004.02 PERSONS INCLUDED IN THE BUDGET.

The assistance budget is computed to determine the need of a recipient for assistance. Consideration is given to the fact that the presence of other related persons living in the home may be essential to the individual’s needs and well-being and affect the individual’s need. The individual requirements of these essential persons may be included in the budget of the recipient. Essential persons in the home may include the spouse, minor or adult children, grandchildren, parents, sisters, or brothers. The decision of whether another related individual is essential to the recipient rests with the recipient. If it has been determined that the related individual is not eligible for medical assistance under another program, and it has been determined that the individual must be in the presence of our recipient full time, then the individual can be an essential person. An individual, who meets the above criteria and who is considered a spouse by Social Security, even though the individual is not married to the recipient, is considered an essential person in the Aged, Blind or Disabled budget. The essential person’s income and resources are included in the recipient’s Aged, Blind or Disabled budget, and their combined income and resources do not exceed standards. (1) A spouse or specified relative can be an essential person; unless: (i) They are not living together; (ii) The spouse or specified relative is an ineligible alien; (iii) The spouse or specified relative is a fleeing felon; (iv) The spouse or specified relative is eligible for assistance in his or her own right, such as receives medical assistance from another program; (v) The spouse or specified relative is sanctioned; (vi) The spouse is receiving Veteran’s benefits and the recipient is current pay Supplemental Security Income; or (vii) The spouse or specified relative failed to comply or apply for potential benefits. Medical health insurance premium and paid medical expenses may be paid for essential persons under Aged, Blind, or Disabled Special Requirements. (2) The needs of an ineligible spouse are not included as an essential person in the recipient's budget. If the ineligible spouse is receiving Veterans benefits based on need that Social Security is disregarding in determining the recipient's Supplemental Security Income, the individual cannot be an essential person. (3) The needs of an essential person may be included in the budget to determine eligibility for payment. When an essential person has been included in the recipient's budget, their combined income and resources cannot exceed standards. (4) If there is no budgetary need, close the case and determine State Disability Payment medical eligibility with a Share of Cost using the appropriate income level. The appropriate maintenance level for the State Disability Medical Program is determined by considering the recipient and the essential person only if the essential person is the spouse or minor child. (5) If the ineligible parent of a minor Assistance to the Aged, Blind, or Disabled or State Disability Program recipient does not have income which has been considered for deeming purposes, the individual’s needs may be included in the minor's budget if it has been determined that the parent's continued full-time presence in the home is necessary for the child's well-being. If the parent has income which is being considered for deeming, the individual’s needs have already been recognized in this process. If a parent's needs have been removed from an Aid to Dependent Child unit for noncooperation, such as Employment First employability or child support, that individual’s needs may not be included in the Blind, Disabled, or State Disability Program child's budget.