2331 Repair/Replacement Funds

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Repair/Replacement Funds

Effective Date:

July 2022

Chapter:

2300

Policy Number:

2331

Previous Policy Number(s):

MT 59

Updated or Reviewed in MT:

MT-65

Requirements

Cash and in-kind items received for the repair or replacement of lost, damaged, or stolen excluded resources may be excluded from resources for up to 18 calendar months.

This is an excluded resource for Family Medicaid.

Basic Considerations

Cash and in-kind items received for the repair or replacement of lost, damaged or stolen excluded resources may come from any source, such as an insurance company, a federal or state agency, a public or private organization or an individual.

These funds include ISM or funds for the purchase of temporary housing but do not include funds received for personal injury.

These funds do not include Federal Disaster Assistance. Refer to 2314 Disaster Assistance.

The above unspent funds are excluded resources for 9 months from the date of their receipt. To be excluded from resources under this provision, the funds must be excluded from countable income.

Unspent cash receipts for the repair or replacement of excluded resources can be excluded from resources for up to an additional 9 months if, for the first 9 months, circumstances beyond the individual’s control hinder the following actions:

  • repair or replacement of the damaged or destroyed property

  • contracting for such repair or replacement.

What the individual intends to do with the funds does not affect their exclusion for the first 9 months.

An individual cannot qualify for an extension of the original 9-month exclusion unless he or she intends to use the funds for their designated purpose.

The extension will terminate as of the date of the change of intent. The previously excluded funds will be taken into account in determining resources for the following month.

Interest earned by funds excluded under this provision is excluded from income and from resources for as long as the funds themselves are excluded.

Procedures

Obtain a copy of any evidence the individual has which verifies the following:

  • The evidence must show the source, value, date(s), and intended purpose of the item received, including whether any cash received is for a purpose other than the replacement or repair of the lost, damaged, or stolen (and excluded) resource.

  • Evidence that establishes the ability of funds to be excluded from income also establishes their ability to be excluded from resources. Refer to 2405 Treatment of Income and 2504 Determining Countable Income.

  • If the individual cannot provide evidence sufficient for a determination, obtain the necessary information from the source of the payment(s).

Summarize the basis for the exclusion. Show the amount excluded and the first and last day of the exclusion period.

Schedule an alert to contact the A/R at least 30 days before the exclusion expires. Obtain evidence of the amount of excluded assistance still unspent.

If assistance remains unspent but the individual alleges good cause and plans to use the funds for their intended repairs or replacement, obtain his or her signed statement. Have the individual submit evidence to substantiate the allegation of good cause.

If the evidence does not establish good cause, include the unspent assistance in determining countable resources as of the first moment of the first day of the month after the month in which the exclusion period expires.

If the evidence shows good cause, discuss with the individual how much additional time is needed and why. On the basis of that discussion, extend the exclusion period for up to an additional 9 months, repeating the development steps above.