MEMORANDUM

DISCUSSION:

This memorandum introduces four new income expense codes.  These income expense codes are deductions from income and are used exclusively for MO HealthNet cases. 

• AA – VA AID AND ATTENDANCE EXPENSES
• DX – VA DEPENDENT EXPENSES
• ME – VA UNUSUAL MEDICAL EXPENSES
• HB – VA HOME BOUND EXPENSES

 

AA - Aid and Attendance

The Aid and Attendance (A&A) Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity.  This portion of a VA pension is included for the Food Stamp, Temporary Assistance and Child Care Programs.  This portion of a VA pension is excluded for all MO HealthNet Programs.

• Enter the full amount of the VA Pension including the Aid and Attendance Pension, as “UI – Unearned Income”, source “VA – Veterans Administration”. 
• Enter the Aid and Attendance portion of the pension as income expense code “AA – VA Aid and Attendance Expenses”.  This portion of the VA pension is excluded for all MO HealthNet programs by FAMIS. 

NOTE: This should not be confused with the dependent care or medical deduction for an attendant.

For the Food Stamp Program maintaining an attendant, homemaker, home health aide, child care provider or, housekeeper necessary due to age, infirmity, or illness is an allowable dependent care deduction.  A deduction is also allowed for an amount equal to the one person coupon allotment if the EU furnishes the majority of the attendant’s meals. The allotment for this meal-related deduction is that allotment in effect at the time of initial certification. Adjust the allotment amount, if necessary, at the time of recertification.

The medical expense paid by an individual in a DMH apartment living arrangement for a health attendant is an allowable medical deduction. If DMH is paying part or all of the expense, however, only allow the medical expense paid by the individual. If an EU incurs attendant care costs that qualify under both the medical deduction and dependent care deduction, consider the cost a medical expense. ( IH, DC, MP)

DX - VA Dependent Expenses

VA often considers the existence of dependents when determining a veteran's or a veteran's surviving spouse's eligibility for pension, compensation, and educational benefits. If dependents are involved, the amount of the pension may be greater. The amount of the VA pension designated for the benefit of the veteran's or veteran's surviving spouse's dependent is included for the Food Stamp, Temporary Assistance and Child Care Programs.  This portion of a VA pension is excluded for all MO HealthNet Programs.

• Enter the full amount of the VA Pension including the portion designated for the veteran’s dependent , as “UI – Unearned Income”, source “VA – Veterans Administration”.
• Enter the portion of the pension designated for the veteran’s dependent as income expense code “DX– VA Dependent Expenses”.  This portion of the VA pension is excluded for all MO HealthNet programs.

ME - VA Unusual Medical Expenses

VA may consider unusual medical expenses when determining some needs-based pension and compensation payments. This consideration may result in an increase in a pension payment or in an extra payment. The amount of the VA pension designated as Unusual Medical Expense is included for the Food Stamp, Temporary Assistance and Child Care Programs.  This portion of a VA pension is excluded for MO HealthNet Programs.

• Enter the full amount of the VA Pension including the portion of the pension designated for unusual medical expenses, as “UI – Unearned Income”, source “VA – Veterans Administration”.
• Enter the portion of the pension designated for unusual medical expenses as income expense code “ME – VA Unusual Medical Expenses”.  This portion of the VA pension is excluded for all MO HealthNet programs by FAMIS. 

HB - VA Home Bound Expenses

VA pays an allowance to veterans, spouses of disabled veterans, and surviving spouses who are housebound. This allowance is combined with the individual's pension payment.  The portion of the veteran's or surviving spouse's VA pension that is designated for housebound allowance is included for the Food Stamp, Temporary Assistance and Child Care Programs.  This portion of a VA pension is excluded for all MO HealthNet Programs.

• Enter the full amount of the VA Pension including the homebound allowance, as “UI – Unearned Income”, source “VA – Veterans Administration”.
• Enter the homebound allowance portion of the pension as income expense code “HB – VA Home Bound Expenses”.  This portion of the VA pension is excluded for all MO HealthNet programs by FAMIS.

Income Maintenance Manual sections 0410.015.15, 0610.010.00, 0805.015.10, 0905.012.75, 0905.012.75.55, 0905.012.75.60, 0905.012.75.65, 0905.012.75.70 have been updated to include this information.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

NEY/JP/ER