4311 Treatment of Assistance Plan - The assistance plan for all medical programs consists of those persons in the family group for whom assistance is requested and any excluded legally responsible person for those individuals.

 

The client may include or exclude any family group members for assistance purposes.

 

Except as noted below, eligibility shall generally be determined within a single assistance plan for those members who qualify under the same category of assistance. For example, if more than one member requests and is eligible for MS, a combined determination is required. This policy would also be applicable to members of a family who qualify for the same medical program but under different individual subtypes (i.e., OA, AB, or AD for MS). Once again, a combined determination of these individuals would be required. For purposes of this provision, the Medicaid poverty level and Title 21 programs shall be viewed as the same category of assistance and a combined determination would be applicable.

 

Separate assistance plans shall be established in the following instances:

 

  1. Each SSI recipient (including 1619b recipients) shall have a separate plan as well as any child whose needs are met through foster care or adoption support payment.
     

  2. Family group members who qualify under different medical programs (e.g., MS, Medicaid poverty level, etc.) shall have separate plans.
     

  3. Each client in a long term care arrangement (including HCBS and PACE) shall have a separate plan. However, a member of an MA CM plan who also receives HCBS or PACE services in the community, may remain part of the MA CM plan as an excluded/disqualified individual (DI) if a separate assistance plan would result in ineligibility for one or more household members.
     

  4. Emancipated minors, minors determined to be able to act in their own behalf, and 18 year old children shall have separate assistance plans apart from their parents.
     

  5. Any child (and his or her siblings) in the family who is not living with a legally responsible person (such as grandchildren, nieces and nephews, etc.) shall have a separate assistance plan.
     

  6. If the only children for whom assistance is requested are stepsiblings or have no blood relation, a separate plan is required as only the income of each child's parent can be considered. Otherwise, where all siblings (excluding unborn siblings) are blood related or adoptive brothers and sisters, a single plan shall be applicable if they qualify under the same category of assistance. This would include family arrangements in which assistance is requested for the non-mutual children of a husband and wife and a mutual child.

 

4312 Additional Assistance Planning Provisions - The following additional principles are applicable for assistance planning purposes:


  1. Marriage establishes legal responsibility between the couple. Any marriage (including same sex) validly established in Kansas or another jurisdiction either through a civil licensed contract or by common-law (see 2. below) shall be recognized. Once established, the marriage (both civil and common-law) may only be dissolved through a formal divorce court proceeding.
  2.  A common-law marriage establishes legal responsibility between the couple. To be considered common-law married, the couple must meet all of the following conditions:

    1. have the legal capacity to marry:

      1. be at least 18 years old

      2. are legally competent

      3. are not already married to someone else

    2. consider themselves to be presently married c. hold themselves out to the public as married.
       
  3. Any individual who does not have the legal responsibility to support a person in need is not required to do so. When such individual in the household, including an SSI recipient, voluntarily and regularly contributes cash to the applicant/ recipient toward household expenses (including his maintenance needs), the net amount of income realized by the household shall be considered. To determine the net amount of income to be counted, the difference in the PIL including the individual and the PIL excluding the individual shall be deducted from the gross amount of the contribution.