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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 200A – Income: ABD Categories Page |124 Effective Month: July 2025 In-Kind Support and Maintenance (ISM) In-kind support and maintenance (ISM) is unearned income in the form of shelter, or both. Receipt of clothing is no longer counted as ISM effective March 9, 2005. Receipt of food is no longer counted as ISM effective September 30, 2024. ISM is an SSI policy principal that may be applicable to all categories of eligibility as described below for SSI-related categories and FPL or institutional categories: • Whenever in-kind payments, as defined above, are received by individuals in SSI- related categories, such as SSI retro cases and former SSI recipient cases, the value of the ISM is determined by one of the three methods discussed under Valuation of ISM below and the ISM is counted as unearned income. • For cases associated with the Federal Poverty Level (FPL) or Institutional Income limit, the source of the in-kind payment determines whether the ISM is countable. If the source of the in-kind payment is for the benefit of the client and the in-kind payment is for shelter, the actual amount of the ISM is countable unearned income. Example: The client is the beneficiary of a trust, which is not a resource. A monthly disbursement of $300 is made from the trust to pay his shelter costs. The amount of the disbursement is countable unearned income. Example: The client’s mother pays his rent of $300 to his landlord from her own funds. This third-party payment is not countable ISM to the Medicaid recipient. Valuation of ISM To determine the value of ISM for an eligible individual or couple in an SSI-related category of eligibility, use the lesser of the three values discussed below when the individual or couple: • Lives in the household of another, • Receives rent free shelter, • Has someone else (a third party) pay for goods and services provided to the eligible, or • Receives rental subsidies.