Section 410IAC3.2-6-1. Financial eligibility

   (a) A child not enrolled as of December 31, 1992, is financially eligible for the CSHCN program services set forth in 410 IAC 3.2-7-2 and 410 IAC 3.2-7-3 if the child's family's gross income is equal to or less than one hundred eighty-five percent (185%) of the financial eligibility standard. A child must also be medically eligible according to section 2 of this rule.

  (b) If funds are available in addition to those required to provide services to enrolled children eligible under subsection (a), and if the gross income of the family of a child not enrolled as of December 31, 1992, is greater than one hundred eighty-five percent (185%), but less than or equal to two hundred fifty percent (250%) of the financial eligibility standard, such child may be determined to be financially eligible to receive CSHCN program services or insurance. A child must also be medically eligible according to section 2 of this rule.

  (c) To determine financial eligibility under the CSHCN program, the county department shall utilize the financial eligibility schedule equal to one hundred eighty-five percent (185%) of the poverty income guideline by family size. The state department of health shall provide the county department with the financial eligibility schedule.

  (d) The state department of health shall publish annually in the Indiana Register the poverty income guidelines used to determine the financial eligibility for the CSHCN program.

  (e) For purposes of determining financial eligibility, income includes the following:

(1) Public assistance or welfare payments.

(2) Monetary compensation for services, including wages, salary, commissions, or fees.

(3) Net income from farm and nonfarm self-employment.

(4) Social Security.

(5) Dividends or interest on savings, stocks or bonds, income from estates or trusts, or net rental income.

(6) Unemployment compensation.

(7) Government pensions, civilian or military, or veterans' payments.

(8) Private pensions or annuities.

(9) Alimony or child support.

(10) Regular contributions from persons not living in the household.

(11) Net royalties.

(12) Other cash income not previously designated. Other cash income includes, but is not limited to:

(A) cash amounts received or withdrawn from any source, including savings, investments, trust accounts, lottery, or other prize winnings;

(B) settlements or awards resulting from lawsuits;

(C) monetary gifts;

(D) contributions and funds raised by popular subscription; and

(E) other resources that are available to the child's family.

  (f) For purposes of determining financial eligibility, the following shall not be considered income:

(1) Payments or allowances received pursuant to the Home Energy Assistance Act of 1980.

(2) The value of assistance to children or their families under the National School Lunch Act, the Child Nutrition Act of 1966, and the Food Stamp Act of 1977.

(3) Reimbursements from the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970.

(4) Any payment to volunteers under Title I (VISTA and others), Title II (RSVP - foster grandparents, and others) of the Domestic Volunteer Service Act of 1973.

(5) Payment to volunteers under Section 8 of the Small Business Act (SCORE and ACT).

(6) Payments received under the Job Training Partnership Act.

(7) Educational grants and student loans.

(8) College or university assistantships.

(9) Subsidized housing.

(10) Food allowance or subsidized housing for military personnel or military housing allowances received by families living off base.

  (g) If an individual or family is temporarily living within another household, only the income of child or family applying for the CSHCN program shall be used for determining financial eligibility.

  (h) The county department shall verify a family's income by reviewing any one (1) or more of the following:

(1) A card or other written documentation indicating that the applicant is currently enrolled in the Special Supplemental Food Program for Women, Infants, and Children (WIC).

(2) Check stubs from the three (3) most recent consecutive pay periods.

(3) Most recently filed federal income tax form.

(4) Other written documentation approved by the director.

  (i) Farm income may be determined by having the applicant show the applicant's most recently filed Internal Revenue Service tax form.

  (j) Nonfarm self-employment may be determined by having the applicant show the most recently filed Internal Revenue Service tax form.

  (k) Monetary compensation for services, including wages, commissions, or fees may be determined by having the applicant show the most recently filed Internal Revenue Service tax form.

  (l) If an applicant states that they receive no income, the county department shall ask the applicant, and document in writing, how the applicant receives economic support for food, shelter, clothing, health care, and other needs. The county department and the state department of health may use this information to assist with care coordination services and referrals.

  (m) Income received irregularly shall be averaged over a twelve (12) month period.

  (n) If a child marries after the child is enrolled in the CSHCN program, the child's financial eligibility shall be reevaluated.

  (o) If a child is adopted after the child is enrolled in the CSHCN program, and there is a court order for support of the child, the child shall continue to be financially eligible for the CSHCN program. (Indiana State Department of Health; 410 IAC 3.2-6-1; filed Apr 12, 1993, 5:00 p.m.: 16 IR 2176; readopted filed Jul 11, 2001, 2:23 p.m.: 24 IR 4234; readopted filed May 22, 2007, 1:44 p.m.: 20070613-IR-410070141RFA; readopted filed Sep 11, 2013, 3:19 p.m.: 20131009-IR-410130346RFA)