Article 13 Section 02 Income Eligibility Criteria
Table of Contents
TITLE PG CITE
Income Eligibility Criteria 130201
Eligibility Categories 130201A
Analysis Of Discretionary Income 130202
Definitions 130202A
130201 Income Eligibility Criteria
130201A Eligibility Categories
A modification to the CMS Program was approved by the San Diego County Board of Supervisors on 051308 14 As a result CMS Program benefits shall be certified under two separate eligibility categories
1 Income of 0 to 165 FPL
a If eligible applicants receive CMS services at no cost
2 Income over 165 FPL
a
Applicants whose monthly net nonexempt income is over 165 but not more than 350 FPL must complete a CMS Hardship application to determine if they are eligible for CMS with or without a share of cost
b
Applicants who are being evaluated for a CMS Hardship are required to sign a Reimbursement Agreement CMS106 as a condition of CMS Hardship eligibility
Note If the CMS applicant fails to complete and sign a Hardship Application or sign the Reimbursement Agreement the worker will deny the CMS application for failure to provide
130202 Analysis of Discretionary Income
130202A 1 Maximum Allowable Monthly Expense Definitions A reasonable level of expenses necessary for a person to cover necessary living expenses The maximum limits listed in Appendix 1303A are set forth by the County based upon costofliving studies
2 NonDiscretionary Expenses The amount necessary to pay for housing including utilities transportation food taxes and miscellaneous personal expenses which include telephone clothing personal care items and recurring household expenses Nondiscretionary expenses may also include court ordered payments towards child support andor alimony and payments on previously incurred medical debt
a Applicants Actual NonDiscretionary Expenses
Actual expenses incurred by an applicant
b Applicants Allowable NonDiscretionary Expenses The lesser amount of Applicants Actual NonDiscretionary Expenses or Maximum Allowable Expense Refer to Appendix 1303A for list of Allowable Expenses and the associated dollar amounts
3
Share of Cost The amount that the CMS recipient must pay or is obligated to pay toward the cost of health care services each month in which CMS services are accessed
4
Total Discretionary Income The amount of an applicants income remaining after the Applicants Allowable NonDiscretionary Expenses total is subtracted from the applicants gross monthly income