Section 120.380 Resources

Section 120

TITLE 89: SOCIAL SERVICES

CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

SUBCHAPTER b: ASSISTANCE PROGRAMS

PART 120 MEDICAL ASSISTANCE PROGRAMS

SECTION 120.380 RESOURCES

Section 120.380  Resources

a)         Unless otherwise specified and for purposes of this Part, the

term "resource" (as defined in 42 USC 1382b, except subsection (a)(1)

of that section, which excludes the home as a resource) means cash or any other

personal or real property that a person owns and has the right, authority or

power to liquidate.

b)         A resource is considered available to pay for a person's own

care when at the disposal of that person; when the person has a legal interest

in a liquidated sum and has the legal ability to make the sum available for

support, maintenance or medical care; or when the person has the lawful power

to make the resource available or to cause the resource to be made available.

c)         The value of nonexempt resources shall be considered in

determining eligibility for any means-tested public benefit program

administered by the Department, the Department of Human Services or the

Department on Aging if eligibility is determined, in part, on the basis of resources

as provided under this Section.

d)         Determination of Resources

1)         In

determining initial financial eligibility for medical assistance:

A)        The

Department considers nonexempt verified resources available to a person as of

the date of decision on the application for medical assistance.  The date of

verification (see Section 120.308(f)) may be prior to the date of decision. Resources

applied to a spenddown obligation in a retroactive month (see Section

120.61(b)) shall not be treated as available in the determination of initial

financial eligibility. Money considered as income for a month is not considered

a resource for that same month

he application for medical assistance.  The date of

verification (see Section 120.308(f)) may be prior to the date of decision. Resources

applied to a spenddown obligation in a retroactive month (see Section

120.61(b)) shall not be treated as available in the determination of initial

financial eligibility. Money considered as income for a month is not considered

a resource for that same month.  If income for a month is added to a bank

account that month, the Department will subtract the amount of income from the

bank balance to determine the resource level. Any income remaining in the

following months is considered a resource.

B)        Effective

June 16, 2014, clients and applicants who receive Supplemental Security Income

(SSI) payments or who were receiving SSI when they entered a nursing home or

the supported living program or initiated other long term support services are

considered to have their current resources verified.

C)        Effective

June 16, 2014, individuals who have verified income at or below 100% FPL and

report resources at or below the appropriate resource disregard in Section

120.382 or 120.510 are considered to have their current resources verified,

unless there is a specific reason to question the value of the resource.

2)         Effective

July 1, 2012, an applicant for medical assistance may be eligible for up to 3

months prior to the date of application if the person would have been eligible

for medical assistance at the time he or she received services if he or she had

applied, regardless of whether the person is alive when the application for

medical assistance is made.  In determining financial eligibility for

retroactive months, the Department will consider the amount of income,

resources and exemptions available to a person as of the first day of each of

the backdated months for which eligibility is sought

me he or she received services if he or she had

applied, regardless of whether the person is alive when the application for

medical assistance is made.  In determining financial eligibility for

retroactive months, the Department will consider the amount of income,

resources and exemptions available to a person as of the first day of each of

the backdated months for which eligibility is sought.

3)         In

determining a person's spenddown obligation (see Section 120.384), the

Department considers the amount of nonexempt resources available as of the date

of decision, in the case of initial eligibility, and the first day of the

month, in the case of retroactive eligibility, that are in excess of the

applicable resource disregard (see Section 120.382).

e)         Subject

to subsection (c) of this Section and 89 Ill. Adm. Code 113.140, the entire

equity value of jointly held resources shall be considered available in

determining a person's eligibility for assistance, unless:

1)         The resource

is a joint income tax refund, in which case one-half of the refund is

considered owned by each person; or

2)         The

person documents that he or she does not have access to the resource.

Appropriate documents may include, but are not limited to, bank documents,

signature cards, trust documents, divorce papers, and papers from court

proceedings that show the person is legally unable to access the resource; or

3)         The resource

is held jointly with an individual eligible under any means-tested public

health benefit program (other than the Supplemental Nutrition Assistance

Program) administered by the Department, the Department of Human Services, or the

Department on Aging; or

4)         The

person can document the amount of his or her legal interest in the resource and

that such amount is less than the entire value of the resource, then the

documented amount shall be considered

ed public

health benefit program (other than the Supplemental Nutrition Assistance

Program) administered by the Department, the Department of Human Services, or the

Department on Aging; or

4)         The

person can document the amount of his or her legal interest in the resource and

that such amount is less than the entire value of the resource, then the

documented amount shall be considered.  Appropriate documentation may include,

but is not limited to, bank documents, trust documents, signature cards,

divorce papers, or court orders that show the person's legal interest is less

than the entire value of the resource; or

5)         The

person documents that the resource or a portion of the resource is not owned by

the person and the person's accessibility to the resource is changed (see

subsections (e)(2) and (4) for documentation examples).

f)         In

determining the eligibility of a person for long term care services whose

spouse resides in the community, all nonexempt resources owned by the

institutionalized spouse, the community spouse, or both shall be considered

available to the institutionalized spouse in determining his or her eligibility

for medical assistance.  From the total amount of such resources may be deducted

a Community Spouse Resource Allowance as provided under Section 120.379.

g)         Trusts

established prior to August 11, 1993 shall be treated in the manner described

in Section 120.346.

h)         Trusts

established on or after August 11, 1993 shall be treated in the manner

described in Section 120.347.

i)          The value of a life estate shall be determined at the time

the life estate in the property is established and at the time the property

(for example, resources) is liquidated.  In determining the value of a life

estate and remainder interest based on the value of the property at the time

the life estate is established or of the amount received when the property is

liquidated, the Department shall apply the values described in Table A

mined at the time

the life estate in the property is established and at the time the property

(for example, resources) is liquidated.  In determining the value of a life

estate and remainder interest based on the value of the property at the time

the life estate is established or of the amount received when the property is

liquidated, the Department shall apply the values described in Table A.  The

life estate and remainder interest are based on the age of the person at the

time the life estate in the property is established and at the time the

property is liquidated and the corresponding values described in Table A.

j)          A

person's entrance fee in a continuing care retirement community or life care

community (as those entities are described in 42 USC 1396r(c)(5)(B)) shall be

considered an available resource to the extent that:

1)         the

person has the ability to use the entrance fee, or the contract provides that

the entrance fee may be used to pay for care should other resources or income

of the person be insufficient to pay for the care;

2)         the

person is eligible for a refund of any remaining entrance fee when the person

dies or terminates the continuing care retirement community or life care

community contract and leaves the community; and

3)         the

entrance fee does not confer an ownership interest in the continuing care

retirement community or life care community

the person be insufficient to pay for the care;

2)         the

person is eligible for a refund of any remaining entrance fee when the person

dies or terminates the continuing care retirement community or life care

community contract and leaves the community; and

3)         the

entrance fee does not confer an ownership interest in the continuing care

retirement community or life care community.

k)         Non-homestead

real property, including homestead property that is no longer exempt (see

Section 120.381(a)(1)), is considered an available resource unless:

1)         the

property is exempted as income-producing to the extent permitted under Section

120.381(a)(3), except Section 120.381(a)(3) shall not apply to farmland

property and personal property used in the income-producing operations related

to the farmland (e.g., equipment and supplies, motor vehicles, tools, etc.)

through December 31, 2013;

2)         ownership

of the property consists of a fractional interest of such a small value that a

substantial loss to the person would occur if the property were sold;

3)         the

property has been listed for sale, in which case the property will not be

counted as available for at least six months as long as the person continues to

make a good faith effort to sell the property. This effort can be verified by

evidence, including advertisements or documentation of the listing of the

property with licensed real estate agents or brokers that includes a report of

any offer from prospective buyers

d for sale, in which case the property will not be

counted as available for at least six months as long as the person continues to

make a good faith effort to sell the property. This effort can be verified by

evidence, including advertisements or documentation of the listing of the

property with licensed real estate agents or brokers that includes a report of

any offer from prospective buyers. The Department will review cases in which

the property has not been sold after six months and will consider the following

factors in determining if extensions of  the initial six months are warranted:

A)        the

asking price is less than the fair market value of the property;

B)        the

property is marketed through a qualified realtor who is acting in good faith;

C)        there

is not a substantial market for the type of property being sold; and

D)        the

person has not rejected any reasonable offer to buy the property; or

4)         the

homestead property that is no longer exempt (see Section 120.381(a)(1)) is

producing annual net income for the person in an amount that is not less than

six percent of the person's equity value in the property. In determining net

income, the Department shall recognize business expenses allowed for federal

income tax purposes.