To be exempt homestead property, the property must serve as the individual’s primary place of residence. In this case, the petitioner owned real estate worth $25,000 and claimed he lived there in a tent, providing documents and photographs corroborating his claim at the hearing. Although the agency argued the denial was based on lack of verification, ALJ Peter McCombs concluded the petitioner had proved his residence and that the agency never gave a sufficient notice or request for verification.
This decision was published with support from the Elder Law & Special Needs Section of the State Bar of Wisconsin and the Wisconsin chapter of the National Academy of Elder Law Attorneys.
Preliminary Recitals
Pursuant to a petition filed on December 21, 2023, under Wis. Stat. § 49.45(5), and Wis. Admin. Code § HA 3.03, to review a decision by the Marathon County Department of Social Services regarding Medical Assistance (MA), a hearing was held on February 7, 2024, by telephone.
The issue for determination is whether the agency correctly terminated petitioner’s Medicaid Purchase Plan (MAPP) enrollment effective January 1, 2024, due to assets exceeding program limits.
There appeared at that time the following persons:
PARTIES IN INTEREST:
Petitioner:
—
Respondent:
Department of Health Services
1 West Wilson Street, Room 651
Madison, WI 53703
By: Karen Smith
Marathon County Department of Social Services
400 E. Thomas Street
Wausau, WI 54403
ADMINISTRATIVE LAW JUDGE:
Peter McCombs
Division of Hearings and Appeals
Findings of Fact
- Petitioner (CARES # —) is a resident of Oneida County and has been enrolled in the MAPP program since August 1, 2020.
- In April of 2022, petitioner reported to the agency that he had purchased land located at —. Petitioner is the sole owner of the property. The land was initially deemed an unavailable asset, in order to allow petitioner to retain his MAPP eligibility under COVID policy.
- Petitioner completed a healthcare benefits review on August 21, 2023, and reported the value of the property as $10,000; his MAPP eligibility remained open.
- On December 8, 2023, the petitioner reported to the agency that the value of the property was $25,000; the agency updated petitioner’s case and issued an About Your Benefits notice on December 11, 2023, informing petitioner that his MAPP enrollment would be ending effective January 1, 2024 due to assets exceeding program limits.
- Per Medicaid Eligibility Handbook (MEH) §16.8.1, the property is a countable asset unless the shelter in which he resides is on the property. Petitioner has previously reported that he is homeless and he has his mail delivered to an office address in —. Petitioner has resided at the property located at —, since May of 2023.
Discussion
To be eligible for MAPP, an individual may have no more than $15,000 of countable assets. See Medicaid Eligibility Handbook (MEH) §26.4.1. The agency’s position, as I understand it, is that Petitioner’s MAPP eligibility was terminated as of January 1, 2024 because he failed to prove that he resides at the real property located at —. Petitioner testified that he has resided at the property since May of 2023. He has been residing in a tent on the property, which is why he has used a — address to receive mail.
Homestead property is not a countable asset. The Medicaid Eligibility Handbook provides the following guidance regarding such assets:
An individual’s home is an excluded asset.
A home is defined as any property an individual has an ownership interest in and which serves as their primary place of residence. An individual’s primary place of residence is the property they consider their principal home and to which, if absent, they intend to return. It can be real or personal property, fixed or mobile, and located on land or water.
The home can include any of the following:
- The shelter in which they reside
- The land on which the shelter is located
- Related buildings on the land
The home can include more than one lot. Land is considered part of the home as long as the lots adjoin one another and are not separated by land in which neither the individual nor their spouse has an ownership interest. Easements and public rights of way, such as utility lines and roads, do not separate other land from the home plot. For example, there are farms where the land is on both sides of a road and considered a part of the home. If land is completely separated from the home property by land in which neither the individual nor their spouse has ownership interest, it should not be considered part of the home.
MEH §16.8.1.
Petitioner has explicitly contended that he has resided on the property since May of 2023. The agency has not substantively refuted this claim.
The agency provided no documentary evidence at hearing. Petitioner provided documentation and photographs corroborating his testimony and establishing that he does, in fact, reside at the property. The agency asserted that petitioner had not provided verification of his residence, though this was not included as a basis for the MAPP termination in the About Your Benefits letter sent to petitioner on December 11, 2023. In any case, and likely owing to the omission of such a termination basis in the agency’s notice, there is nothing in the record identifying any request for such verification. Had the agency identified the failure to verify as a reason for the termination, provided copies of the relevant requests for verification, and/or case notes regarding any communication between agency workers and petitioner, the agency may have established that proper written verification requests were sent, that those notices were sufficiently clear and detailed, that those requests identified specific deadlines, and that agency workers communicated with the petitioner in writing and/or by telephone as to how he could satisfy the verification request.
Because the agency has not established a failure of verification or that petitioner does not reside at the property, the record is not sufficient to establish that the agency’s denial of MAPP benefits effective January 1, 2024 was proper. I find that the petitioner has established that the property located at — is the home of petitioner, as that term is defined at MEH §16.8.1. As such, the property is not a countable asset. I am remanding this matter to the agency with instructions to rescind the termination of Petitioner’s MAPP benefits.
Conclusions of Law
- Petitioner resides at —.
- The agency has not established that it properly denied Petitioner’s application for MAPP eligibility.
THEREFORE, it is
Ordered
The matter is remanded to the agency with instructions to rescind the denial of Petitioner’s MAPP eligibility effective January 1, 2024. The agency shall comply with this order within ten days of the date of this decision.
[Request for a rehearing and appeal to court instructions omitted.]