Department of Human Services: Chapter 1: Section 1.5.4
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Department of Human Services

 
 
 

IMA POLICY MANUAL
PART IV:  NON-FINANCIAL ELIGIBILITY REQUIREMENTS
 
CHAPTER 1:  GROUP COMPOSITION 
 
Other Excluded Persons  1.5.4
 
MA 
AR:  An individual is excluded from the AR assistance unit if:
  • she/he refuses to provide information needed to determine his/her eligibility;
  • she/he is a parent or caretaker who refused without good cause to cooperate with child support cooperation or medical support assignment requirements (see Chapter 2:  Child Support Requirements  in Part V);
  • she/he is a member of another public assistance unit receiving TANF;
  • she/he is a child and the applicant/recipient has requested that the child be excluded from the assistance unit (such as in the case of a child who has significant income that, if included, will make other family members ineligible for Medicaid);
  • he is the expecting father of an unborn child, there are no other children in the assistance unit until the month in which the child is born, and the expecting father is not married to the mother (if the expecting parents are married, then the expecting father’s needs are included provisionally, but he is ineligible for MA benefits with this group until the child is born);
  • she/he is a foster parent and the ward is included in the unit;
  • she/he is a parent whose needs are met by his/her spouse who is not a natural or adoptive parent of the dependent child, and the parent has chosen to be excluded; or
  • she/he is a parent under age 21, his/her needs are met by his/her parent(s) living in the home, and the parent under 21 has chosen to be excluded.
If a natural or adoptive parent of a child applying for MA chooses to exclude him/herself from the unit, the parent is included in the unit provisionally when determining the child’s eligibility for MA.
 
A step-parent may be included in an AR unit at his/her option.  If s/he chooses to be excluded from the unit, his/her income and resources are not counted unless his/her spouse is in the unit.
 
AX:  An individual is excluded from the AX assistance unit if:
  • s/he refuses to provide information needed to determine his/her eligibility;

  • s/he is a parent or caretaker who refused without good cause to cooperate with child support cooperation or medical support assignment requirements (see Chapter 2:  Child Support Requirements in Part V);

  • s/he is a child and the applicant/recipient has requested that the child be excluded from the assistance unit;

  • He is the expecting father of an unborn child, there are no other children in the assistance unit until the month in which the child is born, and the expecting father is not married to the mother (if the expecting parents are married, then the expecting father’s needs are included provisionally, but he is ineligible for MA benefits with this group until the child is born);

  • s/he is a parent whose needs are met by his/her spouse who is not a natural or adoptive parent of the dependent child, and the parent has chosen to be excluded; or

  • s/he is a parent under age 21, his/her needs are met by his/her parent(s) living in the home, and the parent under 21 has chosen to be excluded.
If a natural or adoptive parent of a child applying for MA chooses to exclude him/herself from the unit, the parent is included in the unit provisionally when determining the child’s eligibility for Medicaid.
A step-parent may be included in an AR unit at his/her option.  If s/he chooses to be excluded from the unit, his/her income and resources are not counted unless his/her spouse is in the unit.
 
SR:  A group member is excluded if s/he refuses to provide information necessary to determine eligibility such as their Social Security Number, etc.
 
Resources and income of excluded persons may be considered in determining eligibility (see Chapter 2:  Whose Assets are Counted and Chapter 5:  Whose Income is Counted in Part VI).
 
QM:  See SR.
 
TANF 
The following persons cannot be included in the assistance unit:
  • non-qualified immigrants and certain categories of qualified immigrants (see Chapter 7: Citizenship/Alienage in this Part);

  • a step-parent whose needs are excluded from the grant because s/he does not have a child in common with the parent of a child in the assistance unit;

  • foster children and children receiving adoption assistance.  Such children, however, may qualify the caretaker for TANF assistance (see Section 4.3:  Adoption Subsidy and Section 4.16:  Foster Care Payments in Part VI);

  • unless exempt, an adult who failed to sign the Customer/Agency Agreement. Persons exempt from this requirement are those who are working at least 30 hours per week or who are subject to the school attendance requirement;

  • individuals who failed to cooperate with IMA at the application stage (see Section 3.4.1: Failure to Cooperate with IMA at the Application Stage in Part III); and

  • SSI recipients.  An SSI recipient may be the caretaker of a child but shall not be included in the TANF grant).
A child receiving SSI shall not be included in the TANF grant but may qualify the caretaker.  Two parents may be included in the grant if the SSI child is deprived due to incapacity or unemployment of a parent (see Chapter 8:  TANF Child Deprivation in this Part).

Example
Ms. Roberts lives with her daughter, Sara, who receives SSI.  Ms. Roberts has no source of income.  Ms. Roberts can qualify for a TANF grant based on a group size of one.  Sara would not be included in the grant.

The SSR should never deem the income and/or assets of an SSI recipient to the group.  The SSR should not compute an overpayment (see Chapter 6:  Overpayment and Underpayment) for the dual receipt of TANF and SSI unless:
    • IMA informed SSA that a person would be removed from the grant on a specific date, and
    • the person was not removed from the grant on that date.
If the SSI check was not reduced due to TANF benefit, the SSR should notify SSA of the dual receipt.  SSA will process an SSI overpayment.
 
Individuals who are sanctioned as a result of failing to comply with a program requirement after eligibility has been determined and a grant of assistance is made (see Part V:  Program Requirements and Sanctions for more information) may have their needs removed from the grant.
 
GC
Caretakers cannot be included in a GC assistance unit.
 
FS  
Any individual convicted of trafficking FS benefits of $500 or more is permanently disqualified from receiving FS benefits.
 
In addition, individuals who failed to cooperate with IMA at the application stage (see Section 3.4.1: Failure to Cooperate with IMA at the Application Stage in Part III) are excluded.