433-2 CONDITIONAL BENEFITS

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 .)