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Medical Services Policy Manual, Section H

H 400 Post Eligibility

H-430 Earnings of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Facility Residents MS Manual 08/29/22 Residentsof ICF/IID facilities, including residents of State Human Development Centers, who have earned income may be given an earnings disregard of up to an amount equal to the current SSI standard payment amount (SPA) in addition to the forty dollars ($40) personal needs allowance. Nursing facility residents with earnings may be given a disregard of up to one hundred ($100) of their monthly earnings, provided there is documentation that a physician has prescribed employment activity as a therapeutic or rehabilitative measure. If a nursing home resident receiving skilled care reports earnings, the Division of Provider Services and Quality Assurance (DPSQA) Office of Long-Term Care (OLTC) should be contacted and requested to reevaluate medical necessity. All nursing facility and ICF/IID residentsmust first pass the gross income test, with no disregards allowed. If found eligible, the consideration of earnings will be as follows. 1. Ten Bed ICF/IID Facilities and State Human Development Centers Earnings of residents of these facilities must be taken into consideration for both eligibility and net income determinations. If residents pass the gross income eligibility test, their earnings will be included in the net income determination. In determining the net income to be applied toward the vendor payment, first subtract the mandatory deductions (for example, federal and state income taxes) from gross income and, from the remaining earned income, up to an amount equal to the current SSI SPA for personal needs. Refer to MS H-410 for consideration of earnings at certification. 2. Fluctuating Earnings If the earnings of ICF/IID facility residents stay below the SSI SPA, no reporting of fluctuations is needed. The facility administrator will report to the eligibility worker any month in which a resident’s earnings exceed the SSI SPA. If earnings consistently stay above the SSI SPA, they may be averaged (MS E-415), provided the facility administrator will agree to report to the eligibility worker: • every six (6) months when earnings are fairly stable; or • more frequently if the resident loses employment, changes jobs, or has earnings in any month which are more than fifteen dollars ($15) above the computed average.