SELECTED EXCERPTS FROM THE MEDICAL ASSISTANCE PROGRAM OF THE DISTRICT OF COLUMBIA, STATE PLAN UNDER TITLE XIX, STANDARDS OF ELIGIBILITY FOR MEDICAL ASSISTANCE Exhibit F "The following definitions apply to financial resources in considering them for determination of financial eligibility: "Income is defined as aggregate monies earned and/or received during the year preceding application and projected on a predictable basis through the year following application from sources such as: "Salaries "Commissions "Military Dependency Allowances "Tips "Bonuses "Net Income from Business of Profession "Annuities "Guardianships "Statutory Benefits (Social Security, Veterans Benefits, Railroad Retirement Benefits, Civil Service Retirement Benefits) "Cash Gifts (Regular and Recurring) "Interest "Royalties "Trusts "Court-ordered or Voluntary Support Payments "This definition recognizes the obligation of the applicant to supply information about his income from all pertinent sources which can be predicted reasonably for the year following the date of application. "Other Resources are defined as those assets readily convertible into cash (to mean the ability to exchange assets for cash within a 30 day period). "These assets shall be considered available to applicant to fully, or partially, meet the cost of medical care, to the extent that they exceed the exemption indicated in Table II. "In a family unit (husband and wife; husband, wife and children) only the assets of the husband or wife shall be considered, whether owned singly or jointly. Other resources are defined to include: "Cash on hand "Cash deposits in bank "Bank accounts (if held jointly with a person other than the spouse, divided equally) "Other negotiable securities readily convertible to cash (if held jointly with a person other than a spouse, divided equally) "Bonds (readily convertible to cash) "Stocks (readily convertible to cash) "Credit Union Accounts (if held jointly with a person other than spouse, divided equally) "This definition adheres to the legal requirement that assets shall be considered for payment of medical expenses only if they are readily available for such purposes. "Real Property.-With the exception of net income from such property, whatever equity an applicant for medical assistance may have in real property, whether or not it is singly, jointly, or multiply-owned, shall not be considered as available resource for medical assistance purposes. Real property shall include land, building, dwellings, grounds and improvements thereto. "Life Insurance in force, regardless of the cash surrender or loan value, shall be excluded as a resource in determining financial eligibility for medical assistance." "Provision is made for the exclusion of annual health insurance premiums which are being paid by an individual or a family. This provision is intended to provide encouragement for the retention of health insurance to protect individuals against the cost of medical expenses and, collaterally, to help to reduce the cost of tax-supported services." "Health and medical insurance benefits and other health benefits legally available to an eligible shall be applied to medical care costs before charges are made against the plan." Comparison of proposed financial eligibility levels, D.C. plan for medical assistance under title XIX COMPARISON OF FINANCIAL ELIGIBILITY FACTORS RELATING TO THE TITLE XIX MEDICAL ASSISTANCE PLAN OF 26 STATES, 2 TERRITORIES AND THE DISTRICT OF COLUMBIA, MARCH 14, 1967 1 Only the indigent by public assistance financial criteria are eligible. 2 Number estimated to be served by program during 1st year. NOTE.-There are 2 jurisdictions with maintenance levels above $4,200, 18 with levels below $4,200 and 8 that cover only persons financially eligible for public assistance. 17 of the 18 States which provide care for persons other than the public assistance cases have family of 4 income levels above the 1965 per capita income for that State, and which exceed that per capita income level by 3 to 83 percent. The proposed District of Columbia level exceeds the District of Columbia per capita income by 13 percent. Source: District of Columbia Department of Public Health. Financial eligibility-Items and accounts exempted for maintenance needs (HEW summary of State laws implementing title XIX) "Only the indigent by public assistance financial criteria are eligible. No limit. Number estimated to be served by program during 1st year. Savings. Contributions for support. Total program cost $48,500,000. Federal title XIX reimbursement $12,400,000. This includes $2,200,000 which replaces present Federal medical assistance reimbursements that are included in the present D.C. $32,900,000 program, and which will cease when the title XIX reimbursement commences. Additional cost to the District of Columbia $5,400,000 under the title XIX program. All. DISTRICT OF COLUMBIA NURSES' ASSOCIATION, Hon. JOHN DOWDY, Committee on the District of Columbia, House of Representatives, Washington, D.C. DEAR CONGRESSMAN DOWDY: The membership and Board of Directors of the District of Columbia Nurses' Association appreciated the opportunity to file written testimony with your subcommittee in support of H.R. 3972, which would enable District of Columbia to participate in health and medical assistance benefits under the Social Security Act. We are greatly concerned about the serious gap in the health services now available to the medically indigent and urge the subcommittee to expedite its referral of H.R. 3972 to the consideration of full District Committee with a favorable recommendation. Again thank you for the favor of your many courtesies. Sincerely, WILLIAM A. LANG, |