Revision 11-3; Effective September 1, 2011

In-kind S/M is unearned income in the form of food or shelter or both. Federal requirements stipulate that S/M, along with other forms of unearned income, be considered when determining Medicaid eligibility.

Do not consider S/M in budgeting for Medicaid Buy-In for Children (MBIC).

Two rules are used to determine the value of S/M a person receives:

• the one-third reduction rule; and
• the one-third reduction + $20 rule.

See Appendix XXXI, Budget Reference Chart.

Base the decision on which rule to use on:

• the person’s living arrangement; and
• whether a person receives:
  • both food and shelter; or
  • either food or shelter.

 

E-8110 One-Third Reduction Rule

Revision 09-4; Effective December 1, 2009

Reference: Appendix XIV, Chart A

Instead of determining the actual dollar value of in-kind S/M as unearned income, use the one-third reduction rule; that is, count one-third of the federal benefit rate (FBR) as additional income if a person (or a person and the person's eligible spouse):

• live in another person's household for a full calendar month, except for temporary absences; and
• receive both food and shelter from the other person's household.

Example: Bess Black lives in her son's home. There are no other household members. Monthly household expenses total $650 ($325 pro-rata share). Mrs. Black contributes nothing toward household expenses. Count one-third of the FBR as S/M.

The one-third reduction rule applies in full or not at all. If a person lives in another person's household, and the one-third reduction rule applies, do not apply any income exclusions to the reduction amount. However, do apply appropriate exclusions to any other earned or unearned income received.

If the one-third reduction rule applies, do not count any other in-kind S/M received.

 

E-8120 One-Third Reduction + $20 Rule

Revision 13-4; Effective December 1, 2013

If a person receives in-kind S/M and the one-third reduction rule is not applicable, use the one-third reduction + $20 rule. Instead of determining the actual dollar value of any food or shelter a person receives, presume that it is worth a maximum value. This presumed maximum value is one-third of the federal benefit rate (FBR), plus the amount of the general income exclusion ($20).

The one-third reduction + $20 rule allows a person to show that the S/M is not equal to the presumed maximum value. Do not use the one-third reduction + $20 rule if the person shows that:

• the current market value of any food or shelter the person receives, minus any payment the person makes for them, is lower than the presumed maximum value; or
• the actual amount someone else pays for the person’s food or shelter is lower than the presumed maximum value.

Use the one-third reduction + $20 rule as part of the unearned income if either:

• the person chooses not to question the use of the presumed maximum value, or
• the presumed maximum value is less than the actual value of the food or shelter the person receives.

Use the actual value of the food or shelter received as part of the unearned income if the person shows that the presumed maximum value is higher than the actual value of the food or shelter the person receives.

Note: A religious order has an express obligation to provide full support and maintenance for members of the order who have taken a vow of poverty. Due to this express obligation, in-kind support and maintenance subject to the one-third FBR + $20 must be developed. Income turned over by a member to the religious order is considered to be in fulfillment of the vow of poverty and is not considered a contribution toward the food and shelter received from the order.

 

E-8121 Community Attendant Services

Revision 09-4; Effective December 1, 2009

Reminder: If a person receives S/M and the one-third reduction + $20 rule applies, count the presumed maximum amount, that is, 1/3 federal benefit rate (FBR) + $20. If the person is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be offered an opportunity to rebut and show that the actual value of the S/M is less.

If a person is applying for or receiving Community Attendant Services (CAS), count 1/3 FBR + $20 as S/M. If the person is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that the actual value is less.

Example: Jim Morgan, a CAS applicant, lives in his sister's home. The sister's husband and their child also live there. Mr. Morgan does not pay his pro-rata share of household expenses. Count 1/3 FBR + $20 as S/M. If Mr. Morgan is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Mr. Morgan must be given an opportunity to rebut and show that the actual value is less. Monthly household expenses total $1,050 ($262.50 pro-rata share). Mr. Morgan contributes $200 per month toward general household expenses. The actual value is $62.50 ($262.50 pro-rata share − $200 client's contribution = $62.50).

Note: No S/M for Home and Community-Based Services waivers.

 

E-8130 Support and Maintenance (S/M) Items

Revision 09-4; Effective December 1, 2009

What Is S/M	What Is Not S/M
Food/board	Value of Supplemental Nutrition Assistance Program (SNAP) food benefits (formerly known as food stamps)
Shelter/room	Cable TV
Mortgage	Telephone bill (basic, plus extra services and long distance)
Real property taxes (less any tax rebate credit)	Credit card bills
Rent	VA clothing allowance for medical reasons
Heating fuel (for example, coal, wood and butane)	Life insurance premiums
Gas	Medical care
Electricity	Transportation
Water	Repair of roof, plumbing, etc.
Sewer	General upkeep on home
Garbage removal	Lawn maintenance
Property insurance required by mortgage holder	Paint for the house

 

E-8140 Exceptions to Counting Support and Maintenance (S/M) Income

Revision 18-1; Effective March 1, 2018

The general rule is to count S/M to a person when he or she receives food or shelter, regardless of who is liable for payment of the cost of the food or shelter item received.

There are numerous exceptions to the general rule. When an exception applies, the food or shelter a person receives is not countable S/M. Some of these exceptions result from federal statutory exclusions that specifically exclude from income the value of food or shelter received. Other exceptions result from situations in which the food or shelter received does not constitute income in accordance with regulations.

Do not count S/M if a person receives food or shelter that:

• is specifically excluded by federal law (for example, the Disaster Relief and Emergency Assistance Act) (see Section E-2000, Exempt Income);
• meets the criteria for exclusion of infrequent or irregular unearned income (see Section E-9000, Infrequent or Irregular Income);
• has no current market value;
• is provided under a governmental (federal, state or local) medical or social service program (see Section E-1700, Things That Are Not Income);
• is assistance based on need from a state or one of its political subdivisions (see Section E-2000, Exempt Income);
• is provided by someone living in the same household whose income is subject to deeming to the person;
• is food or shelter received at school by a child under age 22, not subject to deeming, who receives food or shelter only at school while temporarily absent from his parental household;
• is food or shelter received during a temporary absence;
• is received as a replacement of a lost, damaged or stolen resource (this includes temporary housing) (see Section E-1740, Miscellaneous Things That May Not Be Income, and Section E-2000, Exempt Income);
• is excluded under an approved plan for self-support;
• is received because of payments made under the terms of a credit life or credit disability policy (see Section E-1740); or
• is received during medical confinement in an institution.

Support and maintenance are not included as income in the eligibility budget if the person:

• is in an institutional setting and eligibility is being tested for a Home and Community-Based Services waiver program (Note: Community Attendant Services is not a Home and Community-Based Services waiver program); or
• is in an institutional setting for the month, but entered after the first of the month.

Example: Mr. John Bono lives in his own home. His daughter reports that she pays Mr. Bono's garbage removal bill directly to the vendor each calendar quarter, which amounts to no more than $20. Because S/M meets the definition of infrequent or irregular income, it is not counted in the eligibility budget.

Support and maintenance are also not included as income in the eligibility budget if the person:

• lives with a deemor (ineligible spouse/parent) and there are no non-deemors in the household;
• lives in a commercial room-and-board establishment;
• is placed in personal care, adult foster care or supervised living by a public agency, such as Adult Protective Services (APS) or HHSC; or
• pays his pro-rata share of all household expenses.

Example: Alice Beckman lives with her son in his home. Monthly household food and shelter expenses total $350 ($175 pro-rata share). Ms. Beckman contributes $185 per month toward general household expenses. Because Ms. Beckman pays more than her pro-rata share of general household expenses, there is no S/M.

Support and maintenance are also not included as income in the eligibility budget if the person:

• lives in a public assistance household, defined as one in which each member receives cash or vendor payments from one of the following:
  • Temporary Assistance for Needy Families (TANF);
  • SSI;
  • Refugee Assistance Act of 1980;
  • a Bureau of Indian Affairs (BIA) general assistance program;
  • payments based on need provided by a state/local government income maintenance program;
  • Veterans Affairs (VA) pension for veterans or widows;
  • VA dependency and indemnity compensation (DIC) for parents; or
  • payments under the Disaster Relief Act of 1974; or
• is receiving free use of land on which the shelter the person owns is located, or free use of shelter situated on land the person owns.

Example: Marcie Bennett lives in her own mobile home on property owned by her daughter. The daughter charges her no rent for use of the land. Ms. Bennett pays all of her food and utility expenses. There is no S/M because the use of land alone is not a shelter cost.

Example: Janet Smith lives in a mobile home owned by her daughter. The mobile home is situated on a lot owned by Ms. Smith. The daughter does not charge Ms. Smith rent for use of the mobile home. There is no S/M because the use of shelter alone (but not the land) is not a shelter cost.

 

E-8150 Food, Clothing or Shelter as Wages

Revision 09-4; Effective December 1, 2009

If a person receives food, clothing or shelter that constitutes wages or remuneration for work, this is earned income valued at its current market value (CMV) or current market rental value (CMRV).

In this situation, the principles of S/M do not apply; however, the earned income exclusions of $65 and one-half the remainder do apply, unless eligibility is being determined under the institutional income limit.

Example: Joe Ball works as an apartment manager. His employer pays him $300 per month in cash wages and provides a free room, which has a monthly rental value of $200. Because provision of the room by Mr. Ball's employer constitutes wages, Mr. Ball receives $500 in earned income each month. This in-kind earned income in the form of shelter is valued at its CMRV ($200), and the one-third reduction rule and the one-third reduction + $20 rule do not apply. The earned income exclusions of $65 and one-half the remainder apply to Mr. Ball's total earnings of $500 ($300 cash wages + $200 free room), unless eligibility is being determined under the institutional income limit.

 

E-8160 Living Arrangement

Revision 09-4; Effective December 1, 2009

Use a person’s living arrangement to determine if S/M is being received and whether the S/M is to be valued under the one-third reduction rule or under the one-third reduction + $20 rule. Some common living arrangements are:

• noninstitutional care;
• home ownership;
• rental liability, including flat fee for room and board;
• public assistance (PA) households (that is, presumed sharing);
• separate consumption;
• separate purchase of food;
• sharing;
• earmarked sharing; and
• home of another.

E-8210 Household of Another Person

Revision 09-4; Effective December 1, 2009

E-8211 Contributing Less Than Pro-Rata Share

Revision 09-4; Effective December 1, 2009

Reference: Appendix XIV, Chart A

If a person contributes less than his or her pro-rata share of general household expenses, use the one-third reduction rule. No opportunity for rebuttal is offered.

Example: Alice Beckham lives with her son in his home. General household expenses total $350 ($175 pro-rata share). Mrs. Beckham contributes only $125 per month. Count 1/3 FBR as support and maintenance.

E-8212 Contributing an Earmarked Share of Food and Shelter

Revision 15-4; Effective December 1, 2015

If a person contributes a specific amount for food and/or shelter, but the amount contributed is less than the person's pro-rata share for each earmarked expense, use the one-third reduction rule. No rebuttal is offered.

Example 1: A person lives in his sister's home with his sister, the sister's spouse and child. The monthly household food expenses total $240 ($60 pro-rata share); the monthly household shelter expenses total $320 ($80 pro-rata share). The person pays his sister $55 a month for food and nothing for shelter. The person does not pay his pro-rata share of either food or shelter expenses. Count 1/3 FBR as S/M.

Example 2: Another person lives in his daughter's home with her family of five. The household receives SNAP food benefits for all six members, but these benefits do not cover the household's total food expenses. The person does not contribute toward the food expenses not covered by SNAP, nor does he pay anything toward shelter costs. Count 1/3 FBR as S/M.

E-8213 Contributing an Earmarked Share of Either Food or Shelter

Revision 09-4; Effective December 1, 2009

If a person contributes an earmarked pro-rata share of either food or shelter expenses, but not both, count 1/3 FBR + $20. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that actual value is less.

Example: Emily Fairchild lives with her brother and his family of three. Ms. Fairchild contributes her pro-rata share of shelter expenses but not of food expenses. Count 1/3 FBR + $20 as S/M. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Mrs. Fairchild must be given an opportunity to rebut and show that the actual value is less. Monthly household food expenses total $240 ($60 pro-rata share); monthly household shelter expenses total $320 ($80 pro-rata share). Ms. Fairchild contributes $50 per month for food and $85 per month for shelter. The actual value is $5.00 ($140 client's total pro-rata share - $135 client's total contribution = $5.00).

Example: Gladys Haley lives with her son in his home. She pays her pro-rata share of food expenses but not of shelter expenses. Count 1/3 FBR + $20 as S/M. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Ms. Haley must be given an opportunity to rebut and show that the actual value is less. Monthly household food expenses total $200 ($100 pro-rata share); monthly household shelter expenses total $400 ($200 pro-rata share). Ms. Haley contributes $100 for food, but does not contribute anything for shelter. In this situation the actual value is $200 ($300 total pro-rata Share - $100 client's contribution = $200.) Count the presumed maximum S/M of 1/3 FBR + $20 if this is less than the actual value.

E-8214 Separate Food Purchases

Revision 15-4; Effective December 1, 2015

If the person purchases his food separately from other household members, then shelter is the only consideration. Count 1/3 FBR + $20. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, the person must be offered an opportunity to rebut and show that the actual value is less.

Example: A person lives in her daughter's home. The daughter's spouse and their two children also live there. The person purchases her food separate from the rest of the household, but does not pay her pro-rata share of shelter expenses. Count 1/3 FBR + $20. If the person is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial, the person must be given an opportunity to rebut and show that the actual value is less. The monthly household shelter expenses total $700 ($140 pro-rata share), and the person contributes $100. The actual value is $40 ($140 pro-rata share – $100 person's contribution = $40).

E-8220 Ownership or Rental Liability

Revision 09-4; Effective December 1, 2009

A person has an ownership interest or rental liability, and someone else is directly paying all or part of the person's pro-rata share of household expenses. Cash is not given to the person.

If the person is the householder (has ownership interest or rental liability), count 1/3 FBR + $20. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that the actual value of the S/M is less.

Note: The one-third reduction rule never applies if the person is the householder.

E-8221 Receipt of Support and Maintenance (S/M) from Inside the Household

Revision 09-4; Effective December 1, 2009

A person living in his or her own household may be provided in-kind S/M from other household members living in the household.

Note: S/M should be developed only if the 1/3 FBR + $20, in combination with other countable income, would cause ineligibility.

If the person is the householder, others live with him/her, but he/she pays a pro-rata share of household expenses, there is no S/M.

Example: Scott Nance lives in his own home. His daughter and her two children live with him. Household shelter expenses are as follows: annual property taxes of $1,200 ($100 monthly) and monthly utility costs of $110. The pro-rata share of shelter costs is $52.50 ($100 taxes + $110 utilities = $210 total shelter expenses divided by 4 household members = $52.50 pro-rata share). Household food expenses total $550 ($137.50 pro-rata share). Thus, the pro-rata share of total household expenses is $190 ($52.50 for food + $137.50 for shelter = $190). Mr. Nance's daughter pays the taxes and utilities of $210 per month; Mr. Nance pays the $550 for food. Since Mr. Nance pays more than his pro-rata share of household expenses, there is no S/M.

If the person is the householder and others live with him/her, but he/she does not pay his pro-rata share of household expenses, count 1/3 FBR + $20. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that the actual value is less.

Examples:

• Vicki Neal lives in her own home. Her adult son lives with her. Ms. Neal and her son purchase their food separately, but she does not pay her pro-rata share of shelter expenses. Count 1/3 FBR + $20 as S/M. If Ms. Neal is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Ms. Neal must be given an opportunity to rebut and show that the actual value is less. Ms. Neal pays the cost of butane, which is $35 per month. Her son pays the entire electricity bill of $80 per month directly to the vendor. Thus, shelter costs total $115 ($57.50 pro-rata share). The actual value is $22.50 ($57.50 pro-rata share - $35 client's contribution = $22.50 S/M).
• Donna Hipple lives in her own home. Her adult son lives with her. Ms. Hipple does not pay her pro-rata share of household expenses. Count 1/3 FBR + $20 as S/M. If Ms. Hipple is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Ms. Hipple must be given an opportunity to rebut and show that the actual value is less. Monthly household expenses consist of $500 for shelter ($250 pro-rata share) and $300 for food ($150 pro-rata share). Ms. Hipple buys all food ($300), and her son pays all shelter costs ($500). Since the pro-rata share of total household expenses is $400 ($250 pro-rata for shelter + $150 pro-rata for food = $400), the actual value of S/M is $100 ($400 pro-rata share - $300 Ms. Hipple's contribution = $100).

E-8222 Receipt of Support and Maintenance (S/M) from Outside the Household

Revision 18-4; Effective December 1, 2018

If the person is the householder (has ownership interest or rental liability) and someone else outside the household is directly paying all or part of the person's pro-rata share of household expenses, count 1/3 of the Federal Benefit Rate (FBR) + $20.

If counting 1/3 FBR + $20 does not make the person ineligible, no further development of S/M is needed.

If counting 1/3 FBR + $20 results in ineligibility, prior to denial, allow the person the opportunity to rebut and show that the actual value of the S/M is less.

Example: Elizabeth Smith lives alone in a rented apartment. Her rent is $1400 a month. Ms. Smith pays $700 and her daughter, who does not live in the household, pays the other $700 directly to the landlord. Ms. Smith pays all other bills. Current Market Rental Value (CMRV) $1400 -$700 = $700 > 1/3 FBR +$20.  S/M = 1/3 FBR + $20.

Note: The one-third reduction rule never applies if the person is the householder.

E-8222.1 Rental Subsidy - Receipt of Support and Maintenance (S/M) from Outside the Household

Revision 18-4; Effective December 1, 2018

Reference: Appendix XIV, Chart B

Rental subsidy is unearned income that represents S/M from outside the household. Rental subsidy policy applies only when:

• someone in the household has a rental liability;
• the rental property is owned by a parent or child of someone in the household; and
• the One-Third Reduction Rule (1/3 FBR) does not apply.  

If the amount of rent required by the property owner equals or exceeds either the current market rental value (CMRV) or 1/3 FBR + $20, then there is no rental subsidy countable as outside S/M.

If the amount of rent required by the property owner is less than both the CMRV and 1/3 FBR + $20, then the rental subsidy countable as outside S/M is the lessor of the:

• difference between 1/3 FBR + $20 and the amount of rent required; or
• difference between the CMRV and the amount of rent required.

Example: Royce Jones, a disabled adult, lives alone in a home owned by his parents. He pays all his own utilities, but does not pay the CMRV. Mr. Jones pays $50 per month rent. His parents state that the normal rate to rent the house is $250 per month (not including utilities). The difference between the CMRV and the rent value is $200 ($250 - $50). The difference between 1/3 FBR + $20 and the amount of rent required is $126.66 ($176.66 - $50). Because $126.66 is less than $200, $126.66 is countable S/M.

Notes:

• As Rental Subsidy considers only the rental expense, explore potential S/M for remaining household expenses (e.g., utilities or food). 
• Accept owner declaration of CMRV. Contact with a knowledgeable source, such as a realtor, is not required unless the eligibility specialist considers the value questionable.

Related Policy

Receipt of Support and Maintenance (S/M) from Inside and Outside the Household, E-8223

E-8223 Receipt of Support and Maintenance (S/M) from Inside and Outside the Household

Revision 09-4; Effective December 1, 2009

If a person receives S/M from both inside and outside the household, count 1/3 FBR + $20. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that the sum of S/M from inside the household and S/M from outside the household is less.

Example: Bob Davis lives in his own home. His daughter and her child live with him. He receives S/M from both inside and outside the household. Count 1/3 FBR + $20 as S/M. If he is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Mr. Davis must be given an opportunity to rebut and show that the actual value is less. Monthly household food expenses total $300 ($100 pro-rata share). Monthly household shelter expenses total $600 ($200 pro-rata share). The daughter buys the food, but Mr. Davis gives her $50 per month. Mr. Davis' son pays all shelter costs directly to the vendors (taxing authority and utility company). In this situation, the actual value of S/M is $250 ($100 pro-rata share for food - $50 client's contribution = $50 S/M from inside the household + $200 S/M from outside the household = $250). Count the maximum S/M of 1/3 FBR + $20 if this is less than the actual value.

E-8311 Companion Case Not Contributing Pro-Rata Share

Revision 15-4; Effective December 1, 2015

If a person and the person's ineligible spouse do not contribute their pro-rata share of household expenses, count 1/6 Couple FBR (1/3 Couple FBR divided by 2) as S/M for the person. Do not consider the S/M received by the ineligible spouse (the other 1/6 Couple FBR) in the eligibility determination when deeming.

Example: A couple lives in their daughter's home. The daughter's spouse and their three children also live there. Only one member of the couple is applying for the Qualified Medicare Beneficiary (QMB) program. The couple does not contribute toward household expenses. Count 1/6 Couple FBR (1/3 Couple FBR divided by 2) as S/M. No S/M is considered for the ineligible spouse in the eligibility budget when deeming.

 

E-8312 Companion Case Contributing Pro-Rata Share

Revision 15-4; Effective December 1, 2015

If a person and the person's ineligible spouse contribute their pro-rata share of either food or shelter expenses but not both, count 1/6 Couple FBR + $10 as S/M for the person. (The S/M attributable to the ineligible spouse is not counted in the eligibility budget when deeming.) If the person is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, the person must be offered an opportunity to rebut and show that the actual value is less.

Example: A couple lives in their son's home. The son's spouse also lives there. Only one member of the couple is applying for QMB. The couple pays more than their pro-rata share of food expenses, but does not pay their pro-rata share of shelter expenses. Count 1/6 Couple FBR + $10 as S/M for the applicant spouse. (Do not consider S/M received by the non-applicant spouse in the eligibility budget when deeming.) If the applicant is income-eligible, no further development is needed.

If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $600 ($150 pro-rata share for one person x 2 = $300 pro-rata share for the couple); the monthly household shelter expenses total $750 ($187.50 pro-rata share for one person x 2 = $375 couple's pro-rata share). The couple contributes $350 ($175 each) for food, but does not contribute toward shelter. The actual value is $162.50 ($300 couple's pro-rata share for food + $375 couple's pro-rata share for shelter = $675 couple's total pro-rata share – $350 couple's contribution = $325 actual value for both spouses divided by 2 = $162.50 actual value for the applicant). Count the maximum S/M of 1/6 Couple FBR + $10 if this amount is less than the actual value. Any S/M received by the non-applicant spouse is not considered in the eligibility budget when deeming.

 

E-8313 Couple Case Not Contributing Pro-Rata Share

Revision 09-4; Effective December 1, 2009

If neither spouse in a couple case contributes a pro-rata share of household expenses, count 1/3 Couple FBR.

 

E-8314 Couple Case Contributing Pro-Rata Share

Revision 15-4; Effective December 1, 2015

If both spouses in a couple case contribute their pro-rata share of either food or shelter expenses but not both, count 1/3 Couple FBR + $20. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less.

Example: A couple lives with their daughter in the daughter's home. The couple pays their pro-rata share of food expenses but not shelter expenses. Count 1/3 Couple FBR + $20 as S/M. If couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $350 ($116.66 pro-rata share for one person x 2 people = $233.32 pro-rata share for the couple). The monthly household shelter expenses total $600 ($200 pro-rata share for one person x 2 people = $400 pro-rata share for the couple). The couple contributes $250 ($125 each) for food, but does not contribute toward shelter. In this situation, the actual value is $383.32 ($233.32 couple's pro-rata share for food + $400 couple's pro-rata share for shelter = $633.32 total pro-rata share – $250 couple's contribution = $383.32). Count the maximum S/M of 1/3 Couple FBR + $20 if this is less than the actual value.

 

E-8320 Ownership or Rental Liability

Revision 09-4; Effective December 1, 2009

 

E-8321 Couple Case Not Contributing Pro-Rata Share

Revision 15-4; Effective December 1, 2015

If the person and spouse do not pay their pro-rata share of household expenses, count 1/3 Couple FBR + $20. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less.

Example: A couple lives in their own home. Their adult son lives with them. The couple does not contribute their pro-rata share of household expenses. Count 1/3 Couple FBR + $20 as S/M. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less. The monthly household expenses total $750 ($250 pro-rata share for one person x 2 people = $500 pro-rata share for the couple). The son pays the shelter costs of $350 per month. The couple buys all of the food, paying $400 ($200 each) per month. The actual value is $100 ($500 couple's pro-rata share – $400 couple's contribution = $100).

 

E-8322 Companion Case Not Contributing Pro-Rata Share

Revision 15-4; Effective December 1, 2015

If a person and the person's spouse do not pay their pro-rata share of household expenses, count 1/6 Couple FBR + $10 as S/M for the person. (Do not consider S/M received by the ineligible spouse in the eligibility determination when deeming.) If the person is income-eligible, no further development is needed. If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the person must be given an opportunity to rebut and show that the actual value is less.

Example: A couple lives in their own home. Only one member of the couple is applying for QMB. Two of their adult children live with them. The couple does not pay their pro-rata share of household expenses. Count 1/6 Couple FBR + $10 as S/M for the applicant. (The amount of S/M received by the non-applicant spouse is not considered in determining eligibility when deeming.) If the applicant is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household expenses total $1,200 ($300 pro-rata share for one person x 2 people = $600 couple's pro-rata share). The children pay the shelter costs of $900 per month, and the couple buys all food, paying $300 ($150 each) per month. The actual value of S/M for the applicant is $150 ($600 couple's pro-rata share – $300 couple's contribution = $300 actual value for both spouses divided by 2 = $150 actual value to the applicant). (The remaining $150 S/M attributed to the non-applicant spouse is not considered in determining eligibility when deeming.) Count the maximum S/M of 1/6 Couple FBR + $10 if this is less than the actual value.

 

E-8323 Companion Case with Contributions Toward Household Expenses

Revision 15-4; Effective December 1, 2015

If an ineligible spouse's contribution toward household expenses exceeds the ineligible spouse's pro-rata share, then the excess amount is allocated equally as a contribution among the eligible spouse and the couple's children (if any). Persons among whom the ineligible spouse's excess contribution is allocated (for example, the eligible spouse and the couple's children) are referred to as the "deeming unit."

Example: A couple and their 14-year-old child live in a home they are buying. One of the spouse's adult sisters also lives with them. The other spouse is the only one applying for ME-Pickle. The couple pays more than their pro-rata share of food expenses, but does not contribute toward shelter.

Count 1/6 Couple FBR + $10 as S/M for the applicant. (Do not consider S/M received by the non-applicant spouse or the child in the eligibility determination when deeming.)

If the applicant is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $450 ($112.50 pro-rata share); the monthly household shelter expenses total $600 ($150 pro-rata share). The non-applicant spouse buys all food ($450), but does not contribute toward shelter expenses. The applicant and the child do not personally contribute. The non-applicant spouse's sister pays all remaining household expenses ($600).

The non-applicant's "excess contribution" is $187.50 ($112.50 pro-rata share for food + $150 pro-rata share for shelter = $262.50 total pro-rata share – $450 non-applicant's contribution = -$187.50 excess contribution). The $187.50 is divided equally as a contribution among the applicant and the child in the deeming unit. Thus, $187.50 divided by 2 = $93.75 each as a contribution by the applicant and the child. The actual value of the applicant's S/M is $84.38 ($112.50 pro-rata share for food + $150 pro-rata share for shelter = $262.50 total pro-rata share – $93.75 applicant's contribution = $168.75 actual value of S/M for both spouses divided by 2 = $84.38), which is less than 1/6 Couple FBR + $10.

Revision 09-4; Effective December 1, 2009

In rent-free shelter, no household member has ownership interest or rental liability. This type of S/M is subject to the maximum of 1/3 of FBR + $20.

In rent-free shelter situations, a person outside the household provides the dwelling, but the household has no obligation to pay rent in return for shelter.

If the household contributes nothing for shelter, count 1/3 FBR + $20 as S/M. If the person is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial the person must be given an opportunity to rebut and show that the actual value is less. Actual value is based on the current market rental value (CMRV).

Example: Margie Ballard lives in a house owned by her son. She purchases her food and pays all utilities. Her son allows her to live in the home without paying rent. The son reports the CMRV (without utilities) to be $250. Count 1/3 FBR + $20 as S/M. If the person is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Ms. Ballard must be given an opportunity to rebut and show that the actual value is less. In this situation, the actual value is the CMRV of $250. Count the maximum S/M of 1/3 FBR + $20 if this is less than the actual value.

Example: Keith Linder lives in a house owned by his son. The son has requested that Mr. Linder pay his (the son's) monthly mortgage payments of $150 directly to the mortgage-holder in lieu of rent. Mr. Linder pays his own utilities. The son reports the CMRV (without utilities) to be $175. Since the son has requested that Mr. Linder pay his mortgage payment in lieu of rent, this is allowed as a shelter expense. Count 1/3 FBR + $20 as S/M. If Mr. Linder is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, prior to denial Mr. Linder must be given an opportunity to rebut and show that the actual value is less. The actual value is $25 ($175 CMRV - $150 payment on loan = $25).

The actual value of S/M may be reduced by the amount of the household's voluntary payments directly to the provider only for the property owner’s mortgage, real property taxes or rent (in sublease situations). Use only these voluntary payments made directly to vendors to reduce the actual value of the S/M.

Example: Barry Williams lives in a house owned by a relative. He pays his own utilities. The relative allows him to live there free of charge, but states that the CMRV (without utilities) is $300 per month. Although Mr. Williams pays no rent, last month he voluntarily paid his relative's annual real property taxes of $1,000 (or $83.33 monthly prorated taxes) directly to the taxing authority. Mr. Williams' payment of $83.33 for taxes does not equal the CMRV ($300). Count 1/3 FBR + $20 as S/M. If he is income-eligible, no further development is needed. If counting 1/3 FBR + $20 results in ineligibility, Mr. Williams must be given an opportunity to rebut and show that the actual value is less. In this situation, the actual value of the S/M is $216.67 ($300 CMRV - $83.33 client's voluntary payment = $216.67). Count the maximum S/M of 1/3 FBR + $20 if this is less than the actual value.

Revision 09-4; Effective December 1, 2009

Receipt of in-kind S/M must be re-evaluated if a person changes his/her permanent living arrangement. Temporary absences from the permanent living arrangement do not affect S/M.

Example: A person lives in her own home. A friend lives with her. The friend pays more than her own pro-rata share of household expenses, so the person receives S/M of 1/3 FBR + $20. On March 8, the person was hospitalized and was subsequently discharged to her son's home on March 25. The person remained in the son's home while convalescing until April 12, when she returned to her own home. Because the person did not change her permanent living arrangement, continue to count 1/3 FBR + $20 as S/M.

E-8610 Excess Contributions Towards Household Expenses

Revision 09-4; Effective December 1, 2009

If an ineligible parent's contribution towards household expenses exceeds that ineligible parent's pro-rata share, then the excess amount is allocated equally as a contribution among the parent's children (eligible and ineligible) and eligible spouse (if any). Persons among whom the ineligible parent's excess contribution is allocated (for example, children and eligible spouse, if any) are referred to as the "deeming unit."

 

E-8620 Child Living with Parents and Siblings Only

Revision 11-4; Effective December 1, 2011

If an eligible child lives only with his parent(s) and minor children, no S/M is developed for that child.

Example: John Voss, aged 14, is applying for ME-SSI Prior. He lives with his parents and two younger siblings in a home owned by his parents. John does not personally contribute toward household expenses. There is no S/M because John lives with his parents and minor siblings.

 

E-8630 Child Living in Own Household with Parents and Another Adult

Revision 15-4; Effective December 1, 2015

If an eligible child lives with his parent(s) and another adult in his parent’s(s’) household, the child may receive S/M subject to the maximum of 1/3 FBR + $20. (Any S/M received by the parent(s) or ineligible children is not considered in the eligibility determination when deeming.) Any contribution by a parent of the eligible child toward household expenses that is in excess of the parent's own pro-rata share is divided equally as a contribution among all members of the deeming unit (for example, the ineligible parent's children and eligible spouse, if any).

Example 1: A child, age 14, is applying for ME-SSI Prior. He lives with his parents and two minor siblings in a home owned by his parents. His aunt also lives in the home. The applicant does not personally contribute toward household expenses. Count 1/3 FBR + $20 as S/M. If the applicant is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The general household expenses total $1,200 ($200 pro-rata share). One of the applicant’s parents contributes $500 toward household expenses; the other parent does not contribute. The applicant’s aunt pays $700. The one parent’s excess contribution is $300 ($500 contribution – $200 pro-rata share = $300 excess contribution). The $300 is divided equally among the applicant and his two siblings. Thus, $300 divided by 3 = $100 applicant’s contribution. The actual value of S/M received by the applicant is $100 ($200 pro-rata share – $100 applicant’s contribution = $100 actual value of S/M), which is less than 1/3 FBR + $20.

Example 2: Same situation as above, except that both of the applicant’s parents now contribute — one parent contributes $200 and the other parent contributes $300. The applicant’s aunt contributes $700. Count 1/3 FBR + $20 as S/M. If the applicant is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The one parent does not have an excess contribution ($200 contribution – $200 pro-rata share = $0 excess contribution). The other parent’s excess contribution is $100 ($300 contribution – $200 pro-rata share = $100 excess contribution). The $100 is divided equally as a contribution among the parents' children in the household. Thus, the applicant’s contribution is $33.33 ($100 excess contribution divided by 3 children = $33.33). The actual value of S/M received by the applicant is $166.67 ($200 pro-rata share – $33.33 applicant’s contribution = $166.67), which is less than 1/3 FBR + $20.

Example 3: Same situation, except that both of the applicant’s parents each contribute $275 ($550 total) and the aunt contributes $650. Count 1/3 FBR + $20 as S/M. If the applicant is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The excess contribution for each of the applicant’s parents is $75 ($275 parent's contribution – $200 pro-rata share = $75 excess contribution). The total excess contribution for both parents is $150 ($75 x 2 = $150). The $150 is divided equally as a contribution among all three children. Thus, the applicant’s contribution is $50 ($150 divided by 3 = $50). The actual value of S/M received by the applicant is $150 ($200 pro-rata share – $50 applicant’s contribution = $150), which is less than 1/3 FBR + $20.

Example 4: Same situation, except that one of the applicant’s parents is an SSI recipient and contributes nothing personally toward household expenses. Count 1/3 FBR + $20 as S/M for the applicant. If the applicant is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The applicant’s non-SSI parent contributes $500 toward household expenses, and the aunt contributes $700. The contributing parent’s excess is $300 ($500 contribution – $200 pro-rata share = $300 excess contribution). The $300 is divided equally as a contribution among all members of the deeming unit (the three children and the eligible parent). The applicant’s contribution is $75 ($300 divided by 4 people = $75). The actual value of S/M received by the applicant is $125 ($200 pro-rata share – $75 applicant’s contribution = $125), which is less than 1/3 FBR + $20.

 

E-8640 Child Living with Parents in Household of Another Person

Revision 11-4; Effective December 1, 2011

If an eligible child lives with his parent(s) in someone else's household, and the child does not contribute his pro-rata share of household expenses, the child receives S/M valued at 1/3 FBR. (Any S/M received by the parent(s) and ineligible children is not considered in the eligibility determination when deeming.) Any excess contribution by an ineligible parent (for example, contribution in excess of that parent's pro-rata share) is divided equally among the parent's children and eligible spouse (if any).

Example: Rachel Brown, aged 14, is applying for ME-SSI Prior. She lives with her mother and aunt in the aunt's household. General household expenses total $420 ($140 pro-rata share). Rachel has no income, but her mother contributes $200 toward household expenses. The mother's excess contribution is $60 ($140 pro-rata share - $200 mother's contribution = - $60 mother's excess contribution). This $60 is divided equally among the mother's children in the household (Rachel is the only one) and the mother's eligible spouse (there is none). Thus, Rachel's contribution is $60. Since Rachel's contribution of $60 does not equal her pro-rata share ($140) of household expenses, count 1/3 FBR as S/M. No rebuttal is offered.

If an eligible child lives with his/her parent(s) in someone else's household and the child contributes his pro-rata share of either food or shelter expenses, but not both, count 1/3 FBR + $20 as S/M. (Any S/M received by the parent(s) and ineligible children is not considered in the eligibility determination when deeming.) If the child is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the person must be given an opportunity to rebut and show that the actual value is less. Any excess contribution by a parent (for example, contribution in excess of the parent's pro-rata share) is divided equally as a contribution among the parent's children and eligible spouse (if any).

Example: Sonia Barrett, aged 14, is applying for ME-SSI Prior. She lives with her parents and her aunt in the aunt's household. Household food expenses total $350 ($87.50 pro-rata share); household shelter expenses total $500 ($125 pro-rata share). Each of Sonia's parents contributes $150 ($300 total) for food expenses. The parents do not contribute toward shelter expenses. Sonia has no income. Count 1/3 FBR + $20 as S/M. If she is income-eligible, no further development is required. If counting 1/3 FBR + $20 results in ineligibility, the person must be given an opportunity to rebut and show that the actual value is less. The excess contribution for each parent is $62.50 ($87.50 pro-rata share for food + $125 pro-rata share for shelter = $212.50 total pro-rata share - $150 parent's contribution = $62.50 excess contribution per parent). The total excess contribution for both parents is $125 ($62.50 per parent x 2 parents = $125). The $125 is divided equally among all of the parents' children in the home (Sonia is the only one). Thus, Sonia's contribution is $125. The actual value of S/M received by Sonia is $87.50 ($87.50 pro-rata share for food + $125 pro-rata share for shelter = $212.50 total pro-rata share - $125 Sonia's contribution = $87.50), which is less than 1/3 FBR + $20.

Revision 09-4; Effective December 1, 2009

Food and shelter are not considered in the eligibility or co-payment budgets for the month of entry to a long-term care facility (for example, a nursing facility).

Revision 09-4; Effective December 1, 2009

See Appendix XVI, Documentation and Verification Guide.