A. General

In order to determine how much a blind recipient was due under the AB plan, the State determined a monthly amount for the total allowable need (TAN). The TAN consists of minimum needs and special needs and can be determined for either a converted blind recipient or an ineligible spouse.

For a recipient, the State compared net nonexempt income (countable income) to the TAN. If the TAN exceeded the recipient’s net nonexempt income, a payment was due. If the net nonexempt income was great than the TAN, the recipient had unexpended income which was again income in the next month. Include unexpended income in the BCI computation (See SI SF01201.513B and SI SF01210.520).

Use an ineligible spouse’s TAN amount to determine whether any of the recipient’s income can be allocated to meet the unmet need of the ineligible spouse. (SI SF01201.517)

For purposes of these instructions, assume a converted blind recipient and an ineligible spouse each has a TAN equal to $215.

NOTE: When the converted recipient has attendant services, the TAN can exceed $215. See B below.

B. Special Need for Attendant Care Services

1. Determining When Attendant Care Services Amount Permits an Income Exclusion

When the converted blind recipient has attendant services which can be allowed under the State plan as described in 2. and 3. below, subtract from otherwise nonexempt income an amount equal to that by which attendant care (within the limits set in 4. below) causes need to exceed $215.

2. Definitions

Attendant services are domestic or personal care services provided in a recipient’s own home. They include professional, skilled nursing, and ancillary services provided on a visit basis.

For the purposes of this service, “own home” includes a home, apartment, hotel, etc., where the individual is living alone or sharing living arrangements with another person(s) and no landlord-tenant relationship exists between the parties living together.

Determine the need for attendant care for a person living in:

• an out-of-home care facility (other than that described in 3.c. below) or

• someone else’s home and receiving care and services from that person other than those normally associated with a landlord-tenant relationship. (NOTE: After 12/31/73, such services were usually provided as social services under title VI or title XX of the Social Security Act. When this occurs, there is not likely to be an increase in the needs level to accommodate attendant care.

3. Inapplicability of Attendant Services

Attendant services cannot be applicable in the following situations:

• the individual is in a public or private medical institution, nursing home, rehabilitation facility, and family care homes or institutions

• the individual is in a board and room arrangement unless the arrangement with attendant services is essential to an approved rehabilitation plan

• attendant services provided by a parent, spouse, or adult child unless that relative is able to work, but is unable to accept employment or must relinquish employment in order to care for the recipient

4. Maximum Amount

1. Predominantly domestic services - $50

2. Other attendant services - $100 per household with one person requiring the services; $150 per household if more than one recipient requires the services

3. Exceptional social circumstances - $300

Exceptional circumstances are limited to the following:

1. An attendant is needed to provide personal care for more than one recipient in the same household, or to act as homemaker to a recipient who is an incapacitated parent with one or more children living in the home, or

2. The recipient has a very severe, relatively static disability and requires full-time , predominantly personal care services, in addition to those the family is able to provide, or

3. A person who has lived alone must enter an out-of-home care facility to secure appropriate care, but needs a full-time attendant during a short interim period while the change in the living plan is effectuated.