESSING SSI DENIALS; THE SSI APPEAL PROCESS
Interim Assistance continues until Social Security issues its final SSI eligibility decision regarding disability. Which of the four possible SSI levels of decision is final depends upon whether a denied applicant chooses to appeal an SSI decision, and how far the applicant chooses to continue in the SSI appeal process.
There are four possible SSI decision levels in the Social Security administrative process:
1. Initial Determination
The initial determination is handled by an SSA Field Office Claims Representative. However, the Claims Representative does not make the initial medical determination; these are done by Disability Determination Service agencies. In Alaska, initial medical determinations are done by the Disability Determination Service of the Division of Vocational Rehabilitation.
2. Reconsideration
A reconsideration or "recon" decision is the first step in the SSI appeals process. Any person who has received an adverse initial decision on his or her SSI application or open case is entitled to ask for a reconsideration.
3. Administrative Law Judge Hearing
If dissatisfied with the reconsideration decision, the individual may ask for a hearing before an Administrative Law Judge;
4. Appeals Council Review
A request to have the Appeals Council review the decision made by the Administrative Law Judge is the next step if applicant is dissatisfied with the decision of the Administrative Law Judge.
Like the DPA hearing process, a client may withdraw in writing from the SSI appeals process at any point. The appeal process ends upon failure to appear without good cause, or it ends if the client does not timely request the next level of review without good cause. Occasionally, an individual may claim good cause for not filing an appeal in a timely manner. Such individuals are still considered to be in the SSI appeal process while seeking a good cause waiver for an untimely appeal. Once an individual has exhausted the SSI appeal process, he or she may choose to appeal the SSI decision to the federal district court; Interim Assistance is not available pending an appeal to the court.
Once Interim Assistance is approved, it is continued until the client is approved for SSI , receives an adverse SSI decision and does not appeal it to the next appeals level, withdraws or abandons an appeal at any level, or receives an adverse decision from the Appeals Council. However, if DPA discovers or receives clear evidence that the client is not eligible for APA on grounds other than those being appealed through the SSA system, the Interim Assistance case will be closed.
If the IA case is closed because of countable income that exceeds the APA need standard, the APA /Medicaid application is held in pended status until an initial decision on eligibility for SSI benefits is made.
426-6 CASE CONTROLS DURING THE SSI APPEAL PROCESS
426-6 A. VERIFICATION TIMEFRAMES
Under Interim Assistance Reimbursement provisions, SSA will notify the Claims Unit of initial SSI approval or denial decisions for all SSI applicants for whom they have an IAR authorization on file. However, SSA will not notify the Claims Unit about an SSI applicant's appeal status, unless the appeal is successful, in which case SSA will notify the Claims Unit of the SSI approval. The Claims Unit will in turn notify the case worker responsible for the applicant's Interim Assistance case.
Since the time required at each step of the SSI appeals process varies widely by appeal stage, by individual circumstances, and even by the time of year, periodic checks with the Social Security Administration to verify the status of SSI appeals are necessary to ensure that the SSI applicant or recipient has continued the appeals process as required for continued Interim Assistance benefits.
Although the applicant or recipient is responsible for reporting any changes in appeal status, follow-up may be necessary if the client does not report the change. When the client is represented by an attorney or paralegal, the case worker should use that person as a source of verification during the appeal process. The SDX paper printout is another source of verification of SSI appeal status. Field staff may also contact their local servicing SSA district office to verify SSI appeal status if the information is not readily available through other sources.
Reconsideration. After a reconsideration with SSI has been filed, verify the status within 90 days after the date the client filed the request.
Administrative Law Judge hearing. If the client files a hearing request, seek the scheduled date of the hearing within 60 days of the time the client filed and schedule periodic inquiries for verification of the hearing status approximately every 90 days after the scheduled hearing date.
Appeals Council review. After a request for Appeals Council review is filed, verify the decision status approximately every 120 days.
426-6 B. NOTICE REQUIREMENTS
An initial finding of no blindness or disability by SSA forms the basis for the denial of an APA application. Written notice of APA denial must be sent to the APA applicant whenever a case worker becomes aware of an initial SSA finding of no blindness or disability. The denial notice must inform the client that the APA application is denied, and that continued eligibility for Interim Assistance may still exist if the individual appeals the SSI decision. If the appeal process results in a final finding of blindness or disability, the APA application shall be reevaluated.
IA benefits must be continued for a reasonable period of time after a case worker becomes aware of an adverse SSI decision from any level except the final Appeals Council review, to allow the client time to appear, offer good cause, file an appeal to the next level, etc. Written notice of Interim Assistance closure must be sent to each client immediately upon discovery of each adverse SSI decision or notice of failure to appear at an SSI hearing. SSI allows up to 60 days from the point of notice of adverse action for the client to file for the next level of appeal. APA denial notices must give the client at least 30 days to offer proof of re-entry into the SSI appeals process.
The 30-day period for a client to offer proof of re-entry into the SSI appeals process may be extended by the case worker's prudent judgment if there is good reason to believe that 30 days is inadequate for the client to appeal or to offer good cause for not appearing. Examples of good cause are remoteness from an SSA or Alaska Legal Services office and personal or family illness.
When the appeals process ends because of the client's written withdrawal, a 10-day advance notice of closure is sufficient.
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426-7 CONVERTING INTERIM ASSISTANCE TO REGULAR ADULT PUBLIC ASSISTANCE
Interim Assistance payments end when Social Security makes its final SSI eligibility decision and notifies the applicant.
Refer to EIS Procedure 2012-1 for instructions regarding converting IA to APA .
426-7 A. ELIGIBLE FOR SSI - CLIENT HAS SIGNED IAR AUTHORIZATION
If the client is found eligible for SSI , and has signed an IAR authorization, eligibility for Interim Assistance ends the month that SSA makes the SSI eligibility decision. This will normally be the same month that SSA sends the initial SSI payment to the Claims Unit. Regular APA benefits are approved beginning the first day of the month after SSA notifies the individual that he or she is eligible for SSI .
If, for some reason, the IA case cannot be converted to regular APA the month following the SSI decision, the case worker may convert the case beginning with the following month. This situation may occur when IA benefits are issued before the case worker learns of the SSI decision. The individual is still considered eligible for regular APA benefits beginning with the month following the SSI decision, and if otherwise eligible, may receive APA and Medicaid benefits for the months following the SSI decision.
426-7 B. ELIGIBLE FOR SSA RSDI BENEFITS - NOT ELIGIBLE FOR SSI
If, after going through the SSI application process, the client is eligible for Social Security Retirement, Survivor, or Disability Insurance benefits but not for SSI benefits, APA and Medicaid eligibility may exist depending upon the type and amount of the SSA benefit and other financial and non-financial APA eligibility criteria. The case worker will make an eligibility decision based on the eligibility criteria of the APA program.
426-7 C. NOT ELIGIBLE FOR SSI SOLELY BECAUSE OF EXCESS INCOME
If SSI finds the client ineligible solely because of excess income, APA eligibility may exist. The caseworker will make an eligibility decision based on the eligibility criteria of the APA program. Medicaid eligibility may exist if Medicaid eligibility requirements are met. See ADLTC MS 530 .
Note: If the applicant is applying for APA on the basis of blindness or disability, and SSA has not made a blindness or disability determination, the APA application must be pended for a state-only blindness or disability decision from the Disability Determination Service ( DDS ) before APA eligibility can be determined. The individual is not eligible for IA benefits while waiting for a state-only DDS decision. (See section 425-3C. )
426-7 D. NOT ELIGIBLE FOR SSI DUE TO NOT MEETING DISABILITY CRITERIA
IA recipients should not have their IA benefits terminated if their SSI claim is denied for not meeting disability criteria. IA recipients must be given 30 days to provide verification that they are appealing their SSI denial. If they provide verification that they have appealed the SSI decisions, IA benefits should continue during the appeal process described in APA MS 426-5 .
IA applicants are not pended for proof of appeal. As applicants, their APA and Medicaid application should be denied if SSI denies their claim for not meeting disability criteria.
426-7 E. SSA APPROVES SSI BEFORE MEDICAL REVIEWER APPROVES INTERIM ASSISTANCE
If SSA determines that the applicant is disabled before the Medical Reviewer's Interim Assistance ( IA ) decision is received, do not issue IA back to the date the IAR was signed. Since IA is not approved in this situations, the applicant has no IAR obligation.
The APA benefit start date is the first day of the month after SSA awards SSI or SSDS benefits, or the first day of the month after DDS notifies DPA that the applicant is disabled. The client would not be issued any IA payments.
426-8 ELIGIBILITY FOR MEDICAL ASSISTANCE
Eligibility for Interim Assistance does not convey automatic eligibility for Medicaid. Each applicant for IA should be examined for Medicaid eligibility. If the applicant is not eligible for any type of Medicaid, they should be referred to the FFM to see if they're eligible for a qualified health plan and tax credit.
426-8 A. BLINDNESS OR DISABILITY EXAM COSTS
The SSI application process for benefits based on disability or blindness includes a comprehensive evaluation of the applicant's physical or psychological condition. In Alaska, these evaluations are performed by Disability Determination Service (DDS) of the Division of Vocational Rehabilitation.
DPA will not authorize any Medicaid coverage for transportation, escorts, lodging, or examinations for any client whose disability or blindness is to be determined by the DDS . The DDS sets up the entire exam process, pays all expenses, and bills the Social Security Administration for the cost of the examination.
Medicaid does pay for any necessary costs of getting a completed AD 2 or AB 3 . This examination is a Medicaid covered expense. See Aged, Disabled, and Long Term Care Medicaid manual section 501 for instructions for issuing Medicaid authorizations for AD 2 or AB 3 examinations.
426-8 B. RESERVED
426-8 C. MAGI MEDICAID
Interim Assistance recipients may qualify for MAGI Medicaid coverage while receiving Interim Assistance. These individuals must meet the eligibility requirements for these Medicaid coverage categories as specified in the MAGI Medicaid Manual Section 816 .
426-9 TEMPORARY ASSISTANCE AND INTERIM ASSISTANCE
A Temporary Assistance applicant may apply for APA and be found eligible to receive Interim Assistance. However, the Temporary Assistance program considers Interim Assistance payments as countable income, and will reduce or terminate Temporary Assistance benefits because of countable Interim Assistance payments. The APA applicant shall be informed of this provision and given the choice of whether or not he or she wishes to receive Interim Assistance while his or her eligibility for Temporary Assistance is being determined.
A Temporary Assistance recipient is not eligible for Interim Assistance. Once a Temporary Assistance applicant is found eligible to receive Temporary Assistance benefits, eligibility for Interim Assistance ends. A Temporary Assistance recipient may apply for APA and SSI benefits, but may not receive Interim Assistance while awaiting the decision on the APA and SSI applications.
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426 INTERIM ASSISTANCE
Interim Assistance (IA) is a temporary cash grant available to APA applicants who are waiting for a decision on an SSI application. This chapter explains the eligibility requirements for IA.
430-1 RESOURCES DEFINED
Resources are any assets, including cash or any other real or personal property, that an individual (or the individual's spouse or alien sponsor, if any) owns and can convert to cash to be used for his or her support and maintenance.
Any cash or other property received from the sale, exchange, or other disposition of a resource retains the character of a resource. Such resource conversions are not considered to produce income.
Resources may be either liquid or nonliquid. This distinction is important for purposes of determining whether a resource may be excluded as non-business property essential for self-support, and whether the individual or couple whose resources exceed the resource limits might qualify for conditional benefit payments.
Liquid resources. Liquid resources include cash and any other resource that can be converted to cash within 20 working days. (Saturdays, Sundays, and federal holidays do not count as working days.) Examples are cash, stocks, bonds, mutual funds, promissory notes, personal and real property contracts or mortgages, and financial accounts (including joint accounts).
Note: Client statement is allowed regarding resources unless questionable. Cases that involve a trust still require expenditure review. A statement from the institution or an OPA ledger is acceptable verification of questionable resources.
Non-liquid resources. Nonliquid resources are all resources that cannot be converted to cash within 20 working days. Nonliquid resources include:
Personal property such as vehicles, machinery, livestock, household goods, and personal effects.
Real Property such as land, buildings, or other objects that are attached permanently to the land.
Some kinds of resources may be either liquid or nonliquid depending on whether they can actually be converted to cash within 20 working days.
430-2 RESOURCE LIMITS
To be eligible for assistance, countable resources may not exceed:
$2000 for an individual; or
$3000 for a couple, as long as at least one member is eligible for assistance.
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430-3 WHEN RESOURCE VALUES ARE MEASURED
Resources are measured as of the first moment of the month. Anyone whose countable resources exceed the resource limit as of the first moment of the month is ineligible for the entire month, even if some of the assets are disposed of later in the month. Similarly, anyone whose resources do not exceed the resource limit as of the first moment of the month is resource-eligible for the entire month, even if the assets exceed the resource limit later in the month.
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430-4 ASSETS THAT ARE NOT RESOURCES
430-4 A. SOME ASSETS ARE NOT RESOURCES
Not all of an individual's assets are resources for APA purposes. Assets are not resources if the individual does not have:
Any ownership interest; or
The legal right, authority, or power to liquidate them; or
The legal right to use the assets for his or her own support and maintenance.
430-4 B. AN ASSET THAT IS NOT A RESOURCE MAY PRODUCE INCOME
Any money that a person receives from a nonresource is counted as income in the month received, unless it is otherwise excluded. For example, if an individual is the beneficiary of a trust which is not his or her resource, and the trust pays the individual a monthly allowance, the allowance is income to the individual.
430-4 C. ASSETS THAT ARE NOT RESOURCES MAY BECOME RESOURCES
In certain situations, an asset that is not a resource may become one at a later date or vice versa. The distinction must be made because an asset that is not a resource does not count against the resource limit while an asset that is a resource does count against the resource limit.
Example: At the time of his divorce in 1998, Mr. Thomas, an APA recipient, was the sole owner of the house in which his ex-wife and their two children are living. Under terms of the divorce decree, Mr. Thomas must pay the property taxes on the property and maintain it as a home for his ex-wife and their two children until the youngest child reaches age 18 in 2004. The decree also specifies that he is free to sell the property after the youngest child's eighteenth birthday. Although Mr. Thomas clearly owns the property, he is legally barred from selling it until 2004. Therefore, it is not a resource until the month after his youngest child reaches age 18.
430 RESOURCES
To be eligible for assistance, an individual or couple must have countable resources that do not exceed the resource limits of the APA program. This chapter explains the resource requirements of the APA program. Certain resources of ineligible spouses and/or alien sponsors are considered available (deemed) to meet the needs of an individual or couple in determining eligibility for APA . Refer to chapter 460 for the policy on the deeming of resources of ineligible spouses and/or alien sponsors.
Note: Real property (including any structures built on the land) owned by Alaskan Native and American Indian is still a countable resource to the Adult Public Assistance program. Please see ADLTC MS 524-L. for more information on Medicaid Exceptions to APA Resource Policy.
431-1 REAL PROPERTY AND PROPERTY RIGHTS
Note: Real property (including any structures built on the land) owned by Alaskan Native and American Indian is still a countable resource to the Adult Public Assistance program. Please see ADLTC 524-L for more information on Medicaid Exceptions to APA Resource Policy.
431-1 A. NON-HOME REAL PROPERTY
Non-home real property consists of land and buildings or other objects that are attached permanently to the land and that do not meet the definition of a home.
431-1 B. PROPERTY RIGHTS
Even though an individual may not own an item of property, he or she may own certain rights to the property. If the individual can sell these property rights to another party, the property rights are an available resource. Examples of such saleable property rights are listed below:
1. Mineral rights
Mineral rights represent ownership interest in natural resources such as coal, oil, natural gas, and other precious and non-precious metals which normally are extracted from the ground.
2. Timber rights
Timber rights permit one party to cut and remove trees from the property of another party.
3. Easement
An easement gives one party the right to use the land of another party for a particular purpose.
4. Leasehold
A leasehold conveys to one party the use and control of certain property of another party for a specified period.
5. Water rights
Water rights usually confer upon the owner of riverfront or shore front property the right to access and use the adjacent water.
6. Life estate
A life estate conveys to an individual certain property rights for the duration of his or her life, or someone else's life. Most commonly, a life estate conveys a right to use or live on a piece of real property.
The owner of a life estate can sell the life estate but does not have title to the property itself and thus normally cannot sell the property or pass it on as an inheritance. The asset that is potentially countable as a resource is the specific right that is conveyed as a life estate.
Value of a life estate. The value of a life estate is the amount that it would sell for as of the first moment of the month. This value is determined by multiplying the fair market value of the property by a decimal value based on the life estate holder's life expectancy. These life expectancy tables and the applicable decimal multipliers are available on the Internet at the following website: http://policy.ssa.gov/poms.nsf/lnx/0501140120 . If the life estate holder is an SSI applicant or recipient, or someone whose resources are considered available to meet the needs of an SSI applicant or recipient, accept the determination of value made by Social Security.
If an individual wishes to contest the value of a life estate interest determined by a case worker, the individual may obtain an appraisal of the value of a life estate from a knowledgeable source in the area where the property is located. A knowledgeable source is a person or institution that deals in the sale of life estates, such as a financial institution or real estate agent.
7. Remainder interest.
A remainder interest exists if the owner of property conveys it to one party in the form of a life estate, and designates a second party to inherit the property upon the death of the life estate older. The second party has a remainder interest in the property.
Value of a remainder interest. The value of a remainder interest is determined the same way as the value of a life estate, except that the fair market value is multiplied by a different decimal value. These values are available on the Internet at http://policy.ssa.gov/poms.nsf/lnx/0501140120
431-2 PERSONAL PROPERTY
431-2 A. JOINT ACCOUNTS
All funds in a jointly owned checking or savings account to which each owner has unrestricted access are totally available to each owner of the account.
The only exception to this rule is that if each owner of the account is eligible for SSI or APA , the funds in the account are prorated equally to each owner. This exception does not apply to situations where the other joint owner receives another type of assistance such as Temporary Assistance.
An APA applicant or recipient who is an owner of a joint account may argue that some or all the funds in the account do not belong to him or her. To establish non-ownership of the funds, the APA client must:
Provide a written statement that explains why some or all of the funds in the account do not belong to him or her. If the client indicates that only some of the funds do not belong to him or her, the client must specify what portion of the funds are not his or hers; and
Provide a corroborating statement from the other account owner(s). If the other owner(s) of the account is (are) not competent to provide such a statement, a statement from a third party who is familiar with the situation is acceptable; and
Change the account designation to either remove the individual's name from the account, or show that the owner(s) have restricted access to the account.
Once this is done, any funds determined to be owned by the other account holder(s), and that the individual can no longer withdraw from the account, were not and are not a resource to the individual.
431-2 B. TIME DEPOSITS
A time deposit is a contract between an individual and a financial institution where the individual agrees to leave funds on deposit for a specified period and the financial institution agrees to pay interest at a specified rate for that period. Certificates of deposit and savings certificates are common forms of time deposits.
Withdrawal of a time deposit before the specified period expires incurs a penalty. This penalty does not prevent the time deposit from being a resource, but does reduce its value as a resource.
In some situations, the terms of a time deposit will prohibit early withdrawal altogether; in such cases, the time deposit has no value as a resource until it can be withdrawn.
The resource value of a time deposit is the amount that the owner would receive upon withdrawing it at the first moment of the month.
431-2 C. STOCKS
Shares of stock represent ownership in a business corporation. Many stocks are sold publicly. Their value shifts with demand and may fluctuate widely. The value of publicly traded stock is the amount that the stock can be sold for as of the first moment of the month. Broker fees do not reduce the value that stocks have as a resource.
Some stocks may be held within close groups and traded very infrequently. The sale of such stock is often handled privately and may be subject to restrictions. As a rule, such stocks cannot be converted to cash within 20 working days.
Verification: The closing price of publicly traded stock may usually be found in the next day's regular or financial newspaper. If the case worker is unable to determine the value of a stock from this source, the APA client is responsible for providing proof of the value of the stock. The preferred evidence for stock that is not publicly traded is a letter or other written statement from the firm's accountants giving their estimate of the stock's value.
431-2 D. SAVINGS BONDS
U.S. Savings Bonds are obligations of the Federal Government. Unlike other government bonds, savings bonds are not transferable; they can only be sold back to the Department of the Treasury. U.S. Savings Bonds cannot be redeemed for six months after the issue date specified on the bond.
U.S. Savings Bonds are not resources during the six-month mandatory retention period. They are resources as of the first moment of the seventh month. The value of a savings bond increases over time, sometimes even after the maturity date is reached. However, after maturity, the value of a series H and HH bond is its face value.
If more than one individual owns a U.S. Savings Bond, the co-owners own equal shares of the value of the bond. A U.S. Savings Bond is not a resource to a co-owner if another co-owner has and will not relinquish physical possession of it.
431-2 E. MUNICIPAL, CORPORATE, AND GOVERNMENT BONDS
A bond is a written obligation to pay a sum of money at a specific future date. A municipal bond is the obligation of a state or locality (county, city, town, village, or special purpose authority such as a school district). A corporate bond is the obligation of a private corporation. A government bond, as distinct from a U.S. Savings Bond, is a transferable obligation issued or backed by the Federal Government.
Municipal, corporate, and government bonds are negotiable and transferable. Their value as a resource is their fair market value. Their redemption value, which is available only at maturity, is immaterial.
Verification. Bonds are usually bought and sold through brokers, security dealers, or other investors. They may sell for more or less than their face value or purchase price, depending on a variety of factors. The APA applicant or recipient is responsible for providing proof of the value of any bonds.
431-2 F. TRUST PROPERTY
1. Definitions
Trustee. A trustee is a person who holds legal title to property for the use or benefit of another. In most instances, the trustee has no legal right to revoke the trust or use the property for his or her own benefit.
Trust beneficiary. A trust beneficiary is a person for whose benefit a trust exists.
Trustor/grantor. A trustor/grantor is a person who creates a trust.
Totten trust. A Totten trust is a trust in which a trustor makes himself or herself trustee of his or her own funds for the benefit of another. The trustor/trustee can revoke a Totten trust at any time. Should the trustor/trustee die without revoking the trust, the principal reverts to the beneficiary.
Trust principal. The trust principal is the amount placed in trust by the trustor plus any trust earnings paid into the trust and left to accumulate.
Trust earnings. Trust earnings are amounts earned by trust property. They may take such forms as interest, dividends, royalties, rents, etc. Trust earnings are unearned income to the person (if any) legally able to use them for personal support and maintenance.
2. Trust funds and resources
1. Individual cannot revoke trust
The trust principal is not a resource to an individual who is not legally empowered to revoke the trust and use the principal for his or her own support and maintenance. Revocability of a trust depends on the terms of the trust agreement and/or on state law. If a trust is irrevocable, the trust principal is not anyone's resource
2. Individual can revoke trust
The trust principal is a resource to anyone who can revoke the trust and who can access the principal thereafter, whether or not he or she actually does so.
If a trust is revocable, generally the right to revoke is reserved with the trustor. A trust beneficiary will not usually have the authority to revoke the trust. Therefore, the trust principal is not likely to be his or her resource unless the trust itself gives him or her access to the property without trustee intervention. Occasionally, a trustee has the legal authority to revoke a trust.
The trustor/trustee of a Totten trust has the authority to revoke the trust at any time, therefore, the trust principal is his or her resource.
Special Needs or Pooled Trust
A trust that meets the Medicaid criteria for a special needs or pooled trust under Aged, Disabled and Long Term Care (ADLTC) Medicaid Manual Section 527 is not a resource. This exemption applies to trusts established on or after January 1, 2000.
Qualifying Income Trusts (also known as a Miller’s Trust)
The SSI and APA Adult Public Assistance programs do not recognize a QIT Qualifying Income Trust . Therefore, a beneficiary may be eligible for Medicaid but not SSI or APA Adult Public Assistance cash assistance. If funds are retained in a QIT and those funds exceed the APA program’s resource limit, there is no eligibility for APA . For more information about QIT see ADLTC MS 526.
3. Trust funds and income
Individual cannot revoke trust
Trust disbursements from an irrevocable trust that are paid to a beneficiary in cash are income; it does not matter whether the disbursements are from the trust principal or the trust earnings.
Trust earnings and disbursements are not income to the trustor or trustee unless designated as belonging to the trustor or trustee under the terms of the trust. Trust earnings are not income to the beneficiary unless the trust dictates, or the trustee allows, payment to the beneficiary.
Individual can revoke trust
If an individual can revoke a trust and thereby receive the trust principal, the trust is a resource to the individual. Disbursements from the principal of a revocable trust are never income, but represent the conversion of a resource. Trust earnings from a revocable trust are income to such an individual.
4. Verification
The client's access to a trust shall be determined by viewing the trust documents. It is the client's responsibility to provide these documents. If the trust document is unclear, the case worker shall refer the trust document to the APA Policy Specialist for an opinion.
431-2 G. RETIREMENT FUNDS
Retirement funds are annuities or work-related savings plans designed to provide income when employment ends. A retirement fund may be a pension, disability, or retirement plan administered by an employer or union. A retirement fund may be an individual retirement accounts (IRA) or a plan for a self-employed person, sometimes called a Keogh plan.
Retirement funds fall into three general categories:
A retirement savings account that is owned and can be accessed by the individual;
A pension plan established by an employer; and
A deferred compensation plan.
1. RETIREMENT SAVINGS ACCOUNTS
The following types of retirement savings accounts are individually owned, and money may be deposited and withdrawn at will. These accounts are available, countable resources regardless of an individual's employment status:
Individual Retirement Accounts (IRA s);
Keogh plans; and
Simplified Employer Pension Plans (SEP s), which are considered IRA by banks and the IRS .
2. PENSION PLANS
Pension plans (including PERS and SBS ) that are established by an employer are exempt while the individual is employed with that employer. Pension plans include:
457 plans (plans for state and local governments and other tax-exempt organizations);
401(k) plans (generally a cash-or-deferred arrangement and generally limited to profit-making firms);
Federal Employee Thrift Savings plan;
Section 403(b) plans (tax-sheltered annuities available to employees of tax-exempt organizations and state and local educational organizations); and
Section 501(c)(18) plans (retirement plans for union members consisting of employee contributions to certain trusts that were established before June 1959).
Availability of Pension Plan Money:
If an individual is no longer working for the employer who established the pension plan, and is not yet eligible for periodic payments from the plan, it is a countable resource if the individual has the option of withdrawing the money as a lump sum.
When the money in a pension plan cannot be immediately withdrawn and used to meet the needs of the applicant, the account balance is considered unavailable if:
The individual demonstrates that they have applied for and are pursuing access to the account balance; and
Receipt of the money cannot be expected in the month for which eligibility is being determined.
If the individual is eligible for periodic payments from a pension plan, the individual must apply for such payments under development of income requirements. In this situation, the account balance is not a resource, but the periodic payments are counted as income.
If an individual refuses or fails to make a reasonable effort to secure this money, either as a lump sum or as periodic payments, the balance is considered available.
3. DEFERRED COMPENSATION PLANS
Deferred compensation plans are evaluated based on whether the individual can access the money while still employed with the employer that established the account.
If the individual can access the money while still employed, the deferred compensation plan is considered available and countable.
For other deferred compensation plans, such as the one offered by the State of Alaska, the individual may not withdraw the money while still employed. Such plans are treated as pension plans.
4. VALUE OF RETIREMENT FUNDS
The value of any retirement fund is the account balance minus any expected penalties or fees for withdrawal. Any retirement fund belonging to an ineligible spouse is excluded as a resource. ( See manual section 460-4A.)
431-2 H. INHERITANCES
An inheritance is cash, a right, or a noncash item received as the result of someone's death. An inheritance is considered an available resource the month after it is received, unless otherwise excluded. Noncash items are not counted as income when received, but they must be evaluated as a resource the month after they are received.
431-2 I. PROMISSORY NOTES, LOANS, AND PROPERTY AGREEMENTS
1. Definitions
Promissory note. A promissory note is a written, unconditional agreement where one party agrees to pay a specified sum of money at a specified time to another party. It may be given in return for goods, money loaned, or services rendered.
Loan. A loan is a transaction where one party advances money to, or on behalf of another party, who promises to repay the lender in full, with or without interest. The loan agreement may be written or oral. A written loan agreement is a form of promissory note.
Property agreement. A property agreement is a pledge of a particular property for the payment of a debt within a specified time period. Property agreements on real estate are generally referred to as mortgages, but also may be called land contracts, contracts for deed, escrow contracts, or deeds of trust. Personal property agreements are commonly known as chattel mortgages.
2. Resource value
Generally, promissory notes, loan agreements, and personal and real property agreements can be sold to a third party. If it is saleable, the note, loan, or property agreement is a resource in the amount of the outstanding principal balance, unless evidence is established that it has a lesser fair market value. If the fair market value is less than the outstanding principle balance, the resource value is the fair market value.
If the item is not saleable, it is not a resource. A promissory note, loan, or property agreement may be assumed to be unsalable if there is a legal bar to its sale.
3. Installment payments
Notes and property agreements frequently provide for installment payments to the owner of the note or agreement. If the note or agreement is a resource, that portion of any payment received representing payment on the principal is also a resource, and is not treated as countable income. The portion of any payment representing interest on the principal is unearned income in the month that it is received.
If a note or agreement is not a resource because it is not saleable, the total payment received, whether applied toward principal or interest, is unearned income.
4. Verification
The APA applicant or recipient is responsible for providing proof of the value of any promissory note, loan, and property agreement. If the client contends that the value of the item is less than its outstanding principal balance, evidence of its fair market value may be obtained from knowledgeable sources engaged in the business of making such transactions. Such sources include banks or other financial institutions, private investors, and real estate brokers.
431-2 J. LIFE INSURANCE
A life insurance policy is a contract. Its purchaser (owner) pays premiums to the company (insurer) that provides the insurance. In return, the insurer agrees to pay a specified sum of money to a designated beneficiary upon the death of the insured (the person on whom, or on whose life, the policy exists). Life insurance policies which have a cash surrender value are generally called "whole life" insurance policies.
The cash surrender value of all life insurance policies on the life of the same insured person is a resource to the owner of the policies if the combined face value of the policies exceed $1,500. If the insurance policies are on the life of different insured persons, only the face values of the policies on the same insured person are combined to determine if the combined face value of the policies exceeds $1,500. (Refer to section 432-2B for an explanation of the limited life insurance exclusion for policies whose face value is less than $1500.)
Example 1: Mr. Evans is the owner of a whole life insurance policy on himself. The policy has a face value of $10,000 and a cash surrender value of $1,700. He also owns a separate insurance policy on himself with a face value of $1,000 and a cash surrender value of $500. The $10,000 policy is a resource in the amount of its $1,700 cash surrender value because its face value exceeds $1,500. The $1,000 policy is also a resource in the amount of its $500 cash surrender value because its $1,000 face value, in combination with the face value of the $10,000 policy, exceeds $1,500. The resource value of both policies is $2,200 ($1,700 + $500 = $2,200). This resource value may be reduced by the amount of any allowable burial exclusion if Mr. Smith designates one or both of the policies as a burial fund. (See manual section 432-2D for an explanation of the burial fund exclusion.)
Example 2: A similar situation to example 1, except that the smaller $1,000 whole life insurance policy owned by Mr. Evans covers the life of his wife instead of himself. The face value of the $1,000 policy is not combined with the face value of the $10,000 policy because it is on a separate insured person. The cash surrender value of the $1,000 policy is not counted as a resource because its face value does not exceed $1,500. Term insurance with no cash surrender value and burial insurance are not resources and are not taken into account in determining the combined face value of all life insurance policies. Burial insurance is insurance with terms that preclude the use of policy proceeds, including any cash surrender value, for any purpose other than payment of the insured's burial expenses.
431-2 K. RETROACTIVE PAYMENTS
Except for retroactive SSI and RSDI benefits, retroactive benefit payments are a countable resource in the month after the month they are received. Examples of retroactive benefits payments that are considered countable resources the month after they are received include: Retroactive APA benefits, retroactive VA benefits, etc. Refer to section 432-4A for an explanation of the limited resource exclusion allowed for retroactive SSI and RSDI benefits.
431-2 L. CROWDFUNDING
Crowdfunding is the practice of obtaining needed funding by soliciting contributions from a large number of people, typically by from the online community. e.g. go fund me. If the client sets up the account themselves and has access to it, it is countable income in the month received and a countable resource the following month.
If the client is a recipient of funds from a crowdfunding account, it is countable income in the month received, except for any funds directly paid to vendors on behalf of a client.
431-2 M. VIRTUAL CURRENCY/CRYPTOCURRENCY
Virtual currency/cryptocurrency, such as bitcoin, is a non-exempt, non-excludable resource. It is not considered legal tender nor is it considered a household goods or personal effect. It can be used to obtain goods or services, but some virtual currency can be exchanged for real currency.
If the client does not know the value of their virtual currency/cryptocurrency, the caseworker should request a current account statement showing the number of virtual coins owned. If the virtual currency is listed on an exchange, the value should be determined by using that exchange. If the virtual currency is not held on an exchange, utilize https://coinmarketcap.com/ to determine the value. The exchanges website and the exact exchange rate at the time of verification must be documented in case notes.
431 COUNTABLE RESOURCES
This section describes assets that are countable resources in determining eligibility for the APA program.
Unless specified otherwise, the value of a resource is its equity value. Equity value is the fair market value of the resource less any amounts owed or other legal encumbrances.
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432-1 REAL PROPERTY
Note: Adult Public Assistance Policy and Medicaid are different in how real property owned by an Alaska Native and American Indian is counted. Please see ADLTC MS 524-L for more information on Medicaid Exceptions to APA Resource Policy.
432-1 A. THE HOME
1. The home exclusion
An individual's home, regardless of its value, is excluded as a resource.
2. Definition of the home
An individual's home is property in which he or she has an ownership interest and that serves as the individual's principal place of residence. A principal place of residence is the dwelling the individual considers as his or her established or principal home and to which, if absent, the individual intends to return.
The home consists of the home itself, the plot of land on which the home is located, any land that adjoins the home plot (whether or not the land is legally described as a separate plot of land), and any other buildings located on the land. Easements and public rights of way (utility lines, roads, etc.) do not separate adjoining land from the home plot.
3. Temporary absence from the home
A home property may be excluded as a resource while the individual is not living there if:
The individual continues to consider it as his or her principal place of residence and intends to resume living in it; or
The spouse or a dependent relative of the individual continues to live there while the individual is institutionalized.
For the purpose of this exclusion, dependency may be of any kind (financial, medical, etc.). Relative means: a child, stepchild, or grandchild; parent, stepparent, or grandparent; aunt, uncle, niece or nephew; brother or sister, stepbrother or stepsister, half brother or half sister; cousin; or in-law.
Verification. A written statement of an individual's intent to return to a home from which he or she is temporarily absent shall be obtained if the absence is expected to last for more than a full calendar month. The form APA 12, "Statement Regarding Principal Place of Residence", may be used for this purpose. In situations where the absence is due to institutionalization, the case worker may accept the client's written statement that a spouse or dependent relative continues to reside in the home, unless there is reason to question the allegation. If questionable, the client must provide proof of relationship and/or dependency.
432-1 B. PROCEEDS FROM SALE OF A HOME
If an individual sells an excluded home, the proceeds of the sale are excluded from resources if the individual:
Plans to use them to buy another excluded home, and
Does so within 3 full calendar months of receiving them.
If the individual receives any part of the proceeds under an installment contract, the contract is an excluded resource for as long as the individual:
Plans to use the entire down payment and the entire principal portion of each installment payment to buy another excluded home; and
Does so within 3 full calendar months of receiving such down payment or installment payment.
The portion of either the down payment or the installment payment that represents payment against the principal balance is excluded from consideration as income. The portion of any payment that represents interest on the principal is considered as unearned income in the month that it is received, even if it also is reinvested in the replacement home.
This exclusion is not allowed if the proceeds of the sale are not reinvested in a replacement home within the specified three-month period.
432-1 C. JOINTLY OWNED REAL PROPERTY EXCLUSION/ HARDSHIP PROVISION
Jointly owned real property is excluded from countable resources if the sale of the property would cause undue hardship to another joint owner.
For this exclusion to apply, the property must be the other joint owner's principal place of residence, and sale of the property would have to cause the joint owner to move and not have any other housing readily available. (Not having any other housing readily available means that the other joint owner does not own another home that is legally available for his or her occupancy.)
Verification. A written statement from the other joint owner must be provided. The statement must contain the following information: 1. The property is used as the other joint owner's principal place of residence; and 2. The other joint owner would have to move if the property were sold; and 3. The other joint owner has no other housing readily available.
432-1 D. REAL PROPERTY FOLLOWING A 9-MONTH PERIOD OF CONDITIONAL BENEFITS
Real property may continue to be excluded following a 9-month period of conditional benefits if the owner continues to make reasonable efforts to sell the property. Refer to manual section 433-2G for a detailed explanation of this policy.
432-1 E. NATIVE RESTRICTED LAND
Certain Native Americans may hold land either individually within a rural area or community or jointly with their tribe or others in their community. These lands are an exempt resource if they can be classified as Native Restricted Deeds, meaning they cannot be sold, transferred, or otherwise disposed of without permission from other individuals, the land-holder’s tribe, or the Bureau of Indian Affairs. Any house or related structure (such as a garage, tool shed, outhouse, or lean-to) that is permanently attached to restricted deed land is also exempt, even if it is not used as a home. If such a house is rented, the rental income will count for APA purposes. (Refer to sections 432-4 L., 432-4M and ADLTC MS 524-L . for policy on other Alaska Native and American Indian related resource exclusions.)
Note: Verification of Native Restricted Deed status is required. In Alaska, the Bureau of Indian Affairs is the agency that keeps records of Native Restricted Deeds. Verification may also be available from deeds, tax assessor’s records, recorder’s office, realtors or real estate agents, mortgage or escrow documents, or signed surveyors records or reports.
432-1 F. DINGELL ACT LANDS
Certain Alaska Native Americans who served in the Armed Forces during the period between August 5, 1964, and December 31, 1971 and haven't received a Native Allotment may receive up to 160 acres in Alaska from the Dingell Act. This land is an exempt resource.
432-2 PERSONAL PROPERTY
432-2 A. ONE VEHICLE
A vehicle is any vehicle used for transportation. Vehicles used for transportation include but are not limited to cars, trucks, motorcycles, all terrain vehicles (ATVs), boats, snowmobiles, animal-drawn vehicles, and animals. A temporarily broken down vehicle normally used for transportation meets the definition of a vehicle. A vehicle that has been junked or that is used only as a recreational vehicle (for example, a boat used on weekends for pleasure) does not qualify for the vehicle exclusion.
1. Exclusion Regardless of Value
One vehicle per household is excluded regardless of value if it is used for transportation of the eligible individual or couple or a member of the eligible individual’s or couple’s household. Anyone living in the household may drive the vehicle, but it would only be evaluated as a resource if it is owned by the eligible individual or the eligible individual’s spouse.
Example 1: Joe has applied for APA . He reports he is living with his daughter Julie. Joe owns a van valued at $5,000 and Julie owns a Jeep valued at $10,000. Julie uses Joe’s van to take him to his doctor’s appointments or to the store. Joe’s van is excluded because it is used for transportation of an eligible individual. Julie’s Jeep is not considered because her income and resources are not deemed available to her father.
Example 2: Candice applied for APA . At her interview she stated she lived with her roommate, Tim. Most of the time, Tim takes her to the store and doctors appointments in his truck. She own’s a vehicle valued at $6,000 but only drives it occasionally. Tim’s vehicle is not considered because his income and resources are not deemed available to her. Her vehicle is excluded because it is used for transportation.
Example 3: Chris is 22 and lives with his parents. They normally drive him to appointments and other places he wants to go. He own’s a vehicle valued at $3,000 but hasn’t driven it for a couple of years because he no longer has a license due to his medical condition. Because Chris’s vehicle is no longer used for transportation, it is not excluded. He is over the $2,000 resource limit.
Example 4: Bill has applied for APA . He and his wife Jill own a 2006 Durango with an estimated value of $12,000. Bill and Jill also bought their 17 year old daughter Sally a 2010 BMW for her birthday with an estimated value of $60,000. Both vehicles are registered to Bill and Jill and have been paid off. Sally is the main driver of the BMW. Since both the BMW and the Durango are legally accessible resources to Bill and Jill, both vehicles must be evaluated as a resource when determining Bill’s eligibility for APA . The vehicle exclusion would be applied to the vehicle with the greater value see APA MS 432-2A(2).
2. Applying the vehicle exclusion
The vehicle exclusion applies in the manner most advantageous to the individual. If the individual or couple owns more than one vehicle used for transportation, the total exclusion applies to the vehicle with the greater equity value.
3. Other Vehicles
The countable amount of any vehicle that is not totally excluded is the owner’s equity (fair market value minus the amount owed on the vehicle), unless it can be excluded under another provision, such as:
Property necessary for self-support (Section 432-3A ),
Property necessary for an approved plan for achieving self-support (Section 432-3B ),
Conditional benefits (Section 433-2 ).
The fair market value of a vehicle is the average price a vehicle of that particular year, make, model, and condition will sell for on the open market to a private individual in the particular geographic area involved.
The vehicle value does not include optional equipment, nor does it include shells or campers that are mounted on the vehicle. Shells and campers are considered separately as personal property.
4. Vehicles in Remote Areas
Used vehicles such as boats, snow machines, and ATVs that might be salable in urban Alaska may not be salable in remote areas. This does not make such vehicles exempt from consideration as a resource, but may result in a determination that a vehicle has little or no market value in the community.
Caseworkers will determine fair market value and equity value for vehicles in remote areas based on:
The local market conditions and circumstances that exist in the community, including the presence or absence of a significant cash economy. (How much would the vehicle sell for as is, where is? What are other vehicles of its type selling for in the community?);
Accessibility of parts and repair service; and
Information provided by the household.
If the caseworker determines that a countable vehicle is not salable in the community, the vehicle’s resource value is zero.
5. Verification
For countable vehicles, the fair market value and amount owed must be determined.
Find the fair market value of countable vehicles by using the NADA Appraisal Guides on the Internet at www.NADAguides.com . (See Administrative Procedures manual section 105-15 for procedures for using the NADA website.) The fair market value is the base amount quoted as ”Average Trade-in” or ”Low Retail”.
The fair market value of a countable vehicle may also be determined using:
Appraisal from a local dealer;
Local newspaper ads, community bulletin boards, or other local advertisements giving the selling price for similar vehicles; or
In remote areas, collateral contacts from a disinterested knowledgeable source such as a bank, village council, store owner, merchant, or dealer.
Acceptable evidence of the amount owed includes a statement from the lien holder or other reasonable evidence of the current debt on the vehicle
If the household questions the value assigned to their vehicle, discuss with them the reason they think the vehicle is worth less and document this information in the case file. For example, they may explain that the vehicle is not running or needs significant repairs. Accept the household’s stated value unless the explanation provided is questionable.
If the claimed value is questionable, the household must be given the opportunity to verify the lower value. See Administrative Procedures manual section 105-1C for the definition of questionable information.
432-2 B. LIMITED LIFE INSURANCE EXCLUSION
The cash surrender value of all life insurance policies owned by an individual on the life of the same insured person is not a resource to the owner of the policies if the combined face value of the policies does not exceed $1,500.
If the combined face value of all life insurance policies owned by an individual on the life of the same insured person exceeds $1500, the cash surrender value of the policies is a countable resource. (See section 431-2J for related policy on countable life insurance.)
Term insurance with no cash surrender value and burial insurance are not resources and are not taken into account in determining the combined face value of all life insurance policies. Burial insurance is insurance with terms that preclude the use of policy proceeds, including any cash surrender value, for any purpose other than payment of the insured's burial expenses.
432-2 C. BURIAL SPACE EXCLUSION
A burial space or agreement which represents the purchase of a burial space held for the burial of the individual, his or her spouse, or any other member of his or her immediate family is an excluded resource, regardless of value.
The burial space exclusion is allowed in addition to the $1500 burial fund exclusion explained in section 432-2D .
Immediate family members include: parents, including adoptive parents; minor or adult children, including adoptive and step-children; brothers and sisters, including adoptive and step siblings; and spouses of these individuals. Immediate family does not include the members of an ineligible spouse's family unless they meet one of the above definitions.
A burial space is:
burial plot;
gravesite;
crypt;
mausoleum;
casket;
urn;
niche; or
other repository customarily and traditionally used for the deceased's bodily remains.
The term also includes necessary and reasonable improvements or additions to such spaces, including but not limited to:
vaults;
headstones, markers, or plaques;
burial containers (e.g., for caskets); and
arrangements for the opening and closing of the gravesite.
For example, a contract for care and maintenance of the gravesite, sometimes referred to as endowment or perpetual care, can be excluded as a burial space.
Some or all of a prepaid burial contract may also qualify for the burial space exclusion if the burial contract is paid up and the funeral provider is obligated to provide the service. A prepaid (or pre-need) burial contract is an agreement where the buyer pays in advance for a burial that the seller agrees to furnish upon the death of the buyer. Any portion of a prepaid burial contract that clearly represents the purchase of a burial space is excludable, regardless of value. Some or all of the remaining value of the contract may be excludable as burial funds .
Example: A prepaid irrevocable burial contract guarantees the following professional services and merchandise: Value Service or Merchandise $295 services of funeral director and staff $175 transfer of remains to funeral home $1,250 cremation $230 combination unit for cremains $20 transportation to airport $450 airline transportation $801 misc. cash advance The value of all services on this burial contract would be counted towards the $1,500 burial fund exclusion. The value of the merchandise (combination unit for cremains) would be exempt as burial space, regardless of value.
The funeral provider is not obligated to provide burial services until a burial contract is completely paid for. Therefore, until the contract is paid up, funds paid into the contract do not qualify for the burial space exclusion; they must be treated as burial funds.
432-2 D. BURIAL FUND EXCLUSION
The caseworker must explore, as part of the resource determination process, the possibility that the client has set aside funds for his or her own burial or the burial of his or her spouse. The first $1500 of funds set aside for the burial of an eligible individual are excluded as a resource. An additional exclusion of $1500 is applied to funds set aside for the burial of a spouse.
Expenses included for the burial funds exclusion are generally those related to preparing a body for burial and any services prior to burial. They usually include things like transportation of the body, embalming, cremation, flowers, clothing, services of the funeral home director and staff, etc.
Burial funds include:
Revocable burial contracts;
Revocable burial trusts;
Other revocable burial arrangements (including the value of certain installment sales contracts for burial spaces);
Cash;
Financial accounts (e.g., savings or checking accounts); or
Other financial instruments with a definite cash value (e.g., stocks, bonds, certificate of deposit, etc.).
Usually, expenses for items used for interment of the deceased's remains are not included for burial funds exclusions purposes. Such items may be subject to the burial space exclusion.
1. Designation of burial funds
Burial funds may be designated as such by an indication on the burial fund document (for example, the title on a bank account) or a signed statement. A signed statement must show:
The value and owner of the resources:
For whose burial the resources are set aside;
The form(s) in which the resources are held (burial contract, bank account, etc.); and
The date the individual first considered the funds set aside for the burial of the person specified.
The designation may be made by an applicant or recipient, or by a person acting on his or her behalf. The signer may designate the funds as having been set aside since a date before the actual signing of the statement. However, the first month for which the burial funds exclusion is effective is the initial month of application for APA or APA -related Medicaid benefits.
Example: Jim applies for APA on April 1, 2005. During the interview, he states that he owns a whole life insurance policy with a face value of $10,000, and current cash surrender value of $2,000. Jim provides a signed statement designating the life insurance policy as a burial fund. Since the cash surrender value on the date of application is $2,000, $1,500 may be excluded under the burial fund exclusion effective April 1, 2005. The remaining $500 counts as a resource.
2. Burial funds must be separate and identifiable
Burial funds must be kept separate from non-burial-related assets to be excluded. Burial funds may, however, be commingled with other burial-related assets. Burial-related assets are burial funds (both excluded and non-excluded) and burial spaces.
Example: An individual owns a paid-up burial contract worth $4,000. The entire value of the burial contract is a burial-related asset. $2,000 of the contract clearly represents burial spaces (burial plot, casket, etc) and is totally excluded. $1,500 of the remaining $2,000 is excluded as a burial fund. The remaining $500 is counted as a resource. Once burial funds are separated from non-burial-related assets, the burial funds exclusion is allowed the month following the month the funds are separated.
Example: A bank account containing $3,300, $1,500 of which is designated for burial and $1,800 of which is other funds available for living expenses, is not allowable and the $1,500 may not be excluded as a burial fund. If the $1,500 is moved to a separate account and designated as burial funds, the burial funds exclusion is allowed the month after the funds are separated.
3. Reductions in maximum burial funds exclusion
The $1,500 burial funds exclusion is reduced by the amount of other excluded assets that are available to meet the client's burial expenses. However, excluded assets that represent burial spaces do not reduce the $1,500 burial fund exclusion.
Assets that reduce the burial funds exclusion include:
the face value of any term life insurance on the individual; and
the face value of burial insurance on the individual; and
the value of any portion of an irrevocable burial contract or burial trust that does not clearly represent a burial space, and
the face value of any life insurance policies on the individual which have had their cash value excluded because the face value is less than $1500. (Refer to manual section 432-2B .)
Example: An applicant has a $1,900 savings account. The applicant also has a life insurance policy with a face value of $1,000 and a cash value of $750. The cash value of the insurance policy is excluded as a resource because its face value does not exceed $1,500. The $1,500 burial funds exclusion is reduced by $1,000 (the face value of the policy), to $500. The applicant may designate the entire $1,900 savings account as funds set aside for burial, but only $500 of the $1,900 balance in the account qualifies for the burial funds exclusion; the remaining $1,400 value of the savings account is a countable resource. If the applicant or recipient does not designate the entire balance of the $1,900 as funds set aside for burial, the entire $1,900 is a countable resource.
4. Increases in value of burial funds
Interest that is left to accumulate and become part of excluded burial funds, or appreciation in the value of prepaid burial arrangements, will be excluded from income and resources. The exclusion of any increase in the value of excluded burial funds may be applied only to increases in value that have accrued since the most recent date that a recipient became eligible for assistance.
The preferred method for keeping track of excluded increases in the value of burial funds is to keep excluded burial funds separate from other non-excluded burial funds. The caseworker may advise the client of this, but may not require it.
Example: A client designates a $2,000 savings account as having been set aside for burial since October 1, 1986, and $1,500 of this is excluded as funds set aside for burial. The interest that accrues to the excluded portion of the funds from that date is also excluded as income and resources. The interest that accrues to the non-excluded portion of the funds in the account is countable as income in the month of accrual and is a countable resource thereafter.
5. Burial funds used for another purpose
If an individual uses excluded burial funds for a purpose other than the burial arrangements of the individual or the individual's spouse, it may be necessary to correct the burial fund designation to show the current amount. The burial fund exclusion is not lost and reapplied, but merely corrected. Re-designation is only necessary if the amount excluded falls below the previously designated amount. If the use of burial funds does not cause the excluded amount to fall below the previously designated amount, then no re-designation is necessary.
Example 1: Funds fall below designated amount Ron originally designates $1,500 as a burial fund. After several years, interest accumulations increase the excluded amount to $1,750. In November, Ron withdraws $500 to repair his car. Because the remaining $1,250 in the account is below the originally designated amount of $1,500, Ron must re-designate the remaining $1,250 as a burial fund. Ron may choose to replenish the burial funds, but the amount excluded may not exceed $1,500.
Example 2: Funds do not fall below designated amount Cheryl originally designates $1,500 for burial. After several years, interest accumulations increase the excluded amount to $1,850. During June, she uses $250 for another purpose. The remaining amount of $1,600 ($1,500 + $100 interest) will be excluded as a burial fund for July. Because the excluded amount has not fallen below $1,500, Cheryl does not have to re-designate the burial funds.
432-2 E. HOUSEHOLD GOODS AND PERSONAL EFFECTS
Household goods and personal effects are excluded from resources, regardless of their dollar value.
1. Household goods
Household goods are:
Items of personal property, found in or near the home, that are used on a regular basis; and
Items needed by the household for maintenance, use, and occupancy of the premises as a home.
Household goods include, but are not limited to, furniture, appliances, tools, electronic equipment such as personal computers and television sets, carpets, cooking and eating utensils, and dishes.
2. Personal effects
Personal effects are:
Items of personal property ordinarily worn or carried by the individual; and
Articles otherwise having an intimate relation to the individual.
Personal effects include, but are not limited to, personal jewelry including wedding and engagement rings, personal care items, educational or recreational items (such as books or musical instruments), and items of cultural or religious significance to an individual (such as ceremonial attire). Items required because of an individual’s physical or mental impairment (such as prosthetic devices or wheelchairs) are also considered personal effects.
3. Other personal property
Personal property that an individual acquires or holds because of its value or as an investment is not excluded under this section. Such items include, but are not limited to, jewelry that is not worn or held for family significance, gems, and collectibles (such as an art collection).
432-3 REAL OR PERSONAL PROPERTY
432-3 A. PROPERTY NECESSARY FOR SELF-SUPPORT
Certain property may be either totally or partially excluded from resources if it is necessary for self-support. Property excluded under this provision generally falls into the three categories explained below.
To qualify for this exclusion, the property must be in current use in the type of activity that qualifies it as necessary for self-support.
Nonuse exception. Property that is not in current use may continue to be excluded as necessary for self-support only if it has been in use, and there is a reasonable expectation that the use will resume.
Resumption of use must be expected within 12 months of last use.
This 12-month period can be extended for an additional 12 months if nonuse is due to a temporarily disabling condition. For this extension to apply, there must be a reasonable expectation that use will resume within the additional 12-month period.
1. Property excluded regardless of value
a. Property used in a trade or business.
All property used in a trade or business is excluded as a resource. A trade or business is a self-employment activity that is designed to produce income. (Refer to section 441-1D for the definition of self-employment.) The liquid assets of a trade or business are also totally excluded.
b. Property that represents governmental authority.
Any property that represents governmental authority to engage in an income-producing activity is excluded as a resource. This type of property includes Limited Entry Fishing Permits. A Limited Entry Permit that is not being used in an income-producing activity must be treated as personal property and its equity value counted as a resource, unless there is a reasonable expectation that use will resume within 12 months. (See nonuse exception provisions in this section above.)
Note: A Limited Entry Fishing Permit that Commercial Fisheries Entry Commission ( CFEC ) has classified as non-transferable has no value. These permits are valid for the permit holder’s lifetime, as long as they are renewed each year, but they cannot be transferred or sold. (See APA MS 430-4 A )
c. Personal property used by an employee for work.
Personal property used by an employee for work is excluded from resources. Excluded items include tools, safety equipment, uniforms, etc.
2. Nonbusiness property used for subsistence excluded up to $6000 equity regardless of rate of return
Exclude from resources up to $6000 of the equity value of nonbusiness property that is used to produce goods or services for home consumption.
This type of property includes land used to grow produce for home consumption, a boat used to subsistence hunt and fish, and livestock or tools used to produce items for home consumption. A Limited Entry Fishing Permit may also be excluded up to $6000 of its equity value under this provision if the permit is used to access a fishery for subsistence use. If an applicant or recipient owns more than one piece of nonbusiness property under this category, the $6,000 exclusion applies to the combined equity value of all the properties and not to each separate property.
Example: Nick owns a fish camp valued at $5,000. The fish camp is used in the summer to prepare fish for his family's use through the winter. He also owns a cabin valued at $7,000 that is used during hunting season. $ 5,000 Fish Camp + $ 7,000 Cabin $12,000 Combined Equity Value - $ 6,000 Exclusion $ 6,000 Countable Equity Value
3. Nonbusiness property excluded up to $6000 equity if it produces a 6 percent rate of return
Up to $6000 of the equity value of nonbusiness income-producing property is excluded from resources if the property produces a net annual return equal to at least 6 percent of the excluded equity value. Any portion of the property's equity value that exceeds $6000 is treated as a countable resource. The liquid assets of an item of nonbusiness income-producing property are not excluded.
Nonbusiness property that is in current use, but is earning less than 6 percent of its excludable equity value must have its entire equity value treated as a countable resource unless:
Some unusual circumstance has caused a temporary reduction in the net earnings, and
The usual earnings would satisfy the 6 percent test, and
The client furnishes evidence of a reasonable expectation that the property will again satisfy the 6 percent test within 24 months from the end of the taxable year in which the unusual circumstance began.
This type of property includes rental property such as a rental home and land leases.
Example 1: Mr. Jones lives in an apartment and is renting out his formerly excluded home, which has an equity value of $10,000. Even if the property produces a 6% return (6% x $6000 = $360), $4000 of its equity value cannot be excluded under this provision, and must be counted as an available resource.
Example 2: Mrs. Patterson owns a mobile home (not her home) that has an equity value of $3000. She owns other property that has an equity value of $2000. The mobile home produces a net annual return of $750, and the other property produces less than $50 a year. Since the mobile home produces more than a 6 percent return (6% x $3000 = $180), its equity value is excluded. Since the other property produces less than a 6 percent return (6% x $2000 = $120), its equity value counts as an available resource.
432-3 B. RESOURCES SET ASIDE AS PART OF AN APPROVED PLAN FOR ACHIEVING SELF-SUPPORT
A plan for achieving self-support allows blind or disabled (but not aged) individuals to set aside specified income and/or resources necessary for the achievement of its goals. Exclude the resources of a blind or disabled individual if they are needed to fulfill a plan for achieving self-support and the plan has been approved by either the Social Security Administration (in the case of an SSI recipient) or the Division of Vocational Rehabilitation (in the case of a non- SSI APA applicant or recipient).
432-4 RETAINED CASH PAYMENTS AND IN-KIND PAYMENTS
432-4 A. RETROACTIVE SSI AND RSDI PAYMENTS
Any amounts retained from retroactive Social Security Retirement, Survivors, and Disability Insurance ( RSDI ) and SSI benefits are excluded from resource consideration for nine consecutive calendar months following the month of receipt. This exclusion does not apply to retroactive APA payments.
Interest earned by funds excluded under this provision is not excluded.
A dedicated account is an account set up for certain past due SSI monthly payments made on or after August 23, 1996 for SSI recipients under the age of 18. SSI requires a representative payee establish and maintain these accounts in a financial institution. No other funds are allowed to be deposited in the account except for certain subsequent past-due benefits. The use of funds from dedicated accounts is restricted to specific purchases. The restriction continues to apply when the child turns 18, remains eligible for benefits, and goes into direct payment. Any misuse of funds is recoverable by SSA from the payee. Representative payees and recipients 18 or older with dedicated accounts must report annually on the activity of funds in the account to ensure deposits and expenditures are in compliance with the law. They must continue to report until the account is depleted or eligibility for benefits terminate. Any unauthorized expenditures made knowingly by an individual who is his/her own payee will be deducted from future SSI payments. Funds in a dedicated account are exempt resources as long as the funds remain in the dedicated account.
432-4 B. PAYMENTS TO VICTIMS OF NAZI PERSECUTION
Payments received from any source by individuals because of their status as victims of Nazi persecution are excluded from resources.
Interest earned on unspent payments is not excluded from resources.
432-4 C. FEDERAL DISASTER ASSISTANCE
Any unspent assistance received under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (formerly the Disaster Relief and Emergency Assistance Act of 1974), or some other federal statute, because of a presidentially declared major disaster, is permanently excluded from resources.
Interest earned by funds excluded under this provision is also excluded from both income and resources.
Verification. Acceptable proof of federal disaster assistance is documentation or a collateral contact with the source of the payment which specifies that the assistance is provided under federal statute because of a presidentially-declared disaster.
432-4 D. CASH RECEIVED FOR THE REPAIR OR REPLACEMENT OF LOST, DAMAGED, OR STOLEN EXCLUDED RESOURCES
Cash received from any source for the repair or replacement of lost, damaged, or stolen excluded resources are themselves excluded resources for 9 calendar months following the month of their receipt.
Interest earned by funds excluded under this provision is also excluded as income and resources for the period during which the funds themselves are excluded.
432-4 E. FOOD
The value of the SNAP allotment provided under the Food Stamp Act of 1977; the value of assistance provided under the National School Lunch Act; the value of assistance provided under the Child Nutrition Act of 1966; and the value of federally donated foods distributed under section 32 of Public Law 74-320 or section 416 of the Agriculture Act of 1949 are excluded.
432-4 F. COMPENSATION TO VOLUNTEERS
Compensation of any kind that is provided under the Domestic Volunteers Service Act is excluded from resources. This includes payments to people who are volunteers in the Foster Grandparents Program, Senior Companion Program, Retired Senior Volunteer Program, Cooperative Volunteer Program ( RSVP ), Senior Volunteer Program, and Volunteers in Service to America Program ( VISTA ).
432-4 G. REMUNERATION FOR OUT-OF-POCKET EXPENSES
Remuneration for out-of-pocket expenses to people who are volunteers in the Corps of Retired Executives ( CORE ), or in the Active Corps of Executives ( ACE ), is excluded from resources.
432-4 H. FEDERAL HOUSING ASSISTANCE
The value of any assistance paid with respect to a dwelling unit is excluded from income and resources if paid under the United States Housing Act of 1937, the National Housing Act, Section 101 of the Housing and Urban Development Act of 1965, or Title V of the Housing Act of 1949.
The federal government through the Office of Housing and Urban Development ( HUD ) and the Farmers Home Administration ( FmHA ) provides many forms of housing assistance. This assistance may include subsidized housing, loans for renovations, mortgage and investment insurance, guaranteed loans and mortgages, and loans for construction, improvement, or replacement of farm homes and other buildings. This assistance may be provided directly by the federal government or through other entities such as local housing authorities and non-profit organizations.
Any housing assistance in which HUD or FmHA funding is involved is subject to this exclusion. In Alaska, housing assistance which qualifies for this exclusion includes: Section 8 housing assistance, housing assistance provided by the Alaska Housing Finance Corporation ( AHFC ), and housing assistance in rural areas provided by various Native housing authorities.
432-4 I. FEDERAL RELOCATION ASSISTANCE PAYMENTS
Relocation assistance provided under the federal Uniform Relocation Assistance and Real Property Acquisition Act of 1970 is excluded from resources.
This exclusion applies to relocation assistance provided to persons displaced by any federal or federally assisted project. Relocation assistance may be furnished directly by a project or through an agency, such as a housing authority, designated for the purpose of providing relocation assistance. (Refer to manual section 432-4J below for policy on the treatment of relocation assistance provided by a state or political subdivision for a project that does not have any federal involvement.)
Interest earned on unspent relocation assistance payments is not excluded from either income or resources.
Verification. To be excluded from resources under this provision, evidence must show that the payment is relocation assistance. Acceptable evidence includes: • A letter or check stub that indicates the reason for the payment; or • Any other document that indicates the reason for the payment; or • A collateral contact with the federal project or agency that issued the relocation assistance payment.
432-4 J. LIMITED EXCLUSION OF STATE OR LOCAL RELOCATION ASSISTANCE PAYMENTS
Unspent relocation assistance provided by a state or local government for a project that does not have any federal involvement is excluded from resources for 9 calendar months following the month of receipt.
Interest earned on unspent relocation assistance payments is not excluded from either income or resources.
Verification. To be excluded from resources under this provision, evidence must show that the payment is relocation assistance. Acceptable evidence includes: • A letter or check stub that indicates the reason for the payment; or • Any other document that indicates the reason for the payment; or • A collateral contact with the state or local agency that issued the relocation assistance payment.
432-4 K. EDUCATION ASSISTANCE
1. Title IV Higher Education Act and Bureau of Indian Affairs Grants and Awards
The total amount of any grant, scholarship, or award issued under any program funded under the Title IV of the Higher Education Act or under a Bureau of Indian Affairs ( BIA ) student assistance program is excluded from resources, regardless of use.
Payments that fit this category include:
Pell Grants
State Student Incentive Grants (SIG)
Academic Achievement Incentive Scholarships
Byrd Scholars
Federal Supplemental Educational Opportunities Grants (FSEOG)
Federal Educational Loans (Federal PLUS Loans, Perkins Loans, Stafford Loans, Ford Loans, etc.)
Upward Bound
Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs)
LEAP (Leveraging Educational Assistance Partnership)
SLEAP (Special Leveraging Educational Assistance Partnership)
Work-Study Programs
Verification. Verify that the source of the education assistance is Title IV or BIA by viewing the individual's award letter. Contact the awarding institution if the award letter is not available or is unclear.
2. Other Education Assistance
Educational Assistance from public or private agencies that is not received under Title IV of the Higher Education Act, or under a Bureau of Indian Affairs student assistance program, is excluded from resources for nine calendar months only to the extent that the assistance is used or set aside to pay for school attendance costs.
Educational assistance that falls into this category includes Department of Veterans Affairs educational assistance and scholarships from Native organizations.
Educational assistance that is provided directly to an applicant or recipient in the form of cash by a private individual, such as a parent, is considered to be a gift and is also excluded from resources under this provision.
School attendance costs are tuition and fees, including costs for rental or purchase of any equipment, materials, or supplies required by all students in the same course of study. School attendance costs also include allowances for books, supplies, transportation, and miscellaneous personal expenses necessary for a student to attend school on at least a half-time basis.
From the total amount of educational assistance, subtract all expenses paid or reasonably anticipated to be paid for school attendance costs, including expected child care costs necessary for the client to attend school.
Any remaining funds are considered a resource the month following their receipt, unless otherwise excluded.
Verification. Verify the total amount of all educational assistance provided by a public or private agency, which is not received under Title IV of the Higher Education Act of 1965, or under BIA student assistance programs, by viewing documentation from the school or from the source of the assistance.
432-4 L. ALASKA NATIVE CLAIMS SETTLEMENT ACT ( ANCSA ) ASSETS
The Alaska Native Claims Settlement Act ( ANCSA ) excludes the following items from the resources of an Alaska Native, or from the resources of a descendant of an Alaska Native:
1. Alaska Native Fund distributions.
Distributions from the original Alaska Native Fund are excluded from resources regardless of the amount distributed.
2. Stock.
Any stock issued or distributed by an ANCSA corporation (including stock issued as a dividend or distribution on stock) is excluded from resources.
3. Partnership Interests.
A partnership interest received from an ANCSA corporation is excluded from resources. However, income received as a result of a partnership interest is treated as a cash distribution. (See #6 below.)
4. Land.
Any land or any interest in land received from an ANCSA corporation (including any land or any interest in land received as a dividend or distribution on stock) is excluded from resources. This includes any land or interest in land inherited by a descendant. Any house or related structure (such as a garage, tool shed, outhouse, or lean-to) that is permanently attached to the land is also excluded, even if it is not used as a home. If such a house is rented, the rental income will count for APA purposes
5. Interest in a settlement trust.
Any interest in a settlement trust received from an ANCSA corporation is excluded from resources.
6. Cash distributions.
For the purpose of this exclusion, cash distributions from ANCSA corporations are distributions that are made to a class of individuals, such as all shareholders, or all elders. Cash distributions do not include cash payments that are made to individuals or households for a specific purpose such as wages, a door prize, or a general assistance payment from the corporation. This exclusion does not apply to any funds received as a result of the investment or deposit of an individual's ANCSA payments after they are distributed to the shareholders.
Any cash distributions (including cash dividends on stock) received from ANCSA corporations are totally excluded if they were received before February 3, 1988.
For cash distributions received February 3, 1988 or later, the total of all distributions received from ANCSA corporations in a calendar year are excluded up to $2,000 per individual. This means that an individual can accrue up to $2,000 per calendar year from all ANCSA distributions received that year and not have the money counted as a resource for that year or any subsequent year. For example, an individual who keeps at least $2,000 in cash distributions from ANCSA corporations each year for 4 consecutive years may have a total of $8,000 excluded from resources.
If the individual keeps more than $2,000 from any year's distribution, the amount exceeding the $2,000 exclusion for that year is a countable resource. If the individual keeps less than $2,000 from any year's distributions, only the amount retained from that year's distribution qualifies for that year's exclusion.
Note: The Alaska Native Settlement Trust Eligibility Act (HR 42) excludes certain payments from a settlement trust to an aged, blind, or disabled Alaskan Native or descendant of an Alaska Native from being used to determine the individual's eligibility for need-based federal programs. This exclusion applies for a five-year period beginning on the date the law was enacted July 7, 2025 through July 6, 2030. ANCSA payments are excluded from income the month of receipt and as a resource if retained the following month. ANCSA dividends direct deposited into a trust are still countable income for SSI purposes. This income cannot be legally assigned to a trust.
432-4 M. OTHER EXCLUSIONS OF PAYMENTS TO INDIANS
For APA and SSI purposes, various federal statutes provide for the exclusion of certain payments made to members of Indian tribes and groups. Some statutes pertain to specific tribes or Indian groups while others apply to certain types of funds. The following types of payments made to Indian tribes and groups are excluded from both income and resources:
Per capita distribution payments by the Blackfeet and Gros Ventre tribal governments to members, which resulted from judgment funds to tribes, are excluded under Public Law 92-254.
Per capita distribution payments made by the Secretary of the Interior or by the Indian tribe itself to members of Indian tribes who were due judgment funds are excluded under Public law 93-134. This does not include payments of funds distributed or held in trust according to public laws enacted before October 19, 1973.
Receipts derived from certain trust lands and distributed to members of designated Indian tribes are excluded under Public Law 94-114. These lands, mineral rights, and receipts are excluded from income and resources, unless they were subject to the Mineral Leasing Act of 1920 and distributed before October 17, 1975.
These Indian trust lands are all located in the lower 48 states in the states of Idaho, Michigan, Montana, New Mexico, Oklahoma, North Dakota, South Dakota, and Wisconsin. A list of lands conveyed to Indian tribes under Public Law 94-114 is maintained in the Director’s Office. If a case worker becomes aware of funds that may be derived from this source, he or she must contact the APA Policy Specialist for specific directions on the treatment of these funds.
Per capita payments made to, or held in trust for, members of the Grand River Band of Ottowa Indians are excluded under Public Law 94-540.
Judgment funds, including interest and investment income which accrues on Indian judgment funds while held in trust, and initial purchases made with distributed judgment funds, are excluded under Public Law 97-458.
Per capita distributions of funds held in trust by the Secretary of the Interior to members of an Indian Tribe are excluded under Public Law 98-64. These per capita payments may be distributed by the Secretary of the Interior or by the tribe itself. In Alaska, distributions of this type have been made by the Metlakatla Indian Community.
All money and lands transferred to the members of the Puyallup Tribes under the Puyallup Tribe of Indians Settlement Act of 1989 are excluded under Public Law 101-41.
432-4 N. WORLD WAR II RESTITUTION FUNDS
Any funds retained from restitution payments made by the U.S. Government to individual Japanese-Americans and to Aleuts (or, if deceased, payments made to their survivors) who were interned or relocated during World War II are excluded from resources under Public Law 100-383. Restitution payments paid to individual Japanese-Canadians who were interned or relocated during World War II by the Canadian Government are also excluded from resources.
This exclusion also applies to any funds received as a result of the investment or deposit of a restitution payment to eligible Aleuts.
However, any payments subsequently received and retained from a trust established by the Secretary of the Interior appropriated for Aleut residents are counted as a resource. The trustees may use these trust funds for the benefit of the elderly, disabled, seriously ill, students in need of scholarships, the preservation of Aleut cultural heritage and historical records, the improvement of community centers in affected Aleut villages and other purposes to improve conditions of Aleut life.
Verification. The Director’s Office maintains a list of individuals who have received Aleut reparation payments. The case worker may contact the APA Policy Specialist to verify an individual's receipt of Aleut reparations payments. Documents in the client's possession may be used to verify Japanese-American or Japanese-Canadian payments.
432-4 O. AGENT ORANGE SETTLEMENT FUNDS
Any funds retained from Agent Orange settlement payments are excluded from resources under Public Law 101-201 and 101-239. Distribution of Agent Orange settlement payments began in March 1989 and ended in 1994. Qualifying veterans received at least one payment a year for the life of the program. Qualifying survivors of deceased veterans received a single lump sum payment.
Any funds received as a result of the investment or deposit of Agent Orange settlement payments are not excluded from resources.
432-4 P. VICTIMS' COMPENSATION PAYMENTS
Monies retained from payments received from a fund established by a State to aid victims of crime are exempt as a resource for 9 months.
Interest earned on unspent victims' compensation payments is not excluded from either income or resources.
432-4 Q. EARNED INCOME TAX CREDITS AND CHILD TAX CREDITS
Unspent federal tax refunds or payments made by an employer that are related to the Earned Income Tax Credit ( EITC ) or the Child Tax Credit are excluded from resources for the 12 calendar months following the month the refund or payment is received.
Interest Earnings: Interest earned on unspent tax refunds related to the EITC or the Child Tax Credit is not excluded from resources.
432-4 R. GIFTS OF DOMESTIC TRAVEL TICKETS
Under Public Law 101-239, the value of a domestic travel ticket received by an individual or spouse is excluded from resources if the ticket is received as a gift and not converted to cash. Domestic travel is travel among the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. The travel ticket may be for transportation by air, land, or sea.
If the ticket is converted to cash, it becomes unearned income in the month it is converted, and a resource in the month following the month it is converted to cash.
Gifts of non-domestic travel tickets, such as airline tickets to Japan or the Philippines, which can be converted to cash, are not excluded from resources under this provision.
432-4 S. ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PAYMENTS
The Energy Employees Occupational Illness Compensation Act provides compensation to individuals who develop illnesses as a result of employment at certain federally owned facilities in which radioactive materials were used. These payments, if retained, are exempt resources.
432-4 T. RADIATION EXPOSURE COMPENSATION TRUST FUND
Fallout emitted during the U.S. Government’s atmospheric nuclear testing in Nevada during the 1950s and during a brief period in 1962 exposed some individuals to doses of radiation that put their health at risk. In addition, some individuals employed in uranium mines from 1947 through 1971 were exposed to large doses of radiation.
Public Law 101-426 created the Radiation Exposure Compensation Trust Fund and authorizes the Department of Justice to make compensation payments to individuals (or their survivors) who were found to have contracted certain diseases after exposure. The payments will be made as a one-time lump sum. Generally, the exposure occurred in parts of Arizona, Colorado, Nevada, New Mexico, Utah, and Wyoming.
Unspent payments from the Radiation Exposure Compensation Fund are excluded from resources.
432-4 U. INDIVIDUAL DEVELOPMENT ACCOUNT ( IDA )
An Individual Development Account ( IDA ) is a special bank account that helps an individual save for his or her education, the purchase of a first home, or to start a business. An individual contributes money from his or her earnings to an IDA . These contributions are then matched with money from another source. The matching money helps the individual reach his or her goal sooner.
An individual’s contributions, as well as any matching funds, that are deposited into a TANF -funded IDA or Demonstration Project IDA are excluded from resources. Any interest earned on these funds is also excluded from resources. IDA s that are not funded by either TANF or Demonstration Project monies are not excluded from resources.
TANF -funded IDA . The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 authorized states to use money from their TANF grant to carry out a program to fund IDA s.
Demonstration Project IDA . The Assets for Independence Act (enacted on January 27, 1998) created a Federal Demonstration Project to test the effectiveness of IDA s in improving the lives of participating low-income persons. This Act provides for Demonstration Project monies to carry out a program to fund IDA s.
432-4 V. PAYMENTS TO PERSONS CAPTURED AND INTERNED BY NORTH VIETNAM
The Department of Defense provides payments to certain persons who were captured and interned by North Vietnam. If the individual is deceased, payment may be made to a surviving spouse or, if none, to surviving children (including biological and adoptive children) in equal shares. The amount payable is a one-time payment of up to $50,000. These payments are excluded from resources.
432-4 W. RICKY RAY HEMOPHILIA RELIEF FUND
The Ricky Ray Hemophilia Relief Fund Act of 1998, Public Law 105-369, provides for a single payment of $100,000 to:
Individuals with a blood-clotting disorder who may have contracted an HIV infection from a blood transfusion;
Current and former spouses of these individuals who also contracted an HIV infection;
Children of these individuals who also contracted an HIV infection; and
Surviving spouses, children, and parents of the above.
Unspent payments from the Ricky Ray Hemophilia Relief Fund are excluded from resources.
432-4 X. VIETNAM VETERANS’ CHILDREN WITH SPINA BIFIDA
A 1996 study by the National Academy of Sciences found evidence associating parental exposure to herbicides in Vietnam with increased risk of spina bifida in their children. Spina bifida is a congenital birth defect characterized by defective closure of the bones surrounding the spinal cord.
Public law 104-204 authorizes the Department of Veterans Affairs ( VA ) to provide benefits, including a monthly monetary allowance, to certain Vietnam veterans’ children who suffer from spina bifida. VA payments made to or on behalf of such children are excluded from resources.
432-4 Y. FEDERAL INCOME TAX RETURNS
Federal income tax returns received after December 31, 2009 are exempt as a resource for 12 months from the date of receipt.
432-5 COMMINGLED FUNDS
Excluded funds must be identifiable in order to be excluded. Except for burial funds (refer to section 432-2D ), identifiability does not require that excluded funds be kept separate from other countable funds. If excluded funds are maintained in an account with countable funds, any amounts withdrawn are presumed to be from the countable portion of the funds unless the client indicates otherwise.
Example: An individual has a savings account containing $500 in countable funds. The individual receives an excludable $400 distribution from an ANCSA corporation which is deposited into the account. The account balance is $900. The $400 in ANCSA funds are excluded from resources. The individual then withdraws $700. The entire remaining balance of $200 is excluded from resources as an excluded ANCSA distribution. A later deposit of $500 is made with countable funds. The balance is now $700 but $200 of this continues to be excluded as a resource.
The case worker may recommend, but not require, that the client keep excluded resources separate from countable resources; such commingled resources make it difficult for both the client and the case worker to identify which resources must be counted or excluded. The client is responsible for providing documentation needed to determine whether funds are counted or excluded.
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432 RESOURCE EXCLUSIONS
The following exclusions are applied when determining the resources that are measured against the resource limits of the APA program:
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433-1 TRANSFER OF RESOURCES
If an individual (or spouse) transfers a resource for less than its fair market value to become or remain eligible for Adult Public Assistance ( APA ), the individual or couple may be disqualified for up to 36 months. This disqualification will only apply to transfers made on or after October 1, 2001.
433-1 A. DEFINITIONS
1. Fair market value
Fair market value is current market value of a resource at the time the resource is transferred. The current market value of a resource is the going price for which it can reasonably be expected to sell on the open market in the geographic area involved.
2. Equity value
Equity value means the fair market value of a resource less any amounts owed or other legal encumbrances.
3. Transfer
Transfer means any action taken to sell, trade, or give away a resource.
4. Compensation
Compensation is the cash or other valuable consideration provided in exchange for the resource.
5. Uncompensated Equity value
Uncompensated equity value is the difference between the equity value of the resource and the amount of compensation received by the individual in exchange for the resource.
433-1 B. TRANSFERS THAT DO NOT AFFECT ELIGIBILITY
Evaluate each transfer to determine if it causes ineligibility for APA . The following transfers do not affect eligibility, but questionable situations may require verification such as receipts, legal documents, and collateral contacts:
Transfers of exempt resources;
Compensation received was greater than or equal to the equity value of the resource;
Resources that would not have caused ineligibility if they had been retained;
Transfers made to satisfy a court order or settle a debt;
Transfers made as the result of theft, fraud or coercion against the person who transferred the resource;
Transfers to a Special Needs or Pooled Trust ( as described in Aged, Disabled and Long Term Care ( ADLTC ) Manual Section 527);
Transfers to a trust established for the sole benefit of the individual’s child of any age who is blind or disabled;
Transfers to the individual’s spouse, to another person for the sole benefit of the individual’s spouse, or to the individual’s child of any age who is blind or disabled;
Transfer of a non-exempt home (i.e., a home that the individual does not consider to be his or her principal place of residence) that is made to the individual’s spouse, the individual’s child under age of 21, or to the individual’s child of any age who is blind or disabled; and
Transfers returned in the same month the resource was transferred. If the entire resource is returned in a subsequent month, eligibility begins the month after the entire resource is returned.
433-1 C. DETERMINING INTENT OF TRANSFER
When a transfer does not fall into one of the above categories, it is presumed that the client intentionally transferred the resource to become or remain eligible for APA . However, the individual must be given an opportunity to rebut this presumption and to provide proof that the transfer was made unintentionally or for a different purpose.
To determine intent, ask the client why the resource was transferred. If they admit that the transfer was made to qualify for APA , then calculate the disqualification period and take appropriate action on the case.
When intent is questionable, consider the following: What was the client’s life situation and economic health in the time period surrounding the transfer? Did they just lose a job, or did they quit? Have they recently been denied APA for excess resources? How have they survived up until this point? Although these questions are commonly asked during interviews, they can be especially helpful in deciding whether a resource was intentionally transferred to become or remain eligible for APA .
Unless there is good reason to believe otherwise, examples of resource transfers that will not result in a disqualification penalty include situations where:
The individual did not believe the transfer would affect eligibility for APA ; or
The individual was not an APA recipient at the time, and did not expect to apply for assistance when the resource was transferred.
Case workers may wish to investigate further and require additional proof to establish whether or not the transfer was made for the purpose of qualifying for APA .
433-1 D. UNDUE HARDSHIP
The transfer of resource disqualification period may be waived if it appears the individual will suffer an undue hardship as a result of not getting APA benefits. If none of the other exceptions apply, the case worker must determine whether benefits are payable based on undue hardship before applying a transfer of resource disqualification period.
1. General Rule
Undue hardship exists if:
Failure to receive APA benefits would deprive the individual of food or shelter, and
The individual’s total available funds (income and liquid resources) are less than the applicable APA payment standard.
2. Loss of Shelter
An individual would be deprived of shelter if:
He or she would be subject to eviction from the current residence if APA benefits were not received; and
There is no other affordable housing available, or there is no other housing available with necessary modifications for a disabled individual.
3. Couple Cases
When determining total available funds for an eligible couple or an individual with an ineligible spouse, use:
The couple’s applicable APA payment standard; and
The total available funds (income and liquid resources) of both spouses.
433-1 E. DISQUALIFICATION PERIOD
Use the uncompensated equity value of the transferred resource to determine the disqualification period. The disqualification period may not exceed 36 months. It begins on the first day of the month following the month of the transfer, and continues without interruption until the end of the disqualification period.
To calculate the disqualification period, divide the uncompensated equity value by the individual’s or couple’s applicable maximum payment standard. The result, rounded to the nearest whole number, is the individual’s or couple’s period of ineligibility.
Uncompensated Equity Value = Disqualification Period
Maximum Payment Standard (rounded to the nearest whole month)
Example 1 - Applicant: An individual in an independent living arrangement applies for APA in March 2026. In January 2026, the individual transferred property for $1000. The property’s equity value was $6,000. $6,000 Equity Value - 1,000 Compensation $5,000 Uncompensated Equity Value $5,000 Uncompensated Value = 4 Months $1,356 Max. Pymt. Standard* (3.68 Rounded to the nearest whole month) The disqualification period is four months beginning with the month of February, the month after the month of transfer. The individual is not eligible until June 1st. Deny the application. * This example is based on the January 1, 2026 APA maximum payment standard for an individual in an independent living arrangement.
Example 2 - Recipient: In October 2026, an APA recipient in an independent living arrangement inherits a farm worth $100,000. After all taxes are paid, the equity value is $55,000. In October 2026, the individual transfers the title to his sister for $3,000. The individual reports the transfer in December 2026. $55,000 Equity Value - 3,000 Compensation $52,000 Uncompensated Equity Value $52,000 Uncompensated Value = 39 Months $1,356 Max Pymt. Standard* (38.34 Rounded to the nearest whole month) The individual is ineligible for 36 months beginning in November 2026, the month after the month of the transfer. Although the individual’s disqualification period is calculated to be 38 months, the actual penalty cannot exceed 36 months. The individual will not be eligible again until November 1, 2029. The case must be closed and an overpayment claim established for any ineligible months. * This example is based on the January 1, 2026 APA maximum payment standard for an individual in an independent living arrangement.
433-1 F. COORDINATION WITH SSI
1. Length of Disqualification Period
SSI program may also apply a disqualification period if an individual (or spouse) transfers a resource for less than its value. However, because of the SSI program’s lower payment standards, the SSI disqualification period may be different than the APA disqualification period.
If the APA disqualification period ends before the SSI disqualification period, the individual (or couple) may qualify for APA benefits after the end of the APA disqualification period. To qualify for assistance, the individual must meet all other APA eligibility requirements except for receipt of SSI benefits. When the SSI disqualification period ends, the individual will be required to apply for and pursue SSI benefits.
2. SSI Hardship Provisions
The SSI program may decide not to impose a transfer of resource penalty if it determines the penalty would work an undue hardship on the individual. An SSI decision not to impose a transfer of resource penalty because of undue hardship is sufficient reason not to impose an APA disqualification period for transfer of resources.
433-1 G. ONE SPOUSE MOVES AWAY
In some transfer of resource situations, the transferred resource may have belonged to only one spouse. If the spouse who transferred the resource moves away, the disqualification follows that individual. The other spouse is not affected by any months remaining in the disqualification period. The remaining spouse may apply and be found eligible for APA .
433-1 H. MULTIPLE TRANSFERS
For cases involving multiple transfers where the disqualification periods overlap, combine the uncompensated equity value for each transfer and begin the disqualification period the first day of the month following the month of the first transfer.
Example: An individual applies for APA in December 2026. The individual made two intentional transfers with an uncompensated equity value of $5,250 each, one in October 2026 and the other another in November 2026. $10,500 Uncompensated Value = 8 Months $1,356 Max. Pymt. Standard* (7.74 Rounded to the nearest whole month) Because the transfers were so close together, the disqualification periods for each transfer overlap. The disqualification period is therefore calculated using the combined uncompensated equity value from both transfers. The individual is ineligible for eight months, beginning December 1, 2026 and ending July 31, 2027. * This example is based on the January 1, 2026 APA maximum payment standard for an individual in an independent living arrangement.
433-1 I. EFFECT OF RESOURCE TRANSFERS ON INSTITUTIONAL MEDICAID OR MEDICAID WAIVER SERVICES
The transfer of a resource for less than fair market value may affect an individual’s eligibility for institutional Medicaid or Home and Community-Based ( HCB ) waiver services (see Aged, Disabled and Long Term Care ( ADLTC ) Medicaid Manual Section 554). The caseworker must document in the case record any information received regarding the individual’s (or spouse's) transfer of a resource for less than fair market value. The Social Security Administration will provide information to the Division of Public Assistance regarding any such transfers by SSI clients that are discovered.
This information must be retained in the case record for action in case a client enters a nursing home or applies for HCB Medicaid waiver services.
433-2 CONDITIONAL BENEFITS
An individual or couple who meets all non-resource eligibility requirements of the APA program, but fails to meet the resources requirement solely because of excess non-liquid resources may receive conditional APA benefits for a limited period of time. Conditional payments are available because it can take a long time to convert non-liquid resources to cash.
433-2 A. ELIGIBILITY FOR CONDITIONAL BENEFITS
Conditional benefits are available only if the individual or couple meets both of the conditions below:
The individual or couple must agree in writing to dispose of excess non-liquid resources at their current market value and repay from the net proceeds of the disposal the amount of assistance received during the term of the agreement.
The individual's or couple's liquid resources may not exceed 3 times the applicable SSI payment standard. In 2026, liquid resources may not exceed $2,982 ($994 x 3 = $2,982) for an individual or $4,473 ($1,491 x 3 = $4,473) for a couple. (There is no limit to the amount of non-liquid resources an otherwise eligible applicant or recipient may own and qualify for conditional payments.)
Conditional payments are made only if the applicant or recipient is otherwise eligible for regular APA benefits. Interim Assistance payments are not available to individuals under this provision because Social Security does not establish an SSI conditional benefits agreement until the individual is actually found to be otherwise eligible for SSI payments, and APA policy requires that SSI and APA conditional benefits be paid concurrently.
Note: Conditional benefits are not available to APA -related Medicaid-only cases because the Medicaid program does not have any pay-back provisions. (Refer to ADLTC Medicaid Manual Section 524 .)
433-2 B. MANDATORY SSI CLIENTS
APA applicants and recipients who are required to participate in the SSI program must enter into binding agreements with both SSI and DPA to repay the amount of benefits paid during the term of the conditional benefits agreement. For APA purposes, the agreement must be completed using form APA 11 , "Agreement to Sell Property".
Conditional benefits for both the SSI and APA programs must be paid concurrently (for the same benefit months), since the APA client is eligible for conditional benefits only during the months that he or she is also eligible for SSI conditional benefits. The case worker must coordinate the payment of APA conditional benefits with the SSA claims representative handling the SSI case.
433-2 C. NON- SSI CLIENTS
APA applicants and recipients who are not required to apply for SSI , are required only to enter into a binding agreement with DPA to repay the amount of APA benefits paid during the term of the agreement. This agreement is completed using form APA 11 , "Agreement to Sell Property".
433-2 D. REPAYMENT OBLIGATION
The client is obligated to repay any APA benefits received during a conditional benefits period from the net proceeds received from the sale of the nonliquid resource(s) which caused the client's assets to exceed the resource limit. Net proceeds are the amounts received from the sale, less the costs incurred in selling the property and less any legal encumbrances or debts owed on the property.
Once the nonliquid resource is sold, the client must use the net proceeds or profit from the sale to repay the APA conditional benefit payments. If the client also received conditional benefit payments from the SSI program, the net proceeds are applied first to the repayment of SSI conditional benefits, and then to the repayment of APA conditional benefits.
The client is obligated to repay conditional benefits only up to the amount of the net proceeds of the sale, or the amount of conditional benefits, whichever is less. If the net proceeds of the sale are not enough to repay all of the conditional benefit payments that the client received, the amount of conditional benefits that exceeds the net proceeds of the sale is not an overpayment.
Any retained funds remaining after the sale of the nonliquid resource and repayment of conditional benefits must be evaluated as a resource the month after the funds are received.
433-2 E. DISPOSAL PERIOD
The disposal period for individuals who are required to apply for SSI begins on the date that the client signs an agreement with both SSI and APA . The disposal period for clients who are not required to apply for SSI begins on the date the client signs an agreement with APA . The disposal period continues until the end of the last full calendar month for which the client has been approved for conditional benefits.
433-2 F. CONDITIONAL BENEFITS PERIOD
The conditional benefits period for non-liquid personal property is 3 months, with a possible 3-month extension for good cause. Good cause exists if, despite reasonable efforts to sell the property, circumstances beyond the client's control prevent a sale.
The conditional benefits period for real property (land or buildings) is 9 months. There is no extension for good cause available for the real property conditional benefits period.
Eligibility for conditional benefits begins the month after the agreement to repay conditional benefits is signed and continues until the client sells the property, stops making reasonable efforts to sell the property, does not sell the property within the conditional benefits period, or requests cancellation of the agreement in writing.
Example: An individual signs an agreement on January 12, to dispose of real property which causes the client's assets to exceed the resource limit for the APA program. The first month that the individual can receive conditional APA benefits is February. If no sale occurs, the last month that conditional benefits may be paid is October.
433-2 G. DEFINITION OF REASONABLE EFFORTS
Reasonable efforts to sell property mean that :
Within 30 days of signing an APA conditional benefits agreement, the owner must have listed the property with an agent or begun to advertise in at least one of the appropriate local media; and,
Except for gaps of no more than one week, the owner must maintain efforts to sell; and,
The owner must not reject any reasonable offer to buy the property. A reasonable offer is a cash offer at least as great as the amount that similar property in the area where the property is located will sell for.
APA recipients who receive SSI payments are presumed to be making reasonable efforts to sell property.
433-2 H. CONTINUED EXCLUSION OF REAL PROPERTY AFTER A PERIOD OF CONDITIONAL BENEFITS
Real property that an individual has made reasonable but unsuccessful efforts to sell throughout a 9-month period of conditional benefits will continue to be excluded for as long as:
the individual continues to make reasonable efforts to sell the property (as defined in manual section 433-2G above); and
including the property as a countable resource would result in a determination of ineligibility because of excess resources.
Eligibility for APA will continue only so long as reasonable efforts to sell the property are maintained.
Benefits payable under this provision are regular APA benefits, not conditional benefits. If the property is finally sold, only benefits paid during the term of the conditional benefits period are required to be repaid from the net proceeds.
If APA eligibility ends for any reason following a 9-month conditional benefits period and there is at least a one-month period of ineligibility, this exclusion does not apply upon a new application for benefits. Before the property may again be excluded under this provision, the individual must go through a new 9-month period of conditional benefits.
There is no continued exclusion of personal property after a period of conditional benefits. However, the fact that the property did not sell may indicate that it has a lower fair market value than was originally determined. The client should be given the opportunity to provide a revised estimate of its current fair market value and the APA case reevaluated to determine if the client is resource eligible.
Note: The exclusion of real property after a period of conditional benefits does not apply to APA related Medicaid-only determinations. (See ADLTC Medicaid Manual Section 524 .)
433-3 PERMANENT FUND DIVIDEND
Permanent Fund Dividend ( PFD ) payments are not counted as either income or resources for the APA program. However, the SSI program does consider PFD payments as countable income and resources when determining eligibility and benefit amounts. The Medicaid program also considers PFD payments as countable income in very limited situations, but does not count retained PFD payments as a resource.
433-3 A. HOLD HARLMESS FOR SSI APPLICANTS AND RECIPIENTS
The SSI program is not administered by the State of Alaska. However, state law provides for replacement of SSI benefits an individual loses because of receiving or keeping PFD money. The policy below describes the different procedures for SSI applicants and ongoing recipients of SSI benefits.
1. Applications
When SSA opens an applicant's SSI case, the individual's PFD may be counted as income or resources, resulting in ineligibility for SSI.
If SSI benefits are denied or reduced due to PFD income or resources, the caseworker must request a field warrant from System Support to replace the lost benefits. Provide the following information when you are requesting a warrant to replace lost SSI benefits:
Clients name and case number;
Benefit month(s) and amount(s) being requested; and
An explanation that the warrant is being requested to replace SSI benefits lost because of receipt or retention of PFD money during the SSI application period.
Lost benefits may exist back to the date of the SSI application, so it is important to remember the PFD hold harmless period cannot exceed four months for each PFD distribution year.
We may also pay these special retroactive hold harmless benefits if SSA denies SSI to a child under age 18 due to the receipt of PFD .
2. Ongoing Cases
For ongoing SSI cases, SSA will continue paying SSI benefits, declaring overpayments when PFD income or resources cause ineligibility.
If a PFD caused SSI overpayment exists, the PFD Hold Harmless Program will repay the client's overpayment to SSI .
SSA will notify the client of the SSI overpayment due to PFD income, but will not require repayment since the State of Alaska has already repaid the overpayment in full.
No action is required by the caseworker. Reconciliation is accomplished through a buy-out agreement between the state and SSA . The Director's Office is responsible for transferring replacement funds to SSA .
433-4 ABLE ACCOUNT
An ABLE account is a tax-advantage account, similar to a Section 529 qualified tuition program (QTP). An ABLE account can be administered by any state that allows an ABLE account. They must be established for the benefit of the individual. The designated beneficiary is also the owner of the account.
The ABLE account balance is an exempt resource for all public assistance programs and distributions from an ABLE account for qualifying disability expenses will not be counted as income.
1. Who is eligible for an ABLE account?
To be eligible for an ABLE account, a person must be blind or disabled according to the Social Security definition of disability by a condition or conditions that began before age 46. Eligible individuals are limited to one ABLE account.
Generally, ABLE accounts may not receive aggregate contributions during a taxable year in excess of the annual gift tax exemption. Below is a table of the maximum contributions allowed per year. The maximum balance for an ABLE account in Alaska is $400,000 but each state is allowed to set a maximum for their state.
Year Max. Allowable Contribution For Year 2026 $19,000 2025 $19,000 2024 $18,000 2023 $17,000 2022 $16,000 2021 $15,000 2020 $15,000 2019 $15,000 2018 $15,000 2017 $14,000 2016 $14,000
2. Will ABLE account balance count towards the SSI resource limit?
For SSI purposes, the first $100,000 in an ABLE account is excluded as a resource.
3. What happens if an SSI recipient has excess resources held in an ABLE account?
If an individual is ineligible for SSI due to excess resources held in an ABLE account, the SSI benefits will be suspended without a time limit, but the SSI benefits will not be terminated. Medicaid may continue if Medicaid eligibility requirements are still met. See ADLTC MS 530 .
4. Are ABLE accounts transferable?
ABLE accounts are transferable to family members who are also qualified individuals.
5. What distributions are allowed from ABLE accounts and what is their impact on SSI benefits?
ABLE accounts can be used for Qualifying Disability Expenses (QDEs). QDE s are expenses for items or services needed to maintain or improve your health, independence or quality of life. QDE s are not limited to expenses for which there is a medical necessity.
QDE s include education, housing, transportation, employment training and support, assistive technology, personal support services, health prevention and wellness, financial management, administrative services, legal fees, expenses for oversight and monitoring and funeral and burial expenses.
Qualifying distributions from the ABLE account would not generally affect SSI eligibility or payment amount.
6. Retained distributions for a non-qualifying purpose or housing costs are countable the month after the month of receipt.
Example: Riley takes a distribution of $500 from her ABLE account in May to pay her rent in June. She deposits the $500 into her checking account in May, withdraws $500 in cash on June 3, and pays her landlord. This distribution, which is a housing related qualified distribution, is part of her checking balance as of the first of the month in June, which makes it countable resources for the month of June.
7. ABLE account does not replace the need for a Medicaid Qualifying Income Trust.
An ABLE account is an allowable way for a disabled individual to save more than the Medicaid resource limit but does not reduce an individual's countable monthly income.
If an individual has too much countable monthly income to qualify for Medicaid benefits, only an approved and properly funded Medicaid Qualifying Income Trust (Millers Trust, Special Needs Trust, or Pooled Trust) can reduce their countable monthly income in order to establish Medicaid eligibility.
8. Certain employed ABLE account beneficiaries may make additional contributions.
ABLE account owners who work and do not have an employer-sponsored retirement account may contribute an additional amount equal to the lesser of their annual compensation or the FPL for a one-person household in their state of residence for the prior calendar year. See one-person QMB household size in the Medicaid Income standards.
9. What are the caseworker responsibilities with an ABLE account?
The following process must be followed for all initial applications when Medicaid is being established for an individual with an ABLE account.
Request and obtain a copy of the ABLE account enrollment paperwork.
Request and obtain a copy of the ABLE bank account showing when the account was opened and the monies being deposited into the account.
Email the following information to the DHCS TPL at doh.hcs.rec.info@alaska.gov : Copy of the ABLE account enrollment paperwork, and Completed ABLE Account Reporting form (MED 19) located under e-forms.
The following process must be followed at renewal:
Review the file to ensure that we have a copy of the ABLE account enrollment paperwork. If not, request a copy.
Request current bank statement, review for discrepancies by: a. Reviewing balance, and b. Compare current balance with balance from previous year renewal to ensure that the funds have been used appropriately.
If there are any discrepancies; a. Request statements from past 12 months, and b. Discuss use of the ABLE account with the client and clarify appropriate use of the account.
The following process must be followed when closing a case with an ABLE account:
Determine the reason for closure. If the closure was because of death: a. Enter the date of death on the MERE screen, b. Close out the TPR and MCR segments on the MERI screen using the actual date of death and close out the MCR segment with the last day of the month in which they died, and c. Send a closure notice and email a copy to the DHCS TPL Unit at doh.hcs.rec.info@alaska.gov .
433 SPECIAL RESOURCE PROVISIONS
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440-1 INCOME DEFINED
Income is any money that an individual (or the individual's spouse or alien sponsor, if any) receives and can use to meet his or her needs for food or shelter.
Income is either earned or unearned, and different rules apply to each. The APA program generally follows the income-counting rules of the SSI program. However, an important difference between the two programs is that the APA program does not count in-kind income when determining APA eligibility or benefit amounts, while the SSI program counts shelter received from others living in the household as in-kind support and maintenance.
440-1 A. EARNED INCOME
Earned income is money that an individual receives in return for working. Earned income includes the following types of payments: wages, salaries, tips, commissions, net self-employment income, and payments for services performed in a sheltered workshop or work activities center.
440-1 B. UNEARNED INCOME
Unearned income is any income that is not earned. Unearned income includes, but is not limited to, income from annuities, pensions or retirement payments, disability benefits, veteran's compensation and pensions, workers' compensation payments, Social Security payments, Black Lung benefits, Railroad Retirement, unemployment compensation, insurance payments, support and alimony, bingo winnings, gifts and prizes, inheritances, rents, dividends, royalties, interest, income from non-business income producing property, and countable assistance payments such as Temporary Assistance, SSI and Bureau of Indian Affairs General Assistance.
Note: Jury duty fees are disregarded from income as essential expenses of obtaining income (see section 443-3 ).
440-2 WHEN INCOME IS COUNTED
Generally, we count income at the earliest of the following points:
when it is received; or
when it is credited to an individual's account; or
when it is set aside for their use.
Occasionally, a regular periodic payment is received in a month other than the month of normal receipt. As long as there is no intent to interrupt the regular payment schedule, consider the funds to be income in the normal month of receipt.
When a payor advance dates a check because the regular payment date falls on a weekend or holiday, there is no intent to change the normal delivery date. Whenever such an advance dated check is received, consider it income to the recipient in the month of normal receipt.
When an individual's money goes to a bank by direct deposit, the funds may be posted to the account before or after the month they are payable. Whenever this occurs, treat the electronically transferred funds as income in the month of normal receipt. For public assistance benefits, we consider the month of intended use to be the month of normal receipt.
When income is counted in a month other than the month that evidence in the file shows the income was actually received, document the reason in the case note.
Retroactive benefits, whether paid in one lump sum or by installment, are counted as unearned income in the month payment is received.
Exception: Retroactive SSI and SSA Retirement, Survivors, and Disability Insurance (RSDI) benefits are not counted as income in the month of receipt. See APA MS 441-2(Q)
Income must be evaluated as a resource in the month following the month of normal receipt.
Example: A company sends out its retirement pension checks so that they arrive on the first day of each month. However, because January 1 is a holiday, the checks are delivered on December 30. The client brings in his pension check on December 31 as evidence of his income, and explains that he also received a pension check on December 1. The caseworker determines that the amount of the December 30 check is income for the normal month of receipt, which is January. The check is counted as income for January rather than December because of these unusual circumstances.
440-3 ITEMS THAT ARE NOT INCOME
Certain items are not income because an individual cannot use them to get food, clothing, or shelter. Such items are not subject to income exclusions. However, an item that is not income in the month of receipt is subject to evaluation as a resource the month after the month of receipt. The following items are not income:
440-3 A. THE VALUE OF IN-KIND SUPPORT AND MAINTENANCE
Unlike the SSI program, the APA program does not count the value of any support and maintenance that an individual or couple receives in-kind. In-kind support and maintenance is any form of shelter (room, rent, mortgage payments, real property taxes, heating fuel, gas electricity, water, sewer, garbage) received by an individual or couple.
In-kind support and maintenance is considered only in the determination of whether an APA applicant or recipient lives "independently" or "in another's household". (Refer to section 450 for the policy on living arrangements)
440-3 B. MEDICAL OR SOCIAL SERVICES, AND CASH RECEIVED FROM A PUBLIC OR PRIVATE ORGANIZATION IN CONJUNCTION WITH SUCH SERVICES
1. Definitions
Medical services. Medical services are services which are directed toward the treatment of a medical condition and which are performed, directed, or supervised by a state licensed health care professional. Medical services also include any item received as part of such medical treatment, including food and shelter provided during a medical confinement, prescription drugs, eyeglasses, and prosthetic devices.
Social services . A social service is any service which is intended to help a handicapped or socially disadvantaged individual to function in society on a level comparable to that of an individual who does not have such a handicap or disadvantage.
2. Medical and social services
Any medical and social service provided by a governmental, private organization, or by private individual is not income.
3. Cash received for medical or social services that is not income
a. Cash provided by a public organization.
Any cash provided by a governmental medical and social services program is not income. A cash payment made to an individual by the Division of Vocational Rehabilitation is not income if the payment is made as part of a vocational rehabilitation program. Other examples of cash received in conjunction with medical or social services include: One-Time refugee resettlement payments, VA aid and attendance and housebound allowances, VA clothing allowances, and VA payment adjustments for unusual medical expenses. (Refer to section 441-2C (4,5, and 6) for an explanation of these VA benefits. Refer To Administrative Procedures manual section 128-4 for more information about Refugee Assistance.)
b. Cash provided by a private organization.
Cash provided by a nongovernmental organization is not income when the cash is paid for a medical or social service already received by the individual and approved by the organization, or the payment is restricted to the future purchase of a medical or social service. Examples of private organizations which provide cash to pay for medical or social services include: American Red Cross, Salvation Army, St. Vincent de Paul, various church organizations, and private profit and non-profit organizations.
4. Cash received for medical or social services that is income
a. Cash provided by a private individual.
Cash provided by a private individual for medical or social services directly to an applicant or recipient is considered a gift and is counted as unearned income. Direct payments to providers are not income.
b. Flat rate benefit payments from an insurance policy.
Cash from an insurance policy which pays a flat rate benefit to the recipient without regard to the actual charges or expenses incurred is income. Examples of these types of insurance policies are per diem hospitalization or disability insurance, or cancer or dismemberment policies.
5. Verification
a. Governmental medical and social services program.
If the source of the cash payment is questionable, documents in the individual's possession (such as a program identification card, notice, or award letter) may be used to verify that the source of a cash payment is a governmental medical or social service program. In the absence of such proof, a collateral contact with the source of the payment may be used.
b. Cash provided by a private organization for medical or social services.
Receipt of cash from a private organization for medical or social services must be verified. Documents in the individual's possession may be used to verify that the cash is provided either for a medical or social service already received by the individual, or that the use of the payment is restricted to the future purchase of a medical or social service. In the absence of such proof, a collateral contact with the source of the payment may be used.
440-3 C. CONVERSION OR SALE OF A RESOURCE
Cash or property received from the sale, exchange, or replacement of a resource is not income but is a resource that has changed its form. This includes any cash or in-kind item that is provided to replace or repair a resource that has been lost, stolen, or damaged. It is important to note that the conversion or sale of a resource may change the character of a resource; an excluded resource may become a countable resource.
Verification. If the amount of cash or the value of property retained from the conversion or sale of a resource is questionable, the APA applicant or recipient may be required to provide proof of the amount of retained cash or value of the new property. Unless otherwise excluded, any funds or property retained from the conversion or sale of a resource will become a countable resource the month following the conversion or sale.
Example: In April, Mr. Wallace reports that he sold his 1984 Ford Mustang for $1500 on March 25. The money he received from the sale is not income but a resource which has been converted from one form (an excluded automobile) to another form (cash). Mr. Wallace indicates that he spent $500 on living expenses in March and deposited the remaining $1000 into his checking account. The caseworker has no reason to question the amount of cash received from the sale, since the amount Mr. Wallace received is consistent with normal used car values in the area. Because the retained funds are considered to be a countable resource the month following the sale, the caseworker requests proof of the balance in Mr. Wallace's checking account as of the first moment of April.
440-3 D. REBATES AND REFUNDS
When an individual receives a rebate, refund, reimbursement, or other return of money that he or she has already paid, the returned money is not income.
The key idea in applying this policy is that the money returned is the individual's own money. Some "rebates" do not fit this category. For example, if a cooperative operating as a jointly-owned business pays a "rebate" as a return on a member's investment, the money is unearned income similar to a dividend.
Verification. Unless there is reason to question the situation, accept the individual's statement that the a rebate or refund of money is a refund of money already paid and do not count it as income. In questionable situations, make copies of any documents in the individual's possession for the case file, and contact the source of the payment to verify that the payment is a return of money already paid.
440-3 E. FEDERAL INCOME TAX RETURNS
Any federal income tax return received after December 31, 2009 is excluded from income in the month of receipt.
Verification. Client statement or a copy of an individual's income tax return is acceptable proof of the amount of a tax refund.
440-3 F. CREDIT LIFE OR CREDIT DISABILITY INSURANCE PAYMENTS
Credit life and credit disability insurance policies are issued to or on behalf of borrowers to cover payments on loans, mortgages, etc. in the event of death or disability. These policies issue insurance payments directly to loan or mortgage companies, etc. The payments are not available to the individual.
A payment made under a credit life or credit disability insurance policy for an individual is not income. Food, clothing, or shelter received as the result of a credit life or credit disability payment is not income.
Verification. A copy of the insurance contract or other documentation from the insurance company may be used to verify that the insurance payments are not available to the individual. If such evidence is not available, a collateral contact with the insurance company is acceptable.
440-3 G. LOANS
Money that a person borrows is not income because of the obligation to repay the loan. This includes any type of educational loan, including an Alaska State Student Loan, as well any other type of private or commercial loan.
Money that a person loans and then receives back as a repayment is not income to the extent that the repayment represents repayment of the principal of the loan. However, the portion of any repayment that represents interest on the principal is income.
A loan must be bona fide. A bona fide loan is a debt that the borrower has an obligation to repay and expresses his or her intention to repay. If a loan is not bona fide, there is no obligation to repay and the amount received is a gift. A gift is considered as unearned income in the month received.
Verification. To be ignored as income, the bona fide nature of a loan must be verified. Commercial or educational loans may be verified by viewing a copy of the loan agreement or a document identifying the payment as a loan. For personal loans, the bona fide nature of the loan must be verified by both parties. At minimum, the lender must acknowledge that an obligation to repay the loan exists, and the borrower must acknowledge that he or she intends to repay the loan (with or without interest).
440-3 H. BILLS PAID BY A THIRD PARTY (VENDOR PAYMENTS)
Payment of an individual's bills by a third party (including Medicare premiums or other medical insurance premiums) directly to the supplier by a third party is not income.
440-3 I. REPLACEMENT OF INCOME ALREADY RECEIVED
The replacement of lost, stolen, or destroyed income already received is not income if the income being replaced was already used to determine the amount of an APA or SSI payment.
Verification. Written documentation from the person, organization, or agency which issued a replacement payment is used as proof that the payment is a replacement. In the absence of such documentation, a collateral contact with the person, organization, or agency is acceptable.
Example: Mr. Akers, an APA recipient, reports that he received a replacement SSI check after his regular SSI check was damaged in the mail. The caseworker confirms that the check is a replacement by viewing a letter that SSI sent to Mr. Akers. The replacement SSI check is not income to Mr. Akers because the damaged SSI check was already used to determine the amount of his monthly APA payment.
440-3 J. RETURN OF ERRONEOUS PAYMENTS
An erroneous payment is not income when the individual is aware that he or she is not due the money and returns the check uncashed or otherwise refunds all of the erroneously received money by the end of the month following the month the erroneous payment was received. If the erroneous payment is not returned in a timely manner, it is considered as income in the month of receipt, unless there is good cause for a delay in the return of the erroneous payment.
Verification. The return of an erroneous payment must be verified with the agency or organization that issued the payment. Documentation from the issuing agency or organization may be used to verify the return of an erroneous payment. In the absence of such documentation, a collateral contact with the agency or organization is acceptable.
Example: During the latter part of January, Mr. Bob Brown received a $290 check from the Department of Veterans Affairs ( VA ) for the month of January along with a letter explaining that his regular January payment had been delayed due to a computer error. In August, Mr. Brown receives a second VA pension check for January. Realizing the second check is a duplicate payment, he returns the second check to the VA before the end of September. Upon confirming the return of the duplicate payment with the VA , the caseworker determines that the duplicate payment Mr. Brown received in August is not income for APA purposes.
440-3 K. WEATHERIZATION ASSISTANCE
Weatherization assistance from any source that is in the form of in-kind items such as insulation, storm doors, and storm windows is not income.
440-3 L. WAGE-RELATED PAYMENTS
Employers make various payments for their employees that are not earnings and are not available to meet the employee's needs for food, clothing, or shelter. The following wage-related payments are examples of payments that are not income unless they are deducted from the employee's wages:
Contributions by an employer (the employer's share) to a health insurance or retirement fund.
Payment by the employer (the employer's share) of any FICA or unemployment compensation taxes.
440-4 DETERMINING ELIGIBILITY AND BENEFIT LEVEL
For non- SSI recipients, the caseworker determines a household's eligibility and benefit level on a calendar month basis by considering the household’s circumstances for the entire month. The caseworker estimates the amount of monthly income used in this determination by following the guidance in this chapter.
440-4 A. COMMON TERMS AND DEFINITIONS USED IN THIS SECTION
The following terms are specific to this section. Refer to these terms frequently to gain a full understanding of the policy and examples in this section.
Anticipate means expecting a future event; predicting an event. For example, an applicant anticipates receiving child support each month.
Average payment is a basic math calculation that adds payments in a period and divides the total by the number of payments added.
Bi-weekly payments are payments received every other week.
Conversion factor is a basic math calculation used to change (convert) a weekly or bi-weekly payment amount into a monthly amount. It factors in the 3rd and 5th pay check received in some months by multiplying by 4.3 weeks when using a weekly payment, and 2.15 weeks when using a bi-weekly payment.
Estimate means calculating an approximate value. For example, a caseworker will estimate how much income to count.
Full payment period is the period a payment is intended to cover. For example, the full payment period for earnings is the pay period defined by the employer. The full payment period for public assistance payments is a calendar month. The full payment period for unemployment benefits is generally a two-week period, based on the claimant receiving two weekly benefits per payment. Payments cover a full payment period even if the individual did not receive the maximum payment he or she could have received. For example, lower payments are for full payment periods when the employee is employed continuously and was on unpaid leave (including illness) for part of the pay period; or a person is disqualified for part of the UIB two-week benefit period.
Irregular income is income received in unpredictable amounts, on unpredictable dates, or infrequently, and typically not in consecutive months. Unexpected income that cannot reasonably be expected to recur, such as a cash gift, also is irregular income.
Monthly payment is a payment received once a month.
Normal payment is a payment in a typical or usual amount.
Scheduled payment is a payment that will be made by the source at prescribed intervals or on specific dates. For example, unemployment benefits are scheduled to be paid every two weeks; a weekly paycheck is scheduled to be paid once a week; and salaries are paid on specific dates decided by the employer. With new or ending income, the individual may not receive all of the scheduled payments in a month, or some of the scheduled payments they receive may not be for a full payment period.
Twice a month payments are payments received two times in the month on specific dates. For example, the monthly pay dates are the 5th and 20th of each month.
Weekly payment is a payment received once a week.
440-4 B. ESTIMATING THE HOUSEHOLD’S MONTHLY INCOME
The caseworker makes a reasonable estimate of the household’s monthly income based on the information available from the household and the source of the income. The caseworker must confer with the individual to find out about income already received, as well as about income anticipated for the month of application and for subsequent months in the certification or review period.
Once the caseworker has information about the types of income, and when and how much will be received, the caseworker will confirm it by getting verification from the source of the income.
Income is included:
If the household has received it or anticipates receiving it in the month; and
The worker can estimate how much the household will receive in the month and/or in subsequent months.
To anticipate and estimate the household's monthly income, the caseworker must know:
What is the source of the income?
What is the amount of each payment?
Which household members receive income?
When will the income be received - i.e., pay dates?
What is the period of time the payments covers - i.e., pay period start and end dates?
If the income is ending, when is the last payment expected?
When is the first payment expected?
Will payments continue?
How often will the household receive payments - i.e., monthly, twice a month, bi-weekly, weekly, irregularly?
The estimated income amount used in the benefit calculation will be considered correct if:
It is reasonable;
It is based on all available information;
The caseworker applied correct policy; and
How the estimate income amount was determined is documented in the Case Notes (CANO). See MS 400-5 for more on documentation requirements.
The caseworker adjusts the monthly income estimate for subsequent months when a change is reported that affects the amount of anticipated income.
1. CALCULATING MONTHLY INCOME AMOUNT
The method used to calculate a monthly income amount depends on a number of factors, including:
When the payments started;
If it is a scheduled or irregular payment;
If it is a fixed, salaried, or hourly income;
Whether all the payments paid cover a full payment period;
Whether all the scheduled payments will be received in the month; and
Known and verified upcoming changes that might affect the amount of the payment or when the payment will be received.
Note: This policy applies when determining income amounts for all benefit months, including the application month.
Whenever possible, the caseworker uses payment history to determine a normal or average payment to use in estimating monthly income. This history may be in the form of paycheck stubs or a statement showing payments made.
When the payment history shows that the payment amounts vary, the worker calculates an average payment amount by adding together recent payments from the same source and dividing this total by the number of payments.
Example: Averaging Payments Ellie provides her last three pay stubs showing gross earnings of $456, $398, and $430. The caseworker averages these amounts by adding the three figures together ($456 + $398 + $430 = $1284) and dividing by three ($1284/3=$428).
Use recent payments that represent what is likely to be received through the months of the certification/review period. Past payments that do not represent what is anticipated to occur in the period for which income is estimated, such as unusual payments not expected to continue, may be excluded in the calculation, for example, one-time overtime or a one-time increase in hours.
Example: Excluding an Unusual Payment David works varying hours depending on when his employer needs him. He provides his last three pay stubs, showing gross earnings of $600, $900, and $660. David explained that the $900 check was unusually high because he was covering for another shift. The employer confirmed this was a one-time situation and stated that the $600 and $660 checks were the norm. The caseworker excludes the $900 check since it does not represent an amount that can be anticipated in the months for which income is being estimated, and calculates an average payment by adding the two other checks together and dividing by two ($600 + $660 = $1260 divided by 2 payments = $630).
To estimate earnings when the person has new employment or a change in hours for which there is no payment history, the caseworker uses the number of hours that will be worked each pay period or each week, and multiplies this by the hourly rate to calculate a per payment or per week estimate. This amount is then multiplied by the appropriate conversion factor to determine the estimated monthly income. When the change is in the hourly rate, the payment history can be used to estimate the number of hours that will be worked under the new wage rate.
Example: Income from a New Job Maggie reports that she started a new part-time job. She will be paid twice a month earning $12 an hour. Her schedule will vary but the employer estimates that she will work an average of 20 hours each week. Multiply the number of hours per week by the rate of pay to get an estimate of weekly pay (20 hours x $12/hour = $240). Multiply this weekly estimate by 4.3 to get a monthly estimate of income.
Example: Increase in Hourly Wage Terri reports she got a raise to $10 an hour starting July 1. She gets paid twice a month, and provides her last three pay stubs that show 45 hours for pay period ending May 31, 36 hours for pay period ending June 15, and 42 hours for pay period ending June 30. Average the number of hours by adding them together and dividing by three. (45 + 36 + 42 = 123 divided by 3 = 41). Multiply this average number of hours by the new rate of pay to get an average payment per pay period (41 hours x $10/hour = $410).
2. FULL MONTH'S INCOME
When the individual will receive all the scheduled payments in the month and all the payments cover a full payment period , estimate the monthly income by using the normal or average payment amount. Payments received once a month do not need to be converted. If payments are made more than once a month, multiply by a conversion factor to get a monthly amount:
By 2 if the payment is for a half month (i.e., paid twice a month)
By 2.15 if the payment is for a period of two weeks (i.e., paid every other week)
By 4.3 if the payment is for a period of one week (i.e., paid weekly)
Confirm pay period start and end dates and pay dates to ensure the correct conversion factor is used. The distinction between twice a month and every two weeks may be missed if the caseworker simply asks the payroll clerk how often an employee is paid.
If the payment amounts do not vary , multiply the normal payment received each pay day by the appropriate conversion number based on the frequency of payment.
Example: Payment Amounts Do Not Vary Rachel is paid twice a month, on the 4th and the 20th. Her salary is $1000 a pay period. To calculate her monthly income, $1000 is multiplied by 2 ($1000 x 2 = $2000).
If the payment amounts vary , calculate an average payment first, and then multiply it by the appropriate conversion number based on the frequency of payments in the month.
Example: Payment Amounts Vary Val is paid every other Saturday. Her average pay is $428. To calculate her monthly income based on payments every two weeks, $428 is multiplied by 2.15 ($428 x 2.15 = $ 920.20).
Notes: Two pay days in the month that are normally on the same dates, such as on the 5th and 20th, indicate the individual is paid twice a month. Pay days that are 14 days apart and normally on the same day of the week, such as every other Friday, indicate the individual is paid every other week (bi-weekly). Pay days that are 7 days apart and normally on the same day of the week, such as every Monday, indicate the individual is paid weekly. Pay dates may vary when the normal pay date falls on a holiday or weekend.
Some individuals have unusual work schedules, like working one week on and one week off. In these situations when there is no pay history, the caseworker will calculate a monthly estimate of income by determining the amount of income that will be received during a time period and converting this amount into a monthly amount.
Example #1: Unusual Work Schedule Erin works three weeks on and one week off. She just started working and the employer statement indicates she’ll work 10 hour shifts, seven days a week, and will be paid $12 an hour for the first 40 hours per week, and $18 an hour for the remaining hours. The worker calculates she’ll work 120 hours at $12 an hour ($1440) and 90 hours at $18 an hour ($1620) during this 21-day period, for a total amount of $3060. She’ll earn no money during the seven days she has off, so for the four-week period, she’ll earn $3060. The worker divides this amount by 4 to get a weekly average ($3060 divided by 4 = $765), and multiplies this amount by 4.3 to get a monthly estimate of income ($765 times 4.3 = $3289.50).
Example #2: Unusual Work Schedule Pat’s work schedule is one week on and one week off. He normally works 12-hour shifts for seven days, and gets paid $10 an hour regular time (40 hours times $10 = $400) plus $15 an hour overtime (44 hours times $15 = $660), for a total of $1060 per week. Since he works one week on and one week off, this $1060 represents two weeks of employment. The worker multiplies this by 2.15 to get a monthly estimate of income ($2279). Six months later, Pat submits his review application and provides his pay stubs for the pay periods ending May 9 ($1030), May 23 ($1280), and June 6 ($1090). Since these represent two-week pay periods (one week on and one week off), and worker totals them ($3400), divides this amount by 3 to get an average payment ($1133.33 and multiplies this average two-week payment by 2.15 to get a monthly estimate of income ($2436.65).
Full payment periods include pay periods when there is a temporary decrease in the payment amount due to unpaid leave or work schedule changes, or a one-week gap in unemployment insurance benefits. These situations result in a change in the amount of the scheduled payment, but the payment still covers a full payment period. In these situations, the caseworker calculates an average payment just for that month to estimate the month’s income. Another average payment is calculated to estimate income for subsequent months in which the payment amounts return to normal.
Example: Temporary Decrease in Earnings Carolyn works a 40-hour per week job, but the amounts of her last three checks vary significantly due to leave without pay she took for a family emergency. She does not expect to miss any more work. She is paid every two weeks and received $400 gross (40 hours) on August 3, $600 (60 hours) on August 17, and expects a normal pay check of $800 (80 hours) on August 31. Since August income is significantly lower than normal, the caseworker must do a separate budget for this one month. For August the caseworker totals the three payments received in August and divides the amount by three to get an average payment amount ($400 + $600 + $800 = $1800/3 = $600). Carolyn is paid bi-weekly (every other week). The caseworker multiplies this average payment amount by 2.15 to get an estimated monthly income amount for August ($600 x 2.15 = $1290). Since low paychecks are not expected to continue, the caseworker anticipates $800 every two weeks and recalculates an estimated monthly income of $1720 for September and beyond. ($800 x 2.15 = $1720).
Example: Temporary Decrease in Unemployment Benefits Bob is receiving unemployment insurance benefits ( UIB ) of $210 a week, which is paid every two weeks in the amount of $420. He will receive UIB payments on the 2nd, 16th, and 30th of November. However, he did not claim one week of benefits so one of these payments is for $210. He expects to claim every week of benefits in the future. Since November income is lower than normal, the caseworker must do a separate budget for this one month. The caseworker totals the three payments in November and divides the amount by three to get an average payment amount ($420 + $210 + $420 = $1050/3 = $350). Since the payments are bi-weekly (every other week), the caseworker multiplies this average payment amount by 2.15 to get an estimated monthly income amount for November ($350 x 2.15 = $752.50). Since the lower UIB payment is not expected to continue, the caseworker anticipates $420 every two weeks for December and beyond and recalculates an estimated monthly income of $ 903 ($420 x 2.15 = $ 903 ).
Notes: • If an individual is paid once a month and the amount varies, such as child support payments, calculate an average monthly amount to use in estimating total monthly income. • If the caseworker and client anticipate that the lower payment is only for one month, the caseworker recalculates the income using the amount normally received to determine income for subsequent months. • All anticipated changes in income reported and verified at the time of application, review or recertification, or during the recert/review period must be considered when calculating the estimate of income. This may require the worker to calculate multiple budgets for subsequent months until the income stabilizes.
3. NOT A FULL MONTH'S INCOME
a. When the individual will receive all the scheduled payments in the month, but one or some of the payments do not cover a full payment period , total the income already received and any additional amount anticipated to be received during the month, and use this amount for the month. This situation often occurs when the individual begins employment after the pay period starts, or stops working before the pay period ends, resulting in the first or last paycheck covering less than a full pay period. It may also occur when individuals begin receiving or stop receiving unemployment insurance benefits.
When the person is not employed for the full pay period, anticipate the number of hours that will be worked in the pay period and multiply this number of hours by the hourly wage. Use this amount in the estimate of income for this month.
Example: Starting Employment Sue applies for benefits on June 6. She recently started working on May 28. She gets paid $10 an hour and works 5 hours a day, Monday through Friday. She’ll be paid twice a month on the 5th and 20th. Pay periods are the 1st through the 15th and the 16th through the end of the month. Her June 5 check was only $200 for the four days she worked in May (4 days x 5 hours/day = 20 hours x $10 = $200). Her June 20 check is anticipated to be $550 for the eleven work days she anticipates working during the June 1 through 15th pay period (11 days x 5 hours/day = 55 hours x $10 = $550). Sue’s June income is determined by adding the payment she received on June 5 to the payment she expects to receive on June 20. ($200 + $550 = $750). Income in future months will be estimated based on information from Sue and the employer about the amount of pay that is expected.
Example: Starting Unemployment Benefits Elizabeth applies for benefits on April 16. She filed for unemployment benefits last month and received her first unemployment payment on April 13. The caseworker verifies the payments on the Dept of Labor UIB interface, noting that Elizabeth’s UIB ”r;waiting week” was March 25 and she received a $120 payment for only one week on April 13. She will receive another payment on April 27 for $240, representing two benefit weeks. Since the first payment was for only one benefit week due to the waiting week required when benefits begin, for April the caseworker will count $360 unemployment income. For May and beyond, the caseworker anticipates she will get all of the scheduled payments, and will multiply the regular $240 bi-weekly payment by 2.15 to convert it into a monthly income estimate of $516. This amount will be used to determine benefits for subsequent months, unless a change is reported.
Example: Ending Unemployment Benefits Elizabeth reports on June 15 that her unemployment benefits are ending and that she will get her last payment on July 20. It will be for only one week in the amount of $120. She will also get a payment of $240 for two weeks of unemployment benefits on July 6. Since the last payment will be for only one benefit week, for July the caseworker will count $360 unemployment income ($240 + $120 = $360).
Exception: When an individual is paid weekly or bi-weekly and receives a fifth or third payment that covers less than a full payment period, estimate this month’s income by totaling the payments received in the month, dividing this amount by the number of payments to get an average amount, and then multiply the average amount by 4.3 weekly or 2.15 bi-weekly to get an estimated monthly amount.
Example: Exception for Third or Fifth Payment Peggy was laid off from work for the summer. Her last day of work was May 16. She was paid every other week and received $1000 on May 2 (80 hours at $12.50/hour for pay period ending April 25) and $1000 May 16 (for pay period ending May 9). She expects one more check on May 30 for $500 for the 40 hours worked during the pay period ending May 23. The caseworker totals the three checks and divides by three ($1000 + $1000 + $500 = $2500/3 = $833.33) to determine an average payment amount, then multiplies this amount by 2.15 since she is paid every other week ($833.33 x 2.15 = $1791.65). The worker counts $1791.65 earnings for May. No income from this source would be counted in subsequent months. The caseworker must recalculate benefits for June using the amount of anticipated income from other sources, if any.
b. When the individual does not receive all the scheduled payments in the month , total the income already received and anticipated to be received during the month and use this estimated amount for that month. Situations when this may occur include:
The employee is on unpaid leave for an entire pay period due to sickness, temporary lay-off, or vacation;
School district employees have an unpaid holiday break that covers an entire pay period;
UIB "stops" because of ”excess earnings” for two benefit weeks in a row, causing the UIB recipient to miss one or more two-week payment(s).
Example: All Scheduled Pay Checks Not Received Dan reports on December 16 that he will be on unpaid leave for two weeks, December 20 through 31. He normally gets paid every two weeks, but this unpaid leave will cause him to miss one paycheck. For January, he will receive only one two-week paycheck on January 21. The caseworker calculates the January income by counting only the amount anticipated on the January 21 check. For February, the caseworker will estimate a new earned income amount based on regularly scheduled paychecks issued every two weeks.
Example #1: All Unemployment Payments Not Received Jenny is receiving unemployment benefits, but recently got a temporary part-time job. She received her regularly scheduled $200 UIB check on May 7th for the two benefit weeks April 22 and April 29. She was not eligible for unemployment benefits for the next two weeks because of her earnings. She is no longer working and expects to get another $200 UIB check around June 5. Since she only got one unemployment payment in May, the worker counts $200 unemployment income for May and her earnings paid in May. The caseworker must recalculate June benefits based on anticipated income for that month.
Example #2: All Unemployment Payments Not Received Marjie applies for assistance on August 20. She is receiving unemployment benefits of $130 a week, but payments are expected to end next month. According to the DOL system, she was issued $260 on August 10th for benefit weeks ending July 28 and August 4. Her balance remaining is $390. $260 is expected to be issued on August 24, and the remainder in September. The caseworker calculates August income by multiplying the $260 bi-weekly payment by 2.15 ($260 x 2.15 = $559) since both payments covered full payment periods. For September, the caseworker counts only the remaining $130 unemployment income she anticipates receiving ($390-$260=$130) since she will not receive all of the scheduled payments in September. The caseworker must do another estimate for October to remove the unemployment benefit that ends in September.
4. IRREGULAR INCOME
The income is considered irregular when the payments are not made on a regular schedule. An individual may receive income on an irregular or sporadic basis. Examples of irregular income include day labor, on-call work (such as substitute teaching), craft sales, and receipt of child or spousal support. It may also include payments like cash awards or prizes, gifts, and winnings from bingo. Irregular income is counted if the household has already received it in the month or can anticipate receiving it in the month based on the known timing of a payment, or the past history of payments such as child support or craft sales.
The caseworker should thoroughly explore irregular income situations. When the caseworker and the individual can arrive at a reasonable estimate of how much income can be anticipated for the month, that amount of income is included in the estimate. Irregular income that cannot be reasonably anticipated is not included in the estimate of income.
Example: Countable Irregular Child Support Income Terry received multiple child support payments during four of the last six months – two $50 payments in February, two $100 payments in April, one $50 payment in May, and two $100 payments and one $50 payment in July. The caseworker must average the income by totaling all the payments and dividing them over the six-month period the payments were received ($600/6 months). The household received an average payment of $100 a month. The caseworker discusses this with Terry and both agree it would be reasonable to anticipate an average $100 per month.
Example: Countable Irregular Craft Income Aina creates craft items and sells them at a craft store that carries the items on consignment. She receives this self-employment income only after an item is sold. Sales are irregular most of the year; however, sales pick up during the summer tourist season from June to September, and again in November and December. After paying expenses, she normally receives an average of $400 for her craft items during those months. If the period for which the caseworker is determining eligibility includes the months in which sales normally occur based on past sales history, the caseworker would explore anticipated income from the sales and include that amount in the estimate of monthly income to determine benefits. In other months of the year, no income from craft sells would be anticipated.
Example: Irregular Child Support Income That Cannot Be Anticipated: JoLynn applies for assistance in December. She received a child support check in November. Prior to that, the last check she received was in May. She tells the caseworker that she can never predict when the checks will arrive. In this case, payments cannot be reasonably anticipated so no child support income is counted.
Example: Irregular Earned Income That Cannot Be Anticipated: Dave applies for assistance on November 5th. He works on-call for the city shoveling snow during the winter, but has not worked nor received any income in November. Since it cannot be reasonably anticipated when snow will fall, when he will be called into work, or when income from this source will be received, income from this source cannot be included in his estimate of income.
5. SELF-EMPLOYMENT INCOME
For policy on determining self-employment income, see MS 441-1D .
6.VERIFICATION OF INCOME
All countable income available to the household must be verified. Verification obtained must be documented in the Case Notes (CANO). Income can be verified using check stubs, written or oral statements from the source of the income, or data interface information. For self-employment income verification, see MS 441-1D .
Pay stubs are the primary source of verification for earned income. Occasionally pay stubs are not available because the individual may have just started work and have no pay stubs, or may have lost some or all of the stubs. In these circumstances, verification of the individual’s income is obtained from the employer, either by phone or an employment statement completed by the employer.
7. DOCUMENTING HOW THE CASEWORKER DETERMINED MONTHLY INCOME
Good documentation is an essential part of establishing how the household's eligibility was determined. In every situation, the caseworker must document:
Any anticipated changes in the income and what effects, if any, the changes have on the estimate of income.
The source, amount, and frequency (when it is received and how often, i.e., pay period start and end dates and pay dates) of the household’s income, and how this information was verified.
The method used by the caseworker to estimate the monthly income. This must include the reasons certain payments were used or not used in calculating an average payment. This is a key part of documenting self-employment and irregular income where client statements often become part of the verification.
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440 INCOME
To be eligible for assistance, an individual or couple must have countable income that does not exceed the income limits of the APA program. This section explains the income requirements of the APA program. Certain income of ineligible spouses and/or alien sponsors is considered available (deemed) to meet the needs of an individual or couple in determining eligibility for APA . Refer to chapter 460 for the policy on the deeming of income of ineligible spouses and/or alien sponsors.
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441-1 EARNED INCOME
Earned income includes the following types of payments:
441-1 A. WAGES
Wages are what an individual receives (before any deductions) for working as someone else's employee. Wages include salaries, commissions, bonuses, severance pay, and other special payments received because of employment. Wages are counted in the month of receipt.
441-1 B. FLEXIBLE HEALTH BENEFITS
If the employer pays flexible health benefits on behalf of the employee and the employee must use this money to purchase health insurance, only the amount that goes directly to the employee (benefit contribution excess) is counted when determining a household’s gross income. Any amount that the employer pays for mandatory health insurance benefits that the employee does not receive in addition to their regular pay is not counted as income to the employee.
441-1 C. SICK LEAVE
Sick leave is a payment made in place of wages to or for an employee by an employer or a private third party because of sickness or an accident. Sick leave is earned income if the individual receives it within six months after work stopped because of sickness or disability.
Sick leave received more than six months after work stopped are considered to be unearned income.
441-1 D. GARNISHMENTS AGAINST EARNED INCOME
Wages withheld from earned income to satisfy a debt or legal obligation count as earned income. Refer to section 443-1 for the treatment of garnishments against unearned income.
441-1 E. NET EARNINGS FROM SELF-EMPLOYMENT
1. Definition of net self-employment income
Net self-employment income is the gross income from a trade or business less allowable deductions for that trade or business. Allowable deductions are any deductions that are allowed by the Internal Revenue Service, including depreciation. Net self-employment income also includes any profit or loss in a partnership. Self-employment income also includes income received by crew members who are involved in a commercial fishing venture and are paid a share of the profits instead of wages.
2. Determining monthly net self-employment income
Net self-employment income, whether received monthly or less often than monthly, is counted on a taxable year basis. A taxable year is the fiscal year used by the trade or business for IRS purposes.
Net self-employment income is calculated by using the previous tax year's gross self-employment income less allowable deductions to calculate the current tax year's monthly net self-employment income. Allowable deductions can be determined by using a self-employment standard deduction of 50% or actual costs of doing business. Once self-employment income or loss is determined for the entire tax year, the total of these earnings is divided equally by 12 to get the monthly net income.
If, based on subsequent evidence, the case worker decides that the estimate of net self-employment income is inappropriate; he or she will redetermine the net self-employment income for the current tax year.
Allowable costs of doing business are determined using the self-employment standard deduction unless the household chooses to use actual allowable expenses instead. If actual expenses are used, the household must provide verification of the expenses. The caseworker must give the household the choice of using the standard deduction or actual amount of expenses.
a. Using The Self-Employment Standard Deduction as Cost of Doing Business
The self-employment standard deduction is 50% of the estimated gross self-employment income.
Example: Joe is self-employed as a carpenter. His gross self-employment income is $2,000 per month. The allowable costs of doing business is $1,000 ($2,000 x 50%). Joe’s adjusted gross self-employment income is $1,000.
b. Using Actuals as Cost of Doing Business
If the household believes their self-employment expenses are higher than the 50% of their gross self-employment income, they may claim actual expenses as their cost of doing business.
Examples of allowable deductions:
Materials used to produce goods
Maintenance of business property
Space rent
Payroll or wages
Chemicals, fertilizers and supplies used to produce goods or service
Vehicle expenses for business purposes with documentation
Business loans (interest and principal)
Business phone
Banking fees
Depreciation
Examples of deductions not allowed:
Health insurance for the individual and their family
Personal Utilities (no separate meter from home)
Personal phone
Rent or mortgage of our home
Vehicle expenses without documentation
Guaranteed payments
c. Examples Clarifying the use of the Standard Expense Deduction
Below are examples of actions taken using the standard expense deduction.
Example: Actual Expenses Total Less than the Standard Deduction Maria applies for assistance and states she wants to claim actual expenses because she believes they are greater than 50% of her gross income. After receiving verification of her expenses, the caseworker determines her actual expenses are less than the standard deduction. The standard 50% deduction is allowed because it results in a higher benefit to the household. A clear explanation of why the standard deduction was used must be included in the notice to the client and this action documented in the CANO .
Example: Requested Verification Not Provided Brian submitted an application on October 2. He states he wants to claim actual expenses so the caseworker pends the application for verification of these expenses. Brian did not provide proof of his expenses by the requested date. Instead of denying the application, the caseworker works the case and allows the 50% standard deduction. The notice to Brian must explain that the 50% standard deduction was used because he did not provide proof of his expenses by the requested date.
Example: Lack of Business Expenses Carolyn reports she is self-employed as a dog walker. She has no expenses for her business. Since she has no expenses, the self-employment standard deduction is not allowed.
3. Offsetting net loss
If there are net losses from self-employment, these losses are used to offset other earned income only. Net losses from self-employment may not be deducted from unearned income.
Net losses from self-employment are calculated the same way as net self-employment income. The net loss is averaged over the taxable year to get the net loss for each month.
Each month's net loss is then deducted only from other earned income in that month.
4. Verification
Written or verbal verification of self-employment income and expenses is required. Verification may include records showing the history of income and expenses, or documentation for what is expected to be received and spent in the future. Written verification is preferred and includes tax returns or business records. If written verification of self-employment income and expenses is not readily available, verbal verification is acceptable. Verbal verification can be received from collateral contacts or the self-employed individual. Verification of expenses, whether verbal or in writing, must contain enough information for the caseworker to determine allowable expenses. If an expense is not identifiable, the expense is not allowed as a cost of doing business. If the information received is questionable, additional clarification and verification must be sought. See Administrative Procedures Manual section 105-1 C provides policy on when information is considered questionable.
441-1 F. EARNINGS FROM SHELTERED WORKSHOP OR WORK ACTIVITIES CENTER
Payments for services performed in a sheltered workshop or work activities center are what an individual receives for participating in a program designed to help him or her become self-supporting. Payments for such services are earned income.
441-2 UNEARNED INCOME
Unearned income is any income that is not earned. Unearned income includes but is not limited to the following types:
441-2 A. BENEFITS PAID UNDER TITLE II OF THE SOCIAL SECURITY ACT
Retirement, survivors, and disability insurance ( RSDI ) monthly benefits count as unearned income. The amount of any premiums deducted for Supplementary Medical Insurance ( SMI ) under Medicare from RSDI benefits is included in unearned income.
441-2 B. ANNUITIES, PENSIONS, RETIREMENT, OR DISABILITY PAYMENTS
Annuities, pensions, retirement benefits, and disability benefits count as unearned income.
Annuity. An annuity is a sum paid monthly, yearly, or at other specific times in return for the payment of a fixed sum. Annuities may be purchased by an individual or an employer.
Pensions and retirement benefits. Pensions and retirement benefits are payments to a worker following his or her retirement from employment. These payments may be paid directly by a former employer, a trust fund, an insurance company, or other entity.
Disability benefits . Disability benefits are payments made because of injury or other disability. Disability benefits are unearned income, except that certain accident disability benefits paid within 6 months after the month an employee last worked are earned income. (See manual section 441-1C .)
441-2 C. DEPARTMENT OF VETERANS AFFAIRS PAYMENTS
1. Needs based VS not Needs based
The Department of Veteran Affairs ( VA ) compensation payments are based on a service-connected disability or death. VA compensation payments may or may not be based on need. VA compensation payments are countable unearned income. If they are needs based, the $20 general income exclusion does not apply.
Needs Based:
Parents Dependency and Indemnity Compensation (Parents DIC )
Not Needs Based:
Dependency and Indemnity Compensation ( DIC )
Disability Compensation
Surviving Spouse DIC
Surviving Child DIC
Special Monthly Compensation (also known as aid and attendance) is not countable income.
If the veteran or their spouse is receiving extra compensation designated for the veteran's dependent, the augmented portion of the payment that is designated for the dependent is not countable income. An augmented benefit is an increase in the benefit payment to a veteran or a veteran's surviving spouse because of a dependent. We do not count the dependent's portion of the benefit as income to the veteran or the veterans surviving spouse. The dependent's portion is income to the dependent.
All VA Pension payments are countable income (except for the Medal of Honor Pension). If they are needs based, the $20 general income exclusion does not apply.
Needs Based:
Improved Disability Pension
Surviving Spouse Improved Death Pension
Surviving Child Improved Death Pension
Not Needs Based:
Special Act of Congress Pension
Medal of Honor pension (not countable income)
2. EDUCATIONAL PAYMENTS:
The VA provides educational assistance under a number of different programs, including vocational rehabilitation. Depending on the nature of the VA program, different income and resources policies apply. Payments are usually made on a monthly basis only for months in which the veteran is in school. However, if school attendance is less than half time, the payments may be made less frequently. Dependents and survivors of veterans may also be eligible for educational assistance. Some programs are "contributory." That is, the money is contributed by the active service-person to an educational fund and the government matches the money when it is withdrawn while the veteran is pursuing an education. The portion of funds contributed by a veteran are treated as an available resource because the veteran has the right to withdraw this contribution at any time.
Any VA educational benefit payment, or portion of such payment, which is funded by the government, and is not part of a program of vocational rehabilitation, is unearned income for APA purposes. Payments made as part of a VA program of vocational rehabilitation are not income.
Any portion of a VA educational benefit payment which is a withdrawal of the veteran's own contribution is a conversion of resource and is not income. Because of this, only that portion of an educational payment which is income to the individual obtaining the education is subject to the income exclusion for educational expenses. (Refer to manual section 442-3A(7)(b).
Any portion of a VA educational benefit payment that is augmented for a dependent is counted as income to the dependent if the dependent is living with the veteran. If the dependent is not living with the veteran, the augmented portion is disregarded as income to both the veteran and the dependent. However, if the veteran gives any portion of the augmented benefit payment to the absent dependent, that portion is counted as income to the dependent.
Verification. A VA check, award letter, or other documentation in the individuals possession may be used to verify VA benefit amounts. IN the absence of such proof, the case worker MUST contact the VA to obtain the information.
3. VA CLOTHING ALLOWANCE
A VA clothing allowance related to the use of prosthetic or orthopedic appliance is not income. This type of payment is considered as cash received in conjunction with medical and social services from a governmental or private agency. (Refer to manual section 440-3B )
Verification. Accept the individual's allegation concerning a VA clothing allowance received by a veteran who uses a prosthetic or orthopedic appliance.
4. VA PAYMENT ADJUSTMENT FOR UNUSUAL MEDICAL EXPENSES
Any increase in a needs-based VA compensation or pension payment which is the direct result of unusual medical expenses is not counted as income.
Verification. A VA check, award letter, or other documentation in the individual's possession may be used to verify VA benefit amounts. In the absence of such proof, the case worker MUST contact the VA to obtain the information.
441-2 D. INCOME BASED ON NEED
Needs-based income received by an eligible individual or couple (or by an alien sponsor) is counted as unearned income. However, needs-based income received by an ineligible spouse (except for SSI benefits, or income taken into account in determining eligibility for and the amount of SSI benefits) is excluded from the eligible individual's income. (Refer to section 460-6 for the policy on this exclusion for ineligible spouses).
Needs-based income is income that is:
Funded either wholly or partially by the Federal government or by a private non-governmental agency, such as the Salvation Army or Catholic Charities, and
Provided under a program which uses income as a factor of eligibility.
Programs that provide needs-based income include Bureau of Indian Affairs General Assistance ( BIA GA ), most Veteran's Administration ( VA ) pensions, Refugee Cash Assistance and Supplemental Security Income ( SSI ) payments. (Refer to Administrative Procedures Manual section 128-4 for more information about Refugee Assistance.)
Note: Refugee Cash Assistance payments are budgeted like Alaska Temporary Assistance payments. Please see section 452-10 for budgeting information.
The $20 general income exclusion does not apply to needs-based income.
Needs-based income is not the same as needs-based assistance . Certain needs-based assistance is excluded from income; needs-based income is not. (See section 442-3B for policy on the needs-based assistance income exclusion.)
441-2 E. WORKERS' COMPENSATION PAYMENTS
Workers' Compensation payments are awarded to an injured employee or to the employee's survivors because of a job-related injury are counted as unearned income. However, any portion of a Workers' Compensation award designated by the payor for medical expenses or legal or other expenses of obtaining the award is not income. To be disregarded as income, the portion designated for medical, legal, or other expenses must be verified by the payor.
441-2 F. UNEMPLOYMENT INSURANCE BENEFITS
Unemployment insurance benefits are counted as unearned income. Unemployment insurance benefits, also known as unemployment compensation, means payments received under a state or federal unemployment law, as well as additional amounts paid by unions or employers as unemployment benefits.
441-2 G. DEATH BENEFITS
A death benefit is payment received as the result of another's death. Examples of death benefits include: proceeds of life insurance policies, lump sum death benefits from SSA , Railroad Retirement burial benefits, inheritances, and cash gifts from relatives, friends, or community groups to "help out" with expenses related to death. Recurring survivor benefits, such as those received from SSA or from a private pension, are not death benefits.
Death benefits are income to an APA applicant or recipient to the extent that the total amount received by the applicant or recipient exceeds the amount paid, or obligated to be paid, by the applicant or recipient toward the deceased person's last illness and burial.
Last illness and burial expenses include: related hospital and medical expenses, funeral, burial plot, interment expenses, and other expenses related to last illness and burial. Other expenses may include such items as: new clothing to wear to the funeral; food for visiting relatives; taxi fare to and from the hospital or funeral home; etc.
To determine the amount of income derived from death benefits, the total expenses are subtracted from the total death benefits. The countable portion of a death benefit is income in the month it is received. If death benefits are received in more than one month, the case worker will assume that the funds first received are the first spent. For example, if death benefits of $1000 are received in January, and another $1000 is received in February, and the allowable expenses are $1500, $500 is counted as income in February.
Verification . Verify all last illness and burial expenses. Such verification may include: bills, receipts, contact with the provider, etc. If verification cannot be obtained, the case worker may accept a signed statement from the individual. If an expense has been incurred but not yet paid, the case worker will assume that the individual will pay the expense unless there is reason to question the situation.
441-2 H. AWARDS
An award is usually something received as the result of a court decision, board of arbitration, settlement of a civil issue, etc., and is counted as unearned income in the month of receipt.
In some cases, some or all of an award may not count as income. For example, the portion of an award that is a reimbursement for medical or other expenses incurred in getting the award or for the legal cost of obtaining the award is not counted as income. Such expenses are deducted from the first and from any following payments until the expense is completely offset against the income.
Note: The case worker must notify the Division of Health Care Services ( DHCS ), Third Party Liability ( TPL ) Unit at doh.hcs.rec.info@alaska.gov whenever he or she becomes aware of an award which includes reimbursement for a medical expense which may have been paid for by Alaska's Medicaid program.
Verification. It is the client's responsibility to provide proof of the amount of an award. Acceptable proof may consist of documents from the court or source of the award which show the amount of the award, the date it was paid, and the purpose of the award.
441-2 I. CASH GIFTS
A cash gift is considered as countable unearned income.
A cash gift is cash that a person receives that is not a repayment for goods or services the person provided and is not given because of a legal obligation on the giver's part. To be a gift, the cash must be given irrevocably (the giver relinquishes all control). Donations and contributions may meet the definition of a gift.
Small cash gifts may be excluded as infrequent/irregular income. (Refer to section 442-1A for the policy on this income exclusion.)
Verification. If questionable, the amount of a cash gift must be verified. Acceptable proof of a cash gift may consist of a check stub, deposit slip, written statement from the giver, or other documentary evidence that verifies the amount of the gift. A collateral contact with the giver is also acceptable.
441-2 J. PRIZES
A prize is something won in a contest, lottery, or game of chance such as bingo winnings or pull tabs. Cash prizes are unearned income in the month of receipt. Gambling losses are not subtracted from gambling winnings when determining an individual's countable income.
Prizes such as bingo winnings or pull tabs are not anticipated when determining eligibility or payment amount. Only income that can reasonably be expected to be received is counted when anticipating income. Since bingo or pull-tabs are a game of chance, winnings cannot reasonably be anticipated, even if the individual has a previous pattern of winning.
Prize income is only counted after it is received. For example, bingo winnings that an applicant reports receiving in an application month will count in determining APA eligibility and payment for that month.
Small cash prizes may be excluded as infrequent/irregular income. (Refer to section 442-1A for the policy on this income exclusion.)
Verification. It is the client's responsibility to provide proof of income from prizes. Acceptable proof may consist of a prize receipt, letter, or oral or written statement from the source of the prize. If proof is not available from the source of the prize, a statement from the client which specifies the amount and date received is acceptable.
441-2 K. INHERITANCE
An inheritance is cash or any other type of asset that is received as the result of someone's death. An inheritance that is received in the form of cash, or any other liquid asset that can readily be converted to cash, is considered as unearned income.
An inheritance that is received in the form of real or personal property is considered as in-kind support and maintenance, and is not counted as income. Unless otherwise excluded, an inheritance is subject to evaluation as a resource the month after it is received.
441-2 L. SUPPORT AND ALIMONY PAYMENTS
Support and alimony payments received by an individual, or by someone acting on the individual's behalf, which are provided to meet the individual's own needs are counted as unearned income to the individual. Support and alimony payments, which are provided for the support and care of another person are not income to the individual, unless the individual uses the money for his or her own needs.
Verification. Support and alimony payments may be verified by viewing a divorce decree, support order, money order, check, or any other documentation in the individual's possession. Unless there is reason to question the situation, the case worker may presume that support and alimony payments provided for the support and care of an individual are being used by or for that individual.
Exception: Child support income is a benefit for the child not the APA recipient and not countable income if the child is in the home. If the applicant or recipient keeps child support for a child who is no longer in the home and uses the money, it is counted as income to the APA client.
There is a limited income exclusion for child support payments received by or for an individual who is eligible for SSI or APA . This exclusion does not apply to alimony payments. Refer to section 442-3I for an explanation of this limited income exclusion.
441-2 M. RENTAL INCOME
Net rental income counts as unearned income unless it is earned income from self-employment (that is, the recipient is actively involved in the business of renting properties).
Rental deposits are not income to the landlord if they are subject to return to the tenant. Rental deposits used to pay rental expenses become income to the landlord at the point of use.
Rent. Rent is a payment which an individual receives for the use of real or personal property, such as land, housing, machinery, or fishing permits.
Net rental income. Net rental income is gross rent less the ordinary and necessary expenses paid in the same taxable year. Deduct expenses when they are paid, not when incurred.
Ordinary and necessary expenses. Ordinary and necessary expenses are those necessary for the production or collection of rental income. In general, these expenses include:
interest and escrow portions of a mortgage payment on the rental property (at the point the payment is made to the mortgage holder);
real estate insurance;
property taxes;
expenses of managing or maintaining property, such as repairs, lawn care, snow removal, and advertising for tenants; and
the cost of attorney or other agent services needed to collect rents.
Ordinary and necessary expenses do not include: tax depreciation or depletion of property; the principal portion of a mortgage payment; capital expenditures such as an expense for an addition or increase in the value of property.
Verification. Use documents in the individual's possession (bills, receipts, etc.) to verify the rent and the dates received, and the expenses and dates paid. The individual's most recent tax return, including Schedule E, may be helpful in identifying past expenses and in estimating future rental income.
Note: Income received from the lease of a limited entry fishing permit is considered unearned rental income.
441-2 N. HOME OWNER INCOME FROM ROOM RENTAL
When a client receives income from renting a room out in their own home, determine countable income by prorating allowable expenses based on the number of rooms designated for rent compared to the number of rooms in the house. Do not include bathrooms. Do include basements and attics if they have been converted to living spaces.
Allowable expenses:
interest and escrow portions of a mortgage payment (at the point the payment is made to the mortgage holder); real estate insurance; repairs (i.e., minor correction to an existing structure); property taxes; lawn care; snow removal; advertising for tenants; and utilities.
Expenses not allowed:
principle portion of a mortgage payment; and
capital expenditures (i.e., an expense for an addition or increase in value of property which is subject to depreciation for income tax purposes.
Example: Ozzie owns his own home. He rents a room to Abbie for $400 per month. His house has 3 bedrooms, 2 bathrooms, 1 kitchen, 1 living room and 1 converted basement for a total of 6 rooms (not including the bathroom). Ozzie's countable mortgage payment is $937.00 and his utilities (water, electricity, and gas) average $450 per month. Total household expenses are $1387 per month. Rental Income $400.00 Allowable expenses $1387/6 -$231.17 Total countable income $168.83
441-2 O. ROYALTIES
Royalties are payments to the holder of a copyright or patent. Royalties may also be paid to the owner of a mine, oil well, timber tract, or other resource, for the extraction of a product. Royalty payments are unearned income unless they are received in connection with any publication of an individual's own work, or they are received as part of a trade or business, in which case they are treated as earned self-employment income.
Verification. Royalty payments may be verified by viewing any receipts or royalty agreements in the individual's possession which indicate the amount and frequency of the royalty payments. If this documentation is not available, the individual is responsible for providing proof of the royalty payments from the company or source of the royalty payment.
441-2 P. DEPOSITS MADE TO A JOINT ACCOUNT
An APA applicant or recipient may sometimes own a joint bank account with other individual(s) whose income and resources are not considered available (deemed) to meet the needs of the applicant or recipient. The entire amount of deposits made to the joint account by the other individual(s) are income to the applicant or recipient.
The only exception to this rule is that if each owner of a joint account is eligible for SSI or APA , deposits made to the joint account by one account owner are not income to the other account owner(s). This exception does not apply to situations where the other joint owner receives another type of assistance such as Temporary Assistance.
An APA applicant or recipient who is an owner of a joint account may argue that some or all of the funds deposited to the joint account do not belong to him or her. To establish non-ownership of the funds, the APA client must:
Provide a written statement that explains why some or all of the funds in the account do not belong to him or her. If the client indicates that only some of the funds do not belong to him or her, the client must specify what portion of the funds are not his or hers; and
Provide a corroborating statement from the other account owner(s). If the other owner(s) of the account is (are) not competent to provide such a statement, a statement from a third party who is familiar with the situation is acceptable; and
Change the account designation to either remove the individual's name from the account, or show that the owner(s) have restricted access to the account.
Once all three of these things are done, any funds determined to be owned by the other account holder(s), and that the individual can no longer withdraw from the account, were not and are not counted as income to the individual. When this happens, the case worker shall redetermine APA eligibility and benefit amounts for any affected months.
Interest earnings are counted as unearned income to the applicant or recipient in proportion to the percentage of funds that are considered to be a resource to the applicant or recipient.
This policy does not affect the treatment of the funds in a joint account as a resource. Refer to section 431-2A for the resource policy on joint accounts.
441-2 Q. RETROACTIVE PAYMENTS
Except for retroactive SSI and SSA Retirement, Survivors, and Disability Insurance ( RSDI ) benefits, retroactive benefit payments are counted as income in the month of receipt. Examples of retroactive benefit payments that are considered countable income the month they are received include: Retroactive Unemployment Insurance benefits, retroactive VA benefits, etc. Refer to section 440-2 for the income counting policy on retroactive SSI and RSDI benefits.
441 COUNTABLE INCOME
This chapter describes types of income that are counted when determining income eligibility for the APA program. Certain income and resources of spouses and/or alien sponsors is considered available (deemed) to meet the needs of an individual or couple in determining eligibility for APA . Refer to chapter 460 for the policy on the deeming of income and resources of spouses and/or alien sponsors.
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442-1 INCOME EXCLUSIONS WHICH APPLY TO BOTH
Some income exclusions apply only to earned income, some apply only to unearned income, and a few apply to both earned and unearned income. The following income exclusions apply to both earned and unearned income. Income exclusions that apply to both earned and unearned income are applied first to unearned income and then to earned income.
442-1 A. INFREQUENT/IRREGULAR INCOME
Infrequent or irregular income is excluded when the amount received does not exceed $30 per calendar quarter for earned income and $60 per calendar quarter for unearned income. This exclusion may be applied to both earned and unearned income in the same month if the total of each does not exceed the limits above. Thus, it is possible to exclude as much as $90 per calendar quarter under this provision.
For this exclusion to apply, income must be either infrequent or irregular.
Infrequent. An individual receives infrequent income if he or she receives it no more than once in a calendar quarter from a single source. An example of infrequent income is quarterly interest income posted to a savings account.
Irregular. An individual receives irregular income if he or she could not reasonably expect to receive it. Examples of irregular income include small cash gifts or income from a one-time job such as shoveling snow.
Note: Do not confuse this exclusion with the $20 per month general income exclusion. This exclusion is applied before and in addition to the $20 per month general income exclusion.
442-1 B. $20 PER MONTH GENERAL INCOME EXCLUSION
The first $20 per month of any unearned income that an individual or couple receives, other than income based on need, is excluded from income. The $20 per month general income exclusion is not allowed against needs-based income.
The $20 general income exclusion is applied first to unearned income and then to earned income. If an individual or couple has less than $20 of non needs-based unearned income and has earned income, any part of the $20 exclusion not applied against unearned income is applied to the earned income. If the individual or couple has only earned income, or a combination of earned income and needs-based unearned income, the entire $20 exclusion is applied to the earned income.
The $20 general income exclusion is applied only once to a couple, even when both members have income, because the couple's income is combined in determining APA eligibility and payment.
Note: The $20 per month general income exclusion is not allowed in determining nursing home eligibility under the Long Term Care (300%) provision. It is not allowed in completing the post-eligibility Medicaid cost of care calculation.
442-1 C. AMOUNT TO FULFILL A PLAN FOR ACHIEVING SELF-SUPPORT
Any earned or unearned income of a blind or disabled recipient that the recipient needs to fulfill a plan for achieving self-support is excluded from income. To allow this exclusion, the Social Security Administration or the Division of Vocational Rehabilitation must approve any plan for achieving self-support and specify what amount of income is to be excluded.
Verification. Documentation from either the Social Security Administration or the Division of Vocational Rehabilitation shall be used to verify the amount of income to be set aside as part of a plan to achieve self-support. In the absence of such documentation, a collateral contact with the agency involved is acceptable.
442-2 EARNED INCOME EXCLUSIONS
Some earned income is excluded when determining income eligibility for the APA program. Earned income exclusions never reduce earned income to less than zero. Unused earned income exclusions are never applied to unearned income.
Earned income exclusions are applied in the order in which they are listed in this section.
442-2 A. EARNED INCOME EXCLUSIONS AUTHORIZED BY FEDERAL LAWS
Income exclusions specifically authorized by federal laws are excluded from income. Refer to section 442-3A for a listing of these exclusions.
442-2 B. EARNED INCOME TAX CREDIT AND CHILD TAX CREDIT PAYMENTS
The Earned Income Tax Credit ( EITC ) is a special tax credit which reduces the federal tax liability of certain low income working taxpayers. This tax credit sometimes results in a payment to the taxpayer. EITC payments can be received as a payroll advance from an employer or as an end-of-the-year income tax refund.
The Child Tax Credit is a special refundable federal tax credit that is available to certain low income taxpayers with earned income. This Child Tax Credit may provide a refund to individuals even if they do not owe any tax. There is no advance payment with the Child Tax Credit
Any EITC or Child Tax Credit payments received either as an advance or as a tax refund are excluded from income, regardless of the tax year involved.
Verification. An individual's paycheck stub or a copy of the individual's income tax return may be used to verify the amount of an EITC or Child Tax Credit payment.
442-2 C. INFREQUENT/IRREGULAR EARNED INCOME
Up to $30 of earned income in a calendar quarter may be excluded if it is infrequent or irregular. (See section 442-1A for policy on the infrequent/irregular income exclusion.)
442-2 D. STUDENT EARNED INCOME EXCLUSION
The earned income of a blind or disabled student is excluded subject to monthly and yearly maximums. Earned income that exceeds the maximum limits is not excluded. The monthly and yearly limits are shown in Addendum 1 . These amounts are updated every year.
For the purposes of this exclusion, the student must be under the age of 22 and regularly attending school, college, or training that is designed to prepare him or her for a paying job. Regular school attendance means the individual takes one or more courses of study and attends classes:
At least 8 hours a week in a college or university; or
At least 12 hours a week in grades 7 - 12; or
At least 15 hours a week in a course of training to prepare the individual for a paying job if the course involves shop practice; or
At least 12 hours a week in a course of training to prepare the individual for a paying job if the course does not involve shop practice.
School attendance of less than the hours listed above may be allowed if the reason for the shorter hours is beyond the student's control (such as an illness) and the circumstances justify the reduced credit load and attendance. An individual is considered to be attending school during school vacations if he or she intends to return to school once the school vacation ends.
Verification. School attendance may be verified by viewing documents in the individual's possession such as a school ID card, tuition receipt, or any other school records that indicate enrollment and hours of attendance. If either enrollment or hours of attendance are questionable, verification from the school or agency providing the training is required before this exclusion is allowed.
442-2 E. $20 PER MONTH GENERAL INCOME EXCLUSION
Any portion of the $20 general income exclusion which has not been excluded from unearned income in the same month is excluded from earned income. The $20 per month general income exclusion is allowed only once to a couple, even when both members have earned income, because the couple's earned income is combined in determining APA payments. (See section 442-1B for the policy on the $20 per month general income exclusion.)
442-2 F. $65 EARNED INCOME EXCLUSION
$65 per month of any earned income is excluded from the gross amount of any remaining earned income. The $65 earned income exclusion is allowed only once to a couple, even when both members have earned income, because the couple's earned income is combined in determining APA payments.
442-2 G. IMPAIRMENT RELATED WORK EXPENSES FOR DISABLED
Any earned income that a disabled individual uses to pay for impairment-related work expenses is excluded from income. Impairment-related work expenses are any reasonable expenses for items or services that are necessary for the disabled individual to work, and that are directly related to the individual's impairment.
Note: An individual over 65 can qualify for an IRWE if they received SSI or APA the month before turning 65.
Items that may qualify for this exclusion include but are not limited to:
Transportation to and from work if special transportation is needed because of the impairment;
Vehicle modifications;
Attendant care services which are necessary to prepare the disabled individual for work, or which are necessary in the workplace; and
Medical devices such as a wheelchair, respirator, pacemaker, inhalers, or braces;
Any other medical or nonmedical equipment or supplies which are necessary for the disabled individual to work, and are directly related to the individual's impairment.
Verification. All impairment-related work expenses must be verified before this exclusion may be allowed. Acceptable sources of verification include copies of bills and receipts, or other documentation which verifies the amount of the expense.
442-2 H. ONE-HALF OF REMAINING EARNED INCOME
One-half of any earned income is excluded from the gross amount of any remaining earned income.
442-2 I. WORK EXPENSES FOR THE BLIND
Any earned income that a blind individual uses to meet work expenses is excluded from income.
The blind work expense income exclusion is different from the impairment-related work expense income exclusion. For an impairment-related work expense to be allowed as an income exclusion, the expense must be directly related to the disabled individual's impairment and must be necessary for the individual to work. The blind work expense income exclusion is allowed for any work expense, whether or not the expense is directly related to the individual's blindness.
Note: Any individual over 65 can qualify for a work expense for the blind if they received SSI or APA the month before turning 65.
Items that may qualify for this exclusion include but are not limited to:
All items allowed under the impairment-related work expenses exclusion;
Note: If an individual uses his or her own vehicle for transportation to and from work, the blind work expense exclusion allows the business mileage rate permitted by the Internal Revenue Service. Go to https://www.irs.gov/tax-professionals/standard-mileage-rates for current standard mileage rates. The actual cost of transportation is allowed if the individual uses other than his or her own vehicle.
The amount paid for business licenses, professional association dues, or union dues;
Federal, state, and local income taxes withheld from earned income;
Mandatory pension contributions withheld from earnings by the employer; and
The value of meals consumed during work hours.
Verification. All work expenses for the blind must be verified before this exclusion may be allowed. Acceptable sources of verification include copies of bills and receipts, or other documentation which verifies the amount of the work expense.
442-2 J. AMOUNT TO FULFILL A PLAN FOR ACHIEVING SELF-SUPPORT
Any earned income used to fulfill an approved plan to achieve self-support is excluded from income. (See section 442-1C for the policy on this income exclusion.)
442-3 UNEARNED INCOME EXCLUSIONS
The following income exclusions apply only to unearned income.
442-3 A. INCOME EXCLUSIONS AUTHORIZED BY FEDERAL LAWS
1. Volunteer Service Payments
Any assistance, except any payments (salary, wages, stipends or reimbursements) paid to volunteers under the Senior Corps and AmeriCorps programs of the Corporation for National and Community Service (CNCS) are exempt income.
Senior Corps includes Foster Grandparents, the Senior Companion Program, and RSVP (Retired and Senior Volunteer Corps).
AmeriCorps programs include AmeriCorps*State and National, AmeriCorps*Vista, and AmeriCorps*NCCC (National Civilian Community Corps).
Volunteer status and participation in an exempt program must be verified.
2. Remuneration for out-of-Pocket expenses
Remuneration for out-of-pocket expenses to people who are volunteers in the Corps of Retired Executives ( CORE ), or in the Active Corps of Executives ( ACE ), is excluded from income.
3. Certain assistance provided under the Older Americans Act
Except wages or salaries, any assistance provided under Title V of the Older American Act is excluded from income. This includes MASST stipends, meals, job training, caregiver support, transportation and more.
Wages or salaries paid under Title V of the Older Americans Act are counted as earned income.
4. Federal housing assistance
The value of any assistance paid with respect to a dwelling unit is excluded from income and resources if paid under the United States Housing Act of 1937, the National Housing Act, Section 101 of the Housing and Urban Development Act of 1965, or Title V of the Housing Act of 1949.
The federal government, through the Office of Housing and Urban Development ( HUD ) and the Farmers Home Administration ( FmHA ) provides many forms of housing assistance. This assistance may include subsidized housing, loans for renovations, mortgage and investment insurance, guaranteed loans and mortgages, and loans for construction, improvement, or replacement of farm homes and other buildings. This assistance may be provided directly by the federal government or through other entities such as local housing authorities and non-profit organizations.
Any housing assistance in which HUD or FMHA is involved is subject to this exclusion. In Alaska, housing assistance which qualifies for this exclusion include: housing assistance provided by the Alaska State Housing Authority (ASHA), Section 8 housing assistance, and housing assistance in rural areas provided by various Native housing authorities.
5. Federal relocation assistance payments
Relocation assistance provided under the Uniform Relocation Assistance and Real Property Acquisition Act of 1970 is excluded from income.
This exclusion applies to relocation assistance provided to persons displaced by any federal or federally assisted project. Relocation assistance may be furnished directly by a project or through an agency, such as a housing authority, designated for the purpose of providing relocation assistance.
(Refer to section 442-3A(6) below for policy on the treatment of relocation assistance provided by a state or political subdivision for a project that does not have any federal involvement.)
Interest earned on unspent relocation assistance payments is not excluded from either income or resources.
Verification . To be excluded from income under this provision the individual must submit evidence which shows that the payment is relocation assistance. Acceptable evidence includes: • a letter or check stub that indicates the reason for the payment; or • any other document that indicates the reason for the payment; or • a collateral contact with the federal project or agency that issued the relocation assistance payment.
6. State or local relocation assistance payments
Relocation assistance provided by a state or local government for a project that does not have any federal involvement is excluded from income under Public Law 101-508. This exclusion applies to relocation assistance provided to persons displaced by any state, local, or state-assisted or locally-assisted project
Interest earned on unspent relocation assistance payments is not excluded from either income or resources.
Verification . To be excluded from income under this provision, evidence must be submitted which shows that the payment is relocation assistance. Acceptable evidence includes: • a letter or check stub that indicates the reason for the payment; or • any other document that indicates the reason for the payment; or • a collateral contact with the state or local agency that issued the relocation assistance payment.
7. Education Assistance
(a) Title IV Higher Education Act and Bureau of Indian Affairs Grants and Awards
The total amount of any grant, scholarship, or award issued under any program funded under the Title IV of the Higher Education Act or under a Bureau of Indian Affairs student assistance program is not counted as income in determining eligibility or benefit amount.
Payments that fit this category include:
Pell Grants
State Student Incentive Grants (SIG)
Academic Achievement Incentive Scholarships
Byrd Scholars
Federal Supplemental Educational Opportunities Grants (FSEOG)
Federal Educational Loans (Federal PLUS Loans, Perkins Loans, Stafford Loans, Ford Loans, etc.)
Upward Bound
Gear Up (Gaining Early Awareness and Readiness for Undergraduate Programs)
LEAP (Leveraging Educational Assistance Partnership)
SLEAP (Special Leveraging Educational Assistance Partnership)
Work-Study Programs
Verify that the source of the education assistance is Title IV or BIA by viewing the individual’s award letter. Contact the awarding institution if the award letter is not available or is unclear.
(b) Other Education Assistance
Education assistance that is not funded under Title IV of the Higher Education Act or the Bureau of Indian Affairs student assistance program funds is excluded as income if it is used or will be used for paying tuition, fees, or other necessary education expenses at any educational institution, including vocational, technical, and correspondence schools, and schools for people with disabilities.
Any portion of education assistance that will not be used or set aside for paying tuition, fees, or other necessary education expenses is countable unearned income.
(c) Budgeting Countable Education Income
Total all countable education assistance. Do not add any other type of earned or unearned income unless it is received specifically because of the student's status and is intended to pay education-related expenses.
Subtract from the above the costs for tuition and fees charged by the school.
Subtract the costs for books, school supplies, and any special clothing, tools, or other expenses of the student that are related to the cost of attending school.
Subtract costs for childcare necessary for the student to attend school.
Subtract costs for transportation (actual costs, such as bus pass or parking fees, or business mileage rate permitted by the Internal Revenue Service. Go to http://www.irs.gov/taxpros/article/0,,id=156624,00.html for current standard mileage rates.)
Count the remaining amount as income in the month the assistance is received.
Any amount of money retained after the month of receipt is evaluated as a resource under manual section 432-4K(2) .
8. Alaska Native Claims Settlement Act ( ANCSA ) payments
The Alaska Native Claims Settlement Act ( ANCSA ) excludes the following items from the income of an Alaska Native, or from the income of a descendant of an Alaska Native:
(a) Alaska Native Fund distributions.
Distributions from the original Alaska Native Fund are excluded from income regardless of the amount distributed.
(b) Stock.
Any stock issued or distributed by an ANCSA corporation (including stock issued as a dividend or distribution on stock) is excluded from income.
(c) Partnership Interests.
A partnership interest received from an ANCSA corporation is excluded from income. However, income received as a result of a partnership interest is treated as a cash distribution. (See (f) below.)
(d) Land.
Any land or any interest in land received from an ANCSA corporation (including land received as a dividend or distribution on stock) is excluded from income. This includes land or any interest in land inherited by a descendant.
(e) Payments from a settlement trust.
Any interest in a settlement trust received from an ANCSA corporation is excluded from resources. Payments from a settlement trust are treated as countable income. If the payment is made as part of a cash distribution, the first $2,000 per individual per calendar year may be excluded under (f) below.
Note: The 2017 Tax Cuts Jobs Act allowed Alaska Native Corporations to place assets in a settlement trust on effectively pre-tax basis. Payments from the settlement trusts are treated the same as other cash payments from an Alaska Native Corporation. See MS 442-3(A)(8)(f) .
(f) Cash distributions.
For the purpose of this exclusion, cash distributions are distributions that are made to a class of individuals, such as all shareholders, or all elders. Cash distributions do not include cash payments that are made to individuals or households for a specific purpose such as wages, a door prize, or a general assistance payment from the corporation.
Cash distributions (including cash dividends on stock) are excluded from income to the extent that the distributions do not exceed $2,000 per individual per calendar year. When an individual receives more than $2,000 from all ANCSA corporations in a single calendar year, any amounts exceeding $2,000 are considered countable income in the month of receipt.
Income received by an individual applicant or recipient as a result of his or her own investment or deposit of ANCSA payments is not excluded from income.
Note: The Alaska Native Settlement Trust Eligibility Act (HR 42) excludes certain payments from a settlement trust to an aged, blind, or disabled Alaskan Native or descendant of an Alaskan Native from being used to determine the individual's eligibility for need-base federal programs. This exclusion applies for a five year period beginning on the date the law was enacted July 7, 2025 through July 6, 2030. ANCSA payments are excluded from income the month of receipt and as a resource if retained the following month.
9. Other exclusions of payments to Indians
For APA and SSI purposes, various federal statutes provide for the exclusion of certain payments made to members of Indian tribes and groups. Some statutes pertain to specific tribes or Indian groups while others apply to certain types of funds. The following types of payments made to Indian tribes and groups are excluded from both income and resources:
Per capita distribution payments by the Blackfeet and Gros Ventre tribal governments to members, which resulted from judgment funds to tribes, are excluded under Public Law 92-254.
Per capita distribution payments by the Secretary of the Interior or by the Indian tribe itself to members of Indian tribes who were due judgment funds are excluded under Public law 93-134. This does not include payments of funds distributed or held in trust according to public laws enacted before October 19, 1973.
Receipts derived from certain trust lands and distributed to members of designated Indian tribes are excluded under Public Law 94-114. These lands, mineral rights, and receipts are excluded from income and resources, unless they were subject to the Mineral Leasing Act of 1920 and distributed before October 17, 1975.
These Indian trust lands are all located in the lower 48 states in the states of Idaho, Michigan, Montana, New Mexico, Oklahoma, North Dakota, South Dakota, and Wisconsin. A list of lands conveyed to Indian tribes under Public Law 94-114 is maintained at DPA Central Office. If a case worker becomes aware of funds that may be derived from this source, he or she must contact the APA Policy Specialist for specific directions on the treatment of these funds.
Per capita payments made to, or held in trust for, members of the Grand River Band of Ottowa Indians are excluded under Public Law 94-540.
Judgment funds, including interest and investment income which accrued on Indian judgment funds while held in trust, and initial purchases made with distributed judgment funds, are excluded under Public Law 97-458.
Per capita distributions of funds held in trust by the Secretary of the Interior to members of an Indian Tribe are excluded under Public Law 98-64. These per capita payments may be distributed by the Secretary of the Interior or by the tribe itself. In Alaska, distributions of this type have been made by the Metlakatla Indian Community.
All money and lands transferred to the members of the Puyallup Tribes under the Puyallup Tribe of Indians Settlement Act of 1989 are excluded under Public Law 101-41.
10. World War II restitution payments
Any restitution payments made by the U.S. Government to individual Japanese-Americans and to Aleuts (or, if deceased, payments made to their survivors) who were interned or relocated during World War II are excluded from income under Public Law 100-383. Qualifying Japanese-Americans are eligible for a $20,000 payment. Qualifying Aleut-Americans are eligible for a $12,000 payment.
Restitution payments paid to individual Japanese-Canadians who were interned or relocated during World War II by the Canadian Government are also excluded from income.
This income exclusion also applies to any funds received as a result of the investment or deposit of a restitution payment to eligible Aleuts.
However, any payments subsequently received from a trust established by the Secretary of the Interior and appropriated for Aleut residents are counted as income. The trustees may use these trust funds for the benefit of the elderly, disabled, seriously ill, students in need of scholarships, the preservation of Aleut cultural heritage and historical records, the improvement of community centers in affected Aleut villages and other purposes to improve conditions of Aleut life.
Verification. DPA Central Office maintains a list of individuals who have received Aleut restitution payments. The case worker may contact the APA Policy Specialist to verify an individual's receipt of Aleut restitution payments. Documents in the client's possession may be used to verify Japanese-American or Japanese-Canadian payments.
11. Agent Orange settlement payments
Agent Orange settlement payments are excluded from income under Public Laws 101-201 and 101-239. Agent Orange settlement payments began in March 1989 and ended in 1994. Qualifying veterans received at least one payment a year for the life of the program. Qualifying survivors of deceased veterans received a single lump sum payment. VA disability payments for disease attributed to Agent Orange exposure are not exempt. These payments are treated the same as other VA disability payments.
This income exclusion also applies to any funds received as a result of the investment or deposit of Agent Orange settlement payments.
Verification. Documents in an individual's possession shall be used to verify whether a payment is an Agent Orange settlement payment. If the individual has no documentation or there is reason to question the situation, it is the individual's responsibility to provide verification from the provider (Aetna Insurance Company).
12. Gifts of domestic travel tickets
The value of a domestic travel ticket received by an individual or spouse is excluded from income under Public Law 101-239 if the ticket is received as a gift and not converted to cash. Domestic travel is travel among the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. The travel ticket may be for transportation by air, land, or sea.
If an excluded ticket is converted to cash, it becomes unearned income in the month it is converted.
Gifts of non-domestic travel tickets, such as airline tickets to Japan or the Philippines, which can be converted to cash, are counted as income in the month they are received.
13. Victims' compensation payments
Any payment received from a fund established by a State to aid victims of crime is excluded from income.
Interest earned from the deposit or investment of these funds is not excluded as income.
14. Payments to Victims of Nazi Persecution
Payments received from any source by individuals because of their status as victims of Nazi persecution are excluded from income.
Interest earned on unspent payments is also excluded from income.
15. Energy Employees Occupational Illness Compensation Payments
The Energy Employees Occupational Illness Compensation Act provides compensation to individuals who develop illnesses as a result of employment at certain federally owned facilities in which radioactive materials were used. These payments are exempt income.
16. Radiation Exposure Compensation Trust Fund
Fallout emitted during the U.S. Government’s atmospheric nuclear testing in Nevada during the 1950s and during a brief period in 1962 exposed some individuals to doses of radiation that put their health at risk. In addition, some individuals employed in uranium mines from 1947 through 1971 were exposed to large doses of radiation.
Public Law 101-426 created the Radiation Exposure Compensation Trust Fund and authorizes the Department of Justice to make compensation payments to individuals (or their survivors) who were found to have contracted certain diseases after exposure. The payments will be made as a one-time lump sum. Generally, the exposure occurred in parts of Arizona, Colorado, Nevada, New Mexico, Utah, and Wyoming.
Payments from the Radiation Exposure Compensation Fund are excluded from income. Interest earned on unspent Radiation Exposure Compensation Fund payments are also excluded from income.
17. Individual Development Account ( IDA )
An Individual Development Account (IDA ) is a special bank account that helps an individual save for his or her education, the purchase of a first home, or to start a business. An individual contributes money from his or her earnings to an IDA . These contributions are then matched with money from another source. The matching money helps the individual reach his or her goal sooner.
Any earnings that an individual contributes to a TANF -funded IDA or Demonstration Project IDA are deducted from his or her wages in determining countable earned income. In addition, the individual’s contributions, as well as any matching funds, that are deposited into a TANF -funded IDA or Demonstration Project IDA are excluded from income. Any interest earned on these funds is also excluded from income.
TANF -funded IDA . The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 authorized states to use money from their TANF grant to carry out a program to fund IDAs .
Demonstration Project IDA . The Assets for Independence Act (enacted on January 27, 1998) created a Federal Demonstration Project to test the effectiveness of IDAs in improving the lives of participating low-income persons. This Act provides for Demonstration Project monies to carry out a program to fund IDAs .
18. Payments to Persons Captured and Interned by North Vietnam
The Department of Defense provides payments to certain persons who were captured and interned by North Vietnam. If the individual is deceased, payment may be made to a surviving spouse or, if none, to surviving children (including biological and adoptive children) in equal shares. The amount payable is a one-time payment of up to $50,000. These payments are excluded from income. Interest earned on unspent payments is also excluded from income.
19. Ricky Ray Hemophilia Relief Fund
The Ricky Ray Hemophilia Relief Fund Act of 1998, Public Law 105-369, provides for a single payment of $100,000 to:
Individuals with a blood-clotting disorder who may have contracted an HIV infection from a blood transfusion;
Current and former spouses of these individuals who also contracted an HIV infection;
Children of these individuals who also contracted an HIV infection; and
Surviving spouses, children, and parents of the above.
Payments from the Ricky Ray Hemophilia Relief Fund are excluded from income. Interest earned on unspent payments is also excluded from income.
20. Vietnam Veterans’ Children with Spina Bifida
A 1996 study by the National Academy of Sciences found evidence associating parental exposure to herbicides in Vietnam with increased risk of spina bifida in their children. Spina bifida is a congenital birth defect characterized by defective closure of the bones surrounding the spinal cord.
Public law 104-204 authorizes the Department of Veterans Affairs ( VA ) to provide benefits, including a monthly monetary allowance, to certain Vietnam veterans’ children who suffer from spina bifida. VA payments made to or on behalf of such children are excluded from income. Interest earned on unspent payments is also excluded from income.
442-3 B. CERTAIN ASSISTANCE BASED ON NEED
Needs-based assistance , as specified in this section, is excluded from countable income. Excluded needs-based assistance is assistance that is:
Funded wholly by a state, political subdivision of a state, or an Indian tribe; and
Provided under a program that uses income as a factor in determining eligibility.
In Alaska, examples of programs that provide needs-based assistance are General Relief Assistance ( GRA ) and the Alaska Senior Benefits Program.
Needs-based assistance is not the same as needs-based income . Refer to section 441-2D for the policy on needs-based income.
442-3 C. REFUNDS OF TAX PAID ON REAL PROPERTY OR FOOD
Any amount received from any public agency as a return or refund of taxes paid on real property or on food purchased is excluded from income.
Verification. The client's statement that a refund of this nature has been received is acceptable, unless there is reason to question the situation. For example, if the program making the refund is unknown, or the amount of the refund appears inordinate, the case worker may require the client to provide proof from the source of the payment.
442-3 D. DISASTER ASSISTANCE
Any assistance received under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (formerly the Disaster Relief and Emergency Assistance Act of 1974), or some other federal statute, because of a presidentially declared major disaster is excluded from income.
Assistance provided to victims of a presidentially declared disaster includes assistance from: federal programs or agencies; joint federal and state programs; state or local government programs; and private organizations such as the Red Cross.
Interest earned by funds retained from federal disaster assistance is also excluded from income.
Verification. Acceptable proof of federal disaster assistance is documentation or a collateral contact with the source of the payment which specifies that the assistance is provided under federal statute because of a presidential declared disaster.
442-3 E. DIVIDENDS AND INTEREST
Dividends and interest are returns on capital investments such as stocks, bonds, or savings accounts. They are either counted or excluded as unearned income at the earlier of the following: the month they are received by the individual, the month they are set aside for the individual’s use; or the month they are credited to an individual’s account and are available for use.
Dividends and interest earned on countable resources are excluded from income.
Dividends and interest earned on excluded resources may be counted or excluded from income depending on the character of the excluded resource. See the manual section related to a particular resource or income exclusion for further guidance on the treatment of dividends and interest earned on excluded resources
Note: Dividends or interest may be countable resources if retained into the following month.
442-3 F. FOSTER CARE PAYMENTS AND ADOPTION PAYMENTS
A payment made to a foster or adoptive parent by a public or private non-profit agency for the care of a child that is living in the home of the foster or adoptive parent is unearned income to the child. These payments are not income to the foster or adoptive parent.
442-3 G. INCREASE IN VALUE OF BURIAL FUNDS
Any increase in the value of an excluded burial fund, or the excluded portion of a burial fund, because of interest accumulation or appreciation is excluded as income. (Refer to section 432-2D .)
442-3 H. HOME ENERGY ASSISTANCE
Home energy assistance provided to an individual by a private non-profit agency or by an entity which is certified by the state or federal government is excluded from income if the assistance was based on need. Energy assistance is most often provided in the form of a vendor payment, but may also be provided in cash.
Verification. In Alaska, the Heating Assistance program administered by the State and the energy assistance programs administered by various Native organizations qualify for this exclusion. Other sources of home energy assistance may be excluded if verification is provided that the assistance is certified by a state or the federal government and that the assistance is based on need.
442-3 I. CHILD SUPPORT PAYMENTS FROM AN ABSENT PARENT
Child support payments may be made voluntarily or under a court or administrative order. One-third of any child support payment received from an absent (noncustodial) parent or stepparent by or on behalf of a child who is eligible for SSI or APA is excluded from the income of the child. The remaining two-thirds of the child support payment is income to the child, not to the individual who may receive the payment for the child. This exclusion is not allowed to children who are not eligible for SSI or APA .
For purposes of this section, a child is an individual who is neither married nor the head of a household, is under the age of 22, and is a student regularly attending school or college or training that is designed to prepare him or her for a paying job. (Refer to section 442-2D for the policy on regular school attendance.)
Verification. The amount and frequency of child support payments may be verified by the use of: court records; records of an agency through which the payments are made; documents in the individual's possession; or by contact with the source of the payment. If proof of child support payments cannot be obtained in any other way, a signed statement from the client which specifies the amount and date received may be used.
442-3 J. Deposits made to a bank account on behalf of another person
Money deposited into an individual’s bank account is not counted as income if the individual disburses or intends to disburse the money on behalf of another party. The individual is acting as the other party’s “agent”.
442-4 THE ORDER IN WHICH INCOME EXCLUSIONS ARE APPLIED
The order in which income exclusions are applied may affect the total countable income used to determine eligibility and benefit levels for the APA program. Income exclusions are applied first to unearned income, then to earned income. If an income exclusion can be applied to either earned or unearned income, the exclusion is applied first to unearned income and then to earned income.
Earned income exclusions are applied in the following order:
Earned Income Exclusion Manual Section 1. Earned income exclusions authorized by federal laws 442-3A 2. Earned income tax credit payments 442-2B 3. $10 of infrequent/irregular earned income 442-1A 4. Student earnings 442-2D 5. Any unused portion of $20/month general income exclusion 442-1B 6. $65/month of earned income 442-2F 7. Impairment-related work expenses for disabled. (See note below) 442-2G 8. One-half of remaining earned income. 442-2H 9. Work expenses for the blind 442-2I 10. Plan to achieve self-support 442-1C
Note: The EIS APAS screen does not have a data entry field for impairment related work expenses ( IRWE ). To allow the IRWE income exclusion and correctly determine APA eligibility and payment amount, the caseworker must subtract the IRWE from the adjusted gross earned income and enter the new amount in the "ADJ GROSS EARNED INCOME" field on the APAS screen.
Refer to chapter 460 for the policy on income exclusions as they are applied to the income of ineligible spouses and/or alien sponsors.
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442 INCOME EXCLUSIONS
Certain income is excluded in determining the countable monthly income of an APA applicant or recipient, together with the income of his or her spouse. This chapter explains the income exclusions allowed to APA applicants and recipients. Refer to chapter 460 for policy on income exclusions allowed to ineligible spouses and alien sponsors.
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443-1 GARNISHMENT OR OTHER WITHHOLDING
The full amount of income, before amounts are withheld to satisfy a debt, counts as income. Amounts withheld because of a garnishment, or to make certain other payments (such as Medicare premiums or tax payments) are included when determining earned or unearned income amounts.
Items for which amounts may be withheld but considered received include, but are not limited to:
Taxes;
Health or life insurance premiums (including Medicare premiums);
Union dues;
Payments on loans or other debts;
Garnishments;
Child support payments; and
Service fees on checking or savings accounts.
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443-2 RECOUPMENTS
If a benefit program (including the SSI program) withholds any part of an applicant's or recipient's monthly benefit to recover a previous overpayment, the portion of the monthly payment that is withheld is counted as income in determining eligibility and payment for the APA program.
In addition, if SSI withholds any part of an applicant's or recipient's SSI benefits to penalize a recipient for any reason, the gross SSI benefit amount, before withholding, counts in determining eligibility and payment for the APA program.
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443-3 EXPENSES OF OBTAINING UNEARNED INCOME
443-3 A. TREATMENT OF ESSENTIAL EXPENSES
Unearned income does not include that part of a payment which is for an essential expense incurred in getting the payment(s). Amounts remaining after essential expenses have been subtracted are considered as unearned income.
Legal, medical, or other expenses connected with an accident may be subtracted from any payment(s) received for damages in connection with the accident.
Legal fees essential to obtaining benefits from a benefit program (such as Workmans' Compensation payments) other than SSI may be subtracted from a retroactive check issued by that program.
Verification. To be excluded from income, essential expenses of obtaining income must be verified. Acceptable evidence includes bills, receipts, pay stubs, contact with the provider, etc. If an expense has been incurred but not paid, assume that the individual will pay the expense unless there is reason to question the situation.
443-3 B. HOW ESSENTIAL EXPENSES ARE DEDUCTED
Deduct expense money from the first and any subsequent amounts of related income until all expenses are completely eliminated.
443-3 C. EXPENSE MONEY ASSUMPTIONS
Assume that the following payments for expenses do not exceed the expenses and thus do not result in income. It is not necessary to verify the expenses listed below or follow up on how the money was spent. Such payments are assumed to be used in their entirety to meet expenses.
Payments by a government agency for expenses related to a service or participating in a program (for example, per diem expense money provided to jurors).
Lump sum advances or reimbursements by employers to cover expenses of employment paid by the employee (for example, a per diem allowance paid to an employee, or a $100 allowance paid to a school bus driver to pay for gas and maintenance).
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443 SPECIAL INCOME PROVISIONS
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450-1 APA AND SSI LIVING ARRANGEMENTS
The case worker must determine whether an individual or couple lives independently, in another's household, or in an assisted living home. APA and SSI also have special payment standards for individuals who are institutionalized in certain types of institutions for a full calendar month. (Refer to chapter 470 for policy on institutionalization.) Both APA and SSI use different payment standards depending on the individual's or couple's living arrangement.
Except for individuals who reside in assisted living homes, APA and SSI policies for determining living arrangements are identical. If an APA applicant or recipient also receives SSI benefits, the case worker must use the APA need and payment standards that correspond to the living arrangement determined appropriate by Social Security: Living independently (SSI "A" living arrangement); living in another's household (SSI "B" living arrangement); or living in an institution (SSI "D" living arrangement). See manual sections 450-4 and 452-5D for the policy on APA payments for individuals residing in assisted living homes.
450-2 LIVING INDEPENDENTLY ( SSI "A" LIVING ARRANGEMENT)
If an individual or couple receives shelter from others living in the household, and all of their meals are provided by others within the household, they must meet one of the following conditions to be considered as residing in an "A" living arrangement:
The person with whom the client lives is the client's spouse or alien sponsor whose income is deemed available to the client, or
The client, the client's spouse, or the client's alien sponsor whose income is deemed available to the client, has an ownership interest in the shelter or property where the client lives, or
The client, the client's spouse, or the client's alien sponsor whose income is deemed available to the client, is responsible for any part of the rent for the shelter or property where the client lives, or
In determining whether rental liability exists, remember that landlords and tenants may not be part of the same economic household. For the purpose of determining living arrangements, a single economic household shares common living quarters and kitchen or bathroom facilities under domestic living arrangements which create a single economic unit. For example, an individual who rents a room, but does not purchase or prepare food with other household members is living independently.
The client lives in an assisted living home , or
Note: While the SSI program considers an individual residing in an assisted living home to be living independently, the APA program does not, and applies a different payment standard. (Refer to section 450-4 .)
The client lives in a household in which all members receive federal or state cash assistance payments (including Temporary Assistance, APA , SSI , Bureau of Indian Affairs General Assistance, and Veteran's Administration needs-based compensation), or
The client pays at least a prorated share of the monthly household costs. A prorated share is the yearly household costs divided by twelve months and then by the number of people living in the household. Household costs include rent, food, mortgage, property taxes, fuel, gas, electricity, wood, sewage, and garbage collection charges.
Verification. The client is responsible for providing proof that he or she pays at least a prorated share of monthly household costs. Bills or receipts may be used to verify actual household costs. In the absence of such proof, the case worker may accept a signed statement from other household member(s) that indicates the monthly household costs and the amount contributed toward those costs by the APA client.
450-3 LIVING IN ANOTHER'S HOUSEHOLD ( SSI "B" LIVING ARRANGEMENT)
An individual or couple is In another's household and on the lower need and payment standards only if the individual or couple receives shelter and all of their meals from others living in the household unless any of the situations in section 450-2 apply.
450-4 LIVING IN AN ASSISTED LIVING HOME
An assisted living home is a facility licensed by the state that provides residential care to persons who find it difficult or impossible to live by themselves. Care is provided in a residential environment and encourages independent living to the extent possible for each resident.
An individual who resides in an assisted living home for a full calendar month is subject to the Assisted Living Home payment standard. Refer to section 452-5D for calculating the APA payments for residents of assisted living homes. Refer to Addendum 1 for the need and maximum payment standards that apply to assisted living home residents.
Note: A list of currently licensed Assisted Living Homes can be found on the DHCS Assisted Living Licensing website .
450-5 LIVING IN AN INSTITUTION (SSI "D" LIVING ARRANGEMENT)
Residents of eligible institutions, such as hospitals or nursing homes, can be eligible for a reduced SSI monthly benefit. The SSI benefit is limited to a maximum of $30 per month when the recipient is a resident in an eligible institution for a full calendar month. (Refer to chapter 470 for policy on institutionalization.)
Individuals expected to be living in an eligible institution for more than 3 months will have their APA eligibility measured against the $200 monthly NHP income limit. If they have countable income equal to or above $200, they are not eligible for APA benefits.
NOTE: See ADLTC MS 550 for the Medicaid policy regarding an individual living in an institution. Remember that these types of Medicaid cases should be referred to the LTC office.
450-6 POTENTIAL ISSUES INVOLVING SSI PAYMENT AMOUNTS
It may be difficult for the case worker to recognize, based on an individual's or couple's SSI benefit amount, which living arrangement SSI is applying. The SSI benefit amount for an individual or couple living in another's household ( SSI "B" living arrangement) is sometimes the same as the SSI benefit amount for an individual or couple in an independent living situation ( SSI "A" living arrangement).
The SSI "B" living arrangement standard is one third less than the SSI "A" living arrangement standard. However, SSA will also reduce the SSI benefit amount of an individual or couple in an independent living arrangement by up to one third of the independent living standard if the individual or couple receives in-kind support and maintenance. If there is a question about which living arrangement SSI is using, the case worker shall confirm the living arrangement with the SSI Claims Representative at the servicing SSA Field Office.
450 LIVING ARRANGEMENTS
An individual's or couple's living arrangement determines the APA need and payment standards against which countable income is compared when determining APA eligibility and calculating APA benefit amounts. This section describes these different living arrangements and provides guidance in determining the correct living arrangement for APA purposes.
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451-1 INCOME ELIGIBILITY
To be found income eligible for APA , an applicant or recipient must have a total monthly countable income (including countable income of a spouse or alien sponsor) that, after rounding, is equal to or less than the appropriate APA need standard. Income is rounded up to the nearest whole dollar from $ .50 and rounded down to the nearest whole dollar from $ .49.
The appropriate APA need standard is determined by the applicant's or recipient's living arrangement. (Refer to section 450 for the policy on living arrangements. Refer to Addendum 1 for APA need standards.)
Countable income is the amount of income remaining after all possible income allocations and exclusions have been applied to the applicant's or recipient's income, and to the income of the applicant's or recipient's spouse or alien sponsor, if applicable. (Refer to sections 440 , 441 , 442 , and 443 for APA income-counting policy. Refer to section 460 for APA financial deeming policy.)
451-2 INTERIM ASSISTANCE ELIGIBILITY DETERMINATIONS
The same income eligibility procedure that applies to an APA applicant or recipient also applies to individuals who are otherwise eligible to receive Interim Assistance. Once an individual is determined eligible for Interim Assistance, he or she remains income-eligible as long as his or her countable income, after rounding, is equal to or less than the appropriate APA need standard.
451 ELIGIBILITY DETERMINATIONS
Eligibility for APA is always determined prospectively. This means that the case worker must anticipate what financial and nonfinancial circumstances are likely to exist in the benefit month and determine the applicant's or recipient's eligibility for that month based on those expected circumstances. After prospective eligibility is determined, the APA benefit amount is calculated. (Refer to chapter 452 for the policy on APA benefit calculations.)
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452-1 PAYMENT CALCULATIONS
After an applicant or recipient is determined prospectively eligible for assistance, the APA payment is calculated for the benefit month. The benefit month is the month for which assistance is provided, regardless of when it is paid. For example, APA benefits paid to meet the needs of an individual or couple for the month of April are considered to be for the benefit month of April, even if they are paid in the month of May. To be eligible for assistance, the individual or couple must be eligible for at least a $1.00 APA payment.
Monthly maximum payment standards are used to calculate APA and SSI benefit amounts. The APA and SSI payment standards are shown in Addendum 1 .
Note: DPA must calculate the countable income rather than using the amount calculated by SSA .
452-1 A. APA PAYMENTS
APA payments are calculated using the APA countable income received or expected to be received in the benefit month.
Example 1: (based on 2026 payment standards) Olivia, an unmarried APA recipient in an independent living arrangement, expects to receive monthly SSA income of $1077 in the month of October. After the $20 income exclusion is allowed, Olivia's expected net countable income is $1057. The October APA payment is based on the net countable Social Security income expected to be received in October. $1,356 APA Payment Standard for an Individual, Living Independently - 1,057 Net Countable SSA Income $ 299 APA Payment
Example 2: (based on 2026 payment standards) Leo, an unmarried APA recipient in an independent living arrangement receives an SSI payment of $994. $1,356 APA individual, independent living standard - 994 APA net countable income ( SSI individual, "A" living arrangement standard) = $362 APA payment
Example 3: (based on 2026 payment standards) Charlotte, an unmarried APA recipient in an independent living arrangement receives an SSI payment of $957. $1,356 APA individual, independent living standard - 957 APA net countable income ( SSI individual, "A" living arrangement standard) = $399 APA payment
Example 4: (based on 2026 payment standards) A married couple who are both eligible for APA reside in an independent living arrangement. Each member of the couple receives monthly SSI payments. The husband receives $746 and the wife receives $745 totaling $1,491. $2,019 APA couple, both eligible, independent living standard - 1,491 APA net countable income ( SSI "A' living arrangement standard for an eligible couple) = $528 APA payment
Example 5: (based on 2026 payment standards, using allowable earned income exclusions) Amanda, an unmarried APA recipient in an independent living arrangement receives an SSI payment of $777 and $605 of gross monthly wages. ($605 - $20 = $585 - $65 = $520/2=$260 countable wages + $777 SSI = $1,037 countable income) $1,356 APA individual, independent living standard - 1,037 APA net countable income ( SSI individual, "A" living arrangement standard) = $319 APA payment
Example 6: (based on 2026 payment standards, using the ineligible child allocation and allowable earned income exclusions) Emma, a married APA recipient in an independent living arrangement, receives an SSI payment of $499 and Benjamin, her husband, makes $2,144 gross monthly wages. They have one child, Kai. ($2,144 - $497 = $1647 - $20 - $65 = $1562/2= $781 countable wages + $499 SSI = $1,280) $1,515 APA couple one eligible, independent living standard - $1.280 APA net countable income ( SSI "A" living arrangement standard for a couple one eligible) = $235 APA payment
452-1 B. APA PROCESSING INSTRUCTIONS
Refer to EIS Procedure 2019-1 for detailed APA processing instructions.
452-1 C. INTERIM ASSISTANCE PAYMENTS
Interim Assistance payments are always based on the income received or expected to be received in the benefit month. The amount of the Interim Assistance payment is $280 to each individual, except for payments to institutionalized individuals. Institutionalized individuals receive an Interim Assistance payment equal to the APA personal needs allowance of $200, less any other countable income.
If both members of a couple are eligible for Interim Assistance, each member of the couple will receive $280, but eligibility will be based on the appropriate couple, both eligible standard.
If one member of a couple is eligible for Interim Assistance and the other member is eligible for regular APA , each member of the couple is budgeted as an individual until Interim Assistance ends. However, the resource limit for a couple applies in these situations.
452-2 RESERVED
452-3 COST OF LIVING ALLOWANCE ( COLA ) INCREASES
Whenever SSI benefits are increased because of an increase in the cost of living, APA need/payment standards are also increased. These cost-of-living increases occur each year on January 1.
452-4 COMPUTATION OF INCOME
The case worker makes the following computations to determine total monthly income for eligibility and payment determinations:
Identify the monthly income available to the individual or couple (including the income of a ineligible spouse or alien sponsor, if any) by source, type, and amount.
Subtract all possible income allocations and exclusions from these amounts.
Add all amounts together and round the resulting amount to the nearest dollar. (Round up from $ .50, round down from $ .49.) This amount, which cannot be less than zero, is the total monthly income.
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452-5 COMPUTATION OF BENEFITS
452-5 A. REGULAR APA BENEFIT PAYMENTS
The amount of assistance provided for any month is determined by comparing an individual's or couple's total monthly countable income calculated according to manual section 452-4 with the appropriate APA need/payment standard described in manual section 452-1 and Addendum 1 .
Note : DPA must calculate the countable income rather than using the amount calculated by SSA .
452-5 B. INTERIM ASSISTANCE BENEFIT PAYMENTS
1. Regular IA benefit payments.
Except for institutionalized individuals, IA payments are set by state regulation at $280 per month per individual, as long as their other countable income, after rounding, is equal to or less than the applicable APA need standard.
If both members of a couple are eligible for Interim Assistance, they each receive $280. In couple cases where only one spouse is eligible for Interim Assistance, $280 is paid only to that individual. If one member of a couple is eligible for Interim Assistance and the other member is eligible for regular APA benefits, each member of the couple is budgeted as an individual until Interim Assistance ends.
2. IA benefit payments to institutionalized individuals
Individuals who reside in a Medicaid facility such as a nursing home may not receive the regular $280 Interim Assistance monthly payment. However, depending on their other countable income, they may receive an Interim Assistance payment which, combined with any other countable income, is equal to the regular $200 APA personal needs maximum payment standard.
452-5 C. PERSONAL NEEDS BENEFIT PAYMENTS
This section applies to any person who resides in a Medicaid facility such as a nursing home continuously for an entire calendar month, except for individuals who remain eligible for full APA benefits because of temporary institutionalization provisions. (Refer to section 470-2 for the policy on continued benefits for temporarily institutionalized individuals.)
An individual who is eligible for SSI may receive a monthly payment for incidental personal needs from SSI of up to $30. APA will provide an additional payment to provide a total amount of $200 for personal needs.
An individual who is ineligible for SSI , but whose countable income is less than the APA personal needs standard, may receive an APA payment. However, the payment cannot exceed the amount that would be paid to a similarly situated SSI recipient. See section 452-5A(1) above for more information about this payment limit policy.
An individual whose countable income exceeds $200 is not eligible for an APA payment but may be eligible for Medicaid.
Note: Medicaid eligibility policies pertaining to institutionalized individuals may differ from APA policies. See ADLTC 514 for policy on Medicaid eligibility for institutionalized individuals.
452-5 D. ASSISTED LIVING HOME PAYMENTS
Individuals residing in an assisted living home for a full calendar month have their APA eligibility and payment calculated using the assisted living home need/maximum payment standards.
Example: (based on 2026 payment standards) A married couple who are both eligible for APA reside in an assisted living home. The couple's combined income from Social Security benefits is $1,511 per month. After the $20 income exclusion is allowed, the couple's net countable income is $1,491. Use the APA need/maximum payment standard for an eligible couple and subtract the couple's net countable income. $1,691 APA maximum payment standard for a couple, both eligible, in an assisted living home (H2C) - $1,491 Net countable income = $200 APA payment ($100 to each spouse)
452-6 ISSUANCE OF APA PAYMENTS
APA payments may be made by electronic benefit transfer (EBT) to a Quest card or by direct deposit on a monthly basis. The monthly benefit will normally be paid to the recipient on the first day of each month. However, the Eligibility Information System (EIS) also has the capability of issuing initial benefit payments three times a week.
Note: Quest cards cannot be used to make purchases with APA cash benefits or to withdraw cash benefits from ATM s located in bars, liquor stores, gambling or adult entertainment establishments.
452-6 A. INITIAL MONTH'S APA PAYMENT
The APA payment for the initial month of APA eligibility is calculated from the date on which the APA application is received in a DPA office or the date on which the applicant meets all APA eligibility requirements, whichever date is later.
To prorate the initial month's benefit payment, first calculate the APA benefit amount as if the applicant were entitled to a full month's benefit. Multiply the full month's benefit amount by the number of days in the month from the application date forward, divided by the total number of days in the month. Round the result down to the next lower dollar to get the prorated benefit amount. If the prorated, unrounded benefit amount is less than $1.00 and at least $0.01, the individual or couple is still considered eligible for APA , but receives no payment for that month.
Note: If the prorated, unrounded benefit amount is less than $1.00 and at least $0.01, EIS will issue the individual or couple $1.00. This is due to an EIS programming error that cannot be corrected at this time. Staff will consider the $1.00 payment in this situation to be accurate.
Example: An individual applies and is found eligible for APA beginning July 30. Without proration, the individual's full month's benefit for the initial month of July is $200. The prorated benefit amount for July is calculated as follows: $200 X 2 days = $12.90 31 days The $12.90 amount is rounded down to the next lower dollar to get the prorated benefit amount. The prorated APA benefit for the initial month of July is $12.00.
452-6 B. INITIAL MONTH IA PAYMENT
Interim Assistance payments are always paid for an entire calendar month. Proration of initial month's benefits does not apply to Interim Assistance payments.
452-6 C. CONTINUING MONTHLY PAYMENTS
For months following the initial month, payment is made for the entire calendar month.
452-7 TO WHOM PAYMENT IS MADE
452-7 A. PAYMENT TO A RECIPIENT
Except as provided in this section, the APA payment is made to the recipient.
452-7 B. PAYMENT TO A THIRD PARTY PAYEE
1. Payee Types
Mandatory Payees APA payments must be made to a third party if the Social Security Administration requires a third party to receive a recipient’s Social Security benefit. Unless there is good cause not to select the same person as a payee for the individual’s APA benefits, the case worker will select the same payee as the Social Security Administration. If, for some reason, the payee selected by the Social Security Administration cannot be selected to serve as a payee for APA , the case worker will select an alternative payee. Under these circumstances, the individual’s APA payment will be withheld until an alternative payee is selected.
For the purpose of not selecting the Social Security payee, good cause means that the payee:
Resides in another state
Refuses to serve as a payee for the individual’s APA benefits, or
Is determined by the case worker to be unsuitable as a payee.
Non-mandatory Payees An applicant or recipient may request that the APA payment be made to another person. This request must be made in writing. The case worker will make the designated person a payee if, in his or her prudent judgment, there is no substantial reason not to honor the request.
2. Payee Responsibilities
A payee, including an alternative payee, must agree in writing to receive and use the payments to meet the current needs of the client. The payee must also agree, when requested, to provide the case worker with an accounting of how the payments were used. The APA 14 form, Adult Public Assistance Protective Payee Agreement, may be used for this purpose. A payee may withdraw at any time. For non-mandatory payee situations, payment to the recipient will be resumed if, at any time, there is reason to believe that the payments are not being applied to meet the needs of the client. For mandatory payee situations, an alternative payee will be selected.
3. Special Circumstances
In some cases, the applicant or recipient will be either incompetent or too sick to designate payee. In these situations, the case worker may use his or her prudent judgment to make the payment to a responsible person who will act on the client’s behalf. If no action is taken to establish a private guardian, such cases should be referred to the Public Guardian, Office of Public Advocacy, so that a guardian may be established. Until a guardian is established, the case must be checked periodically to assure that benefits are being applied to the client’s needs.
452-7 C. PAYMENT TO A GUARDIAN
If a court authorizes a third party to conduct the financial affairs of an applicant or recipient, payment will be made to the third party unless the third party or the court directs otherwise.
Note: If we have documentation establishing a third party as guardian or conservator we do not need to have them sign the APA 14 . However, without a court authorized agreement, the APA 14 must be signed before benefits can be authorized.
452-7 D. DEATH OF RECIPIENT
Payments issued to a recipient after the date of the recipient's death must be returned to DPA and cancelled as outlined in Admin MS 121-15 .
Payments issued before the date of death, but not negotiated at the time of the recipient's death must be returned to DPA and cancelled. If a legally authorized representative of the deceased client's estate claims such benefits within 90 days of the date of the recipient's death, the payment shall be reissued on a warrant payable to the recipient's estate.
452-8 COUPLE CASES ON EIS
Frequently, both members of a couple are found eligible for assistance. In these situations, a separate APA case for each member of the couple is established on the Eligibility Information System ( EIS ). These cases are cross referenced on EIS and the couple's combined income is compared to the appropriate couple, both eligible payment standard.
The resulting APA benefit is split equally and paid to each member of the couple. If the couple separates, or one member of the couple dies, separate the couple cases on EIS and either maintain separate cases for separated spouses or, in the case of death, maintain a single case for the remaining spouse.
An eligible couple may desire that one person receive the APA payment for both members of the couple. The couple must designate, in writing, who is to receive the payment(s). The designated person may be one member of the couple or some other person. In this situation, the designated person is made a payee for person(s) not wishing to receive the payment.
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452-9 REFUSE CASH CASES
Upon written and signed request, an eligible applicant or recipient may refuse to accept all or part of any APA payment to which he or she is entitled. Refusal of APA cash assistance does not affect eligibility for Medicaid. Refuse Cash APA cases are established and maintained as "0" grant, Medicaid eligible cases.
The recipient may withdraw his or her request to refuse cash at any time. The request to restore the APA cash assistance may be made either orally or in writing. The APA payment will be restored effective the first day of the month in which the client's request to restore the APA payment is received.
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452-10 TEMPORARY ASSISTANCE AND APA
452-10 A. GENERAL POLICY
A Temporary Assistance applicant may receive APA benefits while eligibility for Temporary Assistance is being determined. However, except for Temporary Assistance to APA conversion situations, an APA applicant may not receive APA benefits for any month in which his or her needs were included in the Temporary Assistance case.
This restriction does not apply to an individual whose income and resources were considered available to the Temporary Assistance unit, if the individual was not a member of the Temporary Assistance case.
Note: The budgeting rules in this chapter also apply to families receiving Refugee Cash Assistance listed in section 441-2 D.
If one member of a couple receives Temporary Assistance or Refugee Cash Assistance and the other member receives APA , the APA recipient is budgeted as an individual. However, if the ineligible spouse is not included in the Temporary Assistance or Refugee Cash Assistance case, the APA case is budgeted as a couple, one eligible case.
452-10 B. TEMPORARY ASSISTANCE TO APA CONVERSIONS
In many situations, a Temporary Assistance recipient’s eligibility for APA will begin the month following the month the individual’s needs are removed from the Temporary Assistance case. However, in some situations, the individual will be eligible for APA benefits while his or her needs are still included in the Temporary Assistance case.
An APA applicant whose needs are included in a Temporary Assistance case is potentially eligible for APA benefits beginning with the date the applicant would be eligible for an initial month’s APA payment. See manual section 410-7 .
This situation occurs when the individual’s own countable income, including his or her share of the Temporary Assistance payment, is less than the applicable APA need standard. For APA purposes, the countable income that person derives from a Temporary Assistance grant is the difference between the Temporary Assistance payment actually made to the Temporary Assistance unit, and the Temporary Assistance payment which would have been made had the individual not been included in the grant.
Example 1: Eligible for Temporary Assistance and APA at the same time (based on 2026 Temporary Assistance and APA income standards) In July 15, 2026, a two-parent family containing one child applies for Temporary Assistance for the entire family, and APA for the father. The family is approved for Temporary Assistance, and the APA application is pended for 30 days to be in pay status with SSI . The family's only source of income is their monthly Temporary Assistance check for $923. On July 30, SSA notifies the father that he is eligible for Social Security Disability Insurance benefits of $1,020 per month. The father is potentially eligible for APA beginning August 1, the month after the SSA notification. Because the father is now eligible for APA , his needs are removed from the Temporary Assistance case at the earliest opportunity; in this case, effective August 31st with timely notice of adverse action. Without the needs of the father included, the remaining family members qualify for a maximum monthly Temporary Assistance payment of $821.Therefore, the father’s share of the Temporary Assistance payment for the months of November is $102 ($923 - $821 = $102). Because of the father’s own income of $1,020 SSA and his $102 share of Temporary Assistance grant is less than the applicable 2026 APA need standard of $1,356, he qualifies for APA payments beginning with the month of August.
Example 2: Not eligible for Temporary Assistance and APA at the same time (based on 2026 Temporary Assistance and APA income standards) In July 15, 2026, a single mother and her two children applies for Temporary Assistance for herself and her two children, and APA for herself. The family is approved for Temporary Assistance, and the APA application is pended to be in pay with SSI . The family’s only source of income is their monthly Temporary Assistance check for $923. On July 30th, SSA notifies the mother that she is eligible for Social Security Disability Insurance benefits of $1,050 per month. The mother is potentially eligible for APA beginning August 1, the month after the SSA notification. Because the mother is now eligible for APA , her needs are removed from the Temporary Assistance case at the earliest opportunity following adverse action notice requirements; in this case, effective August 31. Without the needs of the mother included, the remaining family members qualify for a maximum monthly Temporary Assistance payment of $554.Therefore, the mother’s share of the Temporary Assistance payment for the month of August is $369 per month ($923 - $554 = $369). Because the mother’s own income of $1,050 SSA and her $369 share of the Temporary Assistance grant is more than the applicable 2026 APA need standard of $1,356, she does not qualify for APA for the month of August. Her eligibility for APA begins September 1, 2026.
452-11 RESERVED
452-12 RETROACTIVE APA BENEFIT CALCULATIONS
IA recipients qualify for an APA payment when they are approved for SSA or SSI and their case is converted to APA . Refer to manual section 410-7 for the policy regarding when APA payments begin.
Calculate a retroactive APA payment for an IA case conversion by subtracting the countable income from the APA maximum payment standard. Then subtract the IA payment.
Example: IA Recipient (based on 2026 payment standards) Applicant applies for both APA and SSI benefits on July 15, 2026. IA benefits are approved beginning with the benefit month of July. On October 28, 2026, the Social Security Administration notifies the applicant that SSI payments are approved back to the benefit month of August. Because it is too late to stop the IA payment for November, the IA case is closed effective November 30, 2026, and an APA case is opened beginning December 1. Since the applicant was notified of SSI eligibility in October, the applicant is eligible for APA benefits beginning November 1. The retroactive APA payment for November is calculated as follows: $1,356 APA Maximum Payment Standard - 994 SSI Income Standard $ 362 APA payment $362 APA Payment -280 Monthly IA Payment $ 82 Retroactive APA Payment for November
452 PAYMENTS
This section explains the methods used to calculate benefit amounts for the APA program. It also explains how and to whom assistance payments are made. Refer to chapter 460 for related policy on the deeming of income and resources of ineligible spouses and/or alien sponsors.
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460-1 DEFINITIONS
460-1 A. ALLOCATION
An allocation is an amount deducted from income subject to deeming which is considered to be set aside for the support of certain individuals other than the APA applicant or recipient.
460-1 B. DEEMING
Deeming is the process of considering another person's income and resources available to meet the needs of the APA applicant or recipient.
460-1 C. DEPENDENT
A dependent for the purpose of allowing an allocation against the income of an alien sponsor is the same as a dependent for federal income tax purposes; a dependent is someone for whom the taxpayer is entitled to take a deduction on his or her personal income tax return.
460-1 D. INELIGIBLE CHILD
An ineligible child for the purpose of allowing an allocation against the income of an ineligible spouse is the natural or adopted child of either the eligible or ineligible spouse, who lives in the same household with the eligible individual, is not eligible for SSI , and who is:
Under age 18; or
Under age 22 and a student regularly attending a school, college, or a university, or a course of vocational training in preparation for gainful employment.
460-1 E. SPONSOR
A sponsor is an individual who signs an affidavit of support agreeing to support an alien as a condition of the alien's admission for permanent residence in the U.S. An alien may have more than one sponsor. For deeming purposes, a sponsor does not include an organization such as the congregation of a church or a service club, or an employer who only guarantees employment for an alien upon entry but does not sign an affidavit of support.
460-1 F. SPOUSE
Spouses are people who are married to each other. For APA purposes, this definition includes people who are known to their neighbors, relatives, or friends as a married couple or who are holding themselves out to the community as a married couple.
The State of Alaska does not recognize "Common Law" marriages as some states do. The fact that an unmarried couple is living together does not mean that they are holding themselves out to the community as a married couple.
In situations where a couple indicates that they are not married and that they do not hold themselves out to be married, and there is reason to doubt their claim, the case worker must determine their couple status based on the available evidence. Some questions that should be asked to establish whether or not the partners meet the definition of spouses are:
What name or names are they known by? Are they known as Mr. and Mrs.? How do they introduce each other to friends, relatives, or others?
How are legal contracts such as rental agreements, mortgages, loans, and tax bills written; are both names included; are the parties identified as husband and wife?
What names are utility accounts in? Credit cards?
In what names do they receive mail, magazines, or other circulars?
If they have children in common, what names are used on school enrollment records? What names were given for birth records?
Obtain documentary evidence if it is available. In questionable situations, it is essential that the reason(s) for a decision that a couple is holding themselves out to be married is thoroughly documented in the case file.
460-1G. DEPLOYED SPOUSE
An ineligible spouse who is absent from an APA household due to a duty assignment as a member of the Armed Forces on active duty is considered to be living in the same household as the APA applicant or recipient. Normal income and resource deeming rules apply.
460-2 FINANCIAL RESPONSIBILITY
460-2 A. INCOME AND RESOURCES OF SPOUSES
The combined income and resources of spouses who are living together are used to determine APA eligibility and benefit amount. In this section, "living together" means that the couple resides in common living quarters and facilities under domestic arrangements that create one economic unit.
Spouses who no longer live together are treated as individuals as of the first moment of the month following the month they stopped living together. Spouses who live in the same nursing home are treated as individuals, even if they share the same room.
The resources of spouses who do not live together are not considered available to one another unless the resource is jointly owned. Consider the jointly owned resources of spouses to belong totally to each spouse. Do not consider the income of spouses who do not live together available to one another.
The income and resources of spouses may be treated differently depending on whether both spouses are eligible for APA or SSI , or only one spouse is eligible. A spouse is considered eligible only if he or she applies for and accepts APA or SSI benefits.
Note: Medicaid policies may differ from APA policies in the treatment of income and resources of institutionalized spouses. Refer to Aged, Disabled and Long term Care Medicaid manual sections 523 and 524.
1. Income and resources of spouses who are both eligible for APA or SSI
The income and resources of spouses who are both eligible for APA or SSI , and who live together, are considered to be totally available to each other.
Note: If both members of a married couple are eligible for SSI and are homeless, they must be treated as eligible individuals. Living together in a homeless shelter or an automobile is not considered living in a household.
2. Income and resources of spouses, only one of whom is eligible for APA or SSI
The income and resources of an ineligible spouse, who is living with the APA applicant or recipient, are considered to be available to meet the needs of the APA applicant or recipient. The income and resources of the ineligible spouse are subject to the income and resource counting rules listed in the income and resource sections of this manual. However, certain additional income and resource exclusions may be available to the ineligible spouse depending on the situation. For example, Temporary Assistance benefits received by an ineligible spouse, as well as any income used to determine the amount of the Temporary Assistance benefit, are excluded income. See manual sections 460-4A (resource exclusions of ineligible spouse) and 460-6A (income exclusions of ineligible spouse).
Allocations from the income of an ineligible spouse for the care of an ineligible child may also be allowed under certain conditions. See manual section 460-5A .
460-2 B. INCOME AND RESOURCES OF ALIEN SPONSORS
The income and resources of an alien's sponsor and the sponsor's in-home spouse are considered to be available, subject to certain limited income and resource exclusions, and available to an alien applicant or recipient for several years. This deeming period begins with the month the alien is admitted into the U.S. for permanent residence or is granted permanent resident status, and lasts for 3 years. See manual sections 460-4B (resource exclusions of alien sponsors) and 460-6B (income exclusions of alien's sponsor). Alien sponsor deeming applies whether or not the alien and sponsor live together, and whether or not the sponsor actually makes his or her income and resources available to meet the needs of the alien.
Allocations from the income of the alien's sponsor, and from the income of the sponsor's in-home spouse, may be allowed for the sponsor, the sponsor's in-home spouse, and the sponsor's dependents. See manual section 460-5B .
Verification. An alien is responsible for providing proof of who his or her sponsor(s) is, and for obtaining the sponsor's cooperation in the development and documentation of information necessary to determine eligibility for assistance. If either the alien or the sponsor fails to cooperate, APA benefits shall be denied or terminated. If a sponsor cannot be located or leaves the U.S., making verification of the sponsor's income and resources difficult, it is the alien's responsibility to get the necessary proof. If the alien does not provide proof of the sponsor's income and resources, APA benefits shall be denied or terminated. The alien sponsor deeming provisions changed effective October 1, 1996. In addition, the U.S. Citizenship & Immigration Services ( USCIS ) is now using new, legally binding affidavits of support for sponsored aliens. Please contact Central Office policy staff for guidance on processing APA applications for sponsored aliens who applied before October 1, 1996, or sponsored aliens who are admitted under the new USCIS affidavit of support.
460-3 SSI AND APA DEEMING
SSA will calculate the deemed income and resource amounts for SSI recipients. DPA will use SSA 's resource determination for SSI recipients but not their deemed income calculation. APA payment calculations should be made following the guidance outlined in APA MS 452-1 .
For those cases subject to deeming that are not eligible for SSI , the case worker will use the income and resource deeming processes described in this chapter. For example, an APA applicant who is not eligible for SSI because of an ineligible spouse's or alien sponsor's deemed income may still be eligible for APA if the applicant's own countable income in combination with the countable deemed income is equal to or less than the applicable APA need standard.
460-4 RESOURCE EXCLUSIONS OF INELIGIBLE SPOUSE AND/OR ALIEN SPONSOR
In addition to the resource exclusions available to an APA applicant or recipient, certain additional resource exclusions may be applied to the resources of an ineligible spouse and/or alien sponsor when determining the resource eligibility of an APA applicant or recipient.
460-4 A. RESOURCE EXCLUSIONS OF INELIGIBLE SPOUSE
Any retirement fund belonging to an ineligible spouse is excluded as a resource. See APA MS 431-2G for a list of possible retirement funds the ineligible spouse may have.
Example: George Davis, who is not eligible for APA , lives with his disabled wife, Mary Davis. Mr. Davis owns a pension fund worth $55,000. Exclude the pension fund belonging to Mr. Davis as a resource when determining Mrs. Davis' eligibility for APA .
1. OTHER RESOURCE EXCLUSIONS
All resource exclusions that apply to the resources of an APA applicant or recipient also apply to the combined resources of an APA applicant or recipient and an ineligible spouse who lives with him or her.
Example: A similar situation to the example in section 460-4A except that the couple's resources, in addition to the pension fund owned by Mr. Davis, include their home, one vehicle which is used for essential daily activities, a savings account belonging to Mr. Davis containing $1,300, and a joint checking account containing $970. The pension fund is excluded under section 460-4A . The home and the vehicle are excluded from countable resources by allowing the resource exclusions listed in manual section 432-1A and 432-2A . No funds have been designated as burial funds. The checking and savings accounts are both countable resources. The couple's combined countable resources are $2,270 ($1,300 + $970 = $2,270).
460-4 B. RESOURCE EXCLUSIONS OF ALIEN SPONSORS
The following resource exclusions are applied to the resources of an alien sponsor:
1. PENSION FUNDS
If the alien's sponsor is also the alien's ineligible spouse or parent, and that spouse or parent owns a pension fund, exclude the pension fund from resource determinations for the alien. This exclusion does not apply to alien sponsors who are not the alien's ineligible spouse or parent.
2. OTHER RESOURCE EXCLUSIONS
Apply the same exclusions that apply to an APA applicant's or recipient's resources to the resources of an alien's sponsor.
460-5 INCOME ALLOCATIONS
An allocation for an ineligible child may be applied against the income of an ineligible spouse. Certain allocations may also be applied against the income of an alien sponsor and an alien sponsor's spouse. Income allocations are applied first to unearned income and then to earned income.
460-5 A. INCOME ALLOCATIONS OF AN INELIGIBLE SPOUSE
An allocation from an ineligible spouse's income is allowed for each child who is not eligible for SSI and who lives in the same household. No allocation is given for any child who is receiving a public income maintenance payment (such as Temporary Assistance) as defined in section 460-6A(1) . Ineligible child allocations are always applied before the income exclusions listed in section 460-6A are applied.
The amount of the allocation is equal to the difference between the SSI maximum payment standard for a couple in an independent living arrangement and the SSI maximum payment standard for an individual. In 2026, this amount is $497 ($1,491 - $994 = $483). Subtract these allocations from the ineligible spouse's income before any income exclusions are applied.
Each ineligible child's allocation is reduced by the amount of the child's own income, including child support payments received on the child's behalf from an absent parent. (Children who are not eligible for SSI do not receive the one-third child support exclusion that is allowed to an SSI -eligible child.)
Example: In 2026, Mr. Cooper Dawson and his disabled spouse, Janelle, live with their three minor children, Hallyn, Alli, and Gabbie. None of the children are eligible for SSI . Mr. Dawson receives gross monthly earnings of $3,308. Mrs. Dawson's only source of income is a gross monthly pension of $380. Mr. Dawson receives monthly child support of $100 from his ex-wife for one child, Gabbie. The other two children, Hallyn and Alli, receive no income. Allow allocations from Mr. Dawson monthly earned income for each ineligible child living in the home. Gabbie's monthly child support payment of $100 reduces his allocation dollar-for-dollar. Determine the amount of the allocations allowed against the gross monthly income of Mr. Dawson as follows: $ 3,308 Mr. Dawson's gross monthly earned income less ineligible child allocations for: - 397 Gabbie ($483 - $100 = $383) - 497 Hallyn - 497 Alli = $1,917 Amount of Mr. Dawson's gross monthly earned income after subtracting ineligible child allocations. Mr. Dawson's remaining gross monthly income is then combined with that of Mrs. Dawson. This combined income, after the income exclusions listed in section 460-6 are applied, is used to determine APA eligibility and benefit level for Mrs. Dawson. In this example, the $20 general income exclusion is applied against the couple's unearned income of $360 ($380 - $20 = $360), and the $65 plus 1/2 of any remaining earned income exclusions are applied against the couple's earned income amount after allocations of $926 ($1,917 - $65 = $1,852. $1,852/2 = $926). The resulting amount of $1,286 ($360 + $926 = $1,286) is used to determine Mrs. Dawson's APA eligibility and benefit level.
460-5 B. INCOME ALLOCATIONS OF ALIEN'S SPONSOR
The following allocations may be allowed against the income of an alien sponsor:
1. SPONSOR ALLOCATION
An allocation from a sponsor's own income is given for the sponsor when deeming the sponsor's income to an alien. The amount of the allocation for a sponsor is the SSI maximum payment standard for an individual in an independent living arrangement. In 2026, this amount is $994. The allocation reduces the amount of the sponsor's income dollar-for-dollar.
2. SPONSOR'S SPOUSE ALLOCATION
If the spouse is a co-sponsor: An allocation for the sponsor's spouse, who lives in the same household as the sponsor, is given when deeming the sponsors' income to an alien. The amount of the allocation is equal to the SSI maximum payment standard for an individual in an independent living arrangement. In 2026, this amount is $994.
If the spouse is not a co-sponsor: An allocation for the sponsor's spouse, who lives in the same household as the sponsor, is given when deeming the sponsor's income to an alien. The amount of the allocation is equal to one-half the SSI maximum payment standard for an individual living independently (an "A" living arrangement). In 2026, this amount is $497 ($994/2 = $497).
Example: In January 2026, Lucia, an aged alien sponsored by her son, is subject to sponsor deeming. She lives with her son, who is the sole sponsor, and daughter-in-law. They have no children or dependents. The son's total earned and unearned income is $2,600. The daughter-in-law has no income. Lucia has no income of her own and receives both food and shelter from her son. In 2026, the monthly income considered available to Lucia from the sponsor's income is determined as follows: $ 2,600 Income of sponsor and wife - 994 Sponsor allocation - 497 Sponsor's spouse allocation = $1,109 Amount deemed available from sponsor The amount of the sponsor's income considered available to meet the needs of Lucia exceeds the APA eligibility standard for an individual living in another's household ($1,031 in 2026). Lucia is not eligible for APA based on B1E 2026 eligibility standards.
3. SPONSOR'S DEPENDENT ALLOCATION
An allocation for each dependent of a sponsor of an alien is deducted from the sponsor's income before it is deemed to the alien. The allocation for each dependent is equal to one-half the SSI maximum payment standard for an individual in an independent living arrangement. In 2026, this amount is $497 ($994/2 = $497). The dependent allocation is not reduced by the dependent's own income.
Example: A similar situation to example in section 460-5B(2), except that the sponsor's family consists of the sponsor, his wife and child, and one dependent sister. The sponsor's income is $3200 per month. The monthly income considered available to Lucia from the sponsor's income is determined as follows: $ 3,200 Income from sponsor and wife - 994 Sponsor allocation - 497 Sponsor's spouse allocation - 497 Dependent allocation for child - 497 Dependent allocation for sister = $ 715 Amount deemed available from sponsor The amount of the sponsor's income considered available to meet the needs of Lucia does not exceed the APA eligibility standard for an individual living in another's household ($1,031 in 2026). Lucia is income eligible for APA based on B1E 2026 eligibility standards.
460-6 INCOME EXCLUSIONS OF INELIGIBLE SPOUSE
After all possible income allocations are allowed against the income of an ineligible spouse and/or alien sponsor, the following income exclusions are applied against the income of an ineligible spouse and/or alien sponsor when determining the income eligibility of an APA applicant or recipient.
460-6 A. INCOME EXCLUSIONS OF AN INELIGIBLE SPOUSE
The following income exclusions are applied to the income of an ineligible spouse:
1. PUBLIC INCOME MAINTENANCE PAYMENTS
Exclude any public income maintenance payments received by an ineligible spouse, and any income that was counted or considered and excluded in figuring the amount of the payment. This exclusion applies only to the income of the ineligible spouse, not to the resources of the ineligible spouse.
A public income maintenance payment is any financial assistance furnished by a state, political subdivision of a state, or the United States on the basis of need. This exclusion does not apply to SSI benefits, nor to income taken into account in determining eligibility for and amount of SSI benefits. Public income maintenance payments include:
Temporary Assistance;
Bureau of Indian Affairs General Assistance ( BIA-GA );
VA pension payments based on need;
Refugee Cash Assistance; and
All state or local government assistance programs where eligibility is based on need.
Example: Mr. Fred Fisher lives with his wife Elizabeth and their two minor children. Mr. Fisher is eligible for APA as a disabled individual. Mrs. Fisher receives Temporary Assistance for herself and their two children. Mr. Fisher's only source of income is a gross monthly pension payment from the Civil Service of $500. Mrs. Fisher's only sources of income are her monthly Temporary Assistance benefits and the earnings she receives from a part-time job of $600 a month. Part of Mrs. Fisher's earnings are disregarded in the Temporary Assistance eligibility and payment calculations. Because Mrs. Fisher's monthly earnings are used to calculate her Temporary Assistance benefit, exclude both the entire amount of her earnings and her Temporary Assistance benefits. The countable income used to determine the APA benefit is Mr. Fisher's monthly Civil Service payment of $500.
2. SUPPORT PAYMENTS
Exclude any income used by an ineligible spouse to make child or spousal support payments under a court order or in compliance with a state agreement under Title IV-D of the Social Security Act. In Alaska, Title IV-D is handled by the Child Support Enforcement Division ( CSED ). This exclusion is applied before the other income exclusions listed in #3 below.
Example: Mr. Jerry Smith lives with his disabled spouse Joan. Mr. Smith receives monthly gross earnings from work of $1,500. As required by a court order, each month Mr. Smith sends $325 to his ex-wife for the support of his 16-year-old son. Mrs. Smith's only source of income is a monthly Social Security Disability benefit of $100. The amount of support paid by Mr. Smith each month is excluded from Mr. Smith's own income as follows: $ 1,500 Mr. Smith's gross monthly earnings - $ 325 Less child support payment = 1,175 Mr. Smith's gross monthly income after child support exclusion is applied The remaining earned and unearned income of both Mr. and Mrs. Smith is then combined and all other possible income exclusions are applied to the combined income to determine APA eligibility and benefit levels for Mrs. Smith. In this example, the $20 general income exclusion is applied against the couple's unearned income of $100 ($100 - $20 = $80). Then, the $65 plus 1/2 of any remaining earned income exclusions are applied against the couple's remaining earned income amount of $1,175 ($1,175 - $65 = $1,110. $1,110 - $555 = $555.).The resulting amount of $635 ($80 + $555 = $635) is used to determine Mrs. Smith's APA eligibility and benefit level.
3. OTHER INCOME EXCLUSIONS
All income exclusions that apply to an eligible individual's income also apply to the combined income of an eligible individual and an ineligible spouse. Apply these exclusions only after the income of the ineligible spouse is combined with the income of the APA applicant or recipient.
460-6 B. INCOME EXCLUSIONS OF ALIEN SPONSORS
Income exclusions available to an alien sponsor are limited. All the income of an alien sponsor, as well as the income of the alien sponsor's spouse, is included when determining the amount of the sponsor's income that is subject to deeming. From this amount subtract income that is excluded by federal statutes ( as described in manual section 442-3A ) and Home Energy Assistance ( as described in manual section 442-3H ). No other income is subtracted from the income of an alien's sponsor, except for the allocations allowed in section 460-5B .
The deemed sponsor income is considered as unearned income to the APA applicant or recipient. If a person is sponsoring more than one alien, the sponsor's income is not prorated among the aliens. For example, when both members of a couple have the same sponsor, the sponsor's income is deemed to each member of the couple. The couple's deemed sponsor income is the sum of their deemed income amounts.
The income exclusions that apply to the APA applicant's or recipient's own income are applied only after the sponsor's deemed income is combined with the income of the APA applicant or recipient. For example, the $20 general income exclusion is subtracted from the combination of the sponsor's deemed income and the alien's own income.
460-7 SPECIAL RULES FOR A SPOUSE IN THE MILITARY
Members of the military receive their wages through the Leave and Earnings Statement (LES). This statement reflects a military person’s monthly payments and allowances, tax deductions, and other allotments that are deducted from their gross pay. See Addendum 2 for a detailed list of LES Entitlement, Deduction and Allotment definitions and instructions on how to count each in the military household’s benefit determination.
How the resources, income, and deductions of military personnel affect the household’s benefits depends on the program policy.
See APA MS 460-1G for the definition of a deployed spouse.
460-7 A. RESOURCES
Types of resources typical to a military person’s household are as follows:
Joint bank account. Any deposits made by the deployed military person will count as income to the household in the month received and as a resource the following month. See APA MS 441-2P and 431-2A .
Vehicles . There is no special treatment for the vehicles of military spouses. See APA MS 432-2A .
The Thrift Savings Plan (TSP) . This is a form of a government employee retirement and is an excluded resource. See APA MS 431-2G .
Savings bonds . The case in value of a savings bond is a countable resource once the funds can be accessed. See APA MS 431-2D .
460-7 B. INCOME
Types of income typical to a military person’s household are as follows:
1. Countable Income
Payments and allowances shown in the Entitlements section of the LES will be considered income. The most common of these are base pay, or basic pay, basic allowance for subsistence (BAS), a military person’s food allowance, and basic allowance for housing (BAH).
Housing and food allowance (BAS, BAQ or BAH):
Households living on base: exempt income.
Households living off base who receive allowance directly: counts as earned income.
Households living on or off base whose housing expenses are paid directly to the vendor: exempt income.
Example: Tyson and his wife move to a new off-base location. He receives his monthly rent on his LES . His BAH allotment in the entitlement column is $1500. Tyson’s landlord verifies that his monthly rent is $1300. The $1500 BAH is countable income.
Bonuses for reenlistment and special pay for warfare .
Bonuses paid to a military person will appear in the Entitlements section of the LES.
Clothing Maintenance Allowance (CMA)
A cash payment to purchase clothing is countable earned income. This income is exempt if the amount is a refund or reimbursement.
Example: William receives his LES and it shows a CMA of $125 in the entitlement column. In the deduction column, the CMA is listed as $100. Even though William did not spend the entire amount of the clothing allowance the entire $125 is countable income.
2. Excluded Income
Clothing Maintenance Allowance (CMA) is excluded when received as a refund. See APA MS 440-3D .
Dislocation Allowance (DLA) or any other allowance other allowance which are one-time payments, will only count as income if the allowance can be anticipated.
Military retirement pay that goes to an ex-spouse under a divorce decree property settlement is not counted as income to the retiree. See APA MS 460-6(A)(2) .
Combat Pay (hostile fire and imminent danger payment)
Combat pay is excluded as income. Disregard any amount of combat pay that goes to the household in excess of the military person's pre-deployment earnings. Combat pay will be listed in the Entitlements column, and may appear as follows:
Combat pay
Hostile fire pay
Imminent danger pay
Incentive pay for hazardous duty
SAVE
Hardship duty pay-Location
Hardship duty pay-Mission
Hardship duty pay-Involuntary Extension
Note: Combat zones are designated by an Executive Order from the President as areas in which the U.S. Armed Forces are engaging or have engaged in combat. For combat pay to be excluded as income, the military person must be deployed to one of the combat zones listed at: http://www.irs.gov/newsroom/article/0,,id=108331,00.html
3. Budgeting Combat Pay
Once the military person is deployed to a combat zone:
If the amount provided to the household is equal to or less than the amount provided before deployment, the amount provided is countable income.
If the amount provided to the household is more than the amount provided before deployment, the additional amount is considered exempt combat pay.
460 FINANCIAL RESPONSIBILITY AND DEEMING
In determining an individual's eligibility for Adult Public Assistance, certain other individuals are considered financially responsible for the APA applicant or recipient. This chapter explains how the income and resources of financially responsible individuals are treated when determining eligibility and benefit levels for APA .
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470-1 INELIGIBLE INSTITUTIONS
470-1 A. INELIGIBLE INSTITUTIONS
Recipients must live outside of certain institutional settings to qualify for APA benefits. An individual is not eligible for APA during any full calendar month during which he or she lives throughout the month in:
An Alaska Pioneers' Home;
A prison or jail;
A public or private institution for mental disease, such as the Alaska Psychiatric Institute ( API ); or
Any other public institution, except a long term nursing care facility or a hospital.
Note: Alcohol and substance abuse treatment centers are not ineligible institutions for APA and IA purposes. Residents may receive regular APA or IA benefits while undergoing treatment.
Exception: Incarcerated adults who have been admitted to a hospital for more than 24 hours may be eligible for Medicaid for only the hospital stay. The hospital will assist the incarcerated individual with completing an application if they are not already receiving Medicaid. All of the eligibility requirements for Medicaid must still be met to receive this coverage. If an incarcerated individual no longer falls into an eligible Medicaid category, his or her case will be closed or denied. Adverse action is not needed to close Medicaid for an incarcerated individual. When it has been reported that an applicant or recipient is incarcerated, the Medicaid Subtype must be changed to 'incarcerated.' The Medicaid case will close at the end of the certification period unless it has been reported that the individual is no longer incarcerated.
470-1 B. COMMUNITY RESIDENTIAL CENTERS (HALFWAY HOUSES)
APA eligibility may be available to an individual who is living in a Community Residential Center (aka halfway house) ( CRC ) if they have the freedom of movement at the CRC . Community Residential Centers reserve a small number of beds for individuals on probation or parole that may be ordered to live in a structured environment as a condition of their supervision.
Individuals are considered to have freedom of movement if all three of the following criteria are met:
The individual can work outside the CRC in employment available to individuals who are not under justice system supervision; and
The individual can use community resources such as libraries, grocery stores, recreation, education, etc. at will; and
The individual can seek health care treatment in the broader community to the same or similar extent as other Medicaid recipients.
An incarcerated individual living at a CRC may or may not have freedom of movement. Do not attempt to verify freedom of movement by calling the CRC directly. The CRC 's are not staffed by Department of Corrections ( DOC ) employees and only DOC can verify if the inmate is confined or has freedom of movement (furlough placement).
If an individual applies for APA benefits and the application shows a CRC address, the Eligibility Technician must send an email to doc.idodocs@alaska.gov in order to verify if the individual is confined or on a furlough placement. When sending the email to DOC , the subject line should state CRC Verification for APA /Medicaid and the body of the email must include the individual's name and date of birth. See ADLTC Addendum 6 for CRC 's addresses.
470-2 CONTINUED BENEFITS FOR TEMPORARILY INSTITUTIONALIZED RECIPIENT
An APA recipient may continue to receive full APA benefits for up to 3 months while living in an eligible institution. To qualify for continued full APA benefits, the individual must meet and fulfill all of the following requirements:
The individual must be eligible for APA benefits in the month that they enter the eligible institution. Individuals who are SSI recipients must also continue to receive SSI benefits in order to qualify for continued APA benefits under this provision.
The individual must continuously reside throughout the affected month in one or more eligible institution.
A physician must certify, in writing, that they expect that the individual will live in the eligible institution for 90 days or less. The physician must submit the certification no later than the 90th day of admission to the eligible institution or by the day of release, whichever is earlier. The Facility Verification Form ( MED 12 ) may be used for this purpose.
The individual must demonstrate that they need to pay some or all the expenses of maintaining a home or living arrangement to which they intend to return. A written statement which specifies this need is enough to verify the individual's need to maintain a home or living arrangement, unless the case worker has reason to believe otherwise.
Individuals expected to be living in an eligible institution for more than 3 months will have their APA eligibility measured against the $200 monthly NHP income limit. If they have countable income equal to or above $200, they are not eligible for APA benefits.
470-3 TEMPORARY ABSENCE FROM INSTITUTION
470-3 A. TEMPORARY ABSENCE
A resident of an institution who is temporarily absent from the institution for no more than 14 consecutive days, without being discharged from the institution, continues to be considered an institutional resident. If the individual is discharged from the institution, the continuity of the stay is interrupted, even if the individual returns in less than 14 days, and regular APA standards apply for that month.
Note: Questions from facilities regarding Medicaid payment during a temporary absence from a Medicaid facility must be referred to Conduent State Healthcare LLC., the State’s fiscal agent.
470-3 B. TRANSFER TO ANOTHER INSTITUTION
An individual who is transferred from one institution directly to another institution remains an institutional resident.
470-4 PARTIAL MONTH INSTITUTIONAL RESIDENCE
If otherwise eligible, an individual may receive APA benefits for the month of admission or discharge from an institution listed in 470-1 , above, if he or she lives outside the institution for at least one day of the month.
An individual who expects release from an institution may apply for APA before release. The application may be approved upon proof of the applicant's actual discharge from the institution. Benefits will begin with the month the applicant is discharged from the institution or the month in which the applicant meets all eligibility factors for the APA program, whichever is later.
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470-5 PUBLICLY OPERATED COMMUNITY RESIDENCE
A public institution does not include a publicly operated community residence that serves no more than 16 residents. To be a community residence, the facility must provide food and shelter and make available some other services, such as social services, help with personal living activities, training in social interaction or life skills, or occasional or incidental medical or remedial care. There are no publicly operated community residences currently operating in Alaska.
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470 INSTITUTIONS
Individuals who live in institutions must meet certain eligibility requirements to be eligible for APA . This chapter explains these eligibility requirements.
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480-1 REVIEWS
When an APA application or review (GEN 50C or GEN 72) is received from a household it must be used to establish a new certification period.
When a new or review application ( GEN 50C or GEN 72 ) is received for other DPA programs, prior to the APA established date for review, the new or review application should not be used to establish a new certification period for APA benefits. See MS 480-3 for additional information regarding acting on reported changes.
See MS 410 for additional information regarding the application process and signature requirements.
Example 1: A household is receiving APA benefits that are certified through December. They apply for SNAP benefits in September. The SNAP application should not be used to establish a new APA certification period unless APA is marked on the application.
Example 2: A household receiving APA and SNAP benefits. The APA is authorized through September, but a SNAP recertification is due in March. When the household submits the SNAP recertification, the GEN 72 should not be used to redetermine eligibility for APA unless APA is marked on the recertification form.
480-1 A. REVIEWS FOR NON- SSI RECIPIENTS
At least once each calendar year a non- SSI APA recipient, or a person acting on the recipient's behalf, must complete a review application. The proper form for an annual review application is DPA form GEN 72 .
In addition to the completed review application, the recipient must also provide any additional DPA forms and any other information/verification that is necessary to correctly redetermine the recipient's APA eligibility and benefit amount.
480-1 B. REVIEWS FOR SSI RECIPIENTS
SSI recipients are also subject to an annual review process. However, because the APA Adult Public Assistance and SSI programs use nearly identical eligibility criteria, it is only necessary for EIS Eligibility Information System to confirm that the individual is an Alaskan resident and still receives SSI Supplemental Security Income . This is considered to be enough proof that the individual Supplemental Security Income still meets APA Adult Public Assistance eligibility criteria. Medicaid may continue if Medicaid eligibility requirements are still met, see ADLTC MS 530 . The caseworker may ask the recipient to provide any additional Division of Public Assistance information if needed to determine the recipient's APA Adult Public Assistance eligibility and benefit amount.
480-1 C. SPECIAL REVIEWS
A case worker may also require a special review application at any time if he or she considers it necessary. The proper form for a special review application is DPA form GEN 50C . In addition to the completed review application, the recipient must also provide any additional DPA forms and any other information/verification that is necessary to correctly redetermine the recipient's APA eligibility and benefit amount.
480-1 D. INTERVIEW REQUIREMENTS
An interview is required once every 12 months.
An interview does not need to be completed if a household submits their recertification after the end of the certification period but within the following month and they are not due for their annual interview.
Note: Individuals who only receive APA /MED benefits, that also receive any amount of SSI, are not required to complete an annual APA interview. If they stop receiving SSI or are receiving benefits (as the PI or SP) from a program that requires an annual interview, such as SNAP , they are required to complete an APA annual interview. See APA MS 480-1B . The annual APA interview is required even if the SNAP interview is waived.
480-1 E. REVIEW APPLICATION PROCESSING TIMEFRAMES
APA regulations require that DPA make an eligibility decision and mail written notice of the decision within 30 days after the date that a review application is filed. If a review application cannot be processed within this 30-day timeframe, because of either client or agency caused delays, the APA case shall remain open and benefits shall be continued until an eligibility decision is made. (Refer to section 480-2 )
480-1 F. NOTICE OF FINDING ON REVIEW APPLICATION
Adequate notice of action shall be mailed to a recipient once the review application is processed. A notice of action is not required for the annual review process for SSI recipients unless the review results in a change in eligibility or benefit amount. Any adverse action taken on a review, such as a reduction in the amount of benefits or termination of assistance, may also require timely notice. (Refer to section 481-1 and 481-2 for adequate and timely notice requirements.)
480-1 G. LATE REVIEWS
If a review application is received by the last day of the month following the month a case is closed for failure to submit a review application, the review application will be accepted as the individual's reapplication.
In this situation, the case worker will treat the review application as an initial application and prorate the payment for the month of reapplication from the date the review application was received in a DPA office.
When redetermining the individual's eligibility, a face-to-face interview is not required unless the case worker finds it necessary, due to questionable circumstances, to redetermine the individual's eligibility or benefit amount. (See section 480-1B above.)
480-1 H. INTERIM ASSISTANCE REVIEWS
Review applications are not mailed for IA cases. Eligibility for IA continues until the individual is determined ineligible or SSI has made its final eligibility decision regarding disability, see APA MS 426-5 .
On the 14th of the month that the review is due, EIS automatically initializes the case into the next month but does not authorize it. An alert is generated at that time indicating " IA RECERTIFICATION DUE". A caseworker must authorize the next IA certification period before the regular run to ensure timely receipt of benefits. If the case is not reauthorized as required, a second alert will be generated indicating " IA PAYMENT NOT AUTHORIZED".
480-2 PERIOD OF ELIGIBILITY
Once APA eligibility is established, it continues until DPA determines that it no longer exists, or the recipient notifies DPA that he or she no longer desires assistance.
Example: An APA recipient submits his or her annual review application on June 15. The review period ends on June 30. On June 25, the case worker determines that the recipient's bank account balance exceeds the resource limit for APA . July benefits must be authorized, since the case worker was not able to meet timely adverse action notice requirements. Benefits are terminated effective July 31.
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480-3 CHANGES
480-3 A. AGENCY RESPONSIBILITY FOR ACTING ON CHANGES
It is the responsibility of DPA to act promptly upon information from any source if that information might affect a recipient's continued eligibility or benefit amount. The case worker shall investigate any information that might affect a recipient's eligibility or benefit amount and, if necessary, adjust the amount of assistance or suspend or terminate assistance as necessary. Action on changes must be taken within 10 days of the date the change becomes known to DPA .
480-3 B. CLIENT RESPONSIBILITY TO REPORT CHANGES
An APA client, or an individual acting on the client's behalf, must report any change in circumstances that may affect the client's eligibility or benefit amount. All changes that a client is required to report must be reported within 10 days of the date the client knows of the change. Changes reported within 10 days from the date the change actually occurred are considered timely. The client may report these changes in person, by telephone, or by mail, to the nearest Public Assistance Office.
Changes that a client must report include, but are not limited to, any:
Change in mailing or residence address;
Movement of a spouse or child into or out of the household;
Change in amount or source of countable income in the household;
Change in countable resources of the household;
Change in eligibility of a household member for other benefits which might affect APA eligibility or benefit level;
Death of a household member which might affect APA eligibility or benefit level;
Change in the marital status of a household member which might affect APA eligibility or benefit level;
Change in school attendance of a blind or disabled student child which might affect APA eligibility or benefit level;
Significant improvement in the condition of a blind or disabled person;
Refusal of an applicant or recipient to accept vocational rehabilitation services;
Departure of an applicant or recipient, or the applicant's or recipient's spouse or child, from the State, the United States, or both;
Refusal of the applicant or recipient to accept or to continue prescribed treatment for drug addiction or alcoholism;
Admission of the applicant or recipient, or the applicant's or recipient's spouse, to or discharge from a public institution, hospital, or nursing home;
Approval or disapproval of Social Security benefits, or a change in SSI appeal status for the applicant or recipient, or the applicant's or recipient's spouse or child.
480-3 c. EFFECTIVE DATES OF CHANGES
1. CHANGES THAT RESULT IN INCREASED BENEFITS
Changes that result in increased benefits are effective the first day of the month of the agency's receipt of the report of change, unless the change was not reported timely.
NOTE: I f the household reports a change timely and submits any necessary verification by the date requested, the caseworker must recalculate the benefit amount and issue a supplemental payment for the month the change was reported.
Example 1- Change reported timely: Abbie reports on August 7 that her temporary job ended at the end of July. The caseworker verifies with the employer that the job ended on July 28 and the last pay was received July 31. The caseworker may issue a supplement for August.
Example 2 - Change not reported timely: Zeus reports on March 16 that his temporary job ended in January. The caseworker increases the benefits beginning April because the change was not reported timely.
2. CHANGES THAT RESULT IN DECREASED BENEFITS
Changes that result in decreased benefits are effective the first of the month following the adverse action period. When the change is not reported timely, overpayments may be necessary (see APA MS 482-2 ).
Example 1- Change reported timely: Nick reports on July 14 that he started a job on July 10. The caseworker decreases the benefit August 1.
Example 2- Change not reported timely: Oscar reports on October 5 that he started a job on August 31. If the change had been reported timely, the first of the decreased benefits would have been October. An overpayment is processed for October and ongoing benefits decrease effective November 1.
480-4 CONVERSION TO OLD AGE ASSISTANCE
When a blind or disabled APA recipient reaches age 65, the case worker will convert the individual's APA case to the Old Age Assistance ( OAA ) category. The case shall be converted to OAA for the benefit month in which the recipient reaches age 65.
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480-5 SUSPENSION AND TERMINATION
480-5 A. SUSPENSION
If a recipient becomes ineligible for assistance, and it appears that the period of ineligibility will not exceed three benefit months, the APA case will be suspended. A period of suspension may not exceed three months. Assistance shall be reinstated without a new application if eligibility is again found to exist at any time during the suspension period, or for the month following the suspension period. Benefits for the month following the month of suspension begin the 1st of the next eligible month and are not prorated
During a suspension period, a recipient may sometimes remain eligible for Medicaid even though he or she is not eligible for an APA payment. Medicaid eligibility exists for any month(s) during a period of suspension in which the recipient continues to receive an SSI payment and Medicaid eligibility requirements are still met, see ADLTC MS 530 . This is true even if the Social Security Administration later determines that the recipient was not eligible for the SSI payment. See Aged, Disabled and Long Term Care ( ADLTC ) Medicaid Manual Section 530 .
Note: If we become aware that an APA recipient’s SSI benefits have been suspended using code “S06 Address Unknown,” and it appears likely that the individual’s SSI benefits may be re-instated within three months, we may suspend the APA benefits for up to three months and continue to issue the Medicaid benefits on the same case number. Since SSI is not an eligibility factor for Medicaid, the individual’s Medicaid benefits may continue as long as the individual is otherwise eligible. If the recipient’s SSI suspension ends, and SSI benefits are reinstated, APA must also be reinstated. If it subsequently appears that the individual’s SSI benefits will not be reinstated within the three-month APA suspense period, the APA case must be closed with a 10-day adverse action notice at the end of the three month period.
480-5 B. TERMINATION
If a recipient becomes ineligible for assistance and it appears that the period of ineligibility will exceed three months, or is of uncertain or indefinite duration, APA assistance will be terminated. The individual must reapply for assistance on DPA form GEN 50C and provide any other necessary documentation and/or verification to again become eligible for assistance.
Note: If APA eligibility ends, the caseworker must close the APA case, but continue Medicaid while the individual is receiving SSI . (See ADLTC MS 530 A )
480-6 LOSS OF CONTACT
An APA application shall be denied or an ongoing APA case shall be closed if DPA loses contact with the applicant or recipient. An adequate notice of denial or closure shall be mailed to the applicant's or recipient's last known address.
Loss of contact has occurred when:
Mail sent to the individual's last known mailing address is returned by the post office with no indication of a known forwarding address, and the individual has not reported a new address; and
Reasonable attempts to locate the individual by using information in the case file have failed.
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480-7 FAIR HEARINGS
Any APA applicant or recipient whose application is not acted on within 30 days after its receipt, or who is affected by any adverse action taken on his or her case, may request a fair hearing. The fair hearing request must be made in writing to any employee of the Division.
Hearing procedures are detailed in the Administrative Procedures Manual at section 117-2 .
480 CASE MAINTENANCE
This chapter provides information on situations and changes that the case worker must act on to determine ongoing eligibility and benefit amounts for APA recipients. All of the general eligibility factors discussed in the preceding sections of this manual also apply to ongoing APA cases.
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481-1 ADEQUATE NOTICE DEFINED
481-1 A. EVERY NOTICE OF ACTION MUST BE ADEQUATE
A notice of action is any notice which informs an applicant or recipient of any action taken, or which will be taken, on his or her case to approve, deny, terminate, suspend, or change the amount of assistance. A notice of action must be adequate. An adequate notice must meet all the requirements listed below:
The notice must explain what action has been taken on the case.
The notice must explain why the action was taken.
The notice must reference the APA manual section that supports any action to reduce, suspend, deny, or terminate assistance.
The notice must advise the individual of the right to request a fair hearing on any action taken on his or her case. Notices generated by the Eligibility Information System ( EIS ) contain this information on the back of the paper stock on which they are printed.
481-1 B. SITUATIONS WHICH REQUIRE ONLY ADEQUATE NOTICE
For actions taken on a new application, adequate notice must be given or mailed to the applicant by the workday following the day that the case worker makes the eligibility decision.
For all other actions, adequate notice must be given or mailed no later than the workday following the date the action is taken or the date the action becomes effective, whichever is later. Adequate notice must be provided in the following situations:
Action taken on a new application.
Action taken that is not an adverse action, such as an increase in the benefit amount.
Action to close a case because of the confirmed death of the recipient.
Action to close a case because a recipient enters a non-eligible institution such as a jail or Pioneers' Home.
Action to close a case or reduce benefits because a recipient enters a nursing home.
Action to issue a supplemental payment to correct a previous underpayment or to issue retroactive benefits.
Action to close a case because of the recipient's written request for closure.
Action to close a case for loss of contact. (Refer to section 480-6 .)
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481-2 TIMELY NOTICE REQUIREMENTS
481-2 A. TIMELY NOTICE DEFINED
In addition to being adequate, some notices also must be timely. Timely notice must be given for all adverse actions, except for those situations listed in section 481-1(B) above. An adverse action is any action taken to reduce, suspend, deny, or terminate benefits. Timely notice means that:
The notice must meet all the requirements of an adequate notice; and
The case worker must give or mail the notice to the applicant or recipient at least 10 days before the date the action will become effective.
Note: The notice of adverse action shall be considered timely if it is mailed at least 10 days prior to the date the action becomes effective. The 10 day count begins the day after the notice is mailed.
Example: Julie reported a new job on Friday, August 12. On Wednesday, August 17, the ET contacted the employer to verify Julie's pay and took action to reduce her benefits for the following month. The notice was printed overnight and brought to the post office on Thursday, August 18. The 10 day count begins Friday, August 19. Because the 10th day falls on Sunday, August 28, the adverse action notice is considered timely.
481-2 B. SITUATIONS WHICH REQUIRE TIMELY NOTICE
The case worker must provide timely notice in the following situations:
Action to terminate benefits.
Action to reduce or suspend benefits.
Adverse action taken on a review application.
481-3 REQUESTS FOR INFORMATION
To determine a client's eligibility or correct benefit amount, the Division sometimes requires information or documentation that may not be immediately available. The case worker must inform the client, in writing, of what information is necessary and give the client a reasonable amount of time to provide it. A reasonable amount of time is at least 15 days. However, the case worker should give the client more than 15 days if it is unreasonable to expect the client to be able to provide the information within 15 days from the date of mailing.
If the client fails, without good cause, to respond to a written request for information, or fails to provide all of the information requested, eligibility for assistance does not exist. Timely notice requirements apply to termination of benefits for failure to provide requested information.
In certain situations, the case worker must give the client 30 days to provide necessary information. 30-day timeframes apply in the following situations:
When the Division becomes aware that a client may be eligible for other benefits for which he or she must apply, the client must be given 30 days from the date of mailing to provide proof that they have applied.
When an Interim Assistance ( IA ) recipient receives an adverse SSI decision from any level except the final Appeals Council review, the case worker must give the individual at least 30 days to provide proof of entry or re-entry into the SSI appeals process. If the required proof is received within the requested time period, and the client is otherwise eligible, the IA benefits are continued without interruption pending a final SSI decision. (Refer to section 426-6B for special notice requirements for IA recipients.)
481 NOTICES
The case worker must send a notice, in writing, to an APA applicant or recipient for every action taken on his or her case to approve, deny, close, suspend, or change the amount of assistance. All notices must be adequate. Some notices must also be timely.
The case worker also must give an applicant or recipient a reasonable amount of time to provide information that is necessary to decide his or her eligibility. (Refer to section 481-3 for the policy on requests for information.)
Whenever possible, case workers should follow-up a written notice to a blind applicant or recipient with a telephone call.
This chapter explains the notice requirements of the APA program.
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482-1 UNDERPAYMENTS
If DPA discovers that an APA recipient has been underpaid by a total of $25 or more during the previous months, it will issue a corrective payment. If the underpayment in discovered in the current month, the underpayment must be issued regardless of the amount. However, a corrective payment will not be issued if the underpayment was caused by the recipient's failure, without good cause, to report or to report accurately, a change in circumstances which caused the recipient to be underpaid.
482-2 OVERPAYMENTS
The Division will pursue the collection of APA overpayments received by both current and former recipients.
482-2 A. DEFINITION OF AN APA OVERPAYMENT
For APA purposes, a ”overpayment” means the amount of APA benefits to which a recipient was not entitled. It includes the amount of assistance paid to a recipient pending a fair hearing decision, if the hearing authority renders a decision requiring that the assistance be repaid.
An APA overpayment does not include the amount of Interim Assistance paid to an individual whose application for SSI is denied solely because the individual is determined not disabled or blind, or because the individual’s income exceeds SSI income standards.
482-2 B. TREATMENT OF AN APA OVERPAYMENT
The requirement to repay an APA overpayment depends on whether the overpayment is agency-caused or client-caused. Repayment is requested but not required for an agency-caused overpayment. Repayment is required for a client-caused overpayment.
1. Agency-caused overpayment
An overpayment is agency-caused when the overpayment occurs solely as the result of an administrative error or oversight by the Division. Agency-caused overpayments include situations where the agency:
Fails to take timely action on a reported change;
Calculates income, deductions, or payment incorrectly; or
Makes any other error which results in an incorrect payment.
2. Client-caused overpayment
An overpayment is client-caused when the overpayment is the result of an action or inaction by the recipient, or by an individual acting on the recipient’s behalf. Client-caused overpayments include situations where the client:
Fails to provide the agency with correct or complete information;
Fails to report a change; or
Fails to report a change in a timely manner.
482-2 C. ESTABLISHING A CLAIM
When a case worker discovers that an APA overpayment has occurred, he or she will determine the amount of the overpayment, complete a Report of Claim Determination ( Gen 95 ) form and APA Claims Budget Worksheet (APA 5) and send both the Gen 95 form and APA 5 and any other supporting documentation to the Claims Unit. The Claims Unit will establish the overpayment claim on EIS and pursue collection of the claim against the current or former recipient. See Chapter 111 of the Administration Procedures manual for more information about program losses and claims collection.
482-2 D. NOTICE REQUIREMENT
After being advised of the overpayment, the Claims Unit is responsible for sending the current or former recipient a written request for repayment. The overpayment notice must:
State the amount of the overpayment;
Give the reason for the overpayment; and
Advise the individual whether repayment is being requested or required. If repayment is being required, the notice must specify what further actions will be taken if repayment is not made.
482-2 E. REPAYMENT OPTIONS
1. Current Recipients
A current recipient may choose to repay an overpayment in a single payment or in monthly installments. If the recipient chooses to repay the overpayment by monthly installment, the division will withhold from the recipient’s monthly benefit an amount equal to 10 percent of the recipient’s monthly payment, or $10, whichever amount is higher. If the recipient’s assistance payment before withholding is less than $10, the entire payment will be withheld.
A current recipient has 30 days from the date he or she receives a notice requesting repayment of a client-caused overpayment. If the entire amount of the client-caused overpayment is not repaid within 30 days, the Division will begin collecting the overpayment by reducing the individual’s monthly payment according to the method specified above.
2. Former Recipients
A former recipient may choose to repay an overpayment by:
making a single payment;
making monthly installment payments of at least 10 percent of the last monthly assistance payment received by the individual;
making quarterly installment payments of at least 30 percent of the last monthly assistance payment received by the individual; or
assigning the individual’s Permanent Fund Dividend through a valid legal assignment to the Division
A former recipient may choose any combination of the payment options listed above as long as the total annual repayment amount is at lest equal to the amount that would be collected by monthly installment if only that option were chosen. A former recipient who chooses to repay an overpayment with his or her Permanent Fund Dividend(s) must execute a new valid assignment of each years Permanent Fund Dividend until the overpayment is recovered in full.
3. When a Former Recipient Becomes a Recipient Again.
When a former recipient who has not totally repaid a previous client-caused overpayment again qualifies for assistance, the Division must pursue collection of any remaining balance by reducing the recipient’s monthly benefit according to section E.1. above. Withholding begins the second benefit month of the recipient’s new period of eligibility.
482-2 F. HARDSHIP PROVISION
Repayment of a client-caused overpayment may be suspended or adjusted if it will cause extreme economic hardship to the individual. The Claims Unit is responsible for deciding whether to suspend or reduce collection due to hardship as follows:
1. Current Recipients
If a current recipient can demonstrate that the loss of assistance will cause extreme economic hardship, repayment may be suspended for up to three months.
2. Former Recipients
If a former recipient can demonstrate that repayment will result in extreme economic hardship, the Claims Unit may:
allow the former recipient to repay less than the required amount; or
temporarily suspend repayment for up to three months.
482-2 G. COORDINATION WITH SSI
If the APA recipient is also an SSI recipient and it appears that he or she has received SSI benefits to which he or she was not entitled, the case worker shall inform the servicing SSA office and let the SSI claims representative pursue collection of any SSI overpayment.
When documenting the amount of an APA overpayment, the case worker may assume that SSI will collect any SSI overpayment. The amount of any APA overpayment is the difference between the amount of APA the recipient received and the amount of APA the recipient was actually entitled to.
482-3 FRAUD
If the case worker has reason to believe that a recipient has received APA benefits that he or she is not entitled to because the recipient intentionally withheld, concealed, or misrepresented information, a fraud referral may be appropriate. When APA fraud is suspected, refer to the Administrative Procedures Manual, section 112, for proper procedures for fraud referrals.
Previous Section Next Section
482 CLAIMS
An APA recipient may occasionally receive more or less assistance than he or she is entitled to. This chapter contains APA policy regarding overpayment or underpayment situations.
Note: Unintentional household error and agency error claims for APA cases do not have a limit to how far back a claim can be established. Claims should be established beginning the date the error originally occurred
PROGRAM STANDARDS
Substantial Gainful Activity ( SGA )
Year 2023 2024 2025 2026 Monthly Limit $1,470 $1,550 $1,620 $1,690
Student Earned Income Exclusion
Year 2023 2024 2025 2026 Monthly Limit $2,220 $2,290 $2,350 $2,410 Annual Limit $8,950 $9,230 $9,460 $9,730
Supplemental Security Income ( SSI Supplemental Security Income ) Eligibility/Payment Standards
Year 2023 2024 2025 2026 Individual, Independent Living (A Living Arrangement) $914 $943 $967 $994 Individual, In Another's Household (B Living Arrangement) $609.34 $628.67 $644.67 $662.67 Couple, Both Eligible Independent Living (A Living Arrangement) $1,371 $1,415 $1,450 $1,491 Couple, Both Eligible, In Another’s Household (B Living Arrangement) $914 $943.34 $966.67 $994 Eligible Institution (D Living Arrangement) $30 $30 $30 $30
APA Need/Maximum Payment Standards 2026
Year 2023 2024 2025 2026 Individual, Independent Living ( A1E Household Type) $1,276 $1,305 $1,329 $1,356 Individual, In Another’s Household ( B1E Household Type) $977 $997 $1,013 $1,031 Individual, In Assisted Living Home ( H1E Household Type) $1,014 $1,043 $1,067 $1,094 Couple, One Eligible, Independent Living ( A2S Couple, One Eligible, Living Independently (APA Household Type) Household Type) $1,435 $1,464 $1,488 $1,515 Couple, One Eligible, In Another’s Household ( B2S Couple, One Eligible, Living in Another's Household (APA Household Type). Household Type) $1,073 $1,093 $1,109 $1,127 Couple, One Eligible, In Assisted Living Home ( H2S Couple, One Eligible, Living in an Assisted Living Home (APA Household Type) Living Arrangement) $1,014 $1,043 $1,067 $1,094 Couple, Both Eligible Independent Living ( A2C Couple, Both Eligible, Living Independently (APA Household Type) Household Type) $1,899 $1,943 $1,978 $2,019 Couple, Both Eligible, In Another’s Household ( B2C Household Type) $1,457 $1,486 $1,510 $1,537 Couple, Both Eligible, In Assisted Living Home ( H2C Living Arrangement) $1,571 $1,615 $1,650 $1,691 Eligible Institution ( NHP Nursing Home Personal Needs (APA Household Type) Household Type) $200 $200 $200 $200
*ALH means living in an assisted living home
** The Nursing Home Special LTC Income (300%) Standard that was frozen in 2003 was again tied to the prevailing SSI income standard beginning September 1, 2010
***The Need Standard and Payment Standard are the same beginning January 1, 2020.
ADDENDUM 2
The Leave and Earnings Statement
Military personnel receive their wages through the LES (Leave and Earnings Statement).
The Entitlements column reflects a military person’s payments and allowances. The Deductions column shows items that are deducted from the entitlements column including tax withholdings, tax payments, Medicare and debt collections. The Allotments column shows items paid to a qualified person or business.
There are numerous items that can appear in these three columns for different military personnel in different types of deployment and housing situations. The following lists the most common of these items and how each are counted in the budget when determining eligibility.
Note: Military pay is received via direct deposit. The name of the bank and account number are listed at the bottom right of the LES .
ENTITLEMENTS ENTITLEMENT DEFINITIONS COUNTS AS INCOME? ADVANCE DEBT: Debt repayment from advance pay. NO ADVANCE PAY: Pay that can be drawn interest free up to three months in advance. NO AMOUNT BROUGHT FORWARD FROM PREVIOUS MONTH (AMTFWD): Amount of all unpaid pay or allowances brought forward from the previous month. YES AVIATION CAREER INCENTIVE PAY: Special pay to officers who hold positions or are in training to get positions in aviation. YES BAH DIFFERENTIAL (BAH-DIF): The difference between the full married BAH rate and full single BAH is paid to military personnel who do not have custody of their children and are paying court ordered child support. YES BASE PAY OR BASIC PAY: A military person’s base pay before other entitlements are added. YES BASIC ALLOWANCE FOR HOUSING (BAH) or BASIC ALLOWANCE FOR QUARTERS (BAQ): The military offers free or subsidized housing to all its personnel. The amount of BAH is dependent upon the rank, location and whether they have dependents. VARIES SEE APA MS 460-7 BASIC ALLOWANCE FOR SUBSISTENCE (BAS): This is a military person’s food allowance. Most (but not all) of the BAS is automatically deducted from the paychecks of members required to consume meals in the dining facilities. YES CAREER SEA PAY& REGULAR SEA PAY: Special pay received by military personnel on sea duty. YES CAREER ENLISTED FLYER INCENTIVE PAY (CEFIP): Special pay for Navy or Air Force who perform operational flying duties. YES CLOTHING ALLOWANCE (CMA): Annual clothing allowance paid to military personnel for the repair/replacement of military clothing issued during basic training. VARIES COMBAT PAY (or incentive pay for hazardous duty, hostile fire pay, or imminent danger pay): Payments to a military person assigned or deployed to a combat zone. NO COST OF LIVING ALLOWANCE (COLA): Compensation paid to military personnel who are stationed in certain “high-cost” locations in the continental United States. YES DISLOCATION ALLOWANCE (DLA) due to permanent change of location (PCL): Partial payment of relocation expenses (not otherwise reimbursed) paid to military personnel when relocating their household due to a permanent change of location (PCL). NO DIVING DUTY PAY: Special pay for Armed Force military personnel assigned to diving duty. YES FAMILY SEPARATION ALLOWANCE (FSA): Allowance to military personnel with dependents anytime they are away from their families (due to military orders) for 30 days or longer. YES FAMILY SUBSISTENCE SUPPLEMENTAL ALLOWANCE (FSSA): Assistance to certain military personnel and their families so they will not have to rely on SNAP to make ends meet. YES FLIGHT PAY: Allowances to military personnel who are on flying status. YES FOREIGN DUTY PAY (FDP): Special pay received by military personnel on duty outside the 48 contiguous states and the District of Columbia. YES FOREIGN LANGUAGE PROFICIENCY PAY (FLPP): Special pay to military personnel receiving basic pay and certified by the individual service secretary to be proficient in a foreign language. YES HARDSHIP DUTY PAY-INVOLUNTARY EXTENSION: Extra pay for military personnel on designated involuntary extension. VARIES, SEE APA MS 460-7(B) HARDSHIP DUTY PAY-LOCATION(HDP-L): Compensation paid to military personnel assigned outside the continental United States in Quality of Life (QoL) Hardship locations. VARIES, SEE APA MS 460-7(B) HARDSHIP DUTY PAY-MISSION (HDP-M): Special pay to military personnel for performing designated hardship missions. VARIES, SEE APA MS 460-7(B) JUMP PAY: Special pay or allotment if required to jump from an airplane. YES LEAVE OR SEPARATE RATIONS: Special pay to military personnel who live in housing that are not required to consume meals in the dining facilities. YES MOVING HOUSING ALLOWANCE (MIHA), MISCELLANEOUS, RENT, AND SECURITY: MIHA-Up front – Reimbursement for household necessities. MIHA Rent - Reimbursement for one time fees such as real estate agent or redecoration fees. MIHA Security - Reimbursement for security improvements. NO NATIONAL GUARD PAY: Basic pay for service personnel of the National Guard. YES PER DIEM: Special pay to military personnel to help defer the costs of traveling on temporary orders. NO, unless exceeds actual costs REENLISTMENT BONUSES: This payment could be received a lump sum or in installments. YES SAVE PAY: This is pay received by an enlisted military person who accepts an appointment as an officer. NO SPECIAL DUTY ASSIGNMENT PAY (SDAP): Pay to military personnel in addition to basic pay for performing extremely difficult duties, or duties involving as unusual degree of responsibility. YES SPECIAL PAY FOR MEDICAL AND DENTAL OFFICERS: Special pay for health professionals. YES SPECIAL PAY FOR WARFARE: A bonus paid to an officer who remains in active duty in special warfare service for at least one year, up to $15,000 for each year of continuation. YES SUBMARINE DUTY INCENTIVE PAY: Special pay to sailors under orders to a submarine. YES SUPPORT/COMMUNITY DEBT (CHILD SUPPORT): This is normally child or spousal support owed outside the household and is not extra pay. NO WOUNDED WARRIOR PAY: Pay to military personnel receiving medical treatment and rehabilitation until they have returned to active duty. YES
DEDUCTIONS DEDUCTION DEFINITIONS ALLOWABLE DEDUCTION? ARMED FORCES RETIREMENT HOME (AFRH): A retirement community that offers residential living quarters, health care, social services, recreational and entertainment programs. NO DEBT: This is repayment of a debt by a military person. NO FAMILY SGLI (FSGLI): A low cost group life insurance for a military person’s spouse and children. NO REPAY ADVANCE: This is a repayment of advance pay. NO, not an allowable deduction. This is repayment of a debt. SERVICEMEMBER’S GROUP LIFE INSURANCE (SGLI): A low cost group life insurance for military personnel. NO SUPPORT/COMM DEBT (CHILD SUPPORT): This is a child or spousal support payment. YES, if legal child support obligation is verified through CSED or a court order TSP(THRIFT SAVINGS PLAN): This is a retirement savings account NO
ALLOTMENTS ALLOTMENT DEFINITIONS IS IT AN ISSUE? DISCRETIONARY ALLOTMENT: This is a designated amount of money that is automatically distributed from a military person’s pay and may be stopped, started, or adjusted at will. These can include payments of premiums for commercial life insurance for the military person or the military person’s spouse or children. Possible countable resource or deduction. NON-DISCRETIONARY ALLOTMENT: This is a designated amount of money that is automatically distributed from a military person’s pay that may or may not be voluntary and cannot be started or stopped at the member’s will. Possible countable resource or deduction. SAVINGS BONDS: A bond issued by the U.S. Government and backed by its full faith and credit. Possible countable resource. TRI-CARE DENTAL (TDP): A voluntary dental insurance program available to military personnel. Possible countable resource. U.S. DEBT: A repayment of debt to the U.S. government. NO
Note: A list of discretionary or non-discretionary allotments can be found at https://www.dfas.mil/MilitaryMembers/paydeductions/allotments/#:~:text=Non%2DDiscretionary%20allotments%20are%20made,contractor%2C%20to%20collect%20the%20debt. .
Addendum 3
Countable and Excluded Income for adult public assistance
Type of Income Countable for APA Adoption payments, subsidized Yes -- see MS 442-3(F) for additional details American Indian/Alaska Native payments Yes -- see MS 442-3(A)(8) for additional details Annuity Payments Yes Alien Sponsor income Yes -- see MS 460-2(B) for additional details Child Support Yes -- see MS 442-3(I) for additional details Census Income Yes Compensatory payments, court ordered Yes Contractual Income, such as monthly payments from sale of a house Yes Contract Work Yes Corporation income from partnerships, estates, and S-corporations Yes Crowdfunding Yes -- see MS 431-2(L) for additional details Death Benefits Yes -- see MS 441-2(G) for additional details Disaster and Emergency Assistance provided by states, local governments, or disaster assistance organizations No Earned Income Tax Credit (EITC) No Educational Grants, Awards, Scholarships, and Loans issued under any program funded under the Title IV of the Higher Education Act or under a Bureau of Indian Affairs student assistance program No Food Stamp Hold Harmless payment No Foster Care, including Therapeutic Foster Care and boarding home payments No -- see MS 442-3(F) for additional details Gambling and lottery winnings Yes Garnishments Yes -- see MS 443-1 for additional details Inheritances Yes In-kind support and maintenance No -- see MS 440-3(A) for additional details Loans, including educational, personal and commercial No Military Entitlements Yes Missionary Income Yes Needs Based Assistance such as Senior Benefits No -- see MS 442-3(B) for additional details Permanent Fund Dividend No Recoupments Yes Rental income, including room rental Yes -- see MS 441-2(M) & 441-2(N) for additional details Retirement/pension income Yes Self-employment income Yes -- see MS 441-1(E) for additional details Supplemental Security Income ( SSI ) Yes Social Security payments, excluding SSI Yes Spousal Support (Alimony) Yes Tax returns, federal No Title V of the Older American Act, such as MASST stipends See MS 442-3(A)3 for additional details Trust income Yes Unemployment benefits ( UIB ) Yes Veteran Disability Payments Yes Veterans' retirement paid by the Department of Defense Finance and Accounting Services (DFAS) Yes -- see MS 441-2(C) for additional details Veterans Survivor benefits Yes Victims of Crime Compensation No Volunteer Payments from the Corporation for National and Community Service (CNCS), such as Senior Corps and AmeriCorps No Wages, including salaries, bonuses, commissions, tips, overtime, severance, and gratuities. This includes an SSI recipient's wages Yes Workers' Compensation Yes
This chart is not comprehensive.
For questions regarding income types, please email hss.dpa.policy@alaska.gov .
STATE OF ALASKA
Department of Health
Division of Public Assistance
TRANSMITTAL NUMBER : MC #76
MANUAL : Adult Public Assistance
Date : September 1, 2026
Beginning July 4, 2025 the 2025 Reconcilliation Bill (H.R. 1) was signed into law. This law contains several provisions that affect the non citizen requirements of the Medicaid program that are effective October 1, 2026. APA and SSI recipients will no longer be automatically eligible for Medicaid due to the non citizen requirements that are effective October 1, 2026.
Highlights of these and other policy revisions are described below. If you have questions, contact the Policy and Program Development Team at hss.dpa.policy@alaska.gov .
OVERVIEW OF CHANGES
MS 400-1 AN OVERVIEW OF THE ADULT PUBLIC ASSISTANCE PROGRAM
Revised section to reflect APA recipients must also meet Medicaid qualified alien requirements as an eligibility factor for Medicaid effective October 1st, 2026
MS 410-4 VERIFICATION
Added a note regarding the new death match and prisoner match notices
MS 410-7 C ELIGIBILITY FOR MEDICAID
Added note to reflect individuals must meet Medicaid qualified alien requirements as an eligibility factor for Medicaid effective October 1st, 2026
MS 421-6 A VERIFICATION OF U.S. CITIZENSHIP IS NOT REQUIRED FOR
Revised note to remove automatic Medicaid eligibility for APA recipients due to the Medicaid qualified alien requirements effective October 1st, 2026
MS 425-2 C SSA BLINDNESS OR DISABILITY DECISIONS
Revised section to remove automatic Medicaid eligibility for APA recipients due to the Medicaid qualified alien requirements effective October 1st, 2026
MS 425-3 C BLIND OR DISABLED APPLICANTS WHO DO NOT APPEAR ELIGIBLE FOR SSI AND HAVE NOT BEEN DETERMINED ELIGIBLE FOR SSA DISABILITY
Revised section to reflect APA recipients must also meet Medicaid qualified alien requirements, due to the Medicaid qualified alien requirements effective October 1st, 2026
MS 426-7 C NOT ELIGIBLE FOR SSI SOLELY BECAUSE OF EXCESS INCOME
Revised section to reflect the individual meets all other factors of the Medicaid program. Due to Medicaid qualified alien requirements effective October 1st, 2026
MS 433-4 (3) ABLE ACCOUNTS
Revised section to reflect Medicaid alien requirements as an eligibility factor for Medicaid effective October 1st, 2026
MS 480-1 B REVIEWS FOR SSI RECIPIENTS
Revised section to reflect Medicaid may continue if Medicaid eligibility requirements are still met due to Medicaid qualified alien requirements effective October 1st, 2026
MS 480-5 A SUSPENSION
Revised section to reflect Medicaid may continue if Medicaid eligibility requirements are still met due to Medicaid qualified alien requirements effective October 1st, 2026
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #16
MANUAL: Adult Public Assistance
DATE: September 14, 2007
This manual change updates program policy in conjunction with changes to the Medicaid, Alaska Temporary Assistance, and Food Stamp manuals. It revises several sections in the application process chapter and removes references to outdated Medicaid policy regarding the use of conversion factors when estimating income.
This manual change also updates cross references within the manual, corrects agency and program names, and includes several technical changes for minor spelling and wording changes.
Highlights of these policy revisions are described below.
If you have any questions please contact any member of the Policy and Program Development Team at (907) 465-3347 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410, Application Process
Adds " DPA -contracted" next to "fee agent" to clarify that only fee agents who have a contract with DPA can interview the household. This change was also made at MS 410-3C .
MS 410-2C , When is an Application Not Required?
Clarifies that a new application is not required when a household is not eligible for the first month but is eligible for the second month.
MS 410-3E, Interviews Conducted at a DPA Office
Clarifies that the office must schedule an interview if the household contacts the office within 30 days of the application filing date.
MS 410-3F, Changes Reported at the Interview
Clarifies that all applicant households must report all changes at the interview.
MS 410-4, Verification
Clarifies what is expected of a caseworker when checking information systems and interfaces. An example is included.
MS 410-5C, Pending the Application
Removes "attend the interview" from the first sentence. The office is not required to send a notice when an interview is scheduled in person or by telephone.
MS 440-4, Determining the Household’s Monthly Income
Removes references to outdated Family Medicaid policy that prohibited the use of conversion factors when converted income caused Medicaid ineligibility.
MS 441-2H, Awards
Updates the Division of Health Care Services Third Party Liability ( TPL ) Unit email address.
MS 452-10, Temporary Assistance and APA
Corrects the date in Example 1, replacing "October 31" with "November 30."
MS 460-2, Financial Responsibility
Removes the "Note" in subsection B about potential differences between APA and Medicaid for sponsored aliens. The information was outdated and no longer applicable.
MEMORANDUM
DATE: December 3, 1999
TO: Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
SUBJECT : Alaska Adult Public Assistance Program Manual, 1999 Edition
We are pleased to present you with the 1999 edition of the Adult Public Assistance manual. This edition does not present any new policy. However, in an effort to make the manual easier to use, the new edition:
presents information in a slightly different format,
expands the manual index,
updates examples with more current information, and
makes other minor technical corrections.
This new edition also removes information about referrals to the Alaska Longevity Bonus program, and implements new APA need and maximum payment standards beginning with the benefit month of January 2000.
Please address any questions or comments to the Policy and Program Development Team by e-mail at dpapolicy@health.state.ak.us, by SYSM to HPAPOLY, or call us at 465-3347.
COST OF LIVING ALLOWANCE ( COLA ) INCREASE
Effective January 1, 2000, a 2.4 % COLA increase will be granted to recipients of Social Security and SSI . APA need and maximum payment standards will also increase. The new standards are effective for the benefit month of January 2000.
Although the amount of APA benefits to SSI recipients will not change, APA payments to non- SSI recipients may decrease. However, no one will lose APA or APA -related Medicaid eligibility because of this COLA change.
Affected Manual Sections:
Section 451-3, APA Need Standards
This section is updated to reflect the 2.4 % COLA increases in the 2000 APA need standards.
Section 453, Maximum Payment Standards
This section is updated to reflect the increases in APA and SSI maximum payment standards for 2000.
MANUAL CHANGE INSTRUCTIONS
Replace the entire manual.
MEMORANDUM
DATE: December 1, 2000
TO: Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
SUBJECT: Adult Public Assistance Manual Change #1
This manual change implements new APA need and maximum payment standards beginning with the benefit month of January 2001. It also updates the manual’s table of contents, and clarifies APA policy on substantial gainful activity, DDS referral procedures, and educational assistance. This change also makes minor technical corrections. All changes other than the 2001 COLA increases are effective upon receipt of this manual change.
Effective January 1, 2001, a 3.5% Cost of Living Allowance ( COLA ) increase will be granted to recipients of Social Security and SSI . APA need and maximum payment standards will also increase.
Although the amount of APA benefits to SSI recipients will not change, APA payments to non- SSI recipients may decrease. However, no one will lose APA or APA -related Medicaid eligibility because of this COLA change.
The explanation of the manual changes and the affected manual sections are described below.
Please address any questions or comments to the Policy and Program Development Team by e-mail at dpapolicy@health.state.ak.us, or call us at 465-3347.
Explanation of Manual Changes
Old Policy New Policy Table of Contents Lists chapters, sections, and subsections. Retains the chapter titles, but deletes sections and subsections. The deleted information is now available in each chapter’s table of contents. Section 425-1 , Definition of Blindness/Disability Defines what disability means. Expands the disability definition by describing what substantial gainful activity ( SGA ) means. Section 425-2D , State-Only Blindness or Disability Decisions Describes when state-only disability decisions are necessary. Clarifies that DPA case workers are responsible for making state-only disability determinations when substantial gainful activity is involved. Section 425-3 , Procedures for Initial Blindness or Disability Decisions Directs staff to send requests for state-only disability decisions through Field Services. Updates the referral process by directing staff to send requests for state-only disability decisions directly to Disability Determination Services ( DDS ). The change also requires each district office to maintain a log of DDS requests and decisions. Section 432-2A , One Automobile References the ”National Market Reports Red Book” as source of verification for determining vehicle values. Corrects the references to ”National Market Reports Blue Book”. Section 432-4K , Educational Assistance Provides that educational assistance to an undergraduate made or insured under any program administered by the U.S. Commissioner of Education is totally excluded from resources. Clarifies that educational assistance received under Title IV of the Higher Education Act of 1965, and under Bureau of Indian Affairs education programs, is totally excluded from resources. This policy applies to all students, not just undergraduates. Section 442-3A(7) , Educational Assistance Provides that educational assistance to an undergraduate made or insured under any program administered by the U.S. Commissioner of Education is totally excluded from income. Clarifies that educational assistance received under Title IV of the Higher Education Act of 1965, and under Bureau of Indian Affairs education programs, is totally excluded from income. This policy applies to all students, not just undergraduates. Section 451-3, APA Need Standards Provides APA need standards for 2000. Updates the APA Need Standards for 2001. Section 453, Maximum Payment Standards Gives APA and SSI maximum payment standards for 2000. Updates the APA and SSI maximum payment standards for 2001.
Manual Change Filing Instructions
Remove Old Pages Insert New Pages Table of Contents, i through xiv Table of Contents, i through ii Chapter Contents (Chapter 425) Chapter Contents (Chapter 425) H-1 through H-8 H-1 through H-8 L-5 through L-6 L-5 through L-6 L-19 through L-20 L-19 through L-20 P-11 through P-12 P-11 through P-12 S-1 through S-2 S-1 through S-2 U-1 through U-2 U-1 through U-2
MEMORANDUM
DATE: April 17, 2001
TO: Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
SUBJECT: Adult Public Assistance Manual Change #2
Earlier this year, federal regulations were changed to promote employment for disabled persons who want to work. As a result, this manual change updates the substantial gainful activity amount used in making disability determinations and increases the earned income exclusion for a blind or disabled student child. This manual change also simplifies the processing of annual reviews for SSI recipients.
Changes to the substantial gainful activity amount and the earned income exclusion for a blind or disabled child are effective January 1, 2001. The guidance on processing annual reviews for SSI recipients is effective April 1, 2001.
Explanation of Manual Changes
Old Policy New Policy Section 425-1 , Definition of Blindness/Disability Defines ”substantial gainful activity” as an individual’s own average monthly earned income of $700. Raises the SGA amount to $740 per month. Section 442-2D , Earned Income Exclusion of a Blind or Disabled Child Provides for an earned income exclusion against the earnings of a blind or disabled student child of up to $400 per month, but not more than $1620 per calendar year. Raises the earned income exclusion to $1290 per month, and $5,200 per calendar year. Section 480-1 , Reviews Provides directions on how to process annual APA reviews for all recipients. Simplifies the annual review process for SSI recipients.
Implementation Guidelines for Reviews for SSI Recipients
As a result of last year’s Business Analysis and Process Design Conference, field staff representatives made several suggestions for streamlining the operation of the Adult Public Assistance ( APA ) program. One of these suggestions was to streamline the annual APA reviews for SSI recipients. SSI recipients make up about 60 percent of our statewide APA caseload. Our long-term goal is to fully automate the annual APA review process for those APA recipients who also receive SSI benefits. Essentially, this means the Eligibility Information System ( EIS ) will automatically check for Alaska residency and SSI recipient status, and re-certify the APA / SSI recipient for another year. Non- SSI recipients will continue to have their annual APA reviews processed the same as before.
Part of the necessary programming has now been completed. That is, for APA / SSI recipients whose EIS review period ends April 2001 or later, EIS will no longer mail APA Review Due notices and APA review applications to APA recipients who receive SSI benefits. However, programming to automatically check Alaska residency and SSI recipient status, and recertify the APA / SSI recipient for another year has not yet been completed. Until the new APA review process for SSI recipients is fully automated, we have established some interim procedures to reduce paperwork and alleviate your APA workload as much as possible.
Interim Procedures:
Review your monthly caseload report, CR001, at the beginning of the month to identify those APA / SSI cases that need to be reviewed and reauthorized for another year. The first month this must be done is April 2001.
Register a review APA application on EIS for the identified SSI recipients.
Confirm the individual’s Alaska residency and SSI recipient status through the use of the SVES interface or other available information. If the APA recipient meets these two criteria, APA benefits may be approved for another year.
Use alerts to identify APA / SSI cases that still need to be reviewed and processed. An EIS alert will be generated at the end of the month if a review application was not registered on EIS . Alerts of this type must be acted on immediately so that the individual’s APA benefits are delayed no longer than necessary.
Do not send an EIS notice once the review is completed. Because SSI recipients are not required to submit an annual review application, it is no longer necessary to send them an EIS notice (i.e., P802) to advise them that their APA review has been completed.
Please address any questions or comments to the Policy and Program Development Team by e-mail at dpapolicy@health.state.ak.us, or call us at 465-3347. The explanation of the manual changes and the affected manual sections are described below.
Manual Change Filing Instructions
Remove Old Pages Insert New Pages H-1 through H-2 H-1 through H-2 P-3 through P-4 P-3 through P-4 Chapter Contents (Chapter 480) Chapter Contents (Chapter 480) X-1 through X-6 X-1 through X-8
MEMORANDUM
DATE: September 1, 2001
TO: Adult Public Assistance Manual Holders
FROM: The Policy and Program Development Team
Ellie Fitzjarrald, Chief
SUBJECT: Adult Public Assistance Manual Change #3
We’re pleased to present two significant APA policy changes with this manual change:
Prospective budgeting for non- SSI recipients, and
Transfer of resource penalty.
This change also provides new guidance for anticipating monthly income and makes minor technical corrections.
With prospective budgeting the APA payment will better coordinate with the individual’s circumstances and avoid the benefit fluctuations some recipients experienced under retrospective budgeting. This change is not extended to SSI recipients because APA payments to SSI recipients do not fluctuate from month to month; the APA payment remains the same as long as the individual remains eligible for SSI .
The new APA transfer of resource policy is being implemented to bring us into alignment with SSI . We expect few APA applicants or recipients will transfer resources and be affected by this policy. This new policy only applies to APA . Medicaid has a less restrictive transfer of resource policy that must be considered whenever an APA penalty is applied.
Implementation: Prospective budgeting for non- SSI recipients and the transfer of resource penalty changes are both effective October 1, 2001. All other policy clarifications and changes are effective immediately upon receipt of this manual change.
If you have any questions or comments about this change, please contact any member of the Policy and Program Development Team at 465-3347 or email us at dpapolicy@health.state.ak.us.
The explanation of the manual changes and the affected manual sections are described below.
Explanation of Manual Changes
Old Policy New Policy Section 420-2 , Concurrent Participation in the SSI Program States that an APA client whose income is within SSI limits must be eligible for SSI to be found eligible for APA . Adds an exception that allows APA eligibility when an APA transfer of resource penalty ends before the end of an SSI transfer of resource penalty. Section 425-3 , Procedures for Initial Blindness or Disability Decisions Directs staff to get a completed APA #5 form, ”r;Authorization to Release Medical Information”, from APA applicants who need a state-only disability decision from the DDS . Changes the form to the Med #2 form, ”r;Medical Release of Information”. Section 433-1 , Transfer of Resources States that resource transfers for less than fair market value do not affect APA eligibility, but may affect an individual’s eligibility for institutionalized Medicaid coverage. Adds new policy to implement an APA penalty period for up to 36 months if an individual transfers a resource for less than its value on or after October 1, 2001. Section 440-4 , Estimating Income New Section Provides policy guidance for estimating income prospectively. 441-2 , Unearned Income States that prize income, such as bingo or pull-tab winnings, may sometimes be anticipated in determining prospective eligibility. Changes policy to clarify prize winnings may not be anticipated, even if the individual has a previous pattern of winning. 452-1 , Payment Calculations Describes the retrospective budgeting process used to calculate payments for non- SSI recipients. Adds new policy to implement prospective budgeting for non- SSI recipients. All references to retrospective budgeting have been removed. Examples were also updated with January 1, 2001 payment standards 452-3 , Cost of Living Allowance ( COLA ) Increases When determining eligibility and payment amounts, SSA COLA increases are budgeted prospectively, but other types of income are still subject to retrospective budgeting. Removes references to retrospective budgeting. 480-1 , Reviews States that it is only necessary to confirm Alaska residency and continued receipt of SSI for the annual review process for SSI recipients. States that APA payments to non- SSI recipients remain in retrospective budgeting if there is not a one-month break in benefits. Clarifies that EIS will confirm Alaska residency and continued receipt of SSI . Removes all references to retrospective budgeting. 480-5 , Suspension and Termination States that a person may be retrospectively ineligible for APA , but prospectively eligible for Medicaid. Removes all references to retrospective eligibility for APA .
Manual Change Filing Instructions
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MEMORANDUM
DATE: December 3, 2001
TO: Adult Public Assistance Manual Holders
FROM: Ellie Fitzjarrald, Chief
Policy and Program Development Team
SUBJECT: Adult Public Assistance Manual Change #4
Effective January 1, 2002, a 2.6% Cost of Living Allowance ( COLA ) increase will be granted to recipients of Social Security and SSI . This COLA increase also affects the APA program. Beginning with the benefit month of January 2002, this manual change implements new APA need and maximum payment standards, increases the income limit for substantial gainful activity, and raises the earned income exclusion of a blind or disabled student child.
This manual change also adds new policy to exclude any payments to victims of Nazi persecution, incorporates the resource exemption policy for special needs or pooled trusts, and updates the manual index. It also makes minor technical corrections.
Implementation Dates: The 2002 COLA increases are effective January 1, 2002. All other changes are effective upon receipt of this manual change.
The explanation of the manual changes and the affected manual sections are described below. If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or e-mail us at dpapolicy@health.state.ak.us.
Old Policy New Policy Section 425-1 , Definition of Blindness/Disability Defines substantial gainful activity ( SGA ) as an individual’s own average monthly earned income of $740. Raises the SGA amount to $780 per month. Section 425-3C , Blind or Disabled Applicants Who Do Not Appear Eligible for SSI and Have Not Been Determined Eligible for SSA Disability Instructs staff to send a copy of the APA application to the Disability Determination Service. Instructs staff to complete form Gen 141 , Referral for Disability Determination, and removes the requirement to send a copy of the APA application. Section 431-2F , Trust Property Describes APA trust policies. States that a trust that meets the Medicaid criteria for a special needs or pooled trust is not a resource. Section 432-4B , Payments to Victims of Nazi Persecution Excludes German reparation payments from resources. Adds new policy to exclude any payments to victims of Nazi persecution from resources. Section 442-2D , Earned Income Exclusion of a Blind or Disabled Student Child Provides for an earned income exclusion against the earnings of a blind or disabled student child of up to $1,290 per month, but not more than $5,200 per calendar year. Raises the earned income exclusion to $1,320 per month, and $5,340 per calendar year. Section 442-3A(14) , Payments to Victims of Nazi Persecution. New Section Adds new policy to exclude any payments to victims of Nazi persecution from income. Section 451-3, APA Need Standards Provides APA need standards for 2001. Updates the APA Need Standards for 2002. Section 452-6 , Issuance of APA Payments States that assistance payments are issued by state warrant. Adds the option of payment by direct deposit. Section 453, Maximum Payment Standards Gives APA and SSI maximum payment standards for 2001. Updates the APA and SSI maximum payment standards for 2002.
Manual Change Filing Instructions
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MEMORANDUM
DATE: December 20, 2002
TO: Adult Public Assistance Manual Holders
FROM: Ellie Fitzjarrald, Chief
Policy and Program Development Team
SUBJECT: Adult Public Assistance Manual Change #5
Effective January 1, 2003, a 1.4% Cost of Living Allowance ( COLA ) increase will be granted to recipients of Social Security and SSI . This COLA increase also affects the APA program. Beginning with the benefit month of January 2003, this manual change implements new APA need and maximum payment standards, increases the income limit for substantial gainful activity, and raises the earned income exclusion of a blind or disabled student child.
This manual change also eliminates the prohibition against DPA employees acting as payees, and clarifies policy pertaining to SSI alien status requirements and property agreements. It also makes other minor technical corrections.
Implementation Dates: The 2003 COLA increases are effective January 1, 2003. All other changes are effective upon receipt of this manual change.
The explanation of the manual changes and the affected manual sections are described below. If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or e-mail us at dpapolicy@health.state.ak.us.
Old Policy New Policy Section 421-10 , SSI Alien Status Requirements Describes the alien status requirements of the SSI program. Clarifies that aliens who meet APA alien status requirements may still qualify for APA even if they do not meet the more restrictive alien status requirements of the SSI program. Section 425-1 , Definition of Blindness/Disability Defines substantial gainful activity ( SGA ) as an individual’s own average monthly earned income of $780. Raises the SGA amount to $780 per month. Section 431-2I , Promissory Notes, Loans, and property Agreements Describes how promissory notes, loans, and property agreements are treated in determining APA eligibility. Clarifies that the resource value of a promissory note, loan, or property agreement is its fair market value when the fair market value is less than the outstanding principal balance. Section 442-2D , Earned Income Exclusion of a Blind or Disabled Student Child Provides for an earned income exclusion against the earnings of a blind or disabled student child of up to $1,320 per month, but not more than $5,340 per calendar year. Raises the earned income exclusion to $1,340 per month, and $5,410 per calendar year. Section 451-3, APA Need Standards Provides APA need standards for 2002. Updates the APA Need Standards for 2003. Section 452-7B , Payment to a Third Party Describes the policies for providing APA payments to a payee. Eliminates the prohibition against DPA employees acting as a payee. Section 453, Maximum Payment Standards Gives APA and SSI maximum payment standards for 2002. Updates the APA and SSI maximum payment standards for 2003.
Manual Change Filing Instructions
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MEMORANDUM
DATE: March 21, 2005
TO: All Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
Ellie Fitzjarrald, Chief
SUBJECT: Adult Public Assistance Manual Change #10
This manual change implements new policy on estimating income and changes to the student earned income exclusion. It also includes an updated index, and makes other technical changes. Highlights of these policy revisions are described below.
If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or e-mail us at dpapolicy@health.state.ak.us.
Estimating Income
Two recent fair hearing decisions identified an inconsistency between our policy and the federal food stamp regulations for estimating income in the application month. This change corrects that policy. Application month income will no longer be determined based on the amount of income received by the interview date. Instead, the policy for estimating income will be the same for the application month and subsequent months.
In addition, we have clarified and simplified the manual sections. The conversion factors section is simplified by addressing only the two factors that truly convert income to a monthly amount – bi-weekly 2.15 and weekly 4.3, i.e., the third and fifth paycheck situations.
We are adopting these changes for the Food Stamp, APA , ATAP and Family Medicaid programs, so that policy is still aligned, with one exception. The Family Medicaid program prohibits the use of conversion factors when converted income causes Medicaid ineligibility.
The new policy for estimating income in the application months may be applied right away, however, it must be applied to all applications processed on and after May 1, 2005.
Student Earned Income Exclusion
As a result of a change in federal law, the student earned income exclusion that previously applied only to dependent children under the age of 22 has been changed to exclude the earned income of any student under the age of 22, including those who are married, emancipated, or considered as head of household.
OVERVIEW OF CHANGES
MS 440-4 , Determining the Household’s Monthly Income
Clarifies the policy for determining the household’s monthly income
Reorganizes and expands some sections to better explain how averaging is used in converting and estimating income
Revises the conversion factors policy
Includes a reminder that Family Medicaid policy requires the worker to determine Medicaid eligibility by disregarding the third or fifth payment if using converted income causes the household to exceed the Medicaid income limit.
Replaces the estimating income in application month policy with expanded sections on policy for estimating full and partial month’s income.
Updates policy on using work schedules instead of pay history to apply to any situation when changes occur that result in the pay history no longer reflecting the income the individual expects to receive.
MS 442-2D , Student Earned Income Exclusion
Permits the student earned income exclusion to apply to any individual under age 22 who is a student.
Manual Change Filing Instructions
Remove Old Pages Insert New Pages Table of Contents (page ix through xii) Table of Contents (ix through xii) B-5 through B-6 B-5 through B-6 I-5 through I-6 I-5 through I-6 Chapter Contents (Chapter 440) Chapter Contents (Chapter 440) N-11 through N-20 N-11 through N-22 Chapter Contents (Chapter 442) Chapter Contents (Chapter 442) P-3 through P-4 P-3 through P-4 P-23 through P-24 P-23 through P-24 V-13 through V-14 V-13 through V-14 W-1 through W-4 W-1 through W-4 Addendum 1 (pages 1 through 2) Addendum 1 (pages 1 through 2) Index (pages 1 through 14) Index (pages 1 through 14)
MEMORANDUM
DATE: September 1, 2005
TO: All Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
Ellie Fitzjarrald, Chief
SUBJECT: Adult Public Assistance Manual Change #11
In our continuing effort to simplify and align policy across programs where possible, we are pleased to introduce a new Application Process chapter. To the extent that we can, we are presenting policy in the same format and language in the Food Stamp, Adult Public Assistance, Alaska Temporary Assistance, and Family Medicaid program manuals.
This manual change incorporates clarifications to the estimating income policy as a result of discussions during the 2005 Learning Summits, implements new policy for three resource exclusions and changes the definition of income. Also included are updates to the Table of Contents, Appendix 1, the Index, and other minor technical changes. Highlights of the policy revisions are described below.
If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or e-mail us at dpapolicy@health.state.ak.us.
OVERVIEW OF CHANGES
Chapter 410 , Application Process
Reorganizes the sections in the chapter and aligns policy with other programs where possible.
Incorporates policy relating to fee agent applications and applications from remote areas.
Adds policy for accepting Native Family Assistance Program ( NFAP ) application forms and interviews.
Clarifies that the Gen 72 , Eligibility Review Form, may be used as an initial application form only if received in the month following the end of the review period.
Clarifies that an application can still be used when denied for failure to provide verification or attend an interview, if, within 30 days of the application date, the applicant provides the necessary information or reschedules the interview.
Clarifies that changes in household members reported before the application is processed are considered in the determination.
MS 432-2A , One Automobile
Effective immediately, one automobile per household may be excluded from resources regardless of value if it is used for transportation of the individual or couple, or a member of the individual’s or couple’s household. This policy change is the result of a change in SSI policy that occurred on April 1, 2005.
MS 432-2D , Funds Set Aside for Burial
Beginning September 1, 2005, policy for the burial funds exclusion is changed to describe the earliest date on which the exclusion applies. This change only applies to burial fund determinations made on or after September 1, 2005. Burial funds that were excluded under previous policies will continue to be excluded from resources.
In addition, burial funds that are used for another purpose will no longer cause the burial funds exclusion to end.
MS 432-2E , Household Goods and Personal Effects
Effective immediately, the $2,000 limit for this resource exclusion is eliminated. These items are now totally excluded from resources, regardless of their value. However, personal property that a person acquires or holds because of its value or as an investment still count as a resource. This policy change is the result of a change in SSI policy that occurred on April 1, 2005.
MS 440-1 , Income Defined
Federal SSI regulations were amended effective March 9, 2005 to change the definition of income. Previous policy defined income as money that could be used to meet a person’s needs for food, clothing, or shelter. This change removes the term ”r;clothing” from the definition of income. This policy change was previously implemented by a broadcast announcement to staff on April 19, 2005.
MS 440-4 , Determining the Household’s Monthly Income
Revises the section to incorporate policy clarifications and examples for estimating a full month’s income when the income is new or has changed.
Adds an example for a partial month’s income due to a change that occurs during the month.
Manual Change Filing Instructions
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BROADCAST TO ALL DPA STAFF FROM
Ellie Fitzjarrald, Chief
Policy and Program Development
The 2003 policy that created the process for secondary medical screening of applicants for the Interim Assistance program ( IA ) is rescinded.
Effective immediately , all IA disability determinations must be based solely on the information provided by an applicant's physician or psychiatrist on the Preliminary Examination for Interim Assistance ( AD #2 ) form. For purposes of IA , an individual will be considered disabled when the individual's physician or psychiatrist certifies on the AD #2 form that the individual is presumptively disabled or meets the Social Security definition of disability, as defined on the AD #2 .
This policy change is the result of recent litigation and became effective yesterday, September 13, 2005. It must be applied to all IA determinations made on or after September 13, 2005. Any IA applications that may have been denied yesterday or today as a result of the medical screener's findings must be redetermined, using the information provided by the applicant's physician or psychiatrist on the AD #2 .
Attached is APA manual change #12, incorporating this revised IA policy. Please print and replace these pages in your APA manual immediately. Due to the immediacy of this change, we will not be issuing a paper manual change. MC #12 will be incorporated into the on line manual within the next few days.
Please continue to forward AD #2 forms and supporting medical evidence for all applicants determined eligible for IA to the medical screener, as instructed in MC #12.
If you have questions about this change or need additional information please write to DPA policy at dpapolicy@health.state.ak.us .
MEMORANDUM
DATE: December 1, 2005
TO: Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
Ellie Fitzjarrald, Chief
SUBJECT: Adult Public Assistance Manual Change #13
Each year Adult Public Assistance need and maximum payment standards are adjusted to reflect the Cost of Living Allowance ( COLA ) increase in Social Security benefits. This year the COLA increase is 4.1%. This manual change incorporates the 2006 standards, which become effective with the benefit month of January 2006. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity, and
An increase in the earned income exclusion of a blind and disabled student child.
A number of other updates are included:
Revisions to Interim Assistance policies that were previously issued via e-mail broadcast on September 14, 2005.
Increase in the time period during which a completed Interim Assistance Reimbursement ( IAR ) Agreement must be distributed.
A change in how the value of a vehicle may be verified, in response to requests from staff.
Highlights of these policy revisions are described below. If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or email dpapolicy@health.state.ak.us.
OVERVIEW OF CHANGES
MS 426-2C , Interim Blindness or Disability Determination
This section is updated to reflect recent litigation that temporarily rescinds the secondary medical screening process for Interim Assistance approvals. This section was previously updated via broadcast on September 14, 2005.
MS 426-3B(3) , Notification of a Signed IAR Authorization
Instead of 10 working days, caseworkers have 30 calendar days to distribute a completed IAR Authorization form to the Social Security Administration, the client, and the case file.
MS 432-2A(5) , Verification
Changes policy to allow caseworkers to accept the household’s stated value of a vehicle when the household provides a explanation of why the value is lower than the assigned value, and the explanation is not questionable. Thanks to the Mat-Su staff for their persistence in requesting this policy change!
MANUAL CHANGE FILING INSTRUCTIONS
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MEMORANDUM
DATE: January 17, 2006
TO: Adult Public Assistance Manual Holders
FROM: Policy and Program Development Team
Ellie Fitzjarrald, Chief
SUBJECT: Adult Public Assistance Manual Change #14
This manual change reinstates the medical review process for Interim Assistance ( IA ), and introduces a new Preliminary Examination for Interim Assistance ( AD #2 ) form. A copy of the new AD #2 form is attached.
In September 2005, the medical review process for determining IA eligibility was suspended because of litigation. At issue was whether the Department was required to make a change to state regulations before implementing the medical review process. State regulations were subsequently amended to clearly describe this review process, and a medical review must again be completed for all APA applicants who wish to receive Interim Assistance while waiting for an SSI disability decision. Only applicants who the Division determines are likely to meet Social Security disability requirements will be eligible for IA .
Doctors of patients applying for IA will complete the new Preliminary Examination for Interim Assistance ( AD #2 ) form. The APA worker will then send this form and any supporting medical documentation to the Medical Reviewer in Anchorage. DPA’s Medical Reviewer will assess an individual’s eligibility for IA based on the results of the medical examination and other evidence. The APA worker will determine IA eligibility based on the Medical Reviewer’s decision.
In some cases, the Medical Reviewer may need to ask a medical provider for information. To assist in this process the caseworker should obtain an Authorization for Release of Protected Health Information (Gen 150) form from the applicant. A copy of this release form is attached, with recommended language to be inserted on the form that supports the request.
Implementation Date: The policy is effective immediately. The new AD #2 form must be obtained for APA applications received on or after January 18, 2006, and sent to the Medical Reviewer. Caseworkers may continue to use the doctor’s response on the old version of the AD #2 form when determining IA eligibility for APA applications received before January 18, 2006.
If you have any questions, please contact Jim Steele at 465-3201 or e-mail dpapolicy@health.state.ak.us.
Manual Change Filing Instructions
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STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
DATE: April 20, 2007
SUBJECT: Adult Public Assistance Manual Change #15
This manual change includes the aligned education income policy and updates the income eligibility standards announced by broadcast on November 29, 2006. As part of an ongoing effort to align income and resource policies across programs, to the extent possible we have presented education income policy in the same format and language in the Alaska Temporary Assistance, Family Medicaid, and Food Stamp program manuals.
This change also includes the program’s annual Cost of Living Allowance ( COLA ) adjustments. Each year the Adult Public Assistance need and maximum payment standards are adjusted to reflect the COLA increase in Social Security benefits. This year the COLA increase is 3.3%. This manual change incorporates the 2007 standards, which become effective with the benefit month of January 2007. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and
An increase in the student earned income exclusion.
Several minor clarifications and technical changes are also included. Highlights of these policy revisions are described below. If you have any questions please contact any member of the Policy and Program Development Team at 465-3347 or email dpapolicy@health.state.ak.us.
OVERVIEW OF CHANGES
MS 426-2C(3) , Disabled APA Applicants Required to Submit an AD #2 Form
Updates the mailing address for the Division’s Medical Reviewer to include the correct suite # and zip code.
MS 426-2E , IAR Authorization Requirement
Clarifies that a completed Interim Assistance Reimbursement ( IAR ) Authorization form must be provided to Social Security within 30 calendar days, instead of 10 working days.
MS 426-8A , Blindness or Disability Exam Costs
Corrects the cross reference for issuing a Medicaid authorization to add the Aged, Disabled, and Long Term Care Medicaid manual section.
MS 432-4K , Education Assistance
To the extent possible, this section was revised to present policy in the same format and language as in the Alaska Temporary Assistance, Family Medicaid, and Food Stamp program manuals.
Clarifies that education assistance provided under Title IV of the Higher Education Act or a Bureau of Indian Affairs student assistance program is totally excluded from resources, regardless of how long the funds are kept.
MS 442-3A(7) , Education Assistance
To the extent possible, this section was revised to present policy in the same format and language as in the Alaska Temporary Assistance, Family Medicaid, and Food Stamp program manuals.
Clarifies that education assistance is treated the same way, regardless of whether it is received by an undergraduate student or a graduate student.
Addendum 1 , Program Standards
Updates program standards to reflect the COLA changes for 2007.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #17
MANUAL: Adult Public Assistance
DATE: December 1, 2007
Each year the Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 2.3%. We have incorporated the 2008 standards, which become effective with the benefit month of January 2008. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and
An increase in the student earned income exclusion.
We have also added references to state laws and regulations governing the Adult Public Assistance program.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3347 or email dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
MS 400 General Information
Adds references to state laws and regulations governing the Adult Public Assistance program.
MS 433 Special Resource Provisions
MS 452 Payments
MS 460-5 Income Allocations
Updates examples to reflect the 2008 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2008.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #18
MANUAL: Adult Public Assistance
DATE: July 15, 2008
In response to staff requests to clarify estimating income policy, we have revised the Determining Monthly Income chapters in the Adult Public Assistance, Alaska Temporary Assistance, Family Medicaid, and Food Stamp program manuals. To the extent possible, the same format and words are used in all manuals to reinforce the alignment of the policies among programs. This revision does not change policy, but instead, clarifies concepts and methods caseworkers can use to estimate income.
In addition, we made minor changes to other sections of the manual to clarify existing policy.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3347 or email dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
MS 410-7 A (2) Initial Month's APA Payment for Applications Received On Or After July 1, 2004
Clarifies that start date for APA can be determined from the award letter provided by the client or by contacting the Social Security Office.
MS 420-2 B (2) Time Limit for Pursuit of SSI Benefits
Clarifies that clients may still be considered disabled if in non-pay status with SSI .
MS 420-3 C Social Security Administration ( SSA ) Insurance
Clarifies that applicants for Social Security may qualify with between 6 and 40 quarters of work.
MS 432-3 A Property Necessary for Self-Support
Clarifies $6,000 is total exclusion not per piece of property
MS 432-4 P Victim's Compensation Payments
MS 442-3 A (13) Victim's Compensation Payments
Changes language to align with other policy manuals.
MS 433-1 D (1) Undue Hardship
Removes repeated bullet
MS 440-4 Determining the Household's Monthly Income
Revises entire chapter to clarify policy. Adds definition of terms including "full payment period' and 'scheduled payment'. Adds examples to illustrate how policy can be applied to various situations. This revision is included in all the program manuals.
Addendum 1 Program Standards
Updates IRS Mileage Allowance chart with changes for 2008.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #19
MANUAL: Adult Public Assistance
DATE: October 15, 2008
In response to questions from field staff, we are clarifying that fleeing felons who are not eligible for SSI or SSA benefits and individuals who are not eligible for SSI benefits due to the SSI program’s stricter citizenship requirements may be eligible for APA if they meet all other eligibility requirements.
In addition, the IRS mileage allowance table has been removed from Addendum 1. In manual sections where the mileage rate is referenced, a link to the IRS website showing the most current mileage rate has been supplied.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
MS 420-2 A Relationship Between The SSI and APA Programs
Clarifies that applicants who are not eligible for SSI due to fleeing felon status or citizenship requirements may still be eligible for APA if they meet other eligibility requirements.
MS 425-2 D State-Only Blindness or Disability Decisions
Adds fleeing felons and more stringent citizenship requirements to the list of reasons applicants may not qualify for SSI .
MS 430-2 Resource Limits
Clarifies the resource limit for a couple is $3000 as long as at least one member is eligible for assistance.
MS 442-2 I (1) Work Expenses For The Blind
Adds reference to use the business mileage rate
Adds IRS website to get the current business mileage rate
MS 442-3 A (7)(c)(5) Income Exclusions Authorized By Federal Laws
Adds reference to use the business mileage rate
Adds IRS website to get the current business mileage rate
MS 452-5 A (1) Regular APA Benefit Payments
Adds a second example to show how to budget a fleeing felon’s income.
Addendum 1 Program Standards
Removes the IRS mileage allowance table.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #20
MANUAL: Adult Public Assistance
DATE: December 1, 2008
Each year the Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 5.8%. We have incorporated the 2009 standards into the examples and Addendum 1. These standards become effective with the benefit month of January 2009. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and
An increase in the student earned income exclusion.
We made some language changes to the interview section of the Application Process chapter in conjunction with the other program manuals. We aligned policy about Native Restricted Lands with other programs to the extent possible. We also clarified several policy issues requested by field staff.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
MS 410-3E Conducting Interviews
Revises language that incorrectly implied an applicant had to come into a DPA Office for an interview.
MS 410-3F Changes Reported During the Interview
Revises language that incorrectly implied an applicant had to come into a DPA Office for an interview.
MS 425-2A Temporary Disability or Blindness Decisions
Clarifies that chiropractors and osteopaths are considered to be proper medical providers for a temporary disability decision; however psychologists are not.
MS 426-2C Interim Blindness or Disability Determination
Adds a cross reference in subsection 3. to new subsection 4.
Adds a new subsection 4. that provides instructions on how to complete the Authorization for Release of Protected Health Information (Gen 150) form.
MS 432-1E Native Restricted Land
Revises the section to clarify policy and describe what is meant by "Native Restricted Deed."
Clarifies that any house or related structure that is permanently attached to excluded ANCSA land is also excluded from resources.
Changes the ”Verification" note to more clearly describe the requirement to verify Native Restricted Deed status.
MS 432-4L Alaska Native Claims Settlement Act ( ANCSA ) Assets
Clarifies that any house or related structure that is permanently attached to excluded ANCSA land is also excluded from resources.
MS 433-1 Transfer of Resources
Updates examples to reflect the 2009 need and maximum payment standards.
MS 442-4 The Order In Which Income Exclusions Are Applied
Clarifies the IRWE section to inform Eligibility Technicians that they have to manually deduct an IRWE from the adjusted gross earned income on the APAS screen in order to have the payment amount figured correctly.
MS 452 Payments
Updates examples to reflect the 2009 need and maximum payment standards.
MS 460-5 Income Allocations
Updates examples and standards to reflect the 2009 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2009.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #21
MANUAL: Adult Public Assistance
DATE: February 20, 2009
In response to questions from field staff this manual change includes information on how Refugee Cash Assistance and one-time Refugee Resettlement payments are treated for the APA Adult Public Assistance program.
In addition to other technical changes, the section on conducting interviews was revised to correctly describe the date the denial notice is sent for a request for service application. The verification section in Chapter 410 was also updated to add information about the SOLQ interface and remove obsolete information about the Senior Benefit interface.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410-3 E Conducting Interviews
Clarifies the timing of the automatic application denial for no interview when the APA application is registered as a request for service (RP).
MS 410-4 Verification
Adds information about the State Online Query ( SOLQ ) interface and clarifies that caseworkers need to check Social Security interfaces only when it appears the applicant or recipient could be eligible for Social Security benefits.
Adds note to clarify that the SOLQ interface may be used only to determine eligibility for the Alaska Temporary Assistance, Food Stamp, Medicaid, and Adult Public Assistance programs.
Reformats EIS Interface table to clarify that the SDX , PFD , and DOL Wage Match information is accessed through the Interface Inquiry (ININ) item on the INME.
Adds SVES and SOLQ to the EIS Interfaces table.
Removes obsolete information about the Senior Benefits program interface. Since DPA is now administering the program, the interface is no longer available.
MS 440-3 B Medical or Social Services, and Cash Received From a Public or Private Organization in Conjunction With Such Services.
Adds one-time Refugee Resettlement Payments as an example of cash provided by a public organization for social services.
Adds a cross-reference to Administrative Manual section 128-4, Refugee Assistance.
MS 441-2 D Income Based On Need
Adds Refugee Cash Assistance to the list of programs that provide needs-based assistance.
Adds a cross-reference to Administrative Manual section 128-4, Refugee Assistance.
Adds a cross reference to APA Manual section 452-10 for policy on how to budget monthly Refugee Cash Assistance payments.
MS 442-3 B Certain Assistance Based on Need
Replaces obsolete SeniorCare reference with a reference to the new Senior Benefits Program.
MS 452-10 Temporary Assistance and APA
Adds a cross reference to section 452-10A for additional policy in Refugee Cash Assistance.
Clarifies that an APA recipient is budgeted as an individual if the ineligible spouse is receiving Refugee Assistance.
MS 460-6 A Income Exclusions of An Ineligible Spouse
Adds Refugee Cash Assistance to the list of public income maintenance payments.
MS 470-3 Temporary Absence From Institution
Replaces ”First Health Services” with ”Affiliated Computer Systems”
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #22
MANUAL: Adult Public Assistance
DATE: July 1, 2009
This manual change implements the new policy announced by broadcast on June 12 that all AmeriCorps payments are exempt income. This change is effective July 1, 2009.
In addition to other technical changes, the section on allowable absences was revised to explain that an individual remains eligible when out of state for their own illness or that of a family member whether they became ill while out of state or left the state due to illness.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 423-2 B Exceptions For Certain Allowable Absences
Clarifies that a recipient does not have to be out of state when they or a family member becomes ill to remain eligible. If an individual leaves the state due to their own illness or that of a family member and is not able to return within 30 days, they remain eligible for assistance.
MS 426-2 C Interim Blindness or Disability Decision
This section was updated with information about the new GEN 150 IA form.
MS 426-2 E IAR Authorization Requirement
Clarifies which fields must be completed by the caseworker.
MS 442-3 A Volunteer Service Payments
Clarifies that all AmeriCorps payments are exempt income.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #23
MANUAL: Adult Public Assistance
DATE: September 1, 2009
As a result of the Food and Nutrition Service approving the waiver of face-to-face interviews for Alaska, changes have been made to the interview chapter to remove the requirement to document why the face-to-face interview was waived. This change was announced by broadcast on August 4 and is retroactive to June 1, 2009.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410-3 A When Is An Interview Required
Removes the requirement to conduct a face-to-face interview.
MS 410-3 D When Can the Face-to-Face Interview Be Waived
Changes title from "When Can the Face-to-Face Interview Be Waived" to "How To Conduct An Interview"
Removes reasons a face-to-face interview can be waived.
Clarifies interviews can be face-to-face, by phone or by correspondence.
Clarifies caseworker must conduct a face-to-face interview if requested by the client.
MS 410-3 E Scheduling Interviews
Changes title from "Conducting Interviews" to "Scheduling Interviews"
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #24
MANUAL: Adult Public Assistance
DATE: January 4, 2010
Previously policy required applicants attend an interview, meaning they had to appear in person. Since face-to-face interviews are no longer required, the word “attend” has been changed to “participate”.
Written verification such as an individual’s tax returns or business records is the preferred method to verify self-employment income. We revised the self-employment chapter to clarify that verbal verification of self-employment income and expenses is acceptable when written verification is not available.
We updated the Interim Assistance chapter to clarify when a new medical review is required. If an Interim Assistance case closes and a new application is submitted at a later date, it is not necessary to request a new medical review (including requesting a new AD 2, IAR and GEN 151a’s) at reapplication if there was no final SSI decision during the time the Interim Assistance case was closed. A new disability assessment by the Medical Reviewer is only required if a new SSI application was submitted during the individual’s period of ineligibility.
Other highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or e-mail dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
MS 410 Application Process
Replaces the word "attend" with "participate" to reflect that face to face interviews are no longer required.
MS 410-2C When is an Application Not Required?
Adds a note to clarify how APA is registered when an SSI child on Medicaid turns 18.
Adds link to Administrative Manual Section 103-3 & 124-3.
MS 410-4 Verification
In the Direct Data Systems table, replaces the Automatic Status Verification System ( ASVS ) with Verification Information System ( VIS ). The VIS is the online electronic verification system used by the SAVE Program.
MS 425-2 A Who Determines Disability/Blindness
Adds licensed clinical psychologist with a PhD as a physician who can complete the AD #2 form.
MS 426-2C Interim Blindness or Disability Determination
Clarifies that a new medical review is not needed for IA applicants who have not received a final SSI decision while their IA case was closed.
Adds licensed clinical psychologist with a PhD as a physician who can complete the AD #2 form.
MS 432-4 N World War II Restitution Payments
Clarifies that Aleut reparation payments received from a trust established by the Secretary of the Interior are countable resources if retained
MS 432-4O Agent Orange Settlement Funds
Adds the date Agent Orange settlement payments ended.
MS 441-1 D Net Earnings from Self-Employment
Clarifies that verbal verification of self-employment income and expenses is allowed.
MS 442-3A(10) World War II Restitution Payments
Clarifies that Aleut reparation payments received from a trust established by the Secretary of the Interior are countable income.
MS 442-3A(11) Agent Orange Settlement Payments
Adds the date Agent Orange settlement payments ended. Also clarifies VA disability payments for diseases related to Agent Orange exposure are not exempt.
Addendum 1
Adds column for 2010 to the APA and SSI eligibility/payment standard charts. Since there is no COLA increase for 2010 the figures remain the same as 2009.
Update the SGA chart for 2010.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #25
MANUAL: Adult Public Assistance
DATE: April 1, 2010
We are making several changes to incorporate new policy, clarify existing policy and align policies within our program policy manuals. This includes:
An Eligibility Review Form (Gen 72) may be used as an initial application form if it is received in the month following a case closure. The case closure may be for any reason.
Interface verification policies are changed to more clearly describe when an interface must be checked. It is no longer necessary to check all interfaces at each application, recertification, or review.
Beginning December 19, 2009, Afghan and Iraqi special immigrants are treated the same as refugees and are not subject to a five-year bar.
A non-transferable Limited Entry Fishing Permit is an exempt resource.
Funds held in a dedicated account established to hold a minor's retroactive SSI benefits are an exempt resource.
Income received from the lease of a Limited Entry Fishing Permit is treated as unearned rental income.
Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410-2 A What Is An Acceptable Application Form?
Clarifies that the Gen 72, Eligibility Review Form, can be accepted as an initial application in the month following case closure regardless of the reason for closure.
MS 410-4 Verification
Clarifies which interfaces must be checked at every application and review, and which should only be checked if the caseworker receives questionable information.
MS 420-3 Other Commonly Available Benefits For Which An APA Applicant or Recipient Must Apply
Clarifies that an APA applicant or recipient who appears to be eligible for a benefit from another program must apply for that benefit at the earliest opportunity.
MS 420-4 G Benefits Which Do Not Affect Amount of Assistance
Clarifies that APA applicants and recipients are not required to pursue child support income.
MS 421-2 Qualified Aliens
MS 421-3 Five Year Bar
MS 421-4 Proof of Alien Status
MS 421-9 Citizenship Status Declaration
Adds Afghan and Iraqi special immigrants to the list of qualified aliens.
Adds Afghan and Iraqi special immigrants to the list of qualified aliens who are not subject to a five year bar.
Adds information about the type of proof that may be used to verify Afghan and Iraqi special immigrant status.
Changes title from “Citizenship Status Declaration” to “U.S. Citizenship and Eligible Alien Status”
Adds a reference to ADLTC manual section 520 B
Removes requirement to complete citizenship status declaration.
MS 432-3 A Property that represents governmental authority
Clarifies that a Limited Entry Fishing Permit that the Commercial Fisheries Entry Commission (CFEC) have classified as non-transferrable have no value.
MS 432-4 A Retroactive SSI and RSDI Payments
Clarifies that funds held in a dedicated account are exempt.
MS 441-2 M Rental Income
Clarifies that income from the lease of a limited entry fishing permit is considered unearned rental income.
MS 442-3 J Deposits made to a bank account on behalf of another person
Clarifies that an SSI beneficiary receiving money on behalf of another and acting as their “agent” will not have the money counted as income as long as the SSI recipient disburses or intends to disburse the money to the other party.
MS 450-4 Living In An Assisted Living Home
Adds a note to provide a link to identify assisted living homes as well as instructions for using the tool.
MS 460-2 A Income and Resources of Spouses
Adds a note clarifying homeless married couples must be treated as eligible individuals.
MS 480-5 Suspension and Terminations
Clarifies that benefits for the month following suspension are not prorated.
Clarifies that if APA eligibility ends Medicaid continues as long as the client is receiving SSI.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #26
MANUAL: Adult Public Assistance
DATE: October1, 2010
We are making several changes to incorporate new policy, clarify existing policy and align policies within our program policy manuals. This includes:
To the extent possible, we are aligning policies in the U.S. Citizenship and Alien Status chapter with those in our other program manuals.
New policy allows a 50% deduction from self employment income for self-employment expenses. The household can choose to use actual expenses if they believe they are higher than 50%.
Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410-3 E . Scheduling Interviews
Removes the requirement to send a written notice to the applicant informing them of their interview date and time.
Includes three options for informing the applicant of their appointment date and time as well as documentation requirements for each option.
MS 421 U.S. Citizenship and Alien Status
Aligns policies in the U.S. Citizenship and Alien Status chapter with those in our other program manuals.
Moves sponsor alien information from 421-7 and 421-8 to chapter 460.
MS 426-2 C Interim Blindness or Disability Determination
Adds the APA 4 as a required form to be completed and included with the other forms that are sent to the Medical Reviewer.
MS 441-1 D Net Earnings from Self Employment
Adds new policy that allows a 50% deduction from self-employment income for self-employment expenses. The household can choose to use actual expenses if they believe they are higher than 50%.
Addendum 1
Updates the long term care income limit to 300% of the prevailing SSI standard as of September 1, 2010.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #27
MANUAL: Adult Public Assistance
DATE: December 1, 2010
This manual change includes new Interim Assistance Reimbursement procedures (described in the November 19 broadcast to staff) and moves information about contacting the Medical Reviewer to its own subsection.
Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 426-2 F Contacting the Medical Reviewer
Adds new sub-section about how to contact the Medical Reviewer.
Adds the Medical Reviewer email address for staff inquiries.
MS 426-3 Interim Assistance Reimbursement (IAR)
Explains changes to Interim Assistance Reimbursement procedures that went into effect on November 20, 2010.
MS 441-1 B Flexible Health Benefits
Adds new policy that only the contribution amount that goes directly to the employee (benefit contribution excess) is countable income. Any amount the employer pays for mandatory health insurance benefits is not counted as income to the employee.
Reorganizes the earned income section to align more closely with the organization of the other program manuals.
MS 460-2 B Income and Resources of Alien Sponsors
Clarifies that the deeming period for alien sponsors lasts for 3 years.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #28
MANUAL: Adult Public Assistance
DATE: January 3, 2011
This manual change updates program policy in conjunction with changes to the Medicaid, Alaska Temporary Assistance, and Food Stamp manuals.
Also included in this manual change is an update to the program standards for 2011. Each year the Adult Public Assistance need and maximum payment standards are adjusted to reflect the COLA increase in Social Security benefits. There will be no COLA increase for 2011.This manual change updates the 2011 standards, which become effective with the benefit month of January 2011.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 441-1 E (2)(c) Examples Clarifying the use of the Standard Expense Deduction
Adds subsection (c) to show examples of when the standard self-employment expense deduction should be used.
Addendum 1 Program Standards
Updates the addendum to reflect program standards for 2011. Because there was no Social Security COLA adjustment for 2011, the program standards remain the same as those for 2010.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #29
MANUAL: Adult Public Assistance
DATE: April 1, 2011
We are making several changes to incorporate new policy, clarify existing policy, and align policies within our program policy manuals. These changes include:
Clarifying how SSI disability decisions effect retroactive IA issuance.
Clarifying vehicle exemptions when an APA recipient or applicant lives with other individuals.
New policy excluding federal income tax returns as income in the month of receipt and as a resource 12 months from the date of receipt.
Clarifying how to process Medicaid when APA is suspended.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 426-2 C Interim Blindness or Disability Determination
Adds a note clarifying that if SSI makes a favorable disability decision before the Medical Reviewer DPA will not issue retro IA from the date the IAR was signed
MS 432-2 A. One Vehicle
Clarifies that a vehicle is only considered a resource when owned by an eligible individual or the eligible individual’s spouse.
Adds examples to the section.
MS 432-4 Q. Earned Income Tax Credit
Changes exclusion from 9 months to 12 months from the date the refund or payment is received.
MS 432-4 Y. Federal Income Tax Returns
Clarifies that federal income tax returns are exempt as a resource for twelve months from the date of receipt.
MS 440-3 E. Federal Income Tax Returns
Changes title to Income Tax Returns.
Clarifies new law that requires federal income tax returns to be excluded as income in the month of receipt. This section aligns with other policy.
MS 441-2 M . Rental Income
Deletes the word ”necessarily” in net rental income section. Clarifies that expenses are deducted when paid not when incurred.
480-5 A. Suspension
Adds note regarding SSI suspension code SO6 and how to process the Medicaid portion.
Previous
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #30
MANUAL: Adult Public Assistance
DATE: July 1, 2011
Beginning July 1, 2011, new policy increases the personal needs allowance for nursing home residents to $200 per month. This manual change incorporates the new need and maximum payment standards in Addendum 1.
Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 432-1B Proceeds from Sale of a Home
Changes the name of the section to “Proceeds from Sale of a Home” from “Home Replacement Funds”.
MS 433-1 Transfer of Resources
U pdates examples within this section to reflect the 2011 need and maximum payment standards.
MS 452 Payments
U pdates examples within this chapter to reflect the 2011 need and maximum payment standards.
MS 452-1 C. Interim Assistance Payments
Updates the personal needs maximum payment from $75 to $200 per month.
MS 452-5B(2) IA Benefit Payments to Institutionalized individuals
Updates the personal needs maximum payment from $75 to $200 per month.
MS 452-5C Personal Needs Benefit Payments
Updates the personal needs maximum payment from $75 to $200 per month.
MS 460-5 Income Allocations
Updates the year from 2009 to 2011 within the chapter.
U pdates examples within this chapter to reflect the 2011 need and maximum payment standards.
MS 470-2 Continued Benefits For Temporarily Institutionalized Recipient
Updates the personal needs maximum payment from $75 to $200 per month.
Addendum 1
Updates the nursing home personal needs allowance from $75 to $200 per month effective July 1, 2011 in the APA need standard table and the APA maximum payment standards table.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #31
MANUAL: Adult Public Assistance
DATE: September 1, 2011
We are making several changes to incorporate new policy, clarify existing policy, and align policies within our program manuals. These changes include:
A new military pay policy has been added to the financial responsibility and deeming chapter for ineligible spouses. The addition of Addendum 2 to provide an example of an Leave and Earnings Statement (LES) as well as three tables to define types of Entitlements, Allotments and Deductions that may be found on the Leave and Earnings Statement.
Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 421-5(B) Non-Immigrants
Adds a note stating aliens born in the Marshall Islands, the Federated States of Micronesia and Palau can travel freely between the islands and the United States but are considered non-qualified aliens and are not eligible to receive public assistance.
MS 421-6(C) Proof of Qualified Alien Status
Creates a separate row in the table for Cuban or Haitian Entrants. Previous manual combined this immigration status with the Battered Spouse or Child of a U.S. Citizen or Permanent Legal Resident.
MS 431-2(G) Retirement Funds
Aligns policies in the Retirement Funds chapter with those in other program manuals.
MS 442-3(7)(b) Other Education Assistance
Adds that any money that “will not” be used for education expenses is countable unearned income. Previous policy only indicated money that “is not” used for education expenses is countable unearned income.
MS 460-1(G) Deployed Spouse
Adds deployed spouse to the list of definitions. Since the APA program does not have a household comp section, this will allow an explanation of how to budget a spouse that’s been deployed.
MS 460-4(A) Resource Exclusions of Ineligible Spouse
Revises this section to read any retirement fund belonging to an ineligible spouse is excluded.
Adds a link to Retirement Funds sub chapter for list of possible retirement funds an ineligible spouse may have.
MS 460-7 Special Rules for a Spouse in the Military
Adds a new section for income and resources of a spouse in the military to combine all countable and excluded income, and resources of a deployed spouse.
MS 481-2(A) Timely Notice Defined
Adds a note to clarify the count for 10 days adverse action begins the day after the notice is mailed.
Adds example to further clarify when the 10 day count begins.
Addendum 2 The Leave and Earnings Statement
Adds an example of an LES paystub and a definition list to the Addendum to give guidance for interpreting the LES statement
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #32
MANUAL: Adult Public Assistance
DATE: December 1, 2011
This year Social Security announced a Cost of Living Allowance (COLA) increase effective January 2012. The Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 3.6%. We have incorporated the 2012 standards into the examples and Addendum 1. These standards become effective with the benefit month of January 2012. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and An increase in the student earned income exclusion.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 433-1 Transfer of Resources
Updates examples to reflect the 2012 need and maximum payment standards.
MS 433-2 A Eligibility for Conditional Benefits
Updates the SSI payment standard to the new 2012 amount in order to accurately calculate if an applicant is eligible for conditional benefits.
MS 452 Payments
Updates examples to reflect the 2012 need and maximum payment standards.
MS 460-5 Income Allocations
Updates examples and standards to reflect the 2012 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2012.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #33
MANUAL: Adult Public Assistance
DATE: March 1, 2012
We are making several changes clarifying existing policy as a result of suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 421-4 Five-Year Waiting Period
Adds a new section and examples to demonstrate when benefits begin at the end of the 5 year waiting period.
MS 425-1(1) Blindness
Clarifies that if a person meets the APA program's blindness criteria, SGA is not a factor in determining their eligibility for APA. The APA program only considers SGA for disability determinations (not blindness).
MS 425-2(D) State-Only Blindness or Disability Decisions
Clarifies that caseworker should not make a SGA determination on applicants or recipients that have a currently disability (diary date). SGA is only determined if the applicant or recipient is no longer disabled and the disability must be determined by the DDS.
MS 431-2(F) Trust Property
Adds Letter D. for QIT also known as Miller’s trust. The QIT does not protect income or resources for APA. If funds are retained in the trust, and those funds exceed the APA program’s resources limit, there is no APA eligibility.
MS 452-10(B) Temporary Assistance to APA Conversions
Adds 2 more examples involving families with income and how to calculate the APA recipient’s share for 1P and 2P HH once approved for APA.
MS 460-7 Special Rules for a Spouse in the Military
Adds SAVE pay to the list of excluded military income.
MS 470-1 Ineligible Institutions
Adds a note about Alcohol and substance abuse treatment centers are not ineligible institutions for APA purposes. Reside nce may receive regular APA or IA benefits and remain budgeted as A1E HH.
MS 480-1(B) Reviews for SSI Recipients
Adds language to indicate that because the APA and SSI programs use the same eligibility requirements, it is only necessary for EIS to confirm that the individual is an Alaska resident and still receives SSI. This is considered to be enough proof that the individual remains eligible for APA. The caseworker may ask the individual to provide any additional information if needed to determine eligibility.
Addendum 2 Entitlements Table
Correct SAVE pay to indicate it is not countable income. This is considered combat pay.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #34
MANUAL: Adult Public Assistance
DATE: August 31, 2012
As part of the project to combine the PFD HH manual with existing manuals, the explanation of how to replace SSI lost due to receipt of PFD has been added to the APA manual. A few other technical changes have also been made.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 430-4(A)(1) Some Assets are not Resources
Corrects the paragraph to say "Assets are not resources if the individual does not have: Any ownership interest; or the legal right, authority, or power to liquidate them."
MS 433-3 Permanent Fund Dividend
Adds sub chapters referencing hold harmless procedures for SSI applicants and recipients.
MS 452-7(C) Payment to A Third Party
Adds a note stating court appointed guardians or conservators do not need to sign the APA 14.
MS 482 Claims
Adds a note stating the agency does not have a limit to how far back a claim can be established.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #35
MANUAL: Adult Public Assistance
DATE: December 1, 2012
This year Social Security announced a Cost of Living Allowance (COLA) increase effective January 2013. The Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 1.7%. We have incorporated the 2013 standards into the examples and Addendum 1. These standards become effective with the benefit month of January 2013. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and An increase in the student earned income exclusion.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 433-1 Transfer of Resources
Updates examples to reflect the 2013 need and maximum payment standards.
MS 433-2 A Eligibility for Conditional Benefits
Updates the SSI payment standard to the new 2013 amount in order to accurately calculate if an applicant is eligible for conditional benefits.
MS 452 Payments
Updates examples to reflect the 2013 need and maximum payment standards.
MS 460-5 Income Allocations
Updates examples and standards to reflect the 2013 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2013.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #36
MANUAL: Adult Public Assistance
DATE: March 8, 2013
This manual change updates program policy in conjunction with changes to the Medicaid, Alaska Temporary Assistance, and Food Stamp manuals regarding good faith efforts to sell property.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 426 2 (F) CONTACTING THE MEDICAL REVIEWER
Updates the Medical Reviewer's address from Suite 814 to Suite 460.
MS 433-2 G DEFINITION OF REASONABLE EFFORTS
Adds a note clarifying good faith efforts to sell property, gives examples to include examples of "good faith effort" sale listings, i.e. Craigslist, online realtor, newspaper ads, etc
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #37
MANUAL: Adult Public Assistance
DATE: July 1, 2013
This manual change reflects the updated Fair Hearing regulations regarding how a hearing must be requested and includes a link to the Administrative Manual section 117 for this process.
Other changes are either technical in nature or clarifications that are the results of policy questions or suggestions from the field.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 410- 5 (E) WITHDRAWING AN APPLICATION
Updated language to explain that withdrawals for Medicaid applications must be made in writing .
MS 480-7 FAIR HEARINGS
Added reference to Administrative Manual Section 117 to clarify procedures for requests for Fair Hearings, and that Fair Hearing requests must be made in writing.
Addendum 1 PROGRAM STANDARDS
Corrects a typo in 2012 B1E household
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #38
MANUAL: Adult Public Assistance
DATE: December 2, 2013
This year Social Security announced a Cost of Living Allowance (COLA) increase effective January 2014. The Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 1.5%. We have incorporated the 2014 standards into the examples and Addendum 1. These standards become effective with the benefit month of January 2014. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and An increase in the student earned income exclusion.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 433-1 Transfer of Resources
Updates examples to reflect the 2014 need and maximum payment standards.
MS 433-2 A Eligibility for Conditional Benefits
Updates the SSI payment standard to the new 2014 amount in order to accurately calculate if an applicant is eligible for conditional benefits.
MS 452 Payments
Updates examples to reflect the 2014 need and maximum payment standards.
MS 460-5 Income Allocations
Updates examples and standards to reflect the 2014 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2014.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #39
MANUAL: Adult Public Assistance
DATE: March 3, 2014
We are making a change to clarify existing policy as a result Affordable Care Act Medicaid.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
426-8 ELIGIBILITY FOR MEDICAL ASSISTANCE
Added a sentence to explain that a disability determination is needed for APA related Medicaid, if no disability has been determined, check for other eligible categories or refer to the FFM.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #40
MANUAL: Adult Public Assistance
DATE: June 2, 2014
We made a change to clarify existing policy regarding effective date of changes.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
480-3 C EFFECTIVE DATE OF CHANGES
Adds a new section to clarify the effective date of changes including several examples.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #41
MANUAL: Adult Public Assistance
DATE: September 2, 2014
We made a change to clarify existing policy regarding effective date of changes.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
480-3 C EFFECTIVE DATE OF CHANGES
Clarifies when the effective date of change occurs.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #42
MANUAL: Adult Public Assistance
DATE: January 2, 2015
This year Social Security announced a Cost of Living Allowance ( COLA ) increase effective January 2015. The Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 1.7%. We have incorporated the 2015 standards into the examples and Addendum 1. These standards become effective with the benefit month of January 2015. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and An increase in the student earned income exclusion.
Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 433-1 Transfer of Resources
Updates examples to reflect the 2015 need and maximum payment standards.
MS 433-2 A Eligibility for Conditional Benefits
Updates the SSI payment standard to the new 2015 amount in order to accurately calculate if an applicant is eligible for conditional benefits.
MS 452 Payments
Updates examples to reflect the 2015 need and maximum payment standards.
MS 460-5 Income Allocations
Updates examples and standards to reflect the 2015 need and maximum payment standards.
Addendum 1 Program Standards
Updates program standards to reflect the COLA changes for 2015.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #43
MANUAL: Adult Public Assistance
DATE: June 1, 2015
We are making a change to clarify existing policy and adding a new section on rental income.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
426-2F CONTACTING THE MEDICAL REVIEWER
Clarified only IA review inquires can be emailed to the Medical Reviewer.
441-2N HOME OWNER INCOME FROM ROOM RENTAL
Added a new section on how to determine rental income for a home owner.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #44
MANUAL: Adult Public Assistance
DATE: September 1, 2015
We are making changes to clarify existing policy and adding a section on incarcerated adults.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
425-2D STATE-ONLY BLINDNESS OR DISABILITY DECISIONS
Clarifies that a SSA disability decision trumps a DDS disability decision.
441-1C SICK LEAVE
Changed the title from sick payment to sick leave.
460-1F SPOUSE
Clarifies definition of Spouse
470-1 INELIGIBLE INSTITUTIONS
Added clarification that an incarcerated individual may be eligible for Medicaid for hospital stays over 24 hours.
470-3 TEMPORARY ABSENCE
Replace Affiliated Computer Systems with Xerox, the State's fiscal agent.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #45
MANUAL: Adult Public Assistance
DATE: December 1, 2015
We are making changes to clarify the recent Medicaid exclusion of Alaska Native and American Indian real property exclusion does not apply to the Adult Public Assistance program.
Since there is no COLA increase for 2016 the figures remain the same as 2015. Updated Addendum 1 with new SGA limit.
Added the PFD hold harmless section back to the manual.
Highlights to policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at dpapolicy@alaska.gov .
430 RESOURCES
Adds a note to clarify that the change to Medicaid policy regarding Alaska Native and American Indian property does not apply to APA resources.
431-1 REAL PROPERTY AND PROPERTY RIGHTS
Adds a note to clarify that the APA excluded property is different from Medicaid policy regarding Alaska Native and American Indian real property.
432-1E NATIVE RESTRICTED LAND
Added a hyperlink to ADLTC MS 524-L for exempt Alaska Native and American Indian resources for Medicaid
433-3 PERMANENT FUND DIVIDEND
Added the PFD hold harmless section back into the APA manual.
450-4 LIVING IN AN ASSISTED LIVING HOME
Updated the link to ET Resources where the Assisted Living Home and Nursing Home contact list is now house.
Addendum 1
No COLA increase for 2016, updated Addendum 1 to reflect that.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #46
MANUAL: Adult Public Assistance
DATE: April 1, 2016
We are making a couple of changes to clarify existing policy.
Highlights to policy revisions are described below. If you have any questions please contact Policy and Program Development Team at dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
410-4 VERIFICATION
Updates when to check SOLQ, at each application and review. Also, changed the terminology from recertification to review.
442-2 EARNED INCOME EXCLUSIONS
Updates the IRS mileage link.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #47
MANUAL: Adult Public Assistance
DATE: July1, 2016
We are making a couple of changes to clarify existing policy and to correct an oversight.
Highlights to policy revisions are described below. If you have any questions please contact Policy and Program Development Team at dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
441-2 C. DEPARTMENT OF VETERANS AFFAIRS PAYMENTS
Clarified what is needs based and what is not needs based income from Veteran's Administration.
452-2 A . INELIGIBLE SPOUSE'S INCOME EQUAL OR LESS THAN THE DIFFERENCE BETWEEN SSI STANDARDS
Fixed the example from $356 to $367 (the difference between the SSI payment standard for an eligible couple and an eligible individual); i.e. $1100 - $733 = $367.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #48
MANUAL: Adult Public Assistance
DATE: December 1, 2016
This year Social Security announced a Cost of Living Allowance ( COLA ) increase effective January 2017. The Adult Public Assistance need and maximum payment standards are adjusted by the same percentage as the COLA increase in Social Security benefits. This year the COLA increase is 0.3%. We have incorporated the 2017 standards into the examples and Addendum 1 . These standards become effective with the benefit month of January 2017. The COLA adjustment also causes:
An increase in the income limit for Substantial Gainful Activity; and
An increase in the student earned income exclusion.
Highlights of these policy revision are described below. If you have any questions contact the Policy and Program Development Team at email dpapolicy@alaska.gov .
OVERVIEW OF CHANGES
MS 423-3B OTHER STATE'S MEDICAID BENEFITS
Corrected link from FM MS 5012-E to MAGI Medicaid MS 809-F.
MS 426-8C ELIGIBILITY FOR MEDICAL ASSISTANCE
Renamed and revised language to clarify that individual's may be eligible for MAGI Medicaid while receiving Interim Assistance and added a link to the MAGI Medicaid manual. Also, deleted old language regarding Interim Assistance counts as income for Medicaid as this is old Family Medicaid policy.
MS 433-4 ABLE ACCOUNTS
Added new subsection for the policy regarding ABLE accounts.
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #49
MANUAL: Adult Public Assistance
DATE: April 3, 2017
We are making several changes to incorporate new policy, clarify existing policy, and align policies within our program policy manuals. Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights of these policy revision are described below. If you have any questions, contact the Policy and Program Development Team at dpapolicy@alaska.gov .
426-2 F . CONTACTING THE MEDICAL REVIEWER
Added a note to write "terminal", when appropriate, on the Interim Assistance paperwork when sending to the Medical Reviewer
433-3 PERMANENT FUND DIVIDEND
Deleted a reference to the PFD Hold Harmless manual because it no longer exists
433-4 ABLE ACCOUNTS
Clarified that housing distribution from an ABLE account only is counted as a resource the month after the month of receipt
STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #50
MANUAL: Adult Public Assistance
DATE: July 3, 2017
We are making several changes to incorporate new policy, clarify existing policy, and align policies within our program policy manuals. Other changes are either technical in nature or clarifications that are the result of policy questions or suggestions from the field.
Highlights of these policy revision are described below. If you have any questions, contact the Policy and Program Development Team at dpapolicy@alaska.gov .
410-7A . INITIAL MONTHS APA PAYMENT FOR APPLICATION RECEIVED ON OR AFTER JULY 1, 2004
Clarified that eligibility staff can verify the Social Security award information using the Social Security interfaces
410-7D . RETROACTIVE MEDICAID COVERAGE
Removed reference to Family Medicaid Manual and replaced with MAGI Medicaid Manual
426-2C . INTERIM BLINDNESS OR DISABILITY DETERMINATION
Removed note regarding receiving SSA determinations before the Medical Reviewer decision and placed it under 426-7 Converting Interim Assistance
426-7E . SSA APPROVES SSI BEFORE MEDICAL REVIEWER APPROVES INTERIM ASSISTANCE
Added section regarding receiving SSA determinations before the Medical Reviewer decision
This section is unusually large; deeper subsections were cut off. Open a subsection via its designator link — for example (400-400-1-an-overview-of-the-adult-public-assistance-program) — to read its full text.