Selected Sections of The Florida Public Assistance Manual. Here you will find the Department of Children and Families guide to the Florida laws on Medicaid and how they affect eligibilty for public benefits to pay for the costs of long term care. We have broken the selected sections into three part for ease in navigation. Those parts are: Sections 1600 to 1630 Sections 1630 to 1845 Sections 1845 to 1875 1600.00.00 ASSETS   Each individual's assets must be considered to determine eligibility for public assistance.   This chapter presents requirements for determining eligibility based on assets. The chapter discusses policy for the following topics:   - Asset Definition (Section 1605), - Asset Limits (Section 1610), - Asset ownership and Availability (Section 1615), - General Determination of Asset Value (Section 1620), - Types of Assets: Definitions and Value Determination (Section 1625), and - Transfer of Assets (Section 1630).   1605.00.00 ASSET DEFINITION   Assets, liquid or non-liquid, are resources or items of value that are owned (singly or jointly) by an individual who has access to the cash value upon disposition.   Liquid assets are cash resources or resources that are payable in cash on demand. Non-liquid assets are assets that can not be readily converted to cash.   Assets of each member of the SFU must be determined. A determination of whether each asset should be included or excluded must be made.   1610-00.00 ASSET LIMITS   The asset limit is the maximum amount of liquid and/or non-liquid assets that an assistance group can retain and remain eligible for public assistance.   1610.20.00 MEDICALLY NEEDY ASSET LIMITS (MA-AFDC,MA-SSI)   For medically needy, assets must be equal to or below program limits. SFU sizes and the corresponding medically needy asset limits are presented in the following chart.   If the SPU size is... Then the asset limit is...   1 $5,000 2 $6,000 3 $6,000 4 $6,500 5 $7,000 6 $7,500 7 $8,000 8 $8,500 9 $9,000 10 $9,500   When the SFU contains more than 10 individuals, for each additional individual add $500 to the asset limit.   When the needs of her unborn child are included in the SFU of the pregnant woman, the SFU size increases accordingly. The above SFU asset limits apply with the exception of AFDC and AFDC-related deemed individuals.     1610.25.00 ASSET LIMITS (MA-SSI,SFP)   (01/01/93) Total countable assets for an individual or a couple must not exceed $2000 or $3000 respectively.   Exceptions to these asset limits include the following:   - for MEDS-AD, assets cannot exceed $5,000 for an individual and $6,000 for a couple,   - for QMB and SLMB, assets cannot exceed the MEDS/MN asset limit ($5000/$6000)   - for working disabled benefits, assets cannot exceed the MEDS/MN asset limit ($5000/$6000)   - for ICP, and HOSPICE individuals (admitted to an institution on or after September 30, 1989) with Community Spouses, the individuals assets must not exceed $2,000 after the community spouses resource allocation allowance is subtracted from the couple's total countable assets. For ICP- MEDS, the asset limit cannot exceed $5,000 for the institutionalized individual, after allocation of the assets to the community spouse.   1610.35.00 VERIFICATION OF ASSETS (FS,AFDC,RAP,CIC,MA-AFDC,MA-SSI)   (04-01-96) All assets must be verified at the source (for example, by the bank where the account is held) or through a source document. Verification of all assets, except cash, is required in all cases. The worker must refer to the particular type of asset for documentation needed. The individual's allegation of the amount of cash is accepted. If it is clear from the individual's statement that total assets exceed the limitation or if the individual is ineligible on another factor, assets need not be verified.   For Food Stamps, AFDC, RAP, CIC, MA-AFDC, all SSI-MA cases with exception of those noted below, Medically Needy, and SFP, verification of interest income in reported amounts of $10 or less per month or $120 or less per year (and their related bank accounts) is not required unless questionable. Interest income must still be budgeted as unearned income.   The exceptions to this are:   - persons requesting ICP, Hospice, or HCBS (you must always verify); and   - cases that receive an IRS hit. Verification in those cases must be handled in accordance with current policy, which requires a review of these hits. If there is a discrepancy, verification must be secured through a third party (see passage 3035.35.00). This policy was originally clarified by memo on 4-25-95 by policy Transmittal No. 95-04-014.     1610.35.05 General Verification Rule (MA-SSI,SFP)   (04/01/95) On pending applications, if total assets are within $500 of the program asset limit in the earliest month of the eligibility period requested, it is necessary to obtain verification for the interim months.       1615.00.00 ASSET OWNERSHIP AND AVAILABILITY   (11-01-92) Any individual who has the legal ability to dispose of an asset is considered the owner of the asset. The type of ownership (single or joint) of an asset determines to whom the asset is available and the value that is counted to the individual.   (FS: 7 CFR 273.8, AFDC: 45 CFR 233.20, SSI-Related: 20 CFR 416.1201)   1615.05.00 JOINT OWNERSHIP   Joint ownership exists when the legal right to dispose of an asset is shared by more than one individual.   Types of Joint ownership are described in the sections 1615.05.05 through 1615.05.15 that follow.     1615.05.05 Joint Ownership of Bank Accounts   (10-01-95) When an individual is a joint account holder who has unrestricted access to the funds in the account, you must presume all of the funds in the account are owned by the individual. This presumption is made regardless of the source of the funds.   If the individual alleges the funds in the account belong to someone else, you must allow the individual to submit evidence to challenge this presumption. If the challenge is successful, do not count the funds in the account as a resource to the individual for any month. (If the individual never owned the funds, they were never his.) If the challenge to the presumption of ownership is not successful, you must consider the funds as a resource to the individual. This policy applies to checking accounts, savings accounts, certificate of deposits and other jointly owned financial accounts.   For SSI-related coverage groups, if two or more Medicaid eligible individuals or applicants hold a joint account, you must divide the funds equally among them.   See Sections 1615.05.05.05 through 1615.05.05.20 for specific program policy and evidence required.     1615.05.05.16 Proof Needed to Rebut Ownership (MA-SSI,SFP)   (10-01-95) When an individual has unrestricted access to the funds in a joint account but does not consider himself an owner of part or all of the account funds, you must advise the individual that:   - the funds are presumed to be his; and   - he may rebut the presumption of ownership by presenting proof the funds belong to someone else.   To rebut the presumption of ownership, the individual must provide the following information:   First, the individual must provide a written statement and corroborating evidence from the financial institutions and other sources to substantiate:   - any claims about ownership of the funds or interest from the funds;   - the reasons for establishing the joint account;   - whose funds were deposited into the account;   - who made withdrawals from the account; and   - information on how withdrawals were spent.         Second, the individual must provide a written statement from the joint owner(s) explaining their understanding of the ownership of the account(s); that is, claims of ownership, why the account was set up, who deposited funds, withdrew funds and used the account.   When an individual is a co-owner of an account with someone who is incompetent or a minor, the corroborating co-owner statement is not necessary. You must obtain a corroborating statement from a third party who has knowledge of the circumstances.   If there is no third party or the individual is unable to provide all bank verification, you must make a rebuttal determination based on the evidence submitted. Enter an explanation on CLRC why no written corroborating statement was obtained from the joint owner.   To successfully rebut ownership of a joint account, the evidence must clearly support that the individual is NOT a joint owner of the funds.   Legal Basis: 42 U.S.C. 1396a(r) (2); 20 CFR 416.1208   1615.05.05.20 Evaluating Evidence for Rebuttal (MA-SSI,SFP)   (10-01-95) When all proof (per 1615.05.05.16) is received, you must evaluate the evidence to determine if it supports the individuals claim that someone other than the individual (the client) owns the resource. The evidence must clearly corroborate that the funds deposited to the account did not belong to the client and were not used to meet his needs.   If the rebuttal evidence proves that the account funds (all or partially) were deposited, withdrawn and used by the other joint owner(s) only, the individual has successfully proven that he does not own (all or part of) the funds.   If the individual successfully rebuts ownership of all the funds in the joint account, the client's name must be removed from the account, so he no longer has access to the funds in the account. (This is not considered a transfer of assets.) Do not consider the funds in the account as a resource to the individual for any month (even for months prior to the month the individuals access to the account is removed). The individual must submit documentation of the original and revised (if any) account records showing his name has been removed. Photocopies are necessary for the case file.   If the individual successfully rebuts ownership of only a portion of the funds in the joint account, the individual must remove his access to the portion of the funds which does not belong to him. The individual must present evidence showing that either he has removed his funds from the account or the joint owner(s) has removed their funds from the joint account, and the account has been redesignated. Do not consider the portion of the funds owned by the joint owner(s) as a resource to the client for any month, even for months prior to the month the individuals access to the funds is removed. The individual must submit documentation of the original and revised (if any) account records showing his access to the joint owners funds has been removed. Photocopies are necessary for the case file.   If the individual does not successfully rebut ownership of the account, you must consider the total joint account balance as a resource to the client.   Legal Basis: 42 U. S. C. 1396a (r) (2) ; 20 CFR 416.1208     1615.05.10 Joint Ownership of Liquid Assets (MA-SSI,SFP)   Liquid assets may be subject to various types of ownership depending on the asset involved. Some of the more common terms used to indicate joint ownership of an asset include:   - joint ownership; - ownership in common; - tenants by the entirety; and - equitable ownership of trust property (for example, where legal title is with a legal representative).   An individual will be considered a part owner of liquid assets even if the other owner(s) is a member of the same family. When assets are partially owned, it is immaterial whether the parties involved are related or non-related. Only that portion of a liquid asset that is designated as belonging to the individual can be attributed to that individual.   Where partial ownership exists, individuals' shares in the asset may not be equal. In order to determine the value of an individuals share it is important to determine:   - the type of ownership; - the names of the owners; - the relationship of the owners if deeming is applicable; and - the extent of each individuals share.   Generally, an individual's ownership interest in a liquid asset can be disposed of without restrictions. However, if consent to sell is required and such permission is withheld, the property cannot be included as the individuals asset. The determination that the property is not an asset must be based on a legal restriction and must be supported by documentary evidence such as a written agreement, contract, deed, or state law.         1615.05.10.O5 Joint Ownership by Husband and Wife (MA-SSI,SFP)   If a husband and wife own liquid assets as "tenants by the entirety," each owns the property as a whole, not as equal shareholders. Where state law recognizes tenancy by the entirety, one spouse cannot sell the property or his interest in the property without the consent of the other. Upon the death of one, the survivor owns the whole asset.   The tenancy by the entirety arrangement remains valid for any period when the husband and wife are separated. When the marriage is dissolved, the tenancy by the entirety usually becomes an ownership in which each divorced spouse owns 50 percent of the property. However, where state law or a divorce decree indicates another type of ownership, joint ownership is not applicable.   1615.O5.10.10 Trusts Ownership (MA-SSI,SFP)   A legally binding verbal or written trust is a right of property held by one party for the benefit of another (the beneficiary). The beneficiary of a trust does not hold legal title, but has an equitable ownership interest in the property. According to the terms of the particular trust involved, the beneficiary must be the individual designated to receive income from the trust either directly or through the trustee.   Generally, an individual who is appointed a trustee cannot use any of the funds in the trust for personal benefit. In this situation, the trust is not an asset to the individual acting as the trustee.   1615.05.15 Ownership of Real Property   Ownership of real property can consist of an interest in the title or a right to the use of the property without title to the property. The owner of real property is generally the individual who has legal title and the right to control the property.   Section 1615.05.15.05 describes program specific policy on real property ownership.   1615.05.15.05 Ownership of Real Property by Title (MA-SSI,SFP)   An individual may have sole ownership or a shared ownership interest in the title to real property.   When property is hold in "fee simple," this means that the owner has the sole ownership interest. The owner alone (or if the owner is mentally incompetent, the owner's legal guardian) may sell or transfer the ownership interest without conditions imposed by others.       Shared ownership means that ownership interest in the property is vested in more than one individual. Shared ownership may be by "Joint tenancy," "tenancy in common," or for a married couple only, "tenancy by the entirety."   In joint tenancy, each of the joint tenants has an equal interest in the whole property for the duration of the tenancy. On the death of one of two joint tenants, the survivor becomes the sole owner. on the death of one of three or more joint tenants, the survivors are joint tenants of the entire interest.   However, it is possible in most states for the joint tenants to take some action during their lifetime to convert the joint tenancy to a tenancy-in-common. In tenancy-in-common, two or more individuals have an undivided partial interest in the whole property for the duration of the tenancy. There is no right of survivorship to a tenancy-in-common.   "Tenancy by entirety" property ownership, which only applies to a husband and wife, is discussed in Section 1615.05.10.05 Joint Ownership by Husband and Wife.   1615.05.15.10 Shared Ownership of Real Property (MA-SSI,SFP)   When the individual shares ownership with another individual or other individuals, only the individuals ownership interest is included. If there is no documentation defining the portion owned by each individual owner, all owners are assumed to have equal shares in the property.   If the individual cannot sell his share of the property without the consent of the other owner and the other owner refuses to give his consent, the property cannot be considered a countable asset.   1615.05.15.15 Life Estates Ownership (MA-SSI,SFP)   A "life estate" gives the individual certain lifetime rights to the property that generally cannot be inherited upon the individuals death.   The duration of a life estate is measured by the lifetime of the tenant or of another individual, or by the occurrence of some specific event, such as remarriage of the tenant. The owner of a life estate does not have title to the property but has the right of possession, the right to use and obtain profits from the property, and the right to sell his life estate interest.   Where an individual owner conveys property to another individual for life (life estate holder) and to a second individual (the remainder man) upon the death of the life estate holder, both a life estate interest and a remainder interest have been created in the property. Upon the death of the life estate holder, the remainder man receives ownership of the life estate. The property owner may designate several individuals as remainder man who would hold ownership jointly or in common by will or agreement. 1615.05.15.20 Ownership Interest in Unprobated Estate (MA-SSI,SFP)   An individual may have ownership in an unprobated estate if the individual:   - is an heir or a relative of the deceased; - receives any income from the property; - has acquired rights in the property due to the death of the deceased according to state law.   When the property must be included and this places the individuals assets over the limit, ownership must be determined according to the appropriate state laws. In such cases, the individual owns the asset if:   - documents such as a will or court record indicate the individual is an heir to any of the deceased's property; or,   - the individual has use of or receives income from the property; or,   - documents establish a relationship between the individual and the deceased which, under state law, awards the individual a share of the deceased's property; and,   - the distribution and use of the inheritance is not legally contested or limited.   When evidence raises legal questions, the case manager must refer the case to the district legal counsel for a legal opinion regarding whether the individual owns any of the property and, if so, the individuals share of the property.   1615.05.15.30 Home Ownership (MA-SSI,SFP)   Home ownership interest is indicated by documentation such as titles, deeds, tax assessments, and mortgage statements. As long as a home is the individuals principal place of residence it is excluded from assets regardless of the type or degree of ownership.   If the home is not the individuals principal place of residence the home or any portion of the home owned by the individual is included as an asset when determining the individuals eligibility.   Sections 1615.05.15.35 and 1615.05.15.40 describe additional program specific policy on home ownership.         1615.O5.15.35 Establishment Of Home Ownership (MA-SSI,SFP)   Home ownership interest exists if the individuals name or spouses name is shown as an owner on one of the following documents:   - an assessment notice; - a recent tax bill; - a current mortgage statement; - a deed; and - a report of title search, or evidence of legal inheritance from an estate whose distribution is not contested.   Ownership can be established for personal property homes by a current registration document or a title.   Ownership of life estate or similar home property rights for which no title exists can be established by a contract, will, deed, or other legal document.   An individual may also acquire an ownership interest in a home through various actions, such as payment of mortgage, construction of additions to a shelter, improvements, or personal considerations. Even though another person holds sole title to the home, an individual may allege ownership interest if he has contributed to the equity or value of the home.   In order to establish an individuals home ownership based on improving the property equity, the case manager must acquire relevant documents and statements, including written evidence of any mutual understanding or arrangements between the individual and the person holding the title to the home.     1615.05.15.40 Shared Home Ownership (MA-SSI,SFP)   If an individual shares ownership interest in a home with other persons, the home is excluded regardless of the eligibility status of the other owners.   Where the home is personal property, such as a house trailer, and an individual shares ownership of the land on which it rests with other individuals, the land is also excluded. If the individual has no ownership interest in the land, any free use of the land must be excluded as well as the personal property home. Where the home is affixed to land owned solely by another, but the individual is shown to have an interest in the land, the policy in Section 1615.05.15.35 applies.   An individual may also own the land but live in a personal property home owned by another. In such cases, the shelter remains the property of the other individual and the above policy applies although the land is excluded as the individuals place of residence.   1615.10.00 GENERAL AVAILABILITY   Once the individuals ownership interest of an asset(s) is established, the availability of that asset must be determined. Asset(s) determined not to be available are not considered in determining eligibility on the factor of assets.   Assets are considered available to an individual when the individual has unrestricted access to the funds.   Accessibility depends on the legal structure of the account or property. An asset is countable, if the asset is available to a representative possessing the legal ability to make the asset available for the individuals support and maintenance, even though the individual may not choose to do so.   Assets not available due to legal restrictions or factors beyond an individuals control are not considered in determining total available assets. The only exception to this rule occurs when the legal restrictions were caused or requested by the individual.   Sections 1615.10.05 through 1615.10.25 describe program specific policy on asset availability.     1615.10.15 Availability of Joint Bank Account (MA-SSI,SFP)   When an individual owns any portion of a joint bank account and is legally able to withdraw funds from that account, the funds are available to the individual. If it is shown that all funds in an account are legally accessible to the individual only in the event of the death of the co-owner, the funds are not included as the individuals asset.     1615.10.20 Availability of Trusts (MA-SSI,SFP)   The availability of funds held in a trust depends on the conditions (wording) of the trust and whether the individual is the trustee or beneficiary of the trust.     1615.10.20.05 Trust Availability to Trustee (MA-SSI,SFP)   The trust is not a resource to the trustee if the trustee cannot use any of the funds in the trust for his own benefit.   The trust is a resource to the trustee if the individual is the trustee and has the legal ability to revoke the trust and use the money for his own benefit, regardless of whose funds were originally deposited in the trust.   The trust is a resource to the individual if the individual or the individuals spouse created the trust and has the right to dissolve it and use the funds for his own benefit. One type of revocable trust commonly established is a "totten trust." A totten trust is created with an individuals own funds and the individual is named as trustee for another person (the beneficiary). The trustee of a totten trust can revoke the trust at any time during the trustee's lifetime.   If the trustee dies without revoking the trust, the trust principal reverts to the beneficiary. These trusts are usually set up in the form of savings accounts and are not legally recognized in most states. Regardless of whether the totten trust is legally recognized or not, the trust principal is an asset of the trustee.   1615.10.20.10 Trust Availability to Beneficiary (MA-SSI,SFP)   (10-01-94) The trust is an asset to the beneficiary if the beneficiary can access the trust principal (see Sections 1625.85.10 and 1625.85.10.05). If the trustee has access, refer to sections 1625.85.15.20 or 1625.85.15.30.   The individual who is the beneficiary of a totten trust does not have access to the trust principal unless the trustee dies, therefore, the funds are not defined as available to the individual.     If the trustee revokes a totten trust, determine whether the beneficiary has unrestricted access to the trust principal. If the beneficiary has unrestricted access to the principal of the trust, it is counted as a resource.   If the totten trust agreement does not clearly define the availability of funds to the individual who is the beneficiary, the agreement must be referred to the district legal counsel.     1615.10.25 Representative Payee or Legal Guardian (MA-SSI,SFP)   Assets received or managed by an individuals representative payee or legal guardian must be included as assets to the individual.   If an individual is a legally designated representative who is managing the funds of another person on his behalf, none of the funds are included as the individuals asset. These funds must be held in a form that clearly shows that they belong to another.     1615.10.30 Assets Available to Spouse (MA-SSI)   (08/01/92) The following policy applies to ICP, MEDS and HOSPICE individuals admitted to institutions on or after September 30, 1989. This includes SSI recipients applying for institutional services.   The portion of a couple's assets available to the institutional spouse is the amount remaining after the community spouses asset allowance is subtracted from the couple's total included assets. If this figure is over the program's allowable asset limit for an individual, the individual is ineligible until the individuals assets are reduced within the program's standard.   Although the assets of Medicaid recipient's spouse may not have been considered available to the client in the community (e.g., when the couple is separated), when the client applies for institutional services, the assets of both spouses must be considered in determining the client's eligibility for institutional services.   If either spouse can verify that the community spouse resource allowance determined by the agency is inadequate to generate income to raise the community spouses income to the minimum monthly maintenance needs allowance, the resource allowance may be revised through the fair hearing process.   A spouse for these purposes is defined in Chapter 2200, section 2230.10.05.     1615.10.30.05 Prenuptial Agreements (MA-SSI)   (08-01-92) Assets that are included in a prenuptial agreement are considered part of the couple's total assets when determining eligibility for institutional care services.   This policy applies regardless of when the prenuptial agreement was drawn up.   1615.10.35 Assets Available to Spouse After Approval (MA-SSI)   (04-01-96) The following policy applies to ICP, ICP/MEDS and institutionalized HOSPICE individuals admitted to institutions on or after September 30, 1989.   Following approval, none of the assets solely owned by the community spouse are included as available to the institutional spouse. The amount of assets allocated to the community spouse which belong to the institutional spouse and are available to the institutional spouse must be transferred to the community spouse. The FLORIDA system generates an alert at 90 days for the worker to assure that this has occurred. The PAS must work with the client to assure that the resources are transferred to the community spouse; however, the resources will not be counted as available to the institutional spouse until the first scheduled complete redetermination is conducted. In no instance should the failure to transfer the resources to the community spouse within the prescribed time limits result in overpayment.   Any assets received by the institutionalized spouse after approval, which cause the total assets to exceed the asset standard, will not affect the individuals eligibility if they are transferred to an allowable person (see Section 1630) within the month of receipt or if the client receives equitable value. If the assets are still available to the institutionalized spouse the month after receipt, the value of the new assets is considered a countable asset to the institutionalized spouse the month after the assets are received.   If the individual returns home and the case is closed, the couple's assets must be reevaluated if the individual reapplies after a 30 day absence from the institutional facility. This policy does not apply if the individual returns to the institutional facility within 30 days.   1615.15.00 LEGAL RESTRICTIONS TO AVAILABILITY   An individual may be restricted by law from disposing of owned assets. If an asset is unavailable due to legal restrictions, it is not considered an includable asset. Sections 1615.15.05 through 1615.15.15 describe program specific policy.   1615.15.05 Legal Restrictions to Availability   (01-01-94) In general, assets are considered available unless the applicant/ recipient asserts otherwise. If the individual claims an asset is unavailable due to legal restrictions, the case manager will request supporting evidence and make an independent assessment of the availability based on the evidence presented. Additional guidance can be requested from the district program office, district legal counsel or headquarters through the district office.   Refer to passage 1625.85.10 - 1625.85.10.03 for specific information on determining availability of trusts for AFDC and MA-AFDC.   1615.15.10 Legal Restriction to Availability (MA-SSI,SFP)   When there is a need for legal interpretation to determine the legal availability of an asset, clearance must be made with the district legal counsel.   1615.15.20 Comatose Individual (MA-SSI,SFP)   Any resource owned by a comatose individual will be excluded when there is no known legal guardian or other individual who can access the asset.   1615.15.25 Legally Incompetent Individuals (MA-SSI,SFP)   Under the Florida Guardianship Law, only a guardian of the property is authorized to dispose of assets on behalf of a legally incompetent individual. Until a legal guardian is assigned, real property owned by a legally incompetent individual is not available.   Liquid assets (for example, patient fund accounts and checking accounts) are included as available if the individual has free access to the funds.   If a legal guardian must petition the court in order to dispose of the individuals property, the asset is still included for the individual. The fact that the guardian must petition the court does not make the property an unavailable asset.   1615.20.00 ASSETS UNAVAILABLE DUE TO CIRCUMSTANCES BEYOND CONTROL   (08/01/91) Assets unavailable due to circumstances beyond the individuals control are not considered in the determination of eligibility.   The individual must present convincing evidence to prove the asset is unavailable to him due to circumstances beyond his control. The case manager will make an independent assessment of the availability based on the evidence presented. Additional guidance can be requested from the district program office, district legal, or headquarters through the district program office.           1620.00.00 GENERAL DETERMINATION OF ASSET VALUE   The value of an individuals assets is based on the total value of the assets at the time they become available. In order to be eligible, an individuals assets must be within the program limits at the time of application disposition. For FS, assets must be within program limits at the time of the interview.   1620.05.00 TIME WHEN ASSET VALUE AFFECTS ELIGIBILITY   The point in time when an asset determination is made may depend on the program and whether the case manager is processing an application or conducting an eligibility review. Sections 1620.05.05 through 1620.05.15 describe program specific policy in this area. For FS refer to 1620.05.10.     1620.05.05 Asset Eligibility   Assets must be equal to or below program limits as of the application disposition date to be eligible for ongoing assistance. EXCEPTION: For FS the asset level is determined as of the date of the interview.   1620.05.20 When Asset Value Affects Eligibility (MA-AFDC,MA-SSI,SFP)   Individuals who are eligible on any day of the month, are eligible for the whole month.   This policy does not affect the IV-E foster care program.   1620.10.00 DETERMINING ASSET VALUE   The amount of the asset included is the actual value of the asset minus indebtedness. (This is not always true for FS; refer to particular asset policies.) Indebtedness is the amount needed to satisfy contract terms that must be met to establish ownership of the asset.   Cash value and indebtedness determinations will be discussed for each type of asset described in Section 1625.00.00.     1620.10.05 Definition of Actual Value   For assets that are in cash, or payable in cash on demand, the actual value is the cash value. For other forms of assets, the actual value is the fair market value (the amount of cash that could be received by selling or converting the asset).       1620.10.10 Determining Asset Value (MA-SSI,SFP)   The countable value of an asset is the equity an individual or couple has in the asset. in some cases, the asset value counted toward the applicable asset limit is first reduced by an allowable excluded amount.   Equity value is the amount that a resource can expect to sell for on the open market in the particular geographic area involved (that is the fair market value of the asset), less any legal debt on the asset.   Debts are any form of legal indebtedness against the asset in question, such as:   - mortgages, - liens, - loans, - purchase contracts, and - security interests.   Only the amount of the principle owed and any prepayment penalty required by such a debt is deducted from the fair market value in establishing the equity value of the asset.   Any future interest owed as a result of the asset is not considered in establishing equity value.   Outstanding checks that have not cleared the bank yet are considered a form of legal indebtedness against the asset.   1620.15.00 CONVERSION OF ASSETS   Proceeds, including cash, from the sale of an asset or conversion of an asset from one form to another are considered assets rather than income. The proceeds of the item to which the asset is converted must be evaluated to determine if they affect eligibility, and if so, the value of the new asset.   Verification concerning the new asset must be obtained regardless of whether a liquid or non-liquid asset is involved. For example, an individual may have an automobile (non-liquid asset) which he sells for cash (liquid asset), or he may have cash which he uses to purchase an automobile. In either case, the conversion or sale does not result in income to the individual. The newly acquired item is an asset subject to all asset valuation policy.   1620.15.05 Excluded Assets Replacement (AFDC,MA-AFDC,MA-SSI,SFP)   Cash and in-kind replacement (including any interest) received from any source for the purpose of replacing or repairing an asset which is lost, damaged, or stolen is an excluded asset. 1620.15.05.05 Replacement Period-Lost, Damaged, or Stolen Assets (MA-SSI)   The replacement/repair amount or the item is excluded from assets for a period of nine months from the date it is received by the individual.   This includes temporary housing received by an individual as well as the value of any support and maintenance.   An individual is eligible for an extension of the replacement period if factors beyond his control prevent the replacement/repair. The extension cannot exceed nine months or a total of 18 months from the date the cash or in-kind replacement (including temporary housing) was received.   Any of the replacement/repair amount not used after original or extended replacement period, is included as an asset effective the month after the period ends.     1625.00.00 TYPE OF ASSETS: DEFINITIONS AND VALUE DETERMINATIONS   This section describes the policy for determining the value of liquid and non-liquid assets. The different types of these assets are discussed alphabetically in the following subsections. The policies assume that the assets are owned by and available to the individual unless noted otherwise. Policy on asset ownership and availability is described in Section 1615. Refer to Chapter 2200, Standard Filing Unit, which describes whose assets must be considered.   1625.05.00 BANK ACCOUNTS   Bank accounts refer to funds in a bank, credit union, savings and loan association or any other financial institution that are usually payable on demand.   This section provides information on:   - checking and savings accounts; - convenience bank account; and - time deposits, including Individual Retirement Accounts and Keogh Plans.   1625.05.05 Checking and Savings Accounts   The asset value is the balance in the account on the date on which eligibility is established. If the total asset value of the account does not affect eligibility, it is not necessary to determine the amount of any transactions that have not cleared the account or the individuals portion of a joint bank account. However, the individual still may be given the opportunity to rebut full or partial ownership to ensure that future changes to the account will not affect his eligibility. Sections 1625.05.10 through 1625.05.20 discuss program specific policy for bank account assets. Refer to Sections 1615.05.05 through 1615.05.05.20 for ownership and availability policies for bank accounts.     1625.05.15 Time Deposits   The availability of funds is the deciding factor in determining if a time deposit is an asset. Time deposits such as a savings certificate or certificate of deposit usually are available to the individual and are included as assets.   Any interest penalties imposed for withdrawing the time deposit funds prior to maturity are deducted from the total amount when determining the value of the time deposit asset. Interest penalties may involve a reduction in the interest rate and/or loss of interest for a short period of time.   Some time deposits cannot be withdrawn prior to maturity under any circumstances. Funds in this type of account are not included as an asset until they reach maturity and become available.   Interest on time deposits that are available on demand is unearned income the month it becomes available. Interest on time deposits that are only available at maturity are unearned income in the month the time deposit matures. In either case, any interest retained after the month it is available is included as an asset.   1625.05.15.10 Retirement Funds (MA-SSI,SFP)   (01/01/96) Retirement funds are annuities or work-related plans for providing income when employment ends (e.g., retirement plans administered by an employer or union, disability, or pension). Other examples are funds held in an individual retirement account (IRA) and plans for self-employed individuals (sometimes referred to as Keogh plans).   Retirement funds must be considered as a resource or as income, unless they are considered unavailable. Retirement funds purchased on or after April 1, 1995 may be regarded as a transfer of resources under certain conditions (see special policy on ICP, etc. below).   If an individual is eligible to receive regular periodic payments from a retirement fund, the payments are considered unearned income and the fund is not considered a resource to the individual. (If the individual is eligible to receive payments but elects not to, he is ineligible due to failure to file for other benefits to which he is entitled.)   If the individual is NOT eligible to receive periodic payments from the fund, the funds are considered a resource in the amount that is currently available. Any penalty imposed due to early withdrawal can be deducted when computing the value of the funds, but any taxes due are not deductible. Pension funds owned by an ineligible spouse are excluded from resources for deeming purposes; however, any income is still deemed. (Refer to 2230.20.00 for policy on deeming exclusions.)   A retirement fund is not a resource if an individual must terminate employment in order to obtain any payment.   Retirement funds that are unavailable as resources or income due to legal restrictions are NOT counted (e.g., an individual must be a certain age to receive benefits). The payments worker must obtain a written opinion from District Legal Counsel on availability.   In the month a previously unavailable retirement fund becomes available, it is neither an available resource or income unless a periodic payment is received. If a periodic payment is received, it is considered unearned income. in the month following the month the fund becomes available, the fund must be considered an available resource to the individual unless periodic payments begin, in which case the payment is considered unearned income.     - For example, the client owns an IRA which is unavailable until he turns age 59 in December. He must begin to receive periodic payments in January or the IRA will be considered an available resource to him. If he receives periodic payments, the payment is considered unearned income to him beginning in January.   Refer to 1850.05.10.10 for policy on how to consider interest earned on retirement funds.   The following policy applies to ICP, institutionalized MEDS-AD, and HCBS only:   If a retirement fund purchased on or after 04/01/95 is established within the transfer of resources look-back period, an evaluation must be done to determine if the individual can expect to receive fair compensation from the fund in his lifetime (see 1630.20.10.04).   - If the individual can expect to receive fair compensation from the retirement fund in his lifetime, no transfer of resources (or income) has occurred.   - If he cannot expect to receive a fair return in his lifetime, the establishment of the account must be regarded as a transfer of resources.   Refer to Section 1630, et.seq., for procedures on how to determine if fair compensation will be received and if not, how to compute the uncompensated value of the fund.   Reference: SSI POMS 01120.210   1625.05.20 VERIFICATION   Information required for verification of an individuals bank account assets includes:   - the type of account; - the name and location of the financial institution; - the names of any joint owners; and, - the amount of the balance.   The current bank account statement or other statements from the facility are verification sources.   Verification of a time deposit certificate must include information on when the funds can be withdrawn and any penalties for early withdrawal. If the individual cannot provide this information, the case manager must request the information from the individuals financial institution.   1625.10.00 BURIAL CONTRACTS AND OTHER BURIAL ASSETS   This section provides information on burial related assets such as:   - funeral agreements, - prepaid burial contracts, - irrevocable burial trusts, - burial exclusion policy, and - burial spaces.   Sections 1625.10.05 through 1610.10.40 discuss program specific policy in this area.   1625.10.10 Prepaid Burial Contracts (MA-SSI,SFP)   A prepaid burial contract (or special mortuary fund) is an agreement in which an individual prepays his/her burial expenses and the seller agrees to furnish the burial. Prepaid burial contracts should not be confused with burial insurance or burial trusts. The prepaid burial contract funds are not included as an asset if:   - The contract cannot be liquidated without significant hardship to the individual; or   - the contract seller refuses to revoke or liquidate the contract; or   - the contract is irrevocable.   If the contract does not meet the above criteria, the amount the individual would receive by revoking or liquidating the contract, minus any penalties, is the amount included as an asset for the individual.   1625.10.15 State Law Regarding Prepaid Burial Contracts   State laws may impose varying types Of conditions on burial contracts. Depending on the state in which the contract was made, there may be unique provisions for:   - the process for revoking or liquidating prepaid burial contracts; - the conditions required before a burial contract can be revoked or liquidated; and,   - the conditions necessary for a contract to be defined as irrevocable.   Any Medicaid applicant may make an irrevocable contract and exclude this asset. District legal counsel may be consulted when it is necessary to determine if a contract is revocable. If the burial contract was purchased in another state, contact the state program office to determine whether the contract is irrevocable.   1625.10.20 Revocable Prepaid Burial Contract Liquidation (MA-SSI,SFP)   Contract provisions for a revocable prepaid burial contract may prohibit liquidation of the asset. The case manager must examine the contract and determine if it includes this type of provisions.   The contract is not included as an asset if the individual would have to move out of state to liquidate the contract or if another person's consent is required and the person will not agree to liquidate the contract.   1625.10.20.05 Value of the Prepaid Burial Contract (MA-SSI,SFP)   Unless the contract meets a condition for exclusion, the amount the individual would receive upon revoking or liquidating the contract is included as an asset. This amount is often different from the face value of the contract. Guidelines for determining the amount to be received are usually set by state law and differ from contract to contract.   The contract must be examined to determine the amount to be received from liquidating or revoking the contract. If the contract is unclear, the individual or case manager must contact the funeral director to determine the amount.   The value of prepaid burial contracts liquidated by means other than revocation such as sale or transfer is the amount the individual would receive if the contract was sold on the open market.   The individual can rebut the amount with appropriate verification and documents. For example, the State Funeral Directors Association or a local funeral director may provide information showing that sellers of prepaid burial contracts can only expect to receive a percentage of the face value, or the individual may provide proof that only a certain amount was offered or that the contract was advertised for sale and no offers were received.           1625.10.25 Irrevocable Burial Trusts (MA-SSI,SFP)   If the irrevocable burial trust is created in connection with a funeral home or funeral director, it is treated like an irrevocable prepaid burial contract. As long as it is irrevocable, the trust is not considered an asset to the individual.   If the irrevocable burial trust is not created in connection with a funeral home or funeral director, it is considered a transfer of assets. Regular burial exclusion policy is applicable to the uncompensated value of the burial trust fund. Up to $2,500 of the trust can be excluded as a burial asset. The remaining uncompensated value would count as an asset to the individual according to policies in Section 1630.     1625.10.30 Verification of Burial Contracts or Trust (MA-SSI,SFP)   A photocopy of the burial contract or trust should be obtained to document the value of the contract and whether or not it can be revoked. The case record must explain how the determination of revocability and value were made.   1625.10.35 Burial Exclusion Policy (MA-SSI,SFP)   (08-01-92) An individual and the individuals Spouse may set aside funds of up to $2,500 each for burial expenses. These funds are excluded as assets as long as the individual shows that they are clearly designated as being set aside for burial. The funds must be separately identifiable (not commingled with other funds) and clearly designated for burial, unless the asset cannot be separated or it is unreasonable to require it. The individual (or deemed individual) must provide a written statement defining:   - the amount of funds set aside, - for whose burial the funds are set aside, and - the form in which the funds are held.   These funds may be excluded regardless of whether the exclusion is needed to allow eligibility.   The $2,500 limit is not reduced by the value of life insurance policies or irrevocable burial contracts.   If the funds are not clearly designated for burial at the time of the application, the funds may be excluded if the individual provides a written statement that the funds are intended for the individuals burial and agrees to submit evidence that the funds are separately identifiable and designated for burial within 10 days of signing the statement. If the evidence is not provided in 10 days, the funds cannot be excluded until the information is provided.     Assets may be designated as burial funds for any month, including the three months prior to the month of application. (Burial fund accounts for prior months may be commingled with non-burial funds.)   Any increase in the value of excluded burial funds due to interest in such funds which was left to accumulate, is excluded from resources.   1625.10.40 Burial-Spaces/Plots   (11-01-92) The following are considered burial spaces or plots:   - conventional grave sites; - crypts; - mausoleums; and, - urns.   1625.10.40.10 Burial Spaces (MA-SSI,SFP)   Burial spaces owned by the individual are not considered assets as long as they are intended for the use of the individual, the individuals spouse, or any member of the individuals immediate family. For the purposes of this policy the immediate family includes the individuals:   - minor and adult children; - stepchildren; - adopted children; - brothers; - sisters; - parents; - adoptive parents; and, - the spouses of immediate family members.   Dependency and living in the same household are not factors.   Burial space items that are also excludable include:   - caskets, - headstones, and - the opening and closing costs of the grave.   Burial spaces are included as an asset if:   - they are intended for use by someone other than the immediate family; and,     - the deed for the burial space specifies that the individual can sell the property.   If any joint owner refuses to permit the sale of the space or the burial service provider requires a move from the state in order to sell the space, the space is not treated as an included asset to the individual. The case manager must document any restrictions on the sale of the space by obtaining a statement from the joint owner or a copy of the burial contract.   1625.10.40.15 Verification of Burial Spaces   For food stamps the individuals statement is acceptable verification.   For other programs, sources of verification include documents such as deeds to cemetery lots or sales contracts for the purchase of cemetery lots.   There may be more than one grave site per burial plot. If there is a question as to what constitutes a burial plot the case must be examined by the district legal counsel.   For funeral agreements, verification includes copies of the funeral contract or agreement or a letter from the funeral services provider outlining the type and terms of the contract.   1625.15.00 CASH   Cash includes money the individual owns no matter where it is located.   1625.15.02 Verification of Cash   (11-01-92) The individual must provide information on the amount of cash available. While an individuals statement of actual cash on hand is accepted without verification, the individual must be made aware that cash on hand includes:   - amounts in the individuals personal possession; - amounts the individual may have at home; and, - amounts being held for the individual elsewhere.   1625.15.20 Foreign Currency of Coins (MA-SSI,SFP   Foreign currency or coins are included as cash assets in the amount they can be exchanged for United States currency. While coin collections may be cash, they are not liquid assets based on their face value, but non-liquid personal effects based on their collector's value.   1625.15.25 Verification of Cash   The individual must provide information on the amount of cash available. While an individuals statement of actual cash on hand is accepted without verification, the individual must be made aware that cash on hand includes:   - amounts he has on his person; - amounts the individual may have at home; and, - amounts being held for the individual elsewhere.   1625.25.00 DISASTER ASSISTANCE FROM GOVERNMENT SOURCES   Any government payments specifically designated for restoration of a home damaged in a disaster are excluded, if there are penalties for using the funds for purposes other than replacing the home.   Replacement of the home includes replacing items such as appliances, furniture and clothing, unless the payment arrangements do not allow the funds to be used for these purposes.   Examples of government payments for disaster assistance include funds such as:   - payments made by the Department of Housing and Urban Development through the Individual and Family Grant Program; or,   - disaster loans or grants made by the Small Business Administration.   Government payments to bring a home "up to code" are included as assets.   1625.25.05 Disaster Assistance (MA-SSI,SFP)   Any disaster assistance funds excluded from income are also excluded from assets. The amount excluded is any funds remaining after the payment is used for the intended purpose. This exclusion from assets will depend on:   - the date such assistance was first received; - the length of time held; and, - the reason retained if the retention period is more than nine months from the date - the payment was received.   In order to qualify for the exclusion the individual must maintain the assistance funds (plus any interest) separately from any other assets so that the assistance funds can be readily identified.   1625.25.10 Verification   Sources of verification of disaster assistance include:   - official government notices, - disaster loan or grant documents, and - the individuals financial records of deposits, withdrawals and expenditures.   1625.40.00 FOREIGN PROPERTY (MA-SSI,SFP)   Assets in a foreign country owned by an individual residing in the state are subject to the same eligibility rules and limits as domestic property. The individual must provide verification of the status, value, and ownership of foreign property.   Whenever possible, verification is provided through documents the individual possesses. if the individual does not possess the necessary documents it may be necessary to write for them.     1625.45.00 HOME (FS,AFDC,CIC,MA-AFDC,MA-SSI,SFP)   Home property is excluded as an asset, regardless of its value, if it is the individuals principle place of residence. only one residence can be excluded under this provision.   A home is any shelter in which the individual has an ownership interest and that is used by the individual (and spouse, if any) as the principal place of residence. The home may be either real or personal property, fixed or mobile, and located on land or water. The home includes all the land that appertains to it and the buildings located on such land. Houses, cooperative and condominium apartments, mobile homes, motor homes, and houseboats are examples of shelters which may qualify for exclusion.   Home ownership and property are discussed in Section 1615.05.15, Home Ownership of Real Property. If the home property cannot be excluded under this home exclusion policy, refer to Section 1625.50.00 if the property is income producing.   1625.45.15 Good Faith Effort to Sell (FS MA-SSI,SFP)   Property may be temporarily excluded if the individual is making a good faith effort to sell it at fair market value.   The case manager must verify that the property is for sale and that a reasonable offer has not been declined. Verification may be obtained through collateral contacts or documentation such as a listing in a newspaper or with a real estate broker.   For SSI-related program, if the property is alleged to be unmarketable, the individual (or the designated representative) must obtain statements from two different types of knowledgeable sources in the geographic area verifying that the property is not saleable due to a specific condition.   This policy applies if the home cannot be excluded as the individuals principal place of residence.     1625.45.20 Home as Means of Self-Support (FS,MA-SSI,SFP)   If the property is not excluded as a home but is used to produce income needed for personal maintenance, it is excluded regardless of value for MA-SSI, SFP. Refer to Section 1625.50.00. For FS, if the income producing property is not the principal residence of the SFU, the property must be producing income consistent with its fair market value (FMV) to be excluded as an asset.   1625.45.35 Home Verification Requirements (AFDC,MA-SSI,SFP)   The individual must provide the following information:   - the name of property owner; - property included as the home; - the legal description of home property; - affirmation that home is currently occupied or the reason why it is not occupied.   Sources of information include documents such as:   - tax statements; - county property records; - fire department records; and, - police records. If there is any indication that a portion of the individuals property is not physically located in the home plot, the individual must provide evidence of the property's ownership status and that the property is part of the home property. This information is included in the record.   Sources of the evidence can include items such as a copy of the tax assessment, bill, title, deed, or other relevant documents the individual has in his possession.   If the individual cannot provide this evidence or the evidence is insufficient, contact the local source of property tax information for the evidence. Regarding the property boundaries and record the information for the record.   1625.45.40 Home as Principal Place of Residence (MA-SSI)   (04-01-94) An individuals temporary absences from the home do not affect the home's exclusion regardless of the length of absence, if:   - the spouse/dependent relative continues to reside in the home, or   - the individual (or designated representative) states an intent to return home.   The client's or designated representatives verbal statement regarding the above must be recorded in the record and is sufficient to establish this factor of eligibility. There is no limit on how long a home may be excluded.   Note: For purposes of this section, a relative is defined as: son, daughter, grandson, granddaughter, stepson, stepdaughter, halfbrother, halfsister, niece, nephew, grandmother, grandfather, aunt, uncle, sister, brother, stepbrother, or stepsister.   1625.45.40.05 Individuals With Homes in Another State (MA-SSI)   Individuals who meet Florida residency requirements solely because they are institutionalized in a Title XIX Medicaid facility in Florida but who have a home in another state may have that home excluded as an asset if:   - the individuals spouse or dependent relative resides in the home; or   - the individual expresses an intent to return to that home (that is, the home continues to be the individuals principal place of residence) and the state of Florida has an interstate agreement with the individuals home state to provide reciprocal care to Florida residents needing institutional care while in that state.   Statements of intent to return or allegations of dependency are accepted without further development (unless questionable) from the individual, designated representative, and the dependent relative if the individual is incapable of providing such information.   The following states have interstate agreements with Florida:   Alabama Iowa Minnesota Ohio Arkansas Kansas Mississippi South Dakota California Kentucky New Jersey Tennessee Georgia Louisiana New Mexico Texas Idaho Maryland North Dakota West Virginia   1625.45.40.10 Home Replacement Exclusion (MA-SSI,SFP)   The proceeds from sale of an excluded home and any other excluded property sold with the home can be excluded from assets for up to three months while the home is being replaced. Policy details on the three month exclusion limit are provided in Section 1615.45.40.15.   In order to qualify for the exclusion the individual must replace the excluded home with another excluded home or property within the three month time limit. Otherwise, the proceeds from the sale will be an included asset beginning the month after the month the proceeds are received.   If a home is being replaced due to loss or damage resulting from a disaster or accident, the in-kind replacement (temporary housing or support) is excluded for nine months from the date received.   This policy also applies if the individual applies for benefits after selling a home that would have been excluded as an asset under current policy. In this case the three month exclusion period begins the day the individual applies.   1625.45.40.15 Home Replacement Period (MA-SSI,SFP)   An excluded home that has been sold must be replaced within three months in order for the individual to continue excluding home property as an asset. Replacement occurs when the individual pays for the replacement home or signs a written contract to pay for the home.   The three month requirement starts on the date proceeds from the sale are received and ends three months later on the same day of the month that the proceeds were received. The three month replacement period cannot be extended.   If the individual has already received proceeds of a home sale before he applies, the replacement period begins on the date of application.   If the replacement is not completed within the three month limit, all proceeds of the sale are included as assets the day the three month limit ends. Replacement can be verified by evidence such as a contract, canceled check and bill of sale.   If a replacement home is purchased within the time limit, any proceeds remaining after replacement costs are included as assets starting the month after the month when the proceeds were received. Replacement costs include moving expenses and other expenses such as the property taxes needed to complete the replacement.   1625.45.40.20 Verification (MA-SSI)   Verification information is found in Sections 1625.45.15 and 1625.45.35.   1625.50.00 INCOME PRODUCING PROPERTY (FS,MA-SSI,SFP)   An individual can exclude the fair market value of any income producing property the individual owns that is essential to self-support.           1625.50.20 Income Producing Property (MA-SSI,SFP)   (08-01-92) Any income-producing property (including equipment) may be excluded from assets if it annually produces income consistent with its fair market value. The client's statement that the property produces a reasonable return may be accepted. If the rate of return is questionable, the worker must require verification from a knowledgeable source. The following types of income producing property may be excluded:   (1) Property that annually produces income consistent with its fair market value, even if used only on a seasonal basis. Such property shall include rental and vacation homes.   (2) Property such as farm land, or work related equipment, that is essential to the applicant/recipient's employment or self-employment.   (3) Non-liquid assets against which a lien has been placed as a result of a business loan. The security or lien agreement must prohibit the applicant/recipient from selling the asset(s). This exclusion is limited to non-liquid assets such as land, crops, buildings, timber, farm equipment or machinery.   (4) Property, real or personal, to the extent that it is directly related to the maintenance or use of an income producing vehicle. Only that portion of real property determined necessary for maintenance or use is excludable.   EXAMPLE: An applicant/recipient who owns a produce truck to earn a livelihood may be prohibited from parking the truck in a residential area. The applicant/recipient may own a 100 acre field and use a quarter acre of the field to park and/or service the truck. Only the value of the quarter-acre would be excludable, not the entire 100 acre field.   (5) Generally, rental property must produce income consistent with its fair market value. There may be instances, however, in which rental property is exempt because it is essential to the employment or self-employment of a household member. For example, a farmer might own rental houses. He does not rent them out but instead uses them to provide housing for his employees.   (6) Notes and mortgages owned by the applicant/recipient shall be excluded if the contract or agreement is producing income consistent with its fair market value. Non-liquid notes and mortgages are considered to be producing income consistent with its fair market value if the conditions of the contract are being met. The exclusion shall also apply to the value of the property sold under the contract, or held as security in exchange for a purchase price consistent with the fair market value of that property.   (a) If the mortgage is included as a resource because the equity value is below the resource limit, the portion of the payment received representing payment on the principal is also a resource. The portion of the payment that represents interest on the principal is unearned income.   (b) If the mortgage is excluded, the total payment received - whether principal and/or interest - is considered unearned income.   (7) Ownership of timber rights, mineral, or oil exploration rights shall be excluded if the income produced is consistent with the value of the property.   Refer to Chapter 1800 for policy on the treatment of this income.     1625.50.25 Rate of Return Less Than Reasonable (MA-SSI,SFP)   (08-01-92) Income producing property that does not generate income consistent with its fair market value is counted as an asset in full. However, consideration must be given as to why certain properties generate less income than others in the same geographic area (e.g., rundown properties). The income received may be the fair market value for that particular property. In addition, a less than reasonable rate of return is considered acceptable when the following conditions are met:   (1) The property is used in a business or non-business income- producing operation; and   (2) Unusual or untoward circumstances (e.g., a fire, street repairing in front of a store) cause a temporary reduction in the net return; and   (3) The usual net rate of return is reasonable; and   (4) The individual expects the property to again produce a reasonable return within 18 months of the end of the taxable year in which the unusual incident that caused the reduction in rate of return occurred.   Obtain the individuals explanation for the decline in earnings and documentation of prior earnings (e.g., tax returns). If a convincing explanation is furnished and there is a reasonable expectation that the property will again produce a reasonable rate of return, notify the individual that he has 18 months from the end of the taxable year in which the unusual incident that caused the reduction in net return occurred to again have a reasonable net rate of return.   If, at the and of the prescribed time period, the property is not producing a reasonable net return, the value of the property is considered an includable asset. If property does not generate income consistent with its fair market value, the property will count in full as an asset.   1625.55.00 INDIAN LAND   Land that is held by an enrolled member of an Indian tribe is excluded from assets if it cannot be sold or transferred without the permission of other individuals, the tribe, or a federal agency.   1625.60.00 LIFE ESTATE INTEREST (AFDC,MA-AFDC,MA-SSI,SFP)   Any life estate interest held by an individual, the individuals spouse, a child or specified relative is excluded as an asset to the individual. Also, transfers of life estates need not be examined for potential penalties. Although individuals owning life estates have the right to obtain profits from the estate property they do not have exclusive rights to the benefits of the property. Therefore, only that portion of the income made available to the individual will be counted as income to individual.   1625.65.10 Life Insurance (MA-SSI,SFP)   (04-01-94) A life insurance policy is considered only to the extent of its cash surrender value. However, if the face value of all life insurance policies on any one individual totals $2,500 or less, no part of the cash surrender value of any such policy or policies will be taken into account. Life insurance having no cash surrender value (for example, term insurance or burial insurance) is not considered in determining the face value of insurance and is excluded from all computations.   The policy must be owned by the individual or the person whose resources are deemed to the individual to be considered a countable asset to the individual.   When the total face value of all life insurance policies on an eligible individual, or an eligible/ineligible spouse whose assets are deemed to the eligible individual exceed $2,500, the cash surrender values of all such policies must be counted as resources. When the cash surrender values of such policies exceed the asset limitation, an individual may adjust his insurance holdings to policies of a reduced face value. If an adjustment is made, the life insurance policies (and any cash adjustments) are reconsidered in determining eligibility.   The exclusion of a $2,500 face value insurance policy applies to each individual separately. One family member cannot be insured for the total of the amounts allowed for other family members. For example in the case of a couple, one spouse cannot be insured for $5,000 based on the assumption that the couple is allowed a total of $5,000 in life insurance.   1625.65.15 Verification of Life Insurance   (01-01-94) The individual must provide the following information on life insurance policies (this is not required for the food stamp program):   - the owner of the policy; - the individual insured by the policy; - the amount of the policy's cash surrender value, if any; and - the amount of any dividends or interest earned on this policy.   The life insurance policy may provide all the necessary information. If not, the information may be obtained from the insurance company or a local agent. However, with the exception of the MA-SSI and SFP programs, it is not necessary to see the policy(s) or contact the company unless the cash value must be verified.   Refer to 1625.65.00 for Food Stamp program verification requirements. For the AFDC, RAP, CIC and MA-AFDC programs, the cash value must be verified if the face value of the policy is $5,000 or more or the policy is five years old or more. Otherwise, the client's statement can be accepted.   1625.70.00 LOANS   (08-01-92) This section describes:   - loans; - promissory notes; - property agreements; and - student grants, loans, and scholarships.   - A loan is a transaction when one party (lender) advances money to another party (borrower) who promises to repay the debt in full within the borrower's lifetime. Repayment of loans may or may not include interest. A loan may take the form of a formal written document or an informal verbal agreement. A formal written loan agreement is a form of a promissory note.   - A promissory note is a written, unconditional agreement signed by a person who promises to pay a specific sum of money at a specified time, or on demand, to the person, company corporation, or institution named on the note. A promissory note may or may not involve the loan of money or goods (e.g., a promissory note may be given a return for goods or service rendered).   - A personal and real property agreement is a pledge or security of a particular property or properties for the payment of a debt or performance of some other obligation within a specified time period. Property agreements on real estate (land and buildings) are generally referred to as mortgages but may also be called land contracts, contracts for deed, or deed of trust, etc. Personal property agreements (e.g., pledges on crops, fixtures, inventory, etc.) are commonly known as chattel mortgages.   1625.70.10.05 Verification   Documentation or information containing the type, amount, and unpaid balance of loan is required. This information may be secured from:   - the legal document in the individuals possession, or - the person to whom the money was loaned.           1625.70.15 Loan Agreements (MA-SSI,SFP)   Loans may be formal (written) or informal (verbal). Any loan agreement must be legally binding under state law to be considered a bona fide loan for Medicaid purposes.   Loans by verbal agreement that will affect an individuals eligibility must be verified in order to be a bona fide loan. The case manager must request clearance from District Legal Counsel to include the loan as a negotiable asset.   1625.70.15.05 Evaluating Loans (MA-SSI,SFP)   (08-01-92) When the individual is the borrower, the proceeds of the loan requiring repayment are not income the month received, but became an included asset if retained into the following month.   When the individual is the lender, the balance owed to the individual is the amount included as an asset.   When the loan is an informal verbal loan, information such as the type of the loan, parties involved, and the commitment to repay, must be obtained to determine if the loan is legally binding.   To be considered a bona fide loan, the loan agreement must be legally binding under state law and include:   - a statement from the borrower expressing the borrower's intent to repay the loan (including any interest) and his plan to repay by pledging real or personal property or anticipated income; and   - the time and schedule for making payments.   Refer to Section 1625.70.25 for information an student grants, loans, and scholarships.   1625.70.15.10 Verification of Loan (MA-SSI,SFP)   The individual must provide information on the type, amount, purpose and unpaid balance of the loan. The loan contract can be used as the source of this information.   Copies of all written evidence on the loan used to determine eligibility must be included in the record. The evidence must be sufficient to support any decisions made regarding the loan. In addition to the information specific to the loan agreement the record must include the name and title of the official who examined the note or agreement.     1625.70.20 Promissory Notes (MA-SSI,SFP)   (08-01-92) Promissory notes, loans, and property agreements are included as assets for an individual (lender) who has the legal right to sell the loan or owns an interest in the loan that can be converted to cash. The amount included is the outstanding balance shown in payment records unless the individual can provide evidence that a lesser amount is owed.   If any part of a promissory note, loan or property agreement can be converted to cash within 20 days, it is defined as a liquid asset; otherwise, it is a nonliquid asset. If it is determined to be nonliquid it must be evaluated as income producing property. Presume that mortgages are non-liquid assets unless the client states otherwise.   If the note or agreement is determined to be an asset, that portion of any payment received representing payment on the principal is also an asset. The portion of any payment which represents interest on the principal is unearned income. If the note or agreement is determined not to be an asset, the total payments received - whether principal and/or interest - are considered unearned income.   1625.70.20.05 Negotiability and Value of Promissory Note (MA-SSI,SFP)   The note is considered an asset in the amount of the outstanding principal, unless the individual provides reliable evidence of a different amount from a knowledgeable source.   1625.70.20.10 Amount of Promissory Note Available for Use (MA-SSI)   If the individual (lender) alleges that a potentially negotiable loan cannot be sold due to market conditions, the individual must show that a good faith effort has been made to sell the loan. The good faith effort must be verified and put in the record before the loan is excluded as an asset.   Evidence of the good faith effort can include:   - statements from two different knowledgeable sources in the geographic area who agree the loan cannot be sold in the current market conditions; or,   - proof of an attempt to sell the loan at fair market value within six months of application or since the last eligibility review.   "Geographic area" consists of the advertising area where the individual resides or, in the case of real property, the advertising area where the property is located.   The evidence of good faith effort to sell may be furnished in writing or verbally. 1625.70.20.15 Home Equity Conversions (MA-SSI,SFP)   (08-01-92) Home Equity Conversion Plans (HEC) are designed to allow elderly homeowners to convert the value of their homes into cash without being forced to leave their homes. The proceeds from these plans are usually paid out in monthly installments to the elderly person and are not considered an asset unless the proceeds are retained into the following month.   In some cases, an annuity is purchased with the proceeds from a HEC Plan. In this instance, the annuity must be evaluated as to its availability to the client. If the annuity can be reversed, then it would be considered an asset. If it is not reversible the proceeds received would be considered unearned income to the client.   Refer to Chapter 1800, section 1850.10.15 for policy on treatment of this income.   1625.70.25 Student Grants, Loans and Scholarships   (01-01-94) Any grants, loans or scholarships received by the individual are excluded as an asset. This is true even if the loan or other money is received in a lump sum and deposited as cash in a bank. The individual must provide information on the amount and type of the grant, loan or scholarship.   NOTE: For the Food Stamp program, the exclusion applies to the extent and over the time period which the money is prorated as income even if commingled with other funds. Refer to Sections 1860.05.00 through 1860.05.10 for the determination of what funds from these sources will be considered income and, therefore, subject to asset exclusion.   1625.75.00 PERSONAL PROPERTY   Personal property includes personal effects such as clothing, jewelry, tools of a trade, and pets in addition to household goods such as furniture and appliances. Generally, personal property is excluded as an asset. For institutional care (or HCBS) applicants with community spouses, all personal property is excluded if the applicant was admitted to the institution on or after September 30, 1989.   1625.75.10 Personal Property (MA-SSI,SFP)   Household goods and personal effects of reasonable value are excluded as assets. Household goods and personal effects are of reasonable value if the individuals equity in such property does not exceed $2,000. Equity value is the value of an asset on the market less amounts owed on the asset.   Only the equity value in excess of the $2000 limit is included as an asset. If the household goods are owned by more than one individual the excess equity value is divided based on the proportion of the goods owned by each individual.     Two types of household goods are excluded regardless of their value:   - one wedding ring and one engagement ring;   - items required because of an individuals medical or physical condition.   Household goods and personal effects are assumed to be valued at $1000 unless the individual indicates otherwise. No further development is necessary unless the individual declares he owns item(s) of unusual value.   1625.75.10.05 Household Goods/Personal Effects (MA-SSI,SFP)   Household good and personal effect items valued at more than $500 are included as assets. These items are called "items of unusual value and may include items such as:   - expensive china; - silver or glassware; - art works; - oriental, Persian and similar valuable carpets; - antiques; - heirlooms; - musical instruments; - hobby collections; - jewelry made with precious stones or metals; and - expensive furs.   It is the fair market value of the item, rather than its nature, that determines whether an item is of unusual value. For example, a violin worth $600 is an item of unusual value while a violin worth $200 is not.   1625.75.10.10 Household Goods/Personal Effects Verification (MA-SSI,SFP)   The statement on the application that an individual (or spouse) does not own any unusual items worth more than $500 is accepted without further review unless there is evidence to the contrary.   If items of unusual value (with a total estimated FMV of $500 or more), are reported, the individual must provide verification of the FMV of these items. Any reliable and reasonable method may be used to establish and verify FMV; for example, sales slips, insurance, prior appraisals, contacts with local merchants. The development and assessment of values must be recorded for the case record.   Insurance and insurance appraisals often reflect replacement value (the amount it would cost to purchase a similar item new) rather than fair market value of the item in question. The FMV, not the replacement value, is the amount to be used in determining the item's asset value.         1625.75.10.15 Value of Household Goods and Personal Effects (MA-SSI,SFP)   If items of unusual value are involved, the case manager must conclude that the FMV of all other durable household goods and personal effects is $1,000 unless there is evidence to the contrary. This amount is added to the FMV of the items of unusual value. The total less the $2000 equity exclusion described in Section 1625.75.10 is added to the total value of all other included assets.   If the estimated FMV of included household goods and personal effects exceeds allowable limits the FMV must be verified. Any reasonable, practical method can be used to verify FMV.   An individuals records can be used to document their share of ownership and equity in personal property. If there is any doubt about the documentation of any legal debts claimed by the individual, third party verification of any alleged legal debts against the property must obtained.     1625.80.00 STOCKS AND BONDS (FS,AFDC,CIC,MA-AFDC,MA-SSI,SFP)   Investments include the value of stocks and bonds. The current market quotation is considered the asset value. Information sufficient to establish ownership is required in order to determine if the stock/bond value must be included/excluded. Sources of information on the current market value of stocks and bonds may be secured from the bank, investment company, newspapers, and the like. The source and date of the quotation must be recorded.     1625.80.05 Definition of Stocks (AFDC,CIC,MA-AFDC,MA-SSI,SFP)   Shares of stock represent ownership in a corporation. The shares of many corporations are traded on the New York Stock Exchange or the American Stock Exchange. Many stocks are also traded "over-the counter."   Most stocks, for incorporation purposes, are assigned a certain value known as "par value." Par value has no relation to the actual market value of a stock.   The value of a stock is normally determined by the demand for it when it is bought and sold. As the result of constant trading, the value of stocks varies daily. To establish the value of a stock, use the most current closing price.   The individual is required to furnish stock certificates unless the stock is being held for the individual by a securities firm. If so, the case manager must obtain the individuals copy of the firm's most recent Statement concerning the individuals account.     The closing prices (on any particular date) of many stocks may be verified by consulting the following day's newspaper or financial newspaper. If the closing price of a stock is not shown in the next day's newspaper, contact a local securities firm to determine its value.   The value of stocks traded over-the-counter is expressed on a "bid" and "asked" basis. A "bid" is the amount being offered for the stock. The "asked" figure is the amount the seller asked for the stock. Use the bid price to determine the market value of this type of stock.   The individuals statement that a stock is worthless Must be supported by a local securities dealer's statement.   1625.80.10 Stock in a Close Corporation (AFDC,CIC,MA-AFDC,MA-SSI,SFP)   A "close" or closely held corporation is wholly owned or controlled by one or more members of the board. Stock in this type of company must be reviewed to determine if the stock is a liquid or non-liquid asset. Usually the stocks cannot be converted to cash within 20 days and they may qualify for exclusion as property needed for self-support.   If such stocks are not traded publicly the value of the stock is determined by dividing the company's net assets (total assets minus liabilities) by the total number of shares. The corporation's net assets can be obtained from the corporation's most recent tax return.   1625.80.15 Alaskan Native Stock (MA-SSI,SFP)   Federal law excludes certain shares of stock held by natives of Alaska in a regional or village corporation from counting as assets for a period of 20 years from the date they are purchased.   1625.80.20 Mutual Fund Shares (FS,AFDC,MA-AFDC,CIC,MA-SSI,SFP)   A mutual fund is a company that buys and sells securities and other property as its primary business. Mutual fund shares are generally liquid assets.   The value of mutual funds are determined in the same way as stock values are determined.   1625.80.25 Bonds (FS,AFDC,CIC,MA-AFDC,MA-SSI,SFP)     When an individual requests that a bond be sold, about seven to ten days are usually required for the individual to receive the proceeds. Therefore, bonds are generally included as assets. A bond is a written obligation to pay a sum of money at a future specified date. It is a negotiable instrument and is transferable.   Municipal bonds are issued by a state or local government. Corporate bonds are issued by corporations. Government bonds are issued by an agency of the federal government and, except for U.S. Savings Bonds, are transferrable.   A bond -must be held until the specified date of maturity before it can be redeemed for its face value. The current cash value of a bond before maturity is determined by the market for it.   If there is a great demand for a bond, its market value 'may be more than the face value; or if there is little demand, the bond's current market value may be substantially less than the face value. The current price of a bond can generally be determined as it would be for a stock.   1625.80.30 Savings Bonds (FS,AFDC,CIC,MA-AFDC,MA-SSI,SFP)   A U.S. Savings Bond is an obligation of the federal government, but unlike other government bonds it is not transferable - that is, it can only be sold back to the government.   Several series of U.S. Savings Bonds (for example, series I, J, and H) can normally be quickly converted into cash at local banks. These bonds are defined as liquid assets. However, some bonds, including Series E bonds, must be held at least 60 days from the date of issue before they can be converted into cash.   U.S. Savings Bonds are usually registered in the name of the owner(s) shown on the front of the bond and may be redeemed by the owner by completing a form on the back of the bond.   If ownership of the bond is shared, each person's share is equal. All owners must agree to liquidate the bond.   The value of the bond depends on the time elapsed from the date of issue. Do not use the table sometimes provided on the back of the bond to determine its value. The tables often do not reflect changes in interest rates. A bank must be contacted to determine the current value.   The face value of Series H bonds does not change. No further verification of value is necessary for that series; however, interest is paid rather than accrued on these bonds.         1625.85.00 TRUSTS   A trust is a right of property held by one party for the benefit of another. The individual who holds the legal title to property for the benefit or use of another is the "trustee." The individual for whose benefit the trust is created is the "beneficiary."   While most trusts recognized as binding under state law are established by means of a written document, some states also recognize oral trust agreements.   1625.85.15 Trust (MA-AFDC,MA-SSI,SFP)   (07-01-95) This policy does not pertain to the MA-AFDC groups that correspond to the direct assistance groups, the under $10 payment assistance groups, and the assistance groups who opt not to receive direct assistance. (Those groups use AFDC trust policy, 1625.85.00.)   A TRUST is a right of property held by one party for the benefit of another. The term "trust" also includes any legal instrument of devise that is similar to a trust. It does not cover trusts established by will. It can include (but is not limited to) escrow accounts, investment accounts, pension funds, and other similar devises managed by an individual or entity with fiduciary obligations.   The TRUSTEE is the individual who holds the legal title to and manages property for the benefit or use of another. The BENEFICIARY is the individual for whose benefit the trust is created.   A trust is considered REVOCABLE if the trust can be dissolved; it is considered IRREVOCABLE if it cannot be dissolved.   It is important to understand other terms used in reference to trust:   - Grantor (Trustor/Settlor): Sets up the trust.   - Trustee: Manages the trust.   - Beneficiary: Receives benefits from the trust.   - Corpus/Principal: Resources or income used to establish the trust.   - Distributions/Disbursements: Money or resources paid out of the trust (either from the corpus or income produced by the corpus).   Refer to policies in 1625.85.15.10 through 1625.85.15.40 to determine how to consider trust funds.     1625.85.15.10 How to Analyze Trusts (MA-AFDC,MA-SSI)   (07-01-95) How to count funds held in a trust--whether as income or resources--depends on several factors:   - who created the trust;   - when it was created;   - whether the trust is revocable or irrevocable; and   - the conditions and terms of the trust.     1625.85.15.11 Trusts Set Up By Others (MA-SSI)   (10-01-95) For trusts that are established by someone other than the individual, individuals spouse or representative, the trust must be evaluated according to these SSI policies:   - If the individual does not have authority to revoke or direct use of the trust, it is not a resource to him. Conversely, if the individual has the authority to revoke or direct use of the trust, the corpus of the trust is considered a resource to him.   - Cash paid directly from the trust to the individual is unearned income.   - Disbursements made by the trustee directly to a third party are not considered income to the individual.   The above policies also apply to trusts established by a will.   Refer to sections 1625.85.15.20 and 1625.85.15.30 for information on how to treat trusts established by the individual, individuals spouse or representative.   Legal Basis: 1OC-8.014 FAC and 20 CFR 416.1201.   1625.85.15.20 Medicaid Qualifying Trusts Before 10/93 (MA-AFDC,MA-SSI)   (07-01-95) Per 1OC-8.0182 FAC, the following policy applies only to those trusts established before 10-01-93.   A Medicaid qualifying trust is a trust or similar legal device (other than through a will) created by an individual, his spouse, or legal representative under which (a) the individual may be the beneficiary of all or part of the payments from the trust, and (b) the amount of the distribution is determined by one or more trustees who are permitted to exercise any discretion with respect to the amount to be distributed to the individual.   NOTE: The term "Medicaid qualifying trust" (MQT) must not be confused with the term "qualified income trust". The MQT refers to some trusts established prior to 10/l/93 which disqualified individuals for Medicaid, while the "qualified income trust" refers to certain income-only trusts permitted on or after 10/l/93 which allow individuals to qualify for ICP or HCBS.   If the trust meets the definition of a Medicaid qualifying trust, consider the maximum distribution that could be paid to the applicant/recipient by the trustee(s) as an available resource and income to the individual whether or not the distribution is made. These policies apply even if the trust is irrevocable, regardless of the purpose of the trust or whether or not the trustee(s) actually exercise their discretion.   If the trustee has no or limited discretion or ability to disburse funds to the individual, the amount that is unavailable must be considered a transfer of a resource without fair compensation and must be evaluated under transfer of asset policy if it was established within the applicable transfer look-back period.   1625.85.15.21 Exceptions for Trusts Before 10/01/93 (MA-AFDC,MA-SSI)   (07-01-95) Per FAC 10C-8.0182, the following trusts are exempt from the Medicaid qualifying trust provisions:   - Trusts set up by a family member (other than the individual or spouse) under the State of Florida Umbrella Trust Agreement for developmentally disabled or mentally ill individuals in accordance with Florida Administrative Code 10-19. Any money given to the beneficiary by the trustee would be considered as income.   - "Individual trusts" when the beneficiary is a mentally retarded individual who resides in an ICF/DD, provided the trust or initial trust decree was established prior to April 7, 1986 and is solely for the benefit of that mentally retarded individual.   - Trusts established by will.   1625.85.15.22 Undue Hardship/Trusts Set Up Before 10/93 (MA-AFDC,MA- SSI)   (07-01-95) Per FAC 1OC-8.0182, if undue hardship exists, only the amount of the trust that is ACTUALLY made available as income or resources is counted. Undue hardship is defined as any situation in which an individual may be forced to go without life sustaining services because the proceeds from a trust fund are not available to the individual. This may be due to legal restrictions or illegal actions by the trustee. All undue hardship decisions must be reviewed and approved by the district program specialist.   1625.85.15.30 Trusts Established On or After 10/l/93 (MA-AFDC,MA-SSI)   (07-01-95) The following policy applies to trusts established by an individual on or after 10-01-93. This is based on 42 USC 1396p(d).   An individual will be considered to have established the trust if assets of the individual were used to form all or part of the corpus of the trust AND if any of the following individuals established the trust (other than by will):   - the individual;   - the individuals spouse;   - a person, including a court or administrative body, with legal authority to act in place of or on behalf of the individual or the individuals spouse; OR   - a person, including a court or administrative body, acting at the direction or upon request of the individual or individuals spouse.   If the trust was not established by one of the above individuals, refer to section 1625.85.15.11.   If the trust is REVOCABLE:   - Consider the entire principal as an available resource to the individual.   - Consider any payments which can be made as countable income to the individual.   - Consider any other payments from the trust as assets disposed of by the individual without fair compensation.   If the trust is IRREVOCABLE and there are any circumstances under which payment from the trust could be made to or for the benefit of the individual:   - Consider that portion of the principal that could be available, as a resource to the individual.   - Consider payments from that portion of the principal which could be available as income to the individual.   - Consider any other payment from the trust as a transfer of assets.   If the trust is IRREVOCABLE and no payment could be made from the trust under any circumstances:   - Apply the TRANSFER OF ASSETS policy to the individuals resources and income used to establish the trust. The transfer policy applies only to applicants or recipients of nursing facility services and HCBS.   - The trust is not counted as an available resource.   - The above policies apply without regard to:   - the purpose of the trust;   - whether the trustees have or exercise any discretion under the trust;   - any restrictions on when or whether distributions may be made from the trust; or   - any restrictions on the use of distributions from the trust.   For more information on transfer of assets for SSI-related Medicaid, see 1630.20.00.   1625.85.15.31 Exceptions for Trusts Set Up 10-93 or Later (MA-SSI)   (10-01-95) The policies listed in above in Section 1625.85.15.30 do not apply to the following trusts:   - trusts established by a will (see 1625.85.15.11).   - trusts for the disabled under age 65.   - pooled trusts for the disabled.   - qualified income trusts (See 1805.15.20).   All special trusts must be forwarded to the district program office for review and district legal counsels written approval before the case can be approved.   The following special trusts may be created on or after October 1, 1993 for disabled individuals if the trust meets the specific criteria indicated below:   TRUSTS FOR THE DISABLED UNDER 65: A trust containing the resources of a disabled individual under age 65, if:   - it was established on or after 10-01-93; AND   - it was established for the benefit of the individual by a parent, grandparent, legal guardian or a court (CANNOT be established by the disabled individual himself, must be by parent, grandparent, legal guardian or court order); AND   - the trust stipulates the State will receive the balance in the trust upon the death of the individual up to an amount equal to the total medical assistance paid on behalf of the individual.   POOLED TRUSTS FOR THE DISABLED: A trust containing the resources of an individual who is disabled, if:   - it was established on or after 10-01-93;   - the trust is established and managed by a non-profit association;   - a separate account is maintained for the beneficiary of the trust but, for purposes of investment and management, the trust pools the accounts;   - the trust is established solely for the disabled individual by a parent, grandparent, legal guardian, court or the individual himself; AND   - to the extent that amounts remaining in the trust upon the individuals death are not retained by the trust, the trust pays to the State an amount equal to the total amount of medical assistance paid on behalf of the individual.   Both of the above special trusts can only be set up to benefit individuals who meet SSI disability criteria. Trusts for the disabled under 65 can be established only for individuals who are under 65. Pooled trusts for the disabled can be established for individuals of any age.   Disability must be determined for both of the above sp