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Health Care Finance and Administration Policy Manual Number: 110.020 Section: Financial Eligibility Requirements Chapter: ABD Financially Responsible Relatives July 1, 2016 HCFA 4 d. Joint Custody/Parenting Time For the purpose of determining Medicaid eligibility, the custodial parent, often referred to as the primary residential parent in Tennessee, is established based on physical custody specified in a court order, binding separation, divorce, or parenting plan. If there is no court order or parenting plan, custody of a child born out of wedlock is with the mother. If there is a parenting plan, the primary residential parent is the parent with whom the child spends most nights. i. Equally-Shared Joint Custody/Parenting Time When an individual claims that equally-shared (50/50) joint physical and legal custody exists or provides a parenting plan that evenly divides the child(ren)’s living arrangement and parenting responsibilities, the parenting time situation must be carefully examined. Though a court order or parenting plan may evenly divide the care and control of the child(ren), the parents may not, in fact, be following the parenting plan. In cases of alleged equal parenting time (50/50), the Eligibility Specialist must verify that: • Both parents exercise parental guidance. Parental guidance may include issues such as which parent takes the child(ren) to and from school and/or day care, which parent does the school and/or daycare consider the responsible relative, who exercises responsibility for consenting to major medical treatment for the child, etc. • Parents equally share physical custody. If one parent has the child(ren) a majority of the time, this is not considered equally shared parenting time. Child(ren) must spend an equal amount of time living with each parent. The living arrangement may be based on days, weeks, or months, but it must be equal (182.5 days per year with each parent) and parental functions of guidance and physical care cannot be substantially interrupted. (If equal time means six months at a time are spent with each parent, this will be considered extended visits. Eligibility for the parent ceases when the child is with the other parent.) 5. Other Relatives There are no additional financial responsibilities for any other relatives other than the spouse to spouse and parent to child provisions set forth in this section. The income and resources of the spouse or parent not living in the same household with the applicant are considered available only to the extent they are actually contributed.