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MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID e. Impairment–Related Work Expenses (IRWE). This exclusion is applied to earned income of disabled (but not blind) individuals under age 65. The expense must be reasonable; for items/services which are directly related to enabling an impaired individual to work, and which are necessarily incurred by the individual because of a physical or mental impairment. IRWEs are excludable when the cost is paid by the disabled individual and is not reimbursable from another source. f. Subtract 1/2 of the remaining earned income after the above deductions. g. Add countable unearned and earned income to arrive at total countable income. h. Compare the total countable income to the individual SSI Payment Amount (SPA). If the amount is equal to or greater than the SPA, the child is ineligible for Medicaid. F-325 PATIENT LIABILITY

Patient liability is determined for eligible persons in a medical facility. There is no patient liability for any portion of institutionalization in a VA hospital, AGCF, FCH, freestanding psychiatric hospital or RTC. F-325.1 Treatment of Income, Deductions and Expenses When determining patient liability for initial and ongoing cases, budget income for the month it is received and deductions/expenses for the month in which they are paid/incurred. When unanticipated income is received, patient liability will be adjusted for the month in which it was received. Regular unearned income deposited directly into a financial institution is considered received in the month for which it is intended to be received. F-325.2 Partial Month Proration

The amount of patient liability is prorated according to the number of days the client was in a facility when the person is institutionalized less than a full calendar month due to: a. Date of admission b. Discharge to independent living, VA hospital, AGCF, FCH, freestanding psychiatric hospital or RTC. c. Death F-320.4 Division of Welfare and Supportive Services LONG TERM CARE SERVICES Medical Assistance Manual ELIGIBILITY DETERMINATION – PARTIAL MONTH PRORATION 24 Sept MTL 05/24