CHAPTER 51
ELIGIBILITY
[Prior to 7/1/83, Social Services[770] Ch 51]
[Prior to 2/11/87, Human Services[498]]
441—51.1(249) Application for other benefits. An applicant or any other person whose needs are included in determining the state supplementary assistance payment must have applied for or be receiving all other benefits, including supplemental security income or the family investment program, for which the person may be eligible. The person must cooperate in the eligibility procedures while making application for the other benefits. Failure to cooperate shall result in ineligibility for state supplementary assistance.
This rule is intended to implement Iowa Code section 249.3.
441—51.2(249) Supplementation. Any supplemental payment made on behalf of the recipient from any source other than a nonfederal governmental entity shall be considered as income, and the payment shall be used to reduce the state supplementary assistance payment.
441—51.3(249) Eligibility for residential care.
	51.3(1) Licensed facility. Payment for residential care shall be made only when the facility in which the applicant or recipient is residing is currently licensed by the department of inspections and appeals pursuant to laws governing health care facilities.
	51.3(2) Physician’s statement. Payment for residential care shall be made only when there is on file an order written by a physician certifying that the applicant or recipient being admitted requires residential care but does not require nursing services. The certification shall be updated whenever a change in the recipient’s physical condition warrants reevaluation, but no less than every 12 months.
	51.3(3) Income eligibility. The resident shall be income eligible when the income according to 441—paragraph 52.1(3)“a” is less than 31 times the per diem rate of the facility. Partners in a marriage who both enter the same room of the residential care facility in the same month shall be income eligible for the initial month when their combined income according to 441—paragraph 52.1(3)“a” is less than twice the amount of allowed income for one person (31 times the per diem rate of the facility).
	51.3(4) Diversion of income. Rescinded IAB 5/1/91, effective 7/1/91.
	51.3(5) Resources. Rescinded IAB 5/1/91, effective 7/1/91.
This rule is intended to implement Iowa Code section 249.3.
441—51.4(249) Dependent relatives.
	51.4(1) Income. Income of a dependent relative shall be less than $364. When the dependent’s income is from earnings, an exemption of $65 shall be allowed to cover work expense.
	51.4(2) Resources. The resource limitation for a recipient and a dependent child or parent shall be $2,000. The resource limitation for a recipient and a dependent spouse shall be $3,000. The resource limitation for a recipient, spouse, and dependent child or parent shall be $3,000.
	51.4(3) Living in the home. A dependent relative shall be eligible until out of the recipient’s home for a full calendar month starting at 12:01 a.m.	on the first day of the month until 12 midnight on the last day of the same month.
	51.4(4) Dependency. A dependent relative may be the recipient’s ineligible spouse, parent, child, or adult child who is financially dependent upon the recipient. A relative shall not be considered to be financially dependent upon the recipient when the relative is living with a spouse who is not the recipient.
This rule is intended to implement Iowa Code sections 249.3 and 249.4.
[ARC 7605B, IAB 3/11/09, effective 4/15/09; ARC 9965B, IAB 1/11/12, effective 1/1/12; ARC 0064C, IAB 4/4/12, effective 5/9/12; ARC 0489C, IAB 12/12/12, effective 1/1/13; ARC 0633C, IAB 3/6/13, effective 5/1/13]
441—51.5(249) Residence. A recipient of state supplementary assistance shall be living in the state of Iowa.
This rule is intended to implement Iowa Code section 249.3.
441—51.6(249) Eligibility for supplement for Medicare and Medicaid eligibles. The following eligibility requirements are specific to the supplement for Medicare and Medicaid eligibles:
	51.6(1) Medicaid eligibility. The recipient must be eligible for and receiving full medical assistance benefits under Iowa Code chapter 249A without regard to eligibility based on receipt of state supplementary assistance under this rule, and without being required to meet a spenddown or pay a premium to be eligible for medical assistance benefits.
	51.6(2) SSI eligibility. The recipient shall meet all eligibility requirements for supplemental security income benefits other than limits on substantial gainful activity and income.
	51.6(3) Not otherwise eligible. The recipient must not be eligible for benefits under another state supplementary assistance group.
	51.6(4) Medicare eligibility. The recipient must be currently eligible for Medicare Part B.
	51.6(5) Living arrangement. A recipient may live in one of the following:
	a. 	The person’s own home.
	b. 	The home of another person.
	c. 	A group living arrangement.
	d. 	A medical facility.
	51.6(6) Income. Income of a recipient shall be within the income limit for the person’s Medicaid eligibility group, but must exceed 120 percent of the federal poverty level.
This rule is intended to implement Iowa Code section 249.3 as amended by 2005 Iowa Acts, House File 825, section 108.
441—51.7(249) Income from providing room and board. In determining profit from furnishing room and board or providing family life home care, $364 per month shall be deducted to cover the cost, and the remaining amount treated as earned income.
This rule is intended to implement Iowa Code sections 249.3 and 249.4.
[ARC 7605B, IAB 3/11/09, effective 4/15/09; ARC 9965B, IAB 1/11/12, effective 1/1/12; ARC 0064C, IAB 4/4/12, effective 5/9/12; ARC 0489C, IAB 12/12/12, effective 1/1/13; ARC 0633C, IAB 3/6/13, effective 5/1/13]
441—51.8(249) Furnishing of social security number. As a condition of eligibility applicants or recipients of state supplementary assistance must furnish their social security account numbers or proof of application for the numbers if they have not been issued or are not known and provide their numbers upon receipt.
Assistance shall not be denied, delayed, or discontinued pending the issuance or verification of the numbers when the applicants or recipients are cooperating in providing information necessary for issuance of their social security numbers.
This rule is intended to implement Iowa Code sections 249.3 and 249.4.
441—51.9(249) Recovery.
	51.9(1) Definitions.
“Administrative overpayment” means assistance incorrectly paid to or for the client because of continuing assistance during the appeal process.
“Agency error” means assistance incorrectly paid to or for the client because of action attributed to the department as the result of one or more of the following circumstances:
	1.	Misfiling or loss of forms or documents.
	2.	Errors in typing or copying.
	3.	Computer input errors.
	4.	Mathematical errors.
	5.	Failure to determine eligibility correctly or to certify assistance in the correct amount when all essential information was available to the local office.
	6.	Failure to make prompt revisions in payment following changes in policies requiring the changes as of a specific date.
“Client” means a current or former applicant or recipient of state supplementary assistance.
“Client error” means assistance incorrectly paid to or for the client because the client or client’s representative failed to disclose information, or gave false or misleading statements, oral or written, regarding the client’s income, resources, or other eligibility and benefit factors. It also means assistance incorrectly paid to or for the client because of failure by the client or client’s representative to timely report as defined in rule 441—76.10(249A).
“Department” means the department of human services.
	51.9(2) Amount subject to recovery. The department shall recover from a client all state supplementary assistance funds incorrectly expended to or on behalf of the client, or when conditional benefits have been granted.
	a. 	The department also shall seek to recover the state supplementary assistance granted during the period of time that conditional benefits were correctly granted the client under the policies of the supplemental security income program.
	b. 	The incorrect expenditures may result from client or agency error, or administrative overpayment.
	51.9(3) Notification. All clients shall be promptly notified when it is determined that assistance was incorrectly expended. Notification shall include for whom assistance was paid; the time period during which assistance was incorrectly paid; the amount of assistance subject to recovery, when known; and the reason for the incorrect expenditure.
	51.9(4) Source of recovery. Recovery shall be made from the client or from parents of children under the age of 21 when the parents completed the application and had responsibility for reporting changes. Recovery must come from income, resources, the estate, income tax refunds, and lottery winnings of the client.
	51.9(5) Repayment. The repayment of incorrectly expended state supplementary assistance funds shall be made to the department.
	51.9(6) Appeals. The client shall have the right to appeal the amount of funds subject to recovery under the provisions of 441—Chapter 7.
This rule is intended to implement Iowa Code sections 249.3 and 249.4.
[Filed 2/19/76, Notice 1/12/76—published 3/8/76, effective 4/12/76]
[Filed 6/25/76, Notice 5/17/76—published 7/12/76, effective 8/16/76]
[Filed 12/17/76, Notice 11/3/76—published 1/12/77, effective 3/1/77]
[Filed emergency 5/24/77—published 6/15/77 effective 7/1/77]
[Filed 3/27/78, Notice 2/8/78—published 4/19/78, effective 5/24/78]
[Filed emergency 6/28/78—published 7/26/78, effective 7/1/78]
[Filed 7/17/78, Notice 5/31/78—published 8/9/78, effective 9/13/78]
[Filed emergency 6/26/79—published 7/25/79, effective 7/1/79]
[Filed emergency 6/30/80—published 7/23/80, effective 7/1/80]
[Filed emergency 6/30/81—published 7/22/81, effective 7/1/81]
[Filed 6/30/81, Notice 4/29/81—published 7/22/81, effective 9/1/81]
[Filed 10/23/81, Notice 9/2/81—published 11/11/81, effective 1/1/82]
[Filed 11/20/81, Notice 9/30/81—published 12/9/81, effective 2/1/82]
[Filed emergency 9/23/82—published 10/13/82, effective 9/23/82]
[Filed emergency 6/17/83—published 7/6/83, effective 7/1/83]
[Filed emergency 11/18/83, after Notice 10/12/83—published 12/7/83, effective 1/1/84]
[Filed emergency 12/11/84—published 1/2/85, effective 1/1/85]
[Filed without Notice 1/22/85—published 2/13/85, effective 4/1/85]
[Filed 3/22/85, Notice 2/13/85—published 4/10/85, effective 6/1/85]
[Filed emergency 12/2/85—published 12/18/85, effective 1/1/86]
[Filed 4/29/86, Notice 3/12/86—published 5/21/86, effective 8/1/86]
[Filed emergency 12/22/86—published 1/14/87, effective 1/1/87]
[Filed emergency 1/15/87—published 2/11/87, effective 1/15/87]
[Filed emergency 12/10/87—published 12/30/87, effective 1/1/88]
[Filed emergency 12/8/88—published 12/28/88, effective 1/1/89]
[Filed emergency 11/16/89—published 12/13/89, effective 1/1/90]
[Filed 2/16/90, Notice 12/13/89—published 3/7/90, effective 5/1/90]
[Filed emergency 12/13/90—published 1/9/91, effective 1/1/91]
[Filed 12/13/90, Notice 10/31/90—published 1/9/91, effective 3/1/91]
[Filed 2/14/91, Notice 1/9/91—published 3/6/91, effective 5/1/91]
[Filed 4/11/91, Notice 3/6/91—published 5/1/91, effective 7/1/91]
[Filed emergency 12/11/91—published 1/8/92, effective 1/1/92]
[Filed 2/13/92, Notices 12/25/91, 1/8/92—published 3/4/92, effective 5/1/92]
[Filed emergency 12/1/92—published 12/23/92, effective 1/1/93]
[Filed 2/10/93, Notice 12/23/92—published 3/3/93, effective 5/1/93]
[Filed emergency 12/16/93—published 1/5/94, effective 1/1/94]
[Filed 12/16/93, Notice 10/27/93—published 1/5/94, effective 3/1/94]
[Filed 2/10/94, Notice 1/5/94—published 3/2/94, effective 5/1/94]
[Filed emergency 12/15/94—published 1/4/95, effective 1/1/95]
[Filed 2/16/95, Notice 1/4/95—published 3/15/95, effective 5/1/95]
[Filed emergency 12/12/95—published 1/3/96, effective 1/1/96]
[Filed 2/14/96, Notice 1/3/96—published 3/13/96, effective 5/1/96]
[Filed emergency 12/12/96—published 1/1/97, effective 1/1/97]
[Filed 2/12/97, Notice 1/1/97—published 3/12/97, effective 5/1/97]
[Filed emergency 12/10/97—published 12/31/97, effective 1/1/98]
[Filed 2/11/98, Notice 12/31/97—published 3/11/98, effective 5/1/98]
[Filed emergency 12/9/98—published 12/30/98, effective 1/1/99]
[Filed 2/10/99, Notice 12/30/98—published 3/10/99, effective 4/15/99]
[Filed emergency 12/8/99—published 12/29/99, effective 1/1/00]
[Filed 2/9/00, Notice 12/29/99—published 3/8/00, effective 5/1/00]
[Filed emergency 12/14/00—published 1/10/01, effective 1/1/01]
[Filed 2/14/01, Notice 1/10/01—published 3/7/01, effective 5/1/01]
[Filed emergency 12/12/01—published 1/9/02, effective 1/1/02]
[Filed 2/14/02, Notice 1/9/02—published 3/6/02, effective 5/1/02]
[Filed emergency 5/9/02—published 5/29/02, effective 6/1/02]
[Filed 7/15/02, Notice 5/29/02—published 8/7/02, effective 10/1/02]
[Filed emergency 12/12/02—published 1/8/03, effective 1/1/03]
[Filed emergency 11/19/03—published 12/10/03, effective 1/1/04]
[Filed emergency 8/12/04 after Notice 6/23/04—published 9/1/04, effective 8/12/04]
[Filed emergency 12/14/04—published 1/5/05, effective 1/1/05]
[Filed 2/10/05, Notice 1/5/05—published 3/2/05, effective 4/6/05]
[Filed emergency 6/17/05—published 7/6/05, effective 7/1/05]
[Filed 10/21/05, Notice 7/6/05—published 11/9/05, effective 12/14/05]
[Filed emergency 12/14/05—published 1/4/06, effective 1/1/06]
[Filed 2/10/06, Notice 1/4/06—published 3/1/06, effective 4/5/06]
[Filed emergency 12/13/06—published 1/3/07, effective 1/1/07]
[Filed 3/14/07, Notice 1/3/07—published 4/11/07, effective 5/16/07]
[Filed emergency 12/12/07—published 1/2/08, effective 1/1/08]
[Filed 3/12/08, Notice 1/2/08—published 4/9/08, effective 5/14/08]
[Filed emergency 12/10/08—published 12/31/08, effective 1/1/09]
[Filed ARC 7605B (Notice ARC 7472B, IAB 12/31/08), IAB 3/11/09, effective 4/15/09]
[Filed Emergency ARC 9965B, IAB 1/11/12, effective 1/1/12]
[Filed ARC 0064C (Notice ARC 9964B, IAB 1/11/12), IAB 4/4/12, effective 5/9/12]
[Filed Emergency ARC 0489C, IAB 12/12/12, effective 1/1/13]
[Filed ARC 0633C (Notice ARC 0488C, IAB 12/12/12), IAB 3/6/13, effective 5/1/13]