N.M. Admin. Code § 8.102.400.15 - NMW LIVING IN THE HOME
A.
Basic requirements:
(1) To be eligible for
inclusion in the NMW cash assistance benefit group, the dependent child must
live with a parent or a specified relative acting as the head of household. A
child lives with a participant when:
(a) the
participant's home is the primary place of residence for the child, as
evidenced by the child's customary physical presence in the home;
(b) the participant may or may not be the
child's parent or caretaker;
(c)
the caretaker is the person taking primary responsibility for the care of the
child, the caretaker will be a parent, relative or it may be an unrelated
adult; the caretaker may or may not be the head of household.
(2) The determination of whether a
given participant functions as the parent or caretaker relative for NMW
purposes shall be made by the client unless other information known to the
caseworker clearly indicates otherwise.
B. Extended living in the home:
(1) Under the circumstances described in this
section, a child may be physically absent from the home for periods of time,
but, because of the nature of the absence and because the parent or caretaker
relative continues to exercise parental control over and to provide care for
the child during the time the child is physically away from the family's home,
the child nonetheless remains a regular on-going member of the benefit group.
Similarly, under certain circumstances, the caretaker could be physically
absent from the home and still retain membership status as caretaker for
purposes of eligibility.
(2) The
circumstances where this occurs are:
(a)
attending boarding schools or college and
(b) inpatient treatment in medicaid
facilities; in order for either the child or the caretaker to retain
living-in-the-home status, the person acting as the caretaker must retain
responsibilities for providing care, support and supervision for the child
which are appropriate to the child's specific living arrangements.
(3) In considering whether the
caretaker retains care and support responsibilities for a child who is
hospitalized or at school, issues which shall be reviewed include the degree to
which the parent:
(a) provides financial
support to the child from the cash assistance payment;
(b) continues to maintain living quarters for
the child until the child reestablishes full-time physical presence in the
home; and
(c) continues to make
decisions regarding the care and control of the child(ren), including decisions
about medical care and treatment, class scheduling, and other similar parental
decisions;
(d) maintains contact
with the child through regular visits or telephone calls.
(4) The determination whether
living-in-the-home status is retained is fully discussed with the caretaker and
carefully documented in the case record.
(a)
Boarding school: A child or caretaker relative who is attending school away
from home lives in the home if the caretaker relative retains primary
responsibility for the child relative.
(b) Medicaid:
(i) Caretaker: A caretaker receiving
treatment in a Title XIX facility remains a member of the benefit group of
which the caretaker was a member at the time of hospitalization until the
caretaker leaves the facility and returns to that home or some other. If the
caretaker does not return to the home following hospitalization, the
living-in-the-home requirement shall be reassessed.
(ii) Dependent children: For the purposes of
the cash assistance program, a child hospitalized for care or treatment in a
Title XIX (medicaid) facility retains living-in-the-home status, without regard
to the length of hospitalization, provided that the caretaker continues to be
the person with primary responsibility for control of the child and for meeting
the child's physical and emotional needs. This includes children receiving
treatment in acute care hospitals, freestanding psychiatric hospitals and
rehabilitation hospitals as well as residential treatment centers and group
homes reimbursed by medicaid for psychosocial rehabilitation services. Medical
assistance division institutional care staff may be contacted to verify New
Mexico medicaid provider status of RTCs and group homes.
(5) For a child to retain
living-in-the-home status while receiving rehabilitation services, including
psychosocial treatment services, certain conditions must be met. Treatment of
the child is the primary objective, but the program should be family-based with
one objective being strengthening of family ties. Treatment plans must provide
for a significant level of continuing authority, responsibility, and
participation by the caretaker. In order for children receiving treatment in a
Title XIX facility to be "living in the home", the caretaker must retain the
authority to decide when the child should leave the facility, grant authority
for provision of necessary treatment, and retain responsibility for provision
of pocket money, clothing, etc.
(6)
A significant issue in determining whether a child retains living-in-the-home
status is the authority of the caretaker to control the child's treatment and
duration of stay. Under the state's mental health code, a court order placing
the child in a psychiatric facility must be issued. The court findings serve to
make sure that the child needs such treatment. Such orders do not prevent the
specified relative from removing the child from the facility. These orders must
be differentiated from correctional commitments or sentences. A child receiving
treatment in a Title XIX facility, or placed in other substitute care living
arrangements by juvenile authorities as the result of a sentence or commitment
by a judicial authority does not meet the definition of actually living in the
home, as the caretaker no longer has significant control over the
child.
(7) A child may qualify for
extended living-in-the-home provisions under these conditions:
(a) the child must have been living in the
home before hospitalization;
(b)
the child must have been living in the home before attending boarding school or
college.
C.
Joint custody: A child who is in the joint custody of divorced parents who are
living apart and who is actually spending equal amounts of time with both
parents shall not be considered to be living with the caretaker. If the divorce
decree specifies equal joint custody, but the child is actually spending more
time with one parent than the other, the child would be determined to be living
with the parent with whom the child spends the most time.
D. Absence from the home:
(1) A minor child may remain in the benefit
group and remain eligible for benefits for up to 45 days following the date of
departure or expected absence from the home. Such a child may not
simultaneously be in another NMW or GA benefit group.
(2) A child shall be considered to have left
the home, when the child is physically absent from the home and is under the
care, control, custody, of himself, another relative or another adult, social
services or correctional agency, or other agency of state, local, or tribal
government.
E. Reporting
departure of child from the home: Pursuant to Section 408 (a)(10)(C) of the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the
parent, relative, or caretaker of a minor child included in the NMW benefit
group is ineligible to be included in the benefit group if the parent or
relative or caretaker fails to report the absence from the home of a minor
child who is a member of the benefit group. To be eligible, the adult must
report the departure of the minor child by no later than five days after the
adult becomes aware that the child is absent or will be absent in excess of the
45 days allowed under Subsection D of
8.102.400.15 NMAC. The adult shall
remain ineligible for the number of months that the benefit group is sanctioned
for non-reporting as provided for at
8.102.620.11 NMAC.
Notes
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