La. Admin. Code tit. 48 § IX-501

Current through Register Vol. 50, No. 9, September 20, 2024

Section IX-501 - Treatment of Resident Income

A. Definitions

Resident-any individual for whom a state residential facility is responsible for ongoing 24 hour care and whose primary domicile is considered the state facility.

ICF/MR-intermediate care facility for the mentally retarded which is certified to meet federal regulations under 42CFR.

ICF/MR-eligible resident An individual who meets the state and federal eligibility criteria for Medicaid benefits and who resides in an ICF/ MR under an approved placement plan.

Income Cash-from every source which is actually available, or which can be made available, and which is regular and predictable over the period of eligibilty.

Gross Income-the total income received prior to any deductions.

Earned Income-income which the individual earns by his own efforts; that is, requires ongoing activity on his part and is received as a result of performances of services by him.

Unearned Income-all income which is not considered as earned under these definitions. This includes pensions, allotments, dividends from investments, insurance benefits, alimony payments, etc.

B. Treatment of Income. All income of an individual resident in a state residential facility is considered in determination of the amount required to be paid to the facility to assist in financing cost of care. All such income, with the exceptions outlined below, shall be paid to the facility as long as the individual is considered a resident of that facility.

C. Residents Eligible for ICF/MR Services

1. The first $20 of total monthly individual income is reserved for the resident and is not applied against the cost of care.

a. If there is earned income only, the entire $20 is subtracted from that income and reserved for the resident.

b. If there is unearned income only, the entire $20 is subtracted from that income and reserved for the resident.

c. If there is both earned and unearned income, the $20 is subtracted first from the unearned income.

2. Retention of personal care needs will be in accordance with Title XIX policy as promulgated by the Department of Health and Human Resoureces, Office of Family Security.

3. Earned Income

a. In addition to the basic $20 exemption, the next $65 and one-

half the remainder of gross monthly earnings shall be reserved for use by the individual resident. All income in excess of this amount up to the actual cost of care shall be paid to the facility. Any amount over the actual cost of care shall be reserved for the resident.

b. For those individuals who are blind or under an approved plan for achievement of self support as defined by the Social Security Administration, additional earnings may be reserved. These exemptions shall be in keeping with policy of that agency.

4. Interest Income. Interest earned from funds on deposit shall be applied against the cost of care.

D. Residents Ineligible for ICF/MR Services. For those residents who do not qualify for ICF/MR services, the same policies apply as for eligible residents in relation to income. In addition, for those residents under age 18, legally responsible relatives shall contribute toward the cost of care in accordance with Department of Health and Human Resources policy.

La. Admin. Code tit. 48, § IX-501

Promulgated by the Department of Health and Human Resources, Office of Mental Retardation/Developmental Disabilities, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated June 20, 1977 in accordance with R.S. 46:1757, subsequently repealed, July 17, 1978 and replaced with R.S. 36:1 et seq., amended March 20, 1987.