Title 7 . Health and Social Services

Chapter 74 . Assisted Living Homes

Section 45. Payment assistance

7 AAC 74.045. Payment assistance

(a) Payment assistance will be provided in an amount that, when added to the applicant's income and resources, other than those described in (c) of this section, is necessary to cover the appropriate monthly or daily rate. Except as otherwise provided in this section, payment assistance begins on the first day of the month following the month in which the application for payment assistance is approved by the department.

(b) A payment assistance application must contain a complete and accurate disclosure of income and resources, including, for the applicant and for the applicant's spouse,

(1) a description, including location, of all real property owned in whole or in part, whether inside or outside the state, during the preceding 36 months;

(2) a description, including location, of all major resources other than real property owned in whole or in part during the preceding 36 months, including automobiles, boats, airplanes, jewelry, cash, stocks, bonds, notes, livestock, and major equipment;

(3) a listing of the amount and sources of all income that might be received while the applicant is a resident or recipient;

(4) copies of federal income tax filings for the preceding three years; and

(5) the number, location, and contents of all savings, checking, brokerage, or other accounts and safe-deposit boxes held either individually or jointly during the preceding 36 months.

(c) A resident's or a recipient's income and resources, up to the full amount of the income and resources if necessary, must be applied to the appropriate monthly or daily rate established by 7 AAC 74.025 and to ancillary charges. However, the value of the following items held by a resident or recipient is exempt for the purpose of determining eligibility for payment assistance:

(1) any income or asset listed in AS 47.55.020 (d)(1)-(9), subject to the following:

(A) for purposes of AS 47.55.020 (d)(1), the amount to be exempted is $100 a month;

(B) for purposes of AS 47.55.020 (d)(2)(A), the amount to be exempted is $2,000;

(C) for purposes of AS 47.55.020 (d)(7), sufficient burial provisions for the resident or recipient and the resident's or recipient's spouse or dependent include burial insurance, a specific account designed for burial expenses with a value up to $4,500 for each person, or a combination of insurance and a specific account; and

(D) for purposes of AS 47.55.020 (d)(8), and (9), for a resident or recipient with a spouse or dependent,

(i) the resident's or recipient's home or real property used as the primary residence of the resident's or recipient's spouse or dependent is exempt;

(ii) the exemption for other real property not used as the primary residence of the resident's or recipient's spouse or dependent, and personal property, both tangible and intangible, is a total value of not more than $98,000; property necessitated by the resident's or recipient's physical condition, such as a prosthetic device, is not subject to this value limitation;

(iii) the income of the resident's or recipient's spouse is exempt; and

(iv) notwithstanding (ii) of this subparagraph, the department will consider the following to be disregarded personal property: the portion of the resident's or recipient's income that will bring the income of the resident's or recipient's spouse up to $2,000 a month, if that portion is accumulated as personal property in an account to pay for expenses related to the home or real property described in (i) of this subparagraph and if the spouse's income would otherwise be less than $2,000 a month;

(E) for purposes of AS 47.55.020 (d)(8) and (9), for a resident or recipient without a spouse or dependent,

(i) the home or real property used as the primary residence of the recipient is exempt; and

(ii) the exemption for other real and personal property, both tangible and intangible, is a total value of not more than $10,000; property necessitated by the resident's or recipient's physical condition, such as a prosthetic device, is not subject to this value limitation;

(2) a motor vehicle;

(3) Agent Orange Settlement Fund payments made under P.L. 101-201 and sec. 10405 of P.L. 101-239;

(4) one or more life insurance policies except for any cash surrender value of each insurance policy;

(5) burial spaces owned by the resident or recipient and intended for use by the resident or recipient and the resident's or recipient's spouse or dependent.

(d) In determining the resources of an applicant for payment assistance under this section, the department will include the value of any resources owned by the applicant within the 36 months preceding the date of the payment assistance application if the applicant gave away the resource, or sold or assigned it for less than fair market value. The department will rebuttably presume that any such transaction was for the purpose of reducing the applicant's ability to pay the state for services in a pioneers' home.

(e) A resident or recipient who receives payment assistance under this section is indebted to the state for the amount of the assistance. If the resident or recipient who is indebted to the state receives income or a resource that disqualifies the resident or recipient for payment assistance under this section, that resident or recipient shall apply the additional income and resources to reduction of the debt to the state. The resident or recipient may then reapply for payment assistance under (b) of this section if the resident or recipient again becomes financially unable to pay the appropriate monthly or daily rate.

(f) The department may issue tentative approval for payment assistance, and may commence payment assistance, to an applicant who has completed the payment assistance application process and whose income and resources appear to make the applicant eligible for payment assistance, if the applicant requires additional time to supply complete application information, such as a valuation for property. Complete application information must be provided no later than 60 days after tentative approval is issued, unless the department, for good cause shown, authorizes additional time. Failure to provide complete application information within 60 days, plus any extension that may be authorized, will result in denial of the final application, and will require repayment of any payment assistance received as a result of the tentative approval.

(g) The department may issue temporary payment assistance to an applicant who meets the income requirements for payment assistance, but who has noncash resources in excess of those requirements, in order to allow time for the applicant to liquidate those noncash resources at fair market value. Temporary payment assistance under this subsection will not be made unless the applicant agrees in writing to

(1) submit documentation to the department at least once every six months showing active attempts to dispose of the resources; and

(2) repay the payment assistance in full upon the liquidation of the noncash resources.

(h) Failure to submit the documentation required under the agreement described in (g) of this section will result, absent a showing of good cause, in cessation of the payment assistance, and will require repayment of any payment assistance already received. After the noncash resources are liquidated, the applicant's application for payment assistance will be reevaluated, if the applicant reapplies for payment assistance.

History: Eff. 8/1/2004, Register 171; am 10/15/2004, Register 172; am 12/31/2005, Register 176

Authority: AS 47.55.010

AS 47.55.020

AS 47.55.030