He-W 820.02 - Definitions

He-W 820.02. Definitions

As used in this section, the following terms shall have the meanings indicated:

(a) "Assets" means "assets" as defined in 42 USC 1396p(h)(1), that is, all income and resources of the individual and of the individual's spouse. The term includes any income or resources to which the individual or the individual's spouse is entitled but does not receive because of any action by the individual, the individual's spouse, or a person, including a court, or administrative body with legal authority to act in place of or on behalf of the individual, or the individual's spouse, or any person, including a court or administrative body, acting at the direction or upon the request of the individual, or the individual's spouse.

(b) "Fair market value" means the current market value of an asset at the time the asset is transferred. The current market value is the selling price for which it can reasonably be expected to sell on the open market in the geographic area involved.

(c) "Home and community based care (HCBC)" means community services that individuals might need in order to prevent institutionalization as described under subsection (c) or (d) of Section 1915 of the Social Security Act.

(d) "Income" means "income" as described in 42 USC 1382a of the Social Security Act. The term includes both earned and unearned income.

(e) "Institution" means a hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, or any other provider which is an institution as defined by 42 CFR 435.1010.

(f) "Institutionalized individual" means any individual who is an inpatient in a nursing facility, including an intermediate care facility for individuals with intellectual disabilities, or who is an in-patient in a medical facility and is receiving a level of care provided in a nursing facility, or who is receiving care, services, or supplies pursuant to a waiver under subsection (c) or (d) of Section 1915 of the Social Security Act.

(g) "Penalty period" means the period of time in which an individual is ineligible for institutional or HCBC waiver services due to a transfer of an asset for less than fair market value.

(h) "Resources" means "resources" as described in 42 USC 1382b of the Social Security Act, except for, in the case of an institutionalized individual, the homestead exclusion provided for in subsection (a)(1) of that section.

(i) "Transfer" means any action or failure to act which has the effect of changing an ownership interest in an asset from the individual to another person, or preventing an ownership interest the individual would have otherwise enjoyed. A transfer includes any direct or indirect method of disposing of an interest in an asset.

(j) "Unearned income" means all contributions, payments, pensions, benefits, loans, awards, or other income which is not received as compensation for work performed.

(k) "Valuable consideration" means that an individual received in exchange for his or her right or interest in an asset some act, object, service, or other benefit which is tangible and has intrinsic value to the individual that is roughly equivalent to or greater than the value of the transferred asset.

(Derived From Volume XXXVII Number 28, Filed July 13, 2017, Proposed by #12217, Effective 6/22/2017, Expires 6/22/2027.)

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