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VA Auxiliary Grant Income Eligibility

Income Eligibility Rule: In order to be eligible for an Auxiliary Grant, individuals must have non-excluded (countable) income less than the sum of their facility's Auxiliary Grant (AG) Rate and their AG Personal Allowance.

·             AG Rate is the amount charged by your facility (or adult foster care home) to pay for your room, board and services.

NOTE: This income-eligibility rule is listed at: http://www.dss.state.va.us/family/auxgrantcover.html.

Now, this rule is fine if you know what a facility's AG Rate is. If not, then until you determine the actual rate, you can assume that the facility charges the maximum rate allowed by the Department of Social Services (since most facilities do so).

In that case, you can make use of the following equation:

AG Rate + AG Personal Allowance =
Federal Benefit Rate (FBR) + maximum AG Payment Level.

·                      Where the Federal Benefit Rate (FBR) is the full SSI amount received by SSI recipients who have no other countable income or in-kind support; and

·                      The maximum AG Payment Level is the full SSI State Supplement amount you receive if you have no other countable income. (See: SSI State Supplement - Virginia for a listing of the AG Payment Levels.)

So the Income Eligibility Rule above is the same as saying:

Alternate Income Eligibility Rule: Individuals must have countable income less than the sum of FBR and the maximum AG Payment Level to be eligible for an Auxiliary Grant. (This total can be found in the column labeled Combined Federal/State, Individual in the table at: SSI State Supplement - Virginia.)

ALERT: If your facility is one of the few facilities that charge a rate less than the maximum allowable AG Rate, then the Alternate Income Eligibility Rule will not give the correct result. The countable income level at which you become ineligible will be lower than calculated using the alternate rule.

Examples

NOTE: The examples below use June 2003 rates.

Example 1: SSI Recipient – Assisted Living in Norfolk

Currently: Jacob is an SSI recipient who has an Auxiliary Grant and lives in a licensed Assisted Living Facility in Norfolk. Since he has no other income, he receives $552 in SSI and $289 in Auxiliary Grant money, for a total of $841. He pays $779 to the facility (the facility's AG Rate) and he keeps $62 (his AG Personal Allowance) to spend.

Calculating AG Grant Earnings Limit: Jacob would like to get a job. Since he has been developing computer skills, he thinks he may be able to earn a decent wage. For the time being, at least, he wants the security and stability of keeping Medicaid and living at the facility. He wonders how much he could earn without losing his Auxiliary Grant eligibility and his Medicaid eligibility.

He realizes that if he has countable income less than the sum of his AG Payment Rate and FBR ($841), he remains eligible for his Auxiliary Grant. To figure how much he could earn and have countable income less than $841, he multiplies $841 by 2 and adds $85. The result is $1,767 per month. (See Auxiliary Grant Countable Income for an explanation of countable income.)

So, in order to keep his AG Eligibility, Jacob must earn less than $1,767 per month. (Note that if Jacob had any unearned income, the earned income limit would be lower, $1 for every $1 of earned income.)

Medicaid Eligibility: Since Jacob's Medicaid eligibility would be based on his SSI eligibility not on his AG status, losing his AG eligibility would not necessarily mean losing his Medicaid eligibility. He would still be eligible for Medicaid under the provisions of 1619(b) unless he earned more than $1,814 per month. (See State 1619(b) Threshold Amounts.)

Spendable Income: See Example 1 in Auxiliary Grants and Employment to see how much of spendable income Jacob has available at various earning levels.

Example 2: SSDI Beneficiary – Assisted Living in Fairfax

Currently: Buffy lives in a Licensed Assisted Living Facility in Fairfax County. She receives $600 monthly in Social Security Disability Insurance (SSDI). (Her SSDI benefit is too high for her to be eligible for SSI, but she is eligible for Medicaid under the Auxiliary Grant covered group.)

Calculating AG Grant Earnings Limit: Buffy would like to get a job. Since she has been developing technical writing skills, she thinks she may be able to earn a decent wage. For the time being, at least, she wants the security and stability of keeping Medicaid and living at the facility. She wonders how much she could earn without losing her Auxiliary Grant eligibility and her Medicaid eligibility.

She realizes that if the sum of her countable unearned and countable earned income were less than the sum of her AG Payment Rate and FBR ($967), she would remain eligible for her Auxiliary Grant.

So first she calculates that her countable unearned income is $580 (SSDI of $600 minus $20 General Exclusion yields $580). Subtracting $580 from $976 yields $387 of countable earned income. She multiplies $387 by 2 and adds the $65 Earned Income Exclusion. The result is $839 per month. (See Auxiliary Grant Countable Income for an explanation of countable income.)

Medicaid Eligibility: Since Buffy's Medicaid eligibility would be based on her AG status, losing her AG eligibility would mean losing her Medicaid eligibility. Unlike Jacob, she would not be eligible for Medicaid under the provisions of 1619(b). (See SSI Work Incentive - 1619(b).)

Spendable Income: See Example 2 in Auxiliary Grants and Employment to see how to calculate how much of spendable income Buffy has at various earning levels.

Back to:

Auxiliary Grant Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn both from http://www.dss.state.va.us/family/auxgrant.html and communications with the Virginia Department of Social Services (DSS) Division of Benefit Programs.

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