A deduction is considered in the month the expense is billed or
otherwise becomes due. However, in the case of reimbursable medical expenses, a
deduction can only be considered within thirty days of receiving the
verification of the amount of reimbursement. The preceding applies regardless
of when the assistance group intends to pay the expense. Deductions from income
shall be verified in accordance with rule
5101:4-2-09 of the
Administrative Code.
Deductions for each assistance group are allowed only for the
following:
(A) Gross earned income
deduction: twenty per cent deduction of gross earned income. No additional
deductions (i.e., taxes, pensions, union dues, and the like) except for costs
of self-employment, are allowed from earned income. Excluded earned income is
not subject to this deduction. The earned income of a disqualified member is
subject to this deduction.
(B)
Standard deduction: each assistance group regardless of its income receives the
corresponding standard deduction for the assistance group size. In accordance
with
7 C.F.R
273.9 (
in effect
on 1/01/2014
as in effect on the effective date
of this rule), the United States department of agriculture (USDA) food
nutrition service (FNS) determines the amount of the standard deduction based
on the federal poverty guidelines and indexing of the cost of living increase
for each federal fiscal year. The Ohio department of job and family services
(ODJFS) provides this figure to the county agencies on an annual basis via a
food assistance change transmittal, that can be found in the food assistance
certification handbook at the ODJFS website.
(C) Excess medical deduction: that portion of
medical expenses that is nonreimbursable, over thirty-five dollars per month,
excluding special diets, incurred by any assistance group member who is elderly
or disabled as defined in rule
5101:4-1-03 of the
Administrative Code.
(1) Who is eligible for
this deduction?
(a)
Spouses or other persons receiving benefits as a
dependent of the supplemental security income (SSI) or disability recipient are
not eligible to receive the deduction
An
assistance group with potential categorical eligibility that contains a
supplemental security income (SSI) applicant that is determined ineligible but
later becomes categorically eligible and entitled to restored benefits shall
receive restored benefits using the excess medical deduction from the beginning
of the period for which SSI benefits are paid, or the original supplemental
nutrition assistance program (SNAP) application date, whichever is later, when
the assistance group incurs such expenses.
(b) Persons receiving emergency SSI benefits
based on presumptive eligibility are eligible for this deduction.
(c)
An assistance
group with potential categorical eligibility that contains an SSI applicant
that is determined ineligible but later becomes categorically eligible and
entitled to restored benefits shall receive restored benefits using the excess
medical deduction from the beginning of the period for which SSI benefits are
paid, or the original supplemental nutrition assistance program (SNAP)
application date, whichever is later, when the assistance group incurs such
expenses
Individuals who are a dependent of a
recipient of SSI or disability/blindness benefits are not eligible for this
deduction if they are receiving benefits as a spouse or other
person.
(2)
Allowable medical costs are limited to the following:
(a) Medical and dental care, including
psychotherapy and rehabilitation services, provided by a licensed practitioner
authorized by the state or another qualified health professional.
(b) Hospitalization or outpatient treatment,
nursing care, and nursing home care. Also included are payments by the
assistance group for an individual who was an assistance group member
immediately prior to entering a hospital or nursing home provided by a facility
recognized by the state.
(c)
Prescription drugs when prescribed by a licensed practitioner and other
over-the-counter medication (including insulin) when approved by a licensed
practitioner or other qualified health professional. In addition, costs of
medical supplies, incontinence products, sick-room equipment (including rental)
or other prescribed equipment or supplies are deductible. The cost of any
Schedule I controlled substance under the Controlled Substances Act
21 U.S.C.
812 (
1970
12/2018)
including medical marijuana and any expenses associated with its use, are not
deductible.
(d) Health and
hospitalization insurance policy premiums. The costs of health and accident
policies such as those payable in lump-sum settlements for death or
dismemberment, or income maintenance policies such as those that continue
mortgage or loan payments while the beneficiary is disabled are not
deductible.
(e) Medicare premiums
and any cost-sharing or spend-down expenses incurred by medicaid recipients, as
described in
7 C.F.R.
273.9.
(f) Dentures, hearing aids, and
prosthetics.
(g) Costs associated
with any animal (not limited to any type of animal) specially trained to serve
the needs of an elderly or disabled assistance group member when:
(i) The animal is specially trained to assist
the individual with the medical issue for which the animal is prescribed, and
the individual cannot readily perform on their own (specific types of
trainings, credentials or certifications are not required); and
(ii) The costs are associated with securing
and maintaining the animal, including but not limited to, veterinarian bills
and food costs.
(h)
Eyeglasses prescribed by a physician skilled in eye disease or by an
optometrist.
(i) Monthly telephone
fees for amplifiers and warning signals for handicapped persons, and costs of
telephone typewriter equipment for the deaf.
(j) Reasonable costs of transportation and
lodging to obtain medical treatment or services. "Reasonable costs for
transportation" shall be defined as the current federal or state mileage
reimbursement rate, whichever is higher, for private automobiles, or actual
costs when other forms of transportation are used. Verification is required
only when costs exceed the higher of the federal or state mileage reimbursement
rate or the rate charged is for public transportation (e.g., local bus
service).
(k) Maintaining an
attendant homemaker, home health aide, child care services, or housekeeper,
necessary due to age, infirmity, or illness. In addition, an amount equal to
the one-person allotment shall be deducted as a medical expense when the
assistance group furnishes the majority of the attendant's meals. The allotment
for this meal-related deduction shall be that in effect at the time of initial
certification. The county agency is only required to update the allotment
amount at the next scheduled reapplication; however, the county agency may do
so earlier. When an assistance group incurs attendant care costs that could
qualify under both the medical deduction and
the
dependent care deduction,
the county agency shall
treat the cost as a medical expense
the cost
may be deducted as a medical expense or a dependent care expense, but not
both.
(D) Child/dependent care deduction: payments
for the actual verified expenses for the care of an individual for whom the
assistance group provides dependent care, including care of a child under the
age of eighteen or an incapacitated person of any age in need of care. A child
care expense that is reimbursed or paid for by the Ohio works first program
under Title IV-A of the Social Security Act, (42 U.S.C.
618 (
2/2006)
5/2017) shall
not be deductible.
(1) Dependent care expenses
are allowable deductions when determined necessary for a group member to:
(a) Search for, accept or continue
employment;
(b) Comply with the
employment and training requirements described in rule
5101:4-3-30 of the
Administrative Code; or
(c) Attend
training or education in preparation for employment under rule
5101:4-3-30 of the
Administrative Code, unless covered by educational income which has been
excluded under rule
5101:4-4-13 of the
Administrative Code.
(2)
Dependent care expenses must be separately identified, necessary to participate
in the care arrangement, and not already paid by another source on behalf of
the household. Allowable dependent care expenses are limited to:
(a) The costs of care given by a care
facility or an individual care provider, including a relative, so long as the
relative providing care is not part of the same SNAP assistance group as the
child or dependent adult receiving care;
(b) Transportation costs to and from the care
facility; and
(c) Activity or other
fees associated with the care provided to the dependent that are necessary for
the household to participate in the care.
(3) For purposes of paragraph (D) of this
rule, "incapacitated" is defined as any permanent or temporary condition that
prevents an individual from participating fully in normal activities, including
but not limited to work or school, without supervision and that requires the
care of another person to ensure the health and safety of the individual, or a
condition or situation that makes a lack of supervision risky to the health and
safety of that individual.
(4) An
assistance group incurring attendant care expenses that could qualify under
both the medical deduction and/or child/dependent care deduction may be
deducted as either a medical expense or child/dependent care expense, but not
both.
(E) Shelter costs:
monthly shelter costs over fifty per cent of the assistance group's income
after all other deductions contained in this rule have been allowed. When the
assistance group does not contain an elderly or disabled member, as defined in
rule
5101:4-1-03 of the
Administrative Code, the shelter deduction cannot exceed the maximum shelter
deduction provided. These assistance groups shall receive an excess shelter
deduction for the entire monthly cost that exceeds fifty per cent of the
assistance group income after all other deductions contained in this rule have
been allowed. An assistance group with potential categorical eligibility that
contains an SSI applicant that is determined ineligible but later becomes
categorically eligible and entitled to restored benefits shall receive restored
benefits using the excess shelter deduction from the beginning of the period
for that SSI benefits are paid or the original SNAP application date, whichever
is later, when the assistance group incurs such expenses. The maximum shelter
cost deduction shall be adjusted each fiscal year and the county agencies will
be informed of the amount through the issuance of a food assistance change
transmittal, that can be found in the food assistance certification handbook at
the ODJFS website. Shelter costs shall include only the following:
(1) An assistance group that receives the
homeless shelter deduction under paragraph (H) of this rule shall not have its
shelter expense considered under paragraphs (E) and (F) of this rule.
(2) Continuing charges for the shelter
occupied by the assistance group, including rent, first and second mortgages,
condo and association fees, or other continuing charges leading to the
ownership of shelter, such as loan repayments for the purchase of a mobile
home, including interest on such payments. Examples of shelter costs homeless
assistance groups may incur are fees for staying at shelters for the homeless,
fees for renting a motel room for a number of days or hours each month, etc.
When a homeless assistance group is living in its car, the car payment can
qualify as a shelter cost.
(3)
Property taxes, state and local assessments, and insurance on the structure
itself, but not separate costs for insuring furniture or personal belongings.
When an assistance group is living in a car, only that portion of the car
insurance premium that covers the car itself may be allowed. License plate fees
on a motor home or car that represents an assistance group's residence are not
assessments and they are not allowable.
(4) One of the utility allowances listed
under paragraph (F) of this rule when applicable. To receive a utility
allowance there shall be an incurred utility expense. Only separate
identifiable utility costs are allowable.
(5) Charges for the repair of the home itself
that was substantially damaged or destroyed due to a natural disaster such as a
fire or flood. Costs for replacement or repair of normal home furnishings
(e.g., bed, refrigerator, stove) or personal belongings (e.g., clothes,
jewelry, linen) are not covered by this rule. Shelter costs shall not include
charges for repair of the home that have been or will be reimbursed by private
or public relief agencies, insurance companies, or from any other
source.
(6) The shelter costs for
the home when temporarily unoccupied by the assistance group because of
employment or training away from home, illness, or abandonment of the home due
to natural disaster or casualty loss. For the costs of a vacated home to be
included in shelter costs, the assistance group shall intend to return to the
home; the current occupants of the home, when any, shall not be claiming the
shelter costs for SNAP purposes; and the home shall not be leased or rented in
the assistance group's absence. The county agency is not required to assist
assistance groups in obtaining verification of this expense when verification
would have to be obtained from a source outside of the project area.
assistance
Assistance groups shall provide verification of actual
utility costs for unoccupied homes when the costs would result in a deduction.
An assistance group that has both an occupied home and an unoccupied home is
only entitled to one standard utility allowance.
(F) Utility allowance: utility allowances are
established by ODJFS and are reviewed and updated annually. The amounts are
updated in the statewide automated eligibility system and the county agencies
are notified of the amounts by issuance of a food assistance change
transmittal, that can be found in the food assistance certification handbook at
the ODJFS website. The utility allowances include the costs of heating fuel,
electricity, water, sewer, trash collection, and telephone service. A "cooling
cost" is a verifiable utility expense relating to the operation of air
conditioning systems or room air conditioners. This does not include costs
relating to the operation of fans.
Types of utility allowances and who is entitled to them:
Each assistance group charged for a utility expense is entitled
a utility allowance. assistance
Assistance groups that are not directly billed by a
utility company but are billed separately when costs are shared or are owed to
a landlord are entitled to a utility allowance. County agencies shall not
prorate utility allowances.
(1)
Standard utility allowance: deduction for the assistance groups that incur
heating and or cooling costs. The standard utility allowance includes the costs
of heating fuel, electricity, cooling costs, water, sewer, trash collection and
telephone service.
Assistance groups entitled to the use of the standard utility
allowance include:
(a) Assistance
groups that are not considered homeless that incur heating and/or cooling
expenses separately from their rent or mortgage are entitled to the standard
utility allowance.
(b) Assistance
groups that incur verified heating costs during the heating season continue to
qualify for the standard utility allowance throughout the year, regardless of
whether they also incur cooling costs, and vice versa.
(c) Assistance groups in private rental
housing that are billed by their landlords on the basis of individual usage or
that are charged a flat rate based on their individual usage for heating or
cooling expenses separately from their rent are entitled to the standard
utility allowance.
(d) Assistance
groups that received more than twenty dollars of direct or indirect assistance
in the past twelve months under the Low Income Home Energy Assistance Act of
1981 (LIHEAA), 42 U.S.C.
94 (01/2012) such as the home energy assistance
program (HEAP) (which is excluded as income), are entitled to the standard
utility allowance whether or not the assistance group incurs any out-of-pocket
expenses.
(e) Assistance groups
that receive direct or indirect energy assistance that is counted as income and
that incur a heating or cooling expense are entitled to use the standard
utility allowance.
(f) Assistance
groups that receive direct or indirect assistance that is excluded from income
consideration (other than that provided under the
LIHEAA
HEAP) such as
utility reimbursements made by the department of housing and urban development
(HUD) and/or the farmers home administration (FMHA) are entitled to use the
standard utility allowance, only when the amount of their utility heating
and/or cooling expenses exceeds the amount of the energy assistance or utility
reimbursement provided.
(g) An
assistance group that has both an occupied and an unoccupied home is only
entitled to one standard utility allowance.
(h) Assistance groups living in public
housing units that have central utility meters and are charged only for excess
heating or cooling costs are entitled to the standard utility allowance,
regardless when they are charged by the utility company or the
landlord.
(i) All assistance groups
that live with another individual, another assistance group or both, and share
heating and/or cooling costs, are entitled to the full standard utility
allowance.
(2) Limited
utility allowance: deduction for the assistance groups that incur two or more
utility expenses, none of which is a heating or cooling expense, but may
include a telephone expense.
(3)
Single standard utility allowance: deduction for assistance groups that incur
one utility expense that is not a heating, cooling or telephone
expense.
(4) Standard telephone
allowance: deduction for assistance groups that only incur a telephone
expense.
(G) Child
support: a deduction is provided for legally obligated child support payments
paid by an assistance group member to or for a nonhousehold member, including
payments made to a third party on behalf of the nonhousehold member (vendor
payments). The county agency shall allow a deduction for amounts paid toward
arrearages. Alimony payments made to or for a nonhousehold member shall not be
included in the child support deduction. County agencies shall budget child
support payments prospectively regardless of the budgeting system used for the
assistance group's other circumstances.
(H) Homeless shelter deduction: an assistance
group that is considered to be homeless is eligible to have this deduction
taken in the determination of its net income. To be eligible for this
deduction, the homeless assistance group shall incur shelter costs during the
month. Homeless assistance groups shall be given the choice of the homeless
shelter deduction or actual shelter costs. A homeless assistance group
receiving the homeless shelter deduction cannot have its shelter expenses
considered under paragraphs (E) and (F) of this rule. The homeless shelter
deduction is established by FNS and the amount, when changed, will be issued
through a food assistance change transmittal. Food assistance change
transmittals can be found in the food assistance certification handbook on the
Ohio department of job and family services website.
(I) Verification of deductions
Nonreimbursable medical expenses of elderly or disabled members
shall be verified at initial certification, reapplication, and whenever a
change of more than twenty-five dollars is reported. Shelter and utility
expenses, shelter and utility expenses for an unoccupied home, other shelter
expenses, dependent care expenses, and legal obligation and actual child
support payments shall be verified. Also, when other deductible expenses
claimed will result in a deduction, the expenses shall be verified. Information
on the application is questionable when it is inconsistent with information
elsewhere on the application or previous application, statements made by the
applicant, information received by the county agency, or in the case of utility
expenses, inconsistent with normal costs for the season and shall be
verified.
(J) When a
deductible expense shall be verified and obtaining the verification may delay
the assistance group's certification, the county agency shall advise the
assistance group that the assistance group's eligibility and benefit level
shall be determined without deducting the unverified expense. When the expense
cannot be verified within thirty days of the date of application, the county
agency shall determine the assistance group's eligibility and benefit level
without deducting the unverified expense. When the assistance group
subsequently provides the missing verification, the county agency redetermines
the assistance group's benefits, and provides increased benefits, when any, in
accordance with the timeliness standards for reported changes. The assistance
group is entitled to the restoration of any benefits as a result of the
disallowance of the expense only when the expense could not be verified within
the thirty-day processing standard because the county agency failed to allow
the assistance group sufficient time to verify the expense. When the assistance
group would be ineligible unless the expense is allowed, the assistance group's
application shall be handled as provided in rule
5101:4-5-07 of the
Administrative Code.
Notes
Ohio Admin. Code 5101:4-4-23
Effective:
12/1/2019
Five Year Review (FYR) Dates:
8/27/2019 and
12/01/2024
Promulgated
Under: 111.15
Statutory
Authority: 5101.54
Rule
Amplifies: 5101.54
Prior
Effective Dates: 06/02/1980, 04/01/1981, 06/01/1981, 10/01/1981, 01/22/1982,
02/01/1982, 05/01/1982, 01/01/1983, 05/20/1983, 09/24/1983 (Temp.), 11/11/1983,
02/01/1984 (Temp.), 04/01/1984, 10/01/1984 (Emer.), 11/17/1984, 08/16/1985
(Emer.), 11/01/1985 (Emer.), 01/01/1986, 05/01/1986 (Emer.), 06/15/1986
(Emer.), 08/01/1986 (Emer.), 10/30/1986, 04/10/1987 (Emer.), 06/22/1987,
08/01/1987 (Emer.), 10/25/1987, 10/29/1987 (Emer.), 01/22/1988, 09/01/1988
(Emer.), 11/28/1988, 10/01/1989 (Emer.), 12/21/1989, 01/05/1990 (Emer.),
03/22/1990, 10/01/1990 (Emer.), 11/08/1990, 07/01/1991, 10/01/1991 (Emer.),
12/20/1991, 08/01/1992 (Emer.), 10/01/1992 (Emer.), 10/30/1992, 10/01/1993,
11/15/1993, 07/01/1994, 09/01/1994 (Emer.), 10/01/1994, 12/01/1994 (Emer.),
01/01/1995, 05/01/1995, 10/01/1995 (Emer.), 10/31/1995, 12/15/1995, 02/01/1996
(Emer.), 03/14/1996, 09/22/1996 (Emer.), 10/01/1996 (Emer.), 12/21/1996,
01/01/1997 (Emer.), 03/23/1997, 04/01/1997 (Emer.), 06/06/1997, 10/01/1997
(Emer.), 11/20/1997, 03/01/1998 (Emer.), 06/01/1998, 10/01/1998 (Emer.),
12/31/1998, 10/01/1999 (Emer.), 12/16/1999, 10/01/2000 (Emer.), 12/10/2000,
03/01/2001 (Emer.), 06/01/2001 (Emer.), 10/01/2001 (Emer.), 12/13/2001,
10/01/2002 (Emer.), 11/11/2002, 10/01/2003 (Emer.), 12/11/2003, 10/01/2004
(Emer.), 12/06/2004, 10/01/2005 (Emer.), 12/22/2005, 10/01/2006 (Emer.),
11/23/2006, 10/01/2007 (Emer.), 10/29/2007, 10/01/2008 (Emer.), 12/18/2008,
05/01/2009, 07/01/2013, 09/01/2014, 03/01/2017, 01/01/2018,
07/01/2019