TN 47 (07-99)

A. Policy — general

• A resident of an institution is not a member of a household because a household cannot exist in an institution. Therefore, the VTR cannot apply. The PMV rule must be used to determine the value of ISM for a resident of an institution (SI 00835.300).

• When an individual is in a medical confinement, any food and shelter received from the institution is not income (SI 00815.100).

• ISM may be provided by the institution itself or by a third party who pays the institution for the food and shelter provided to the individual.

• The ISM determination is based on the current market value (CMV) of the food and shelter provided to the individual in the institution. The CMV is the institution's monthly charge for food and shelter.

B. Policy — who pays for the food and shelter

1. Individual Pays With Own Funds

1. There is no ISM if the individual pays the CMV of the food and shelter provided by the institution with his/her own funds.

2. Payments to an institution by the individual with his/her own funds include payments made directly by the individual and payments made by:

   • the individual's representative payee, guardian, or other fiduciary who uses the individual's funds;

   • an eligible spouse (SI 00501.001);

   • a deemor, if deeming is applicable for the month; or

   • a federally funded, income based on need (IBON) program. Such payments are counted as unearned income to the eligible individual (SI 00830.170 and
     SI 00835.706C.5.).

NOTE: In general, make the presumption that any payment made by the individual to the institution is a payment towards the CMV of the food and shelter. However, there may be instances (e.g., impairment related work expenses, plans for achieving self-support) when it might not be to the individual's advantage to apply this presumption. In such a situation, the individual's payment should be attributed in the manner that is most advantageous to the individual. See Example 2 in SI 00835.790B.

2. Third Party Pays

A third party payment to the institution for the individual's food and shelter may result in countable income depending on the source.

3. Institution Pays

If neither the individual nor a third party pays for the food and shelter, then the institution may be providing countable ISM.

C. Policy — third party payments to institutions

When a third party pays the institution for the food and shelter provided to an individual, ISM must be considered. Follow these policies to determine whether a third party payment results in countable ISM.

1. Assistance Based On Need (ABON) From a State or Political Subdivision

• Any assistance provided by a State (or the District of Columbia) or political subdivision which is based on need and wholly funded by State or local funds is excluded from countable income. Therefore, it is not ISM (SI 00830.175).

   

2. Medical or Social Services Program

1. If a governmental medical or social services program is the source of payment to the institution, any food and shelter provided as a result of the payment usually is not income (see (SI 00815.050 and SI 00830.015).

2. If a nongovernmental medical or social services program is the source of payment to the institution, the individual may receive ISM (SI 00815.050). The amount of ISM would be subject to the PMV rule.

3. State-Certified Private Nonprofit Organization

If the institution is paid by a State-certified private nonprofit organization and the criteria for excluding support and maintenance assistance (SMA) are met, there is no chargeable ISM because of the organization's payment (SI 00830.605).

4. Absent Parent

When an absent parent pays for the food and shelter of a child (as defined in SI 00501.010), one-third of the payment is excluded from countable income because of the child support exclusion (SI 00830.417). The remaining two-thirds of the payment to the institution for the food and shelter is countable ISM subject to the PMV rule (SI 00835.300). A parent is considered absent if the parent and child do not reside in the same household (SI 00830.420).

5. Federally Funded Income Based on Need (IBON)

If the source of payments for the care is federally funded income based on need (e.g., foster care under title IV-E, Bureau of Indian Affairs general assistance), the total payment is considered cash income(type F or type O income) to the individual and the SSI payment is reduced dollar-for-dollar (SI 00830.170, SI 00830.410, and SI 00830.800). No ISM is countable because of such a payment.

6. Local/State Education Agency

When a local/State education agency pays for the food and shelter provided at an educational or vocational (ED/VOC) training institution (SI 00520.400), the recipient receives countable ISM if the funds are not otherwise excludable.

7. Other Organizations, Programs or Individuals

When any other organization, program, or individual makes direct payment for food and shelter to an institution for an individual who resides in the institution, consider whether income from the source of payment is excludable (SI 00830.099). If so, no countable ISM results from the payment. If no exclusion applies, the payment results in ISM subject to the PMV rule.

D. References

• Medical and Social Services, SI 00815.050

• Income Based on Need (IBON), SI 00830.170

• Assistance Based on Need (ABON), SI 00830.175

• Support and Maintenance Assistance Exclusion, SI 00830.605

• Presumed Maximum Value Rule, SI 00835.300