130 Maximum Cash Payment

Amounts PURPOSE: This rule states the maximum payment amounts and exceptions to these amounts for the various assistance programs. (1) When the appropriation for General Relief (GR) assistance payments is not suffi- cient to make full payments on the basis of maximum legal allowance, all GR payments (except for the types listed in this rule) will be subject to a percentage of reduction. An exception will be made for each GR person whose budget includes an allowance for inter- mediate or residential II nursing home care. This type of case will be known as a Full Grant Case. No reduction will be applied to the GR payment made to that person. (Origi- nal rule filed May 13, 1948, effective May 23, 1948. Amended Sept. 1, 1972, effective Sept. 10, 1972.) (2) Maximum Supplemental Aid to the Blind (SAB) Payments. (A) For those persons who apply for Aid to the Blind (AB) on or after January 1, 1974, the maximum amount of payment they may receive is authorized in 209.040, RSMo; pro- vided, however, that if the person is a resident of a residential care facility or an intermedi- ate care or skilled nursing facility (ICF/SNF) and not eligible for Medicaid nursing care benefits; the maximum payment will be as authorized in section (7) of this rule. (B) Persons who are eligible for vendor payments in their behalf for skilled nursing home care or ICF care will not be eligible for SAB payments. (C) The amount of the SAB payment will be determined by subtracting the amount of any Supplemental Security Income (SSI) ben- efit from the amount of the maximum SAB payment, as described here. The amount of the SAB payment will be the remainder, rounded to the nearest dollar, except that if the remainder is one cent through forty-nine cents (1¢–49¢), the claimant will be eligible for an AB supplemental payment of one dol- lar ($1). (Original rule filed Nov. 29, 1973, effective Dec. 9, 1973. Amended Sept. 26, 1975, effective Oct. 6, 1975.) (3) Persons who become ineligible for SSI due to an increase in other income may con- tinue to be eligible for Missouri Supplemen- tal Payment (SP). The amount of the Mis- souri SP, in these cases, will be determined by subtracting the current income from the December 1973 total income plus the Old Age Assistance (OAA), Permanent and Total Disability (PTD) or AB assistance grant that was legally received for the month of Decem- ber 1973. The amount of the SP shall not be greater than an amount needed to provide total income at the December 1973 level; if the person’s income equals or exceeds the total amount, no Missouri SP shall be made. These persons must continue to meet all eli- gibility requirements that were in effect for OAA, PTD or AB for the month of Decem- ber 1973. (Original rule filed April 25, 1974, effective May 5, 1974.) (4) Persons who are eligible for SSI (as a result of the conversion from OAA, PTD or AB in December 1973) but are not eligible for Missouri SP in January 1974, may become eligible for Missouri SP at a later time if their total income drops below the total income they received in December 1973. In those cases, the amount of the Mis- souri SP will be the difference between the present total income and the total income received in December 1973. (Original rule filed April 25, 1974, effective May 5, 1974.) (5) The Division of Family Services will compute the Missouri SP in SSI-SP cases based on the amount of SSI for which the claimant is eligible and not the SSI payment which is actually received. (Original rule filed April 11, 1975, effective April 21, 1975.) (6) No intermediate care or skilled nursing payment shall be made to a person residing in a licensed ICF or in a licensed SNF—unless the person has been determined by his/her own physician or doctor to medically need those services, subject to review and approval by the Department of Social Services, based upon the standards in 13 CSR 15-9.030(3) and (4). Residential care payments may be made to persons residing in a licensed inter- mediate care facility (ICF) or licensed skilled nursing facility (SNF), who do not meet this requirement and are otherwise eligible for supplemental nursing care. (7) The maximum payment for eligible recip- ients of supplemental nursing care benefits will be one hundred forty-eight dollars ($148) if residing in a licensed residential care facil- ity I, two hundred seventy-six dollars ($276) if residing in a licensed residential care facil- ity II and three hundred sixty-eight dollars ($368) if residing in an ICF or SNF and not eligible for Medicaid nursing care benefits. (8) In accordance with state law, section 208.030.5, RSMo, any person eligible to receive a cash nursing home grant, will also receive twenty-three dollars ($23) per month personal expense allowance. These funds are to be used by the claimant for his/her person- al needs and MUST be treated as the claimant’s personal spending monies. These funds are not to be applied to the claimant’s monthly expenses associated with—room and board/rent, any contracted services provided through the facility, or both. Individuals who are provided funds for personal use by the Department of Mental Health will not be eli- gible to receive the twenty-three dollars ($23) personal needs funds through the Division of Family Services program. AUTHORITY: section 207.020, RSMo 1986.* Filing dates for original rules are shown in the text of the rule. This version of rule filed March 24, 1976. Amended: Filed June 1, 1977, effective Sept. 11, 1977. Amended: Filed April 5, 1983, effective July 11, 1983. Emergency amendment filed July 1, 1983, effective July 11, 1983, expired Oct. 12, 1983. Amended: Filed July 1, 1983, effective Oct. 13, 1983. Emergency amendment filed Oct. 9, 1986, effective Oct. 19, 1986, expired Feb. 6, 1987. Amended: Filed Oct. 9, 1986, effective Jan. 12, 1987. Amended: Filed March 22, 1988, effective July 11, 1988. Amended: Filed Sept. 6, 1988, effective Dec. 11, 1988. Amended: Filed Oct. 16, 1989, effective Jan. 12, 1990. Emergency amend- ment filed June 27, 1990, expired Nov. 3, 1990, effective Jan. 12, 1990. Amended: Filed June 27, 1990, effective Nov. 30, 1990. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986.