452-5        COMPUTATION OF BENEFITS

452-5 A.   REGULAR APAAdult Public Assistance BENEFIT PAYMENTS

The amount of assistance provided for any month is determined by comparing an individual's or couple's total monthly countable income calculated according to manual section 452-4 with the appropriate APAAdult Public Assistance need/payment standard described in manual section 452-1 and Addendum 1.

Note:

DPADivision of Public Assistance must calculate the countable income rather than using the amount calculated by SSASocial Security Administration.

452-5 B.   INTERIM ASSISTANCE BENEFIT PAYMENTS

1. Regular IAInterim Assistance benefit payments.

Except for institutionalized individuals, IAInterim Assistance payments are set by state regulation at $280 per month per individual, as long as their other countable income, after rounding, is equal to or less than the applicable APAAdult Public Assistance need standard.

If both members of a couple are eligible for Interim Assistance, they each receive $280.  In couple cases where only one spouse is eligible for Interim Assistance, $280 is paid only to that individual.  If one member of a couple is eligible for Interim Assistance and the other member is eligible for regular APAAdult Public Assistance benefits, each member of the couple is budgeted as an individual until Interim Assistance ends.

2. IAInterim Assistance benefit payments to institutionalized individuals
 

Individuals who reside in a Medicaid facility such as a nursing home may not receive the regular $280 Interim Assistance monthly payment.  However, depending on their other countable income, they may receive an Interim Assistance payment which, combined with any other countable income, is equal to the regular $200 APAAdult Public Assistance personal needs maximum payment standard.

452-5 C.   PERSONAL NEEDS BENEFIT PAYMENTS

This section applies to any person who resides in a Medicaid facility such as a nursing home continuously for an entire calendar month, except for individuals who remain eligible for full APAAdult Public Assistance benefits because of temporary institutionalization provisions.  (Refer to section 470-2 for the policy on continued benefits for temporarily institutionalized individuals.)

An individual who is eligible for SSISupplemental Security Income may receive a monthly payment for incidental personal needs from SSISupplemental Security Income of up to $30.   APAAdult Public Assistance will provide an additional payment to provide a total amount of $200 for personal needs.

An individual who is ineligible for SSISupplemental Security Income , but whose countable income is less than the APAAdult Public Assistance personal needs standard, may receive an APAAdult Public Assistance payment.  However, the payment cannot exceed the amount that would be paid to a similarly situated SSISupplemental Security Income recipient.  See section 452-5A(1) above for more information about this payment limit policy.

An individual whose countable income exceeds $200 is not eligible for an APAAdult Public Assistance payment but may be eligible for Medicaid.  

Note:  

Medicaid eligibility policies pertaining to institutionalized individuals may differ from APAAdult Public Assistance policies.  See ADLTCAged, Disabled and Long Term Care Manual 514 for policy on Medicaid eligibility for institutionalized individuals.

452-5 D.   ASSISTED LIVING HOME PAYMENTS

Individuals residing in an assisted living home for a full calendar month have their APAAdult Public Assistance eligibility and payment calculated using the assisted living home need/maximum payment standards.  

Example: (based on 2024 payment standards)

A married couple who are both eligible for APAAdult Public Assistance reside in an assisted living home. The couple's combined income from Social Security benefits is $1,435 per month. After the $20 income exclusion is allowed, the couple's net countable income is $1,415. Use the APAAdult Public Assistance need/maximum payment standard for an eligible couple and subtract the couple's net countable income.

 $1,615      APAAdult Public Assistance maximum payment standard for a couple, both eligible, in an assisted living home (H2C)
- $1,415    Net countable income
= $200       APAAdult Public Assistance payment ($100 to each spouse)