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Decision by the Division of Social Services (DSS) to close Medical Assistance


In re: DCIS No. Redacted Redacted

Appearances:
Redacted, pro se, Appellant
Redacted, Appellant's Spouse
Angela Kellam, Senior Social Worker/Case Manager, Division of Social Services
Andrea Fuller, Social Worker Supervisor, Division of Social Services

I.

Redacted ("Appellant") opposes a decision by the Division of Social Services ("DSS") to close his Medical Assistance case based upon being over the income eligibility limit for a household of two (2).

The Division of Social Services ("DSS") contends that the Appellant is over the income limit for a household of two (2).

II.

By notice dated December 11, 2004, DSS announced a decision to discontinue the appellant's medical assistance effective after December 31, 2004. (Exhibit 3)

On December 22, 2004, the Appellant filed a request for a fair hearing and requested that benefits continue until a hearing decision was issued. (Exhibit 2). According to the Fair Hearing Summary benefits have continued. (Exhibit 1)

The Appellant was notified by certified letter dated January 12, 2005, that a fair hearing would be held on February 8, 2005. The hearing was conducted on that date in Georgetown, Delaware.

This is the decision resulting from that hearing.

III.

In December 2004, DSS learned that Mr. Redacted was to begin receiving $1,097.20 per month in Social Security benefits as of January 1, 2005.

Pursuant to DSSM 16230, countable income is used to determine eligibility for benefits. DSSM 16230 defines countable income as earned or unearned income minus any disregards, if applicable. In this case, the Appellant did not receive an earned income deduction because all of his income is considered unearned under DSSM 16250. Pursuant to DSSM 16230.1.1, DSS is only permitted to utilize gross income, and not net income (after expenses), for purposes of eligibility.

Based upon the information provided, I find that DSS correctly determined that the Appellant's unearned monthly countable income is $1,097.20. I also find that the income eligibility limit for a household of two (2) for adult poverty medical assistance benefits on the date that the notice was issued was $1,041.00 per month. As a result, the Appellant was properly sent a Notice to Close Your Medical Assistance. (Exhibit 3)

IV.

For these reasons, the decision of the Division of Social Services to close Appellant's Adult Poverty Medical Assistance case effective after December 31, 2004 is AFFIRMED.

Date: March 19, 2005

STEVEN A. GREENSPAN
HEARING OFFICER

THE FOREGOING IS THE FINAL DECISION OF THE DIVISION OF SOCIAL SERVICES

POSTED
SAG/vmd

cc:
Redacted
Angela Kellam, DSS Pool 808
Andrea Fuller, DSS Pool 808

EXHIBITS FILED IN OR FOR THE PROCEEDING

  • EXHIBIT #1 - Copy of DSS Hearing Summary consisting of two (2) pages date-stamped January 4, 2005.
  • EXHIBIT #2 - Copy of the Appellant's request for a fair hearing dated December 22, 2004, consisting of one (1) page.
  • EXHIBIT #3 - Copy of the Notice to Close Your Medical Assistance dated December 11, 2004, consisting of three (3) pages.


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