N.J. Admin. Code § 10:69-3.31 - Legally responsible relatives (LRRs)
(a) Certain
relatives are legally considered responsible to provide support if financially
able and may be a source of income for an AFDC-related Medicaid applicant or
beneficiary. The CWA shall determine the capacity of LRRs to contribute to the
support of AFDC-related Medicaid applicants and beneficiaries.
(b) The CWA director is authorized under
specified circumstances to apply to the appropriate court for a support order.
In cases where a court order appears to be the only means of insuring
consistent and actual support, the applicant/beneficiary may elect to receive
from the CWA the grant for which he or she is eligible and request the CWA to
collect the support payments (see
N.J.A.C.
10:69-3.36) . The applicant shall be fully
informed of these provisions and their impact:
1. The following chart identifies relatives
who are recognized as legally responsible under AFDC-related Medicaid:
AFDC-related Medicaid | |
Legally Responsible Relative | Program |
Spouse | X |
Child under age 55 | X |
Parent of a child under 18 or of a | X |
child over age 18 who is not an | |
AFDC-related Medicaid parent or | |
parent-person |
(c) All legally responsible relatives shall
be contacted in completing the investigation:
1. Regardless of where the relative lives, it
is the responsibility of the eligibility worker to obtain the necessary
information by the most direct and practical method.
i. The legally responsible relative shall be
the primary source of the information required to evaluate his or her capacity
to support.
ii. When the evidence
submitted by the relative is inadequate or shows a discrepancy, or he or she is
unable to submit evidence, he or she shall understand that it shall be
necessary for the agency to obtain verification directly from his or her
employer, bank and so forth.
(d) Legally responsible relatives shall be
reevaluated at least once every 12 months. See
10:69-5.3 regarding reevaluation
and situations in which contact need not be made.
(e) Priorities of obligations to support
legally responsible relative are:
1. A
person's obligation to support those relatives for whom he or she is legally
responsible takes precedence over voluntarily assumed obligations.
2. Responsibility of a person for the support
of his or her own minor children takes priority over any obligations for other
relatives.
(f) The
eligible unit shall not be eligible for AFDC-related Medicaid when the amount
of the legally responsible relative's evaluated capacity to support equals or
exceeds his or her adjusted allowance and this support is actually provided to
the eligible unit.
1. The LRR's contribution
shall be considered available only when there is affirmative and persuasive
evidence that such amount or its equivalent in goods or services is in fact
provided to members of the eligible unit. (For details see
10:69-3.7.)
2. When any LRR fails or refuses to provide
any portion of his or her contribution the agency shall, within 30 days, take
appropriate action in accordance with available procedures to compel
contribution in the amount of the adjusted allowance or the evaluated capacity
to support, whichever is less.
3.
Whenever the LRR fails or refuses to furnish information concerning his or her
ability to support members of the eligible unit, it shall be deemed a failure
or refusal to provide support as required by law.
i. In such cases the agency shall take
appropriate action within 30 days, in accordance with available procedure to
secure judicial determination of the LRR's ability to support the eligible unit
member(s). Until such determination is made, each LRR shall be considered a
potential resource.
4.
For a LRR in the home of the eligible unit, see
N.J.A.C.
10:69-3.10.
(g) When it has been determined by judicial
process that a child of an applicant for or beneficiary of AFDC-related
Medicaid has been abandoned, deserted or not supported by the applicant or
beneficiary during his or her minority, such person is legally excused and
relieved of obligation and shall not be considered a legally responsible
relative.
(h) When an individual
(under the age of 19) who is himself or herself a parent lives in the same home
as his or her own parent(s) or legal guardian(s), and the adolescent parent
applies for AFDC-C or -F, the income of such parent(s) or legal guardian(s)
shall be considered available to the eligible unit in accordance with the
deeming provisions of
N.J.A.C.
10:69-10.44.
Notes
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